Cardone Monica, Polito Vinicia Assunta, Pepe Stefano, Mann Linda, D'Azzo Alessandra, Auricchio Alberto, Ballabio Andrea, Cosma Maria Pia
Telethon Institute of Genetics and Medicine, Naples, Italy.
Hum Mol Genet. 2006 Apr 1;15(7):1225-36. doi: 10.1093/hmg/ddl038. Epub 2006 Feb 27.
Mucopolysaccharidosis type II (MPSII; Hunter syndrome) is a lysosomal storage disorder caused by a deficiency in the enzyme iduronate 2-sulfatase (IDS). At present, the therapeutic approaches for MPSII are enzyme replacement therapy and bone marrow transplantation, although these therapies have some limitations. The availability of new AAV serotypes that display tissue-specific tropism and promote sustained expression of transgenes offers the possibility of AAV-mediated gene therapy for the systemic treatment of lysosomal diseases, including MPSII. We have characterized in detail the phenotype of IDS-deficient mice, a model of human MPSII. These mice display a progressive accumulation of glycosaminoglycans (GAGs) in many organs and excessive excretion of these compounds in their urine. Furthermore, they develop skeleton deformities, particularly of the craniofacial bones, and alopecia, they perform poorly in open-field tests and they have a severely compromised walking pattern. In addition, they present neuropathological defects. We have designed an efficient gene therapy approach for the treatment of these MPSII mice. AAV2/8TBG-IDS viral particles were administrated intravenously to adult MPSII mice. The plasma and tissue IDS activities were completely restored in all of the treated mice. This rescue of the enzymatic activity resulted in the full clearance of the accumulated GAGs in all of the tissues analyzed, the normalization of the GAG levels in the urine and the correction of the skeleton malformations. Overall, our findings suggest that this in vivo gene transfer approach has potential for the systemic treatment of patients with Hunter syndrome.
II型粘多糖贮积症(MPSII;亨特综合征)是一种溶酶体贮积病,由艾杜糖醛酸2-硫酸酯酶(IDS)缺乏引起。目前,MPSII的治疗方法是酶替代疗法和骨髓移植,尽管这些疗法存在一些局限性。新型腺相关病毒(AAV)血清型具有组织特异性嗜性并能促进转基因的持续表达,这为包括MPSII在内的溶酶体疾病的全身治疗提供了AAV介导的基因治疗的可能性。我们已经详细描述了IDS缺陷小鼠(人类MPSII的模型)的表型。这些小鼠在许多器官中显示出糖胺聚糖(GAGs)的渐进性积累,并在尿液中过量排泄这些化合物。此外,它们出现骨骼畸形,尤其是颅面骨畸形和脱发,在旷场试验中表现不佳,行走模式严重受损。此外,它们还存在神经病理学缺陷。我们设计了一种有效的基因治疗方法来治疗这些MPSII小鼠。将AAV2/8TBG-IDS病毒颗粒静脉注射给成年MPSII小鼠。所有治疗小鼠的血浆和组织IDS活性均完全恢复。酶活性的恢复导致所有分析组织中积累的GAGs完全清除,尿液中GAG水平正常化,骨骼畸形得到纠正。总体而言,我们的研究结果表明,这种体内基因转移方法具有对亨特综合征患者进行全身治疗的潜力。