Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
Department of Pediatrics, University of Texas Southwest Medical Center, Dallas, Texas.
Hum Gene Ther. 2020 Mar;31(5-6):339-351. doi: 10.1089/hum.2019.225. Epub 2020 Jan 16.
Dravet syndrome (DS) is a neurodevelopmental genetic disorder caused by mutations in the gene encoding the α subunit of the NaV1.1 voltage-gated sodium channel that controls neuronal action potential firing. The high density of this mutated channel in GABAergic interneurons results in impaired inhibitory neurotransmission and subsequent excessive activation of excitatory neurons. The syndrome is associated with severe childhood epilepsy, autistic behaviors, and sudden unexpected death in epilepsy. Here, we compared the rescue effects of an adeno-associated viral (AAV) vector coding for the multifunctional β1 sodium channel auxiliary subunit (AAV-NaVβ1) with a control vector lacking a transgene. We hypothesized that overexpression of NaVβ1 would facilitate the function of residual voltage-gated channels and improve the DS phenotype in the mouse model of DS. AAV-NaVβ1 was injected into the cerebral spinal fluid of neonatal mice. In untreated control mice, females showed a higher degree of mortality than males. Compared with control mice, AAV-NaVβ1-treated mice displayed increased survival, an outcome that was more pronounced in females than males. In contrast, behavioral analysis revealed that male, but not female, mice displayed motor hyperactivity, and abnormal performance on tests of fear and anxiety and learning and memory. Male mice treated with AAV-NaVβ1 showed reduced spontaneous seizures and normalization of motor activity and performance on the elevated plus maze test. These findings demonstrate sex differences in mortality in untreated mice, an effect that may be related to a lower level of intrinsic inhibitory tone in female mice, and a normalization of aberrant behaviors in males after central nervous system administration of AAV-NaVβ1. The therapeutic efficacy of AAV-NaVβ1 in a mouse model of DS suggests a potential new long-lasting biological therapeutic avenue for the treatment of this catastrophic epilepsy.
德拉维特综合征(DS)是一种神经发育性遗传疾病,由编码电压门控钠通道α亚单位的 基因的突变引起,该通道控制神经元动作电位的发射。这种突变通道在 GABA 能中间神经元中的高密度导致抑制性神经传递受损,随后兴奋性神经元过度激活。该综合征与严重的儿童癫痫、自闭症行为和癫痫猝死有关。在这里,我们比较了编码多功能β1 钠通道辅助亚基的腺相关病毒(AAV)载体(AAV-NaVβ1)与缺乏转基因的对照载体的挽救效果。我们假设 NaVβ1 的过表达将促进残留电压门控通道的功能,并改善 DS 小鼠模型中的 DS 表型。AAV-NaVβ1 被注射到新生 小鼠的脑脊液中。在未治疗的对照 小鼠中,雌性的死亡率高于雄性。与 对照小鼠相比,用 AAV-NaVβ1 治疗的 小鼠的存活率增加,这种结果在雌性中比雄性中更为明显。相比之下,行为分析显示雄性而非雌性 小鼠表现出运动过度活跃,以及在恐惧和焦虑、学习和记忆测试中表现出异常行为。用 AAV-NaVβ1 治疗的雄性 小鼠自发癫痫发作减少,运动活动和在高架十字迷宫测试中的表现正常化。这些发现表明未治疗的 小鼠死亡率存在性别差异,这种效应可能与雌性小鼠内在抑制性音调较低有关,并且中枢神经系统给予 AAV-NaVβ1 后雄性的异常行为正常化。AAV-NaVβ1 在 DS 小鼠模型中的治疗效果表明,针对这种灾难性癫痫的潜在新的长效生物治疗途径。