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<dc:title xml:lang="fr">Approches thérapeutiques pour le traitement de la myopathie myotubulaire</dc:title>
<dcterms:alternative xml:lang="en">Therapeutic approaches for the treatment of the myotubular myopathy</dcterms:alternative>
<dc:subject xml:lang="fr">Myopathie myotubulaire</dc:subject>
<dc:subject xml:lang="fr">Gène MTM1</dc:subject>
<dc:subject xml:lang="fr">Thérapie génique</dc:subject>
<dc:subject xml:lang="fr">Traitement thérapeutique</dc:subject>
<dc:subject xml:lang="fr">Virus associés aux adénovirus (AAV)</dc:subject>
<dc:subject xml:lang="fr">Modèle murin</dc:subject>
<dc:subject xml:lang="fr">MTMR2</dc:subject>
<dc:subject xml:lang="fr">Activité phosphatase</dc:subject>
<dc:subject xml:lang="en">Myotubular myopathy</dc:subject>
<dc:subject xml:lang="en">MTM1 gene</dc:subject>
<dc:subject xml:lang="en">Genesis therapy</dc:subject>
<dc:subject xml:lang="en">Therapeutic treatment</dc:subject>
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<dc:subject xml:lang="en">Phosphatase activity</dc:subject>
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<dcterms:abstract xml:lang="fr">La myopathie myotubulaire (XLMTM, OMIM 310400) est causée par des mutations dans le gêne MTM1 situé sur le chromosome X et apparaît à une fréquence de 1/50 000 naissances mâles. Les patients présentent une hypotonie et une faiblesse musculaire généralisées et de graves problèmes respiratoires à la naissance. En absence de traitement, les patients sont nombreux à décéder durant la première année de vie. Mon travail de thèse consiste à développer un traitement de thérapie génique pour la myopathie myotubulaire. L'injection intraveineuse du vecteur thérapeutique rAAV9-DES-Mtm1 chez le modèle murin de la myopathie myotubulaire permet d'obtenir de la protéine transgénique dans l'ensemble des muscles squelettiques de l'organisme. Un an après le traitement, les muscles malades retrouvent une morphologie normale et les souris sont en vie. La seconde partie porte sur l'évaluation des effets de la protéine MTMR2, un homologue de la myotubularine (MTM1), sur le muscle déficient en myotubularine, comme alternative à la thérapie génique avec MTM1. L'administration d'un vecteur AAV comportant le transgène MTMR2 dans le muscle malade améliore, partiellement, le phénotype musculaire. Ces résultats suggèrent que l'augmentation du niveau d'expression de MTMR2 dans le muscle malade pourrait être un traitement efficace. Enfin j'ai étudié le rôle de l'activité phosphatase de la myotubularine dans son action thérapeutique. J'ai comparé l'effet d'une forme inactive de myotubularine (MTMIC375S) à celui du transgène thérapeutique sur le muscle atteint de myopathie myotubulaire. Les résultats montrent que l'activité phosphatase de la myotubularine est nécessaire pour son activité thérapeutique.</dcterms:abstract>
<dcterms:abstract xml:lang="en">Myotubular myopathy (XLMTM, OMlM 310400) is caused by mutations in the MTM1 gene located on the X chromosome and appeared at a frequency of 1/50 000 male births. Most of the patients arc affected by hypotonia and generalized muscular weakness as weIl as grave respiratory problems in the birth. In absence of an effective therapeutic treatment they are many to die during the first year of their life. My thesis work consists in developing a treatment of gene therapy for myotubular myopathy. The intravenous injection of the therapeutic vector rAAV9-DES-MTM1 into the murin model of the myotubular myopathy allows transgenic protein in the whole skeletal muscle of the body. The therapeutic protein cures the muscular phenotype rapidly after injection. At one year after treatment, the thick muscles still be cured, mice are alive and recovered a normal development. Then, I estimated the effects of the protein MTMR2, a counterpart of the myotubularine (MTM1), on muscles from mice devoid of myotubularin, as alternative at the gene therapy with MTM1. The administration of a vector AAV containing the transgene MTMR2 in the thick muscles improves, partially, the muscular phenotype. These results suggest that the increase of MTMR2 protein level MTMR2 thick muscle could be an effective treatment. Finally, I studied the role of myotubularin phosphatase activity on its therapeutic action, I compared the effect of an inactive shape of myotubularin (MTM1C375S) on muscle affected by myotubular myopathy as the effect of therapeutic transgene on the same muscle. The results show that the phosphatase activity of the myotubularin is necessary for its therapeutic activity.</dcterms:abstract>
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