ASSAYS FOR ALPHA-DYSTROGLYCAN GLYCOSYLATION AND METHODS FOR USING SAME
Provided are methods of determining an amount of a glycosylated form of alpha-dystroglycan (αDG) in a sample. In some embodiments, the methods provided herein may be useful in the diagnosis, evaluation, and/or monitoring of a subject having a dystroglycanopathy, such as Walker-Warburg Syndrome, Muscle Eye Brain Disease, Fukuyama Congenital Muscular Dystrophy (CMD), or a Limb Girdle Muscular Dystrophy.
1 . A method, comprising:
a) determining a difference between a first amount of a glycosylated form of alpha-dystroglycan (αDG) in a first sample taken from a subject undergoing treatment for a dystroglycanopathy at a first time and a second amount of αDG in a second sample taken from the subject at a second time; and
b) based at least in part on a),
i) determining that the treatment should be continued,
ii) determining that the treatment should be discontinued, or
iii) determining that the treatment should be adjusted.
2 . A method of evaluating a subject undergoing treatment for a dystroglycanopathy, comprising:
a) providing a first sample containing a first amount of a glycosylated form of alpha-dystroglycan (αDG) from a subject, wherein the first sample is taken from the subject at a first time;
b) providing a second sample containing a second amount of a glycosylated form of αDG from the subject, wherein the second sample is taken from the subject at a second time later than the first time;
c) determining the first amount in the first sample;
d) determining the second amount in the second sample; and
e) determining a difference between the first amount and the second amount.
3 . (canceled)
4 . (canceled)
5 . The method of claim 2 , further comprising f) based at least in part on the difference determined in e), i) determining that the treatment should be continued, ii) determining that the treatment should be discontinued, or iii) determining that the treatment should be increased or decreased.
6 . (canceled)
7 . (canceled)
8 . The method of claim 2 , wherein the first time is prior to commencement of the treatment for the dystroglycanopathy, and the second time is during or after the treatment of the dystroglycanopathy.
9 . (canceled)
10 . The method of claim 8 , wherein the second time is at least about 3 months, 6 months, 9 months, or 12 months after the first time.
11 - 13 . (canceled)
14 . The method of claim 2 , wherein the first sample and the second sample are tissue biopsy samples.
15 . The method of claim 14 , wherein the first sample and the second sample are tibialis anterior (TA) samples.
16 . The method of claim 2 , wherein determining the difference between the first amount and the second amount comprises performing a Western blotting analysis.
17 . The method of claim 16 , wherein the first amount and the second amount are determined by integrating a signal over a range of interest and interpolating the signal to a standard curve, wherein the standard curve is based on amounts of glycosylated αDG measured for healthy subjects not undergoing treatment for a dystroglycanopathy, and wherein the interpolation is performed using regression to a quadratic equation.
18 . (canceled)
19 . (canceled)
20 . The method of claim 2 , wherein determining the first amount and the second amount comprise contacting the first sample and the second sample with one or more antibodies.
21 . The method of claim 20 , wherein an antibody of the one or more antibodies is used to determine an amount of the glycosylated form of αDG having a molecular weight in the range of interest of between about 125 kiloDaltons (kDa) and about 260 kDa.
22 . The method of claim 20 , wherein the one or more antibodies are selected from AF6868 alpha-dystroglycan, IIH6C4 alpha-dystroglycan, IR800CW Mouse Anti-Sheep, and IR680 Goat Anti-Mouse antibodies.
23 . The method of claim 2 , wherein determining the first amount and the second amount comprises detection of a fluorescent signal at about 700 nanometers (nm) and/or 800 nm.
24 . The method of claim 2 , wherein the dystroglycanopathy is selected from Walker-Warburg Syndrome, Muscle Eye Brain Disease, Fukuyama Congenital Muscular Dystrophy (CMD), or a Limb Girdle Muscular Dystrophy.
25 . The method of claim 24 , wherein the dystroglycanopathy is limb girdle muscular dystrophy type 2i (LGMD2I/R9), LGMD type 2m (LGMD2m), or LGMD type 2u (LGMD2u).
26 . (canceled)
27 . The method of claim 2 , wherein the dystroglycanopathy is associated with a defect in fukutin (FKTN), Fukutin-related protein (FKRP), or isoprenoid synthase domain-containing protein (ISPD).
28 . The method of claim 2 , wherein the treatment for the dystroglycanopathy comprises administration of a therapeutically effective amount of ribitol.
29 - 31 . (canceled)
32 . The method of claim 2 , wherein the treatment comprises administering 0.5 grams of ribitol per day (g/day), 1 g/day, 1.5 g/day, 2 g/day, 3 g/day, 4 g/day, 5 g/day, 6 g/day, 7.5 g/day, 10 g/day, 12 g/day, 12.5 g/day, 15 g/day, 20 g/day, 25 g/day, 30 g/day, 35 g/day, 40 g/day, 45 g/day, 50 g/day, 55 g/day, or 60 g/day.
33 . The method of claim 2 , wherein the treatment comprises administering ribitol at a dose effective to achieve an area under the concentration-time curve (AUC0-24) steady state level of between 100 (μg·h)/mL and 8000 (μg·h)/m.
34 . The method of claim 2 , wherein ribitol is administered once, twice, three times, or four times daily.
35 . The method of claim 2 , further comprising evaluating the subject using a North Star Assessment for Limb Girdle Type Muscular Dystrophies (NSAD), Performance of upper limb test 2.0 (PUL2.0), 10-meter walk test (10MWT), 100-meter timed test (100 MTT), forced vital capacity (FVC) assessment, serum creatine kinase (CK) levels, or a combination thereof.
36 - 39 . (canceled)
40 . The method of claim 2 , further comprising determining (i) a first ratio of the glycosylated form of αDG to the total αDG in the first sample and (ii) a second ratio of the glycosylated form of αDG to the total αDG in the second sample.