Department of Biological Chemistry and Pharmacology, The Ohio State University Wexner Medical Center, Columbus, Oh, USA.
Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, Oh, USA.
J Neuromuscul Dis. 2017;4(1):59-66. doi: 10.3233/JND-170209.
Spinal Muscular Atrophy (SMA) is an autosomal recessive motor neuron disease that results in loss of spinal motor neurons, muscular weakness and, in severe cases, respiratory failure and death. SMA is caused by a deletion or mutation of the SMN1 gene and retention of the SMN2 gene that leads to low SMN expression levels.The measurement of SMN mRNA levels in peripheral blood samples has been used in SMA clinical studies as a pharmacodynamic biomarker for response to therapies designed to increase SMN levels. We recently developed a postnatal porcine model of SMA by the viral delivery of a short-hairpin RNA (shRNA) targeting porcine SMN (pSMN). scAAV9-mediated knockdown of pSMN mRNA at postnatal day 5 results in denervation, weakness and motor neuron and ventral root axon loss that begins 3-4 weeks after viral delivery, and this phenotype can be ameliorated by subsequent viral delivery of human SMN (hSMN).
To determine if the effect of modulating SMN levels using gene therapy can be measured in blood.
We measured expression of pSMN mRNA and hSMN mRNA by quantitative droplet digital PCR (ddPCR).
We found that the endogenous expression of pSMN mRNA in blood increases in the first month of life. However, there were no significant differences in blood levels of pSMN mRNA after knock-down or of human SMN mRNA after gene therapy.
Our results, obtained in a large animal model of SMA that is similar in size and anatomy to human infants, suggest that measurement of SMN mRNA levels in blood may not be informative in SMA clinical trials involving intrathecal delivery of SMN-modulating therapies.
脊髓性肌萎缩症(SMA)是一种常染色体隐性运动神经元疾病,导致脊髓运动神经元丧失、肌肉无力,在严重情况下,还会导致呼吸衰竭和死亡。SMA 是由 SMN1 基因缺失或突变以及 SMN2 基因保留引起的,导致 SMN 表达水平降低。外周血样本中 SMN mRNA 水平的测量已被用于 SMA 临床研究中,作为对旨在提高 SMN 水平的治疗反应的药效学生物标志物。我们最近通过靶向猪 SMN(pSMN)的短发夹 RNA(shRNA)的病毒传递,建立了一种产后猪 SMA 模型。在出生后第 5 天,scAAV9 介导的 pSMN mRNA 敲低导致去神经支配、无力以及运动神经元和腹根轴突丢失,这一表型在病毒传递后 3-4 周开始出现,并且可以通过随后的人 SMN(hSMN)病毒传递来改善。
确定使用基因疗法调节 SMN 水平的效果是否可以在血液中测量。
我们通过定量液滴数字 PCR(ddPCR)测量 pSMN mRNA 和 hSMN mRNA 的表达。
我们发现,血液中内源性 pSMN mRNA 的表达在生命的第一个月增加。然而,在敲低后或在基因治疗后,血液中 pSMN mRNA 的水平或 hSMN mRNA 的水平没有显著差异。
我们在一种与人类婴儿大小和解剖结构相似的 SMA 大型动物模型中获得的结果表明,在涉及鞘内递送 SMN 调节疗法的 SMA 临床试验中,血液中 SMN mRNA 水平的测量可能没有信息性。