Daly T M, Vogler C, Levy B, Haskins M E, Sands M S
Department of Pathology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Proc Natl Acad Sci U S A. 1999 Mar 2;96(5):2296-300. doi: 10.1073/pnas.96.5.2296.
For many inborn errors of metabolism, early treatment is critical to prevent long-term developmental sequelae. We have used a gene-therapy approach to demonstrate this concept in a murine model of mucopolysaccharidosis type VII (MPS VII). Newborn MPS VII mice received a single intravenous injection with 5.4 x 10(6) infectious units of recombinant adeno-associated virus encoding the human beta-glucuronidase (GUSB) cDNA. Therapeutic levels of GUSB expression were achieved by 1 week of age in liver, heart, lung, spleen, kidney, brain, and retina. GUSB expression persisted in most organs for the 16-week duration of the study at levels sufficient to either reduce or prevent completely lysosomal storage. Of particular significance, neurons, microglia, and meninges of the central nervous system were virtually cleared of disease. In addition, neonatal treatment of MPS VII mice provided access to the central nervous system via an intravenous route, avoiding a more invasive procedure later in life. These data suggest that gene transfer mediated by adeno-associated virus can achieve therapeutically relevant levels of enzyme very early in life and that the rapid growth and differentiation of tissues does not limit long-term expression.
对于许多先天性代谢缺陷病而言,早期治疗对于预防长期发育后遗症至关重要。我们已采用基因治疗方法在黏多糖贮积症VII型(MPS VII)小鼠模型中证实了这一概念。新生MPS VII小鼠通过静脉单次注射5.4×10⁶感染单位的编码人β-葡萄糖醛酸酶(GUSB)cDNA的重组腺相关病毒。在肝脏、心脏、肺、脾脏、肾脏、大脑和视网膜中,1周龄时即可达到治疗水平的GUSB表达。在为期16周的研究中,GUSB表达在大多数器官中持续存在,其水平足以降低或完全预防溶酶体贮积。特别重要的是,中枢神经系统的神经元、小胶质细胞和脑膜几乎完全清除了疾病。此外,对MPS VII小鼠进行新生儿期治疗可通过静脉途径进入中枢神经系统,避免了日后进行更具侵入性的操作。这些数据表明,腺相关病毒介导的基因转移能够在生命早期实现与治疗相关的酶水平,并且组织的快速生长和分化并不限制长期表达。