Center for Genome Engineering, Department of Genetics, Cell Biology and Development, University of Minnesota, Minneapolis, Minnesota, USA.
bluebird bio, Inc., Cambridge, Massachusetts, USA.
Hum Gene Ther. 2022 Dec;33(23-24):1279-1292. doi: 10.1089/hum.2022.141. Epub 2022 Nov 23.
Mucopolysaccharidosis type II (MPS II, Hunter syndrome) is an X-linked recessive lysosomal disease caused by deficiency of iduronate-2-sulfatase (IDS). The absence of IDS results in the accumulation of the glycosaminoglycans (GAGs) heparan sulfate and dermatan sulfate. Currently, the only approved treatment option for MPS II is enzyme replacement therapy (ERT), Elaprase. However, ERT is demanding for the patient and does not ameliorate neurological manifestations of the disease. Using an IDS-deficient mouse model that phenocopies the human disease, we evaluated hematopoietic stem and progenitor cells (HSPCs) transduced with a lentiviral vector (LVV) carrying a codon-optimized human IDS coding sequence regulated by a ubiquitous MNDU3 promoter (MNDU3-IDS). Mice treated with MNDU3-IDS LVV-transduced cells showed supraphysiological levels of IDS enzyme activity in plasma, peripheral blood mononuclear cells, and in most analyzed tissues. These enzyme levels were sufficient to normalize GAG storage in analyzed tissues. Importantly, IDS levels in the brains of MNDU3-IDS-engrafted animals were restored to 10-20% than that of wild-type mice, sufficient to normalize GAG content and prevent emergence of cognitive deficit as evaluated by neurobehavioral testing. These results demonstrate the potential effectiveness of MNDU3-IDS LVV-transduced HSPCs for treatment of MPS II.
黏多糖贮积症 II 型(MPS II,亨特综合征)是一种 X 连锁隐性溶酶体疾病,由艾杜糖-2-硫酸酯酶(IDS)缺乏引起。IDS 的缺乏导致糖胺聚糖(GAG)硫酸乙酰肝素和硫酸皮肤素的积累。目前,MPS II 的唯一批准的治疗选择是酶替代疗法(ERT),即艾拉酶。然而,ERT 对患者要求很高,并且不能改善疾病的神经表现。使用一种模拟人类疾病的 IDS 缺陷型小鼠模型,我们评估了携带受广泛调控的 MNDU3 启动子(MNDU3-IDS)调控的密码子优化的人 IDS 编码序列的慢病毒载体(LVV)转导的造血干细胞和祖细胞(HSPCs)。用 MNDU3-IDS LVV 转导的细胞治疗的小鼠在血浆、外周血单核细胞和大多数分析组织中表现出超生理水平的 IDS 酶活性。这些酶水平足以使分析组织中的 GAG 储存正常化。重要的是,MNDU3-IDS 移植动物大脑中的 IDS 水平恢复到野生型小鼠的 10-20%,足以使 GAG 含量正常化并防止认知缺陷的出现,这通过神经行为测试进行评估。这些结果表明,MNDU3-IDS LVV 转导的 HSPC 用于治疗 MPS II 具有潜在的有效性。