Department of Neurology, Duke University School of Medicine, Durham, NC 27710, USA.
Ionis Pharmaceuticals, Carlsbad, CA 92008, USA.
Sci Transl Med. 2018 Oct 31;10(465). doi: 10.1126/scitranslmed.aap8677.
Spinocerebellar ataxia type 7 (SCA7) is an autosomal dominant neurodegenerative disorder characterized by cerebellar and retinal degeneration, and is caused by a CAG-polyglutamine repeat expansion in the gene. Patients with SCA7 develop progressive cone-rod dystrophy, typically resulting in blindness. Antisense oligonucleotides (ASOs) are single-stranded chemically modified nucleic acids designed to mediate the destruction, prevent the translation, or modify the processing of targeted RNAs. Here, we evaluated ASOs as treatments for SCA7 retinal degeneration in representative mouse models of the disease after injection into the vitreous humor of the eye. Using Ataxin-7 aggregation, visual function, retinal histopathology, gene expression, and epigenetic dysregulation as outcome measures, we found that ASO-mediated Ataxin-7 knockdown yielded improvements in treated SCA7 mice. In SCA7 mice with retinal disease, intravitreal injection of ASOs also improved visual function despite initiating treatment after symptom onset. Using color fundus photography and autofluorescence imaging, we also determined the nature of retinal degeneration in human SCA7 patients. We observed variable disease severity and cataloged rapidly progressive retinal degeneration. Given the accessibility of neural retina, availability of objective, quantitative readouts for monitoring therapeutic response, and the rapid disease progression in SCA7, ASOs targeting might represent a viable treatment for SCA7 retinal degeneration.
脊髓小脑共济失调 7 型(SCA7)是一种常染色体显性遗传性神经退行性疾病,其特征为小脑和视网膜变性,由 基因中的 CAG-聚谷氨酰胺重复扩展引起。SCA7 患者会逐渐出现锥杆细胞营养不良,通常会导致失明。反义寡核苷酸(ASO)是一种经化学修饰的单链核酸,旨在介导靶向 RNA 的破坏、阻止翻译或修饰其加工。在此,我们在疾病的代表性小鼠模型中,通过玻璃体内注射来评估 ASO 作为 SCA7 视网膜变性的治疗方法。我们使用 Ataxin-7 聚集、视觉功能、视网膜组织病理学、基因表达和表观遗传失调作为结果测量指标,发现 ASO 介导的 Ataxin-7 敲低可改善治疗后的 SCA7 小鼠。在有视网膜疾病的 SCA7 小鼠中,即使在症状出现后开始治疗,玻璃体内注射 ASO 也能改善视觉功能。通过彩色眼底摄影和自发荧光成像,我们还确定了人类 SCA7 患者的视网膜变性性质。我们观察到不同的疾病严重程度,并对快速进展性视网膜变性进行了分类。鉴于神经视网膜的可及性、用于监测治疗反应的客观、定量读数的可用性以及 SCA7 中的快速疾病进展,针对 的 ASO 可能代表 SCA7 视网膜变性的一种可行治疗方法。