Goldschleger Eye Research Institute, and.
Department of Human Molecular Genetics and Biochemistry, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Clin Invest. 2023 Jun 15;133(12):e159316. doi: 10.1172/JCI159316.
Dravet syndrome (DS), an intractable childhood epileptic encephalopathy with a high fatality rate, is typically caused by loss-of-function mutations in one allele of SCN1A, which encodes NaV1.1, a 250-kDa voltage-gated sodium channel. In contrast to other epilepsies, pharmaceutical treatment for DS is limited. Here, we demonstrate that viral vector-mediated delivery of a codon-modified SCN1A open reading frame into the brain improves DS comorbidities in juvenile and adolescent DS mice (Scn1aA1783V/WT). Notably, bilateral vector injections into the hippocampus and/or the thalamus of DS mice increased survival, reduced the occurrence of epileptic spikes, provided protection from thermally induced seizures, corrected background electrocorticographic activity and behavioral deficits, and restored hippocampal inhibition. Together, our results provide a proof of concept for the potential of SCN1A delivery as a therapeutic approach for infants and adolescents with DS-associated comorbidities.
德拉维雷综合征(DS)是一种难以治疗的儿童癫痫性脑病,其死亡率较高,通常由 SCN1A 基因一个等位基因的功能丧失性突变引起,该基因编码 NaV1.1,一种 250kDa 的电压门控钠离子通道。与其他癫痫症不同,DS 的药物治疗有限。在这里,我们证明了通过病毒载体将密码子修饰的 SCN1A 开放阅读框递送到大脑中,可以改善青少年 DS 小鼠(Scn1aA1783V/WT)的共患病。值得注意的是,将载体双侧注射到 DS 小鼠的海马体和/或丘脑可以提高生存率,减少癫痫样尖峰的发生,防止热诱导的癫痫发作,纠正背景脑电图活动和行为缺陷,并恢复海马体抑制。总之,我们的结果为 SCN1A 递送来治疗与 DS 相关共患病的婴儿和青少年提供了一个概念验证。