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考虑采用基因疗法预防X连锁耳聋DFNX2及相关神经发育障碍。

Considering gene therapy to protect from X-linked deafness DFNX2 and associated neurodevelopmental disorders.

作者信息

Defourny Jean

机构信息

GIGA-Neurosciences, Unit of Cell and Tissue Biology University of Liège, C.H.U. B36 Liège Belgium.

出版信息

Ibrain. 2022 Sep 27;8(4):431-441. doi: 10.1002/ibra.12068. eCollection 2022 Winter.

Abstract

Mutations and deletions in the gene or upstream of the gene encoding the POU3F4 transcription factor cause X-linked progressive deafness DFNX2 and additional neurodevelopmental disorders in humans. Hearing loss can be purely sensorineural or mixed, that is, with both conductive and sensorineural components. Affected males show anatomical abnormalities of the inner ear, which are jointly defined as incomplete partition type III. Current approaches to improve hearing and speech skills of DFNX2 patients do not seem to be fully effective. Owing to inner ear malformations, cochlear implantation is surgically difficult and may predispose towards severe complications. Even in cases where implantation is safely performed, hearing and speech outcomes remain highly variable among patients. Mouse models for DFNX2 deafness revealed that sensorineural loss could arise from a dysfunction of spiral ligament fibrocytes in the lateral wall of the cochlea, which leads to reduced endocochlear potential. Highly positive endocochlear potential is critical for sensory hair cell mechanotransduction and hearing. In this context, here, we propose to develop a therapeutic approach in male mice based on an adeno-associated viral (AAV) vector-mediated gene transfer in cochlear spiral ligament fibrocytes. Among a broad range of AAV vectors, AAV7 was found to show a strong tropism for the spiral ligament. Thus, we suggest that an AAV7-mediated delivery of complementary DNA in the spiral ligament of mice could represent an attractive strategy to prevent fibrocyte degeneration and to restore normal cochlear functions and properties, including a positive endocochlear potential, before hearing loss progresses to profound deafness.

摘要

编码POU3F4转录因子的基因或其上游区域的突变和缺失会导致人类X连锁进行性耳聋DFNX2以及其他神经发育障碍。听力损失可以是单纯的感音神经性的,也可以是混合性的,即同时具有传导性和感音神经性成分。受影响的男性表现出内耳的解剖学异常,这些异常共同被定义为不完全分隔III型。目前改善DFNX2患者听力和言语技能的方法似乎并不完全有效。由于内耳畸形,人工耳蜗植入手术困难,且可能易引发严重并发症。即使在安全进行植入的情况下,患者的听力和言语结果仍存在很大差异。DFNX2耳聋的小鼠模型显示,感音神经性听力损失可能源于耳蜗外侧壁螺旋韧带纤维细胞的功能障碍,这会导致内淋巴电位降低。高度正性的内淋巴电位对于感觉毛细胞的机械转导和听力至关重要。在此背景下,我们在此提出基于腺相关病毒(AAV)载体介导的基因转移到耳蜗螺旋韧带纤维细胞中,在雄性小鼠中开发一种治疗方法。在广泛的AAV载体中,发现AAV7对螺旋韧带有很强的嗜性。因此,我们认为在小鼠螺旋韧带中通过AAV7介导递送互补DNA可能是一种有吸引力的策略,可在听力损失发展为重度耳聋之前预防纤维细胞变性并恢复正常的耳蜗功能和特性,包括正性内淋巴电位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1b4/10529175/dfdafb648cbe/IBRA-8-431-g003.jpg

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