Rare and Neurologic Diseases, Sanofi, 49 New York Avenue, Framingham, MA, 01701, USA.
Genomic Medicine Unit, Sanofi, Framingham, MA, 01701, USA.
Sci Rep. 2021 Oct 22;11(1):20945. doi: 10.1038/s41598-021-00404-5.
Mutations in GBA, the gene encoding the lysosomal enzyme glucocerebrosidase (GCase), represent the greatest genetic risk factor for developing synucleinopathies including Parkinson's disease (PD). Additionally, PD patients harboring a mutant GBA allele present with an earlier disease onset and an accelerated disease progression of both motor and non-motor symptoms. Preclinical studies in mouse models of synucleinopathy suggest that modulation of the sphingolipid metabolism pathway via inhibition of glucosylceramide synthase (GCS) using a CNS-penetrant small molecule may be a potential treatment for synucleinopathies. Here, we aim to alleviate the lipid storage burden by inhibiting the de novo synthesis of the primary glycosphingolipid substrate of GCase, glucosylceramide (GlcCer). We have previously shown that systemic GCS inhibition reduced GlcCer and glucosylsphingosine (GlcSph) accumulation, slowed α-synuclein buildup in the hippocampus, and improved cognitive deficits. Here, we studied the efficacy of a brain-penetrant clinical candidate GCS inhibitor, venglustat, in mouse models of GBA-related synucleinopathy, including a heterozygous Gba mouse model which more closely replicates the typical GBA-PD patient genotype. Collectively, these data support the rationale for modulation of GCase-related sphingolipid metabolism as a therapeutic strategy for treating GBA-related synucleinopathies.
GBA 基因突变是导致包括帕金森病(PD)在内的神经核蛋白病的最大遗传风险因素。此外,携带突变 GBA 等位基因的 PD 患者发病更早,运动和非运动症状的疾病进展速度也更快。神经核蛋白病的小鼠模型的临床前研究表明,通过抑制鞘氨醇代谢途径来调节神经细胞穿透小分子葡糖脑苷脂合成酶(GCS)可能是治疗神经核蛋白病的一种潜在治疗方法。在这里,我们旨在通过抑制 GCase 的主要糖脂底物葡萄糖脑苷脂(GlcCer)的从头合成来减轻脂质储存负担。我们之前已经表明,全身性 GCS 抑制可减少 GlcCer 和葡萄糖神经酰胺(GlcSph)的积累,减缓海马体中α-突触核蛋白的积累,并改善认知缺陷。在这里,我们研究了一种脑穿透性临床候选 GCS 抑制剂 venglustat 在 GBA 相关神经核蛋白病小鼠模型中的疗效,包括更接近典型 GBA-PD 患者基因型的杂合 Gba 小鼠模型。总的来说,这些数据支持调节 GCase 相关鞘脂代谢作为治疗 GBA 相关神经核蛋白病的治疗策略的原理。
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