Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
Department of Molecular and Cellular Medicine, College of Medicine, Texas A&M University, College Station, TX 77843, USA.
Sci Transl Med. 2023 Mar 22;15(688):eabf4077. doi: 10.1126/scitranslmed.abf4077.
Angelman syndrome is a devastating neurogenetic disorder for which there is currently no effective treatment. It is caused by mutations or epimutations affecting the expression or function of the maternally inherited allele of the ubiquitin-protein ligase E3A () gene. The paternal allele is imprinted in neurons of the central nervous system (CNS) by the antisense () transcript, which represents the distal end of the small nucleolar host gene 14 () transcription unit. Reactivating the expression of the paternal allele in the CNS has long been pursued as a therapeutic option for Angelman syndrome. Here, we described the development of an antisense oligonucleotide (ASO) therapy for Angelman syndrome that targets an evolutionarily conserved region demarcating the start of the transcript. We designed and chemically optimized gapmer ASOs targeting specific sequences at the start of the human transcript. We showed that ASOs targeting this region precisely and efficiently repress the transcription of , reactivating the expression of the paternal allele in neurotypical and Angelman syndrome induced pluripotent stem cell-derived neurons. We further showed that human-targeted ASOs administered to the CNS of cynomolgus macaques by lumbar intrathecal injection repress and reactivate the expression of the paternal allele throughout the CNS. These findings support the advancement of this investigational molecular therapy for Angelman syndrome into clinical development (ClinicalTrials.gov, NCT04259281).
安格曼综合征是一种严重的神经遗传疾病,目前尚无有效的治疗方法。它是由影响母源性泛素蛋白连接酶 E3A()基因表达或功能的突变或表观遗传改变引起的。父源性等位基因通过反义()转录本在中枢神经系统(CNS)的神经元中被印记,该转录本代表小核仁宿主基因 14()转录单元的远端。长期以来,激活 CNS 中父源性等位基因的表达一直被视为安格曼综合征的一种治疗选择。在这里,我们描述了一种针对安格曼综合征的反义寡核苷酸(ASO)治疗方法,该方法针对的是区分转录起始的保守区域。我们设计并化学优化了针对人类转录起始特定序列的 gapmer ASO。我们表明,靶向该区域的 ASO 可精确且有效地抑制的转录,从而重新激活神经典型和安格曼综合征诱导多能干细胞源性神经元中父源性等位基因的表达。我们进一步表明,通过腰椎鞘内注射向食蟹猴中枢神经系统给药的靶向人类的 ASO 可抑制并重新激活整个中枢神经系统中父源性等位基因的表达。这些发现支持将这种探索性的分子治疗方法推进到安格曼综合征的临床开发中(ClinicalTrials.gov,NCT04259281)。
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