Günaydin Caner, Sondhi Dolan, Kaminsky Stephen M, Lephart Hailey C, Leopold Philip L, Hackett Neil R, Khanna Richie, Crystal Ronald G
Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, USA.
LEXEO Therapeutics, New York, NY, USA.
Mol Ther. 2024 Dec 4;32(12):4303-4318. doi: 10.1016/j.ymthe.2024.11.003. Epub 2024 Nov 6.
Gene therapy to treat hereditary disorders conventionally delivers the normal allele to compensate for loss-of-function mutations. More effective gene therapy may be achieved using a gain-of-function variant. We tested the hypothesis that AAVrh.10-mediated CNS delivery of the human APOE2 allele with the Christchurch mutation (R136S) (E2Ch) will provide superior protection against APOE4-associated Alzheimer's disease (AD) in mice compared to the unmodified APOE2 allele (E2). The vectors were assessed in two mouse strains with humanized APOE4: APP.PSEN1/TRE4 "amyloid mice" and P301S/TRE4, "tau mice." Both the E2Ch and E2 vectors prevented Aβ42 and Aβ40 accumulation and decreased β-amyloid aggregates in amyloid mice, but only the E2Ch vector suppressed tau tangles in tau mice. Microglial activation and reactive astrocytes were significantly suppressed by both vectors in amyloid mice but only the E2Ch vector mediated significant suppression of Iba1 and glial fibrillary acidic protein (GFAP) in tau mice. In four behavioral assays, the E2 and E2Ch vectors had similar benefits in amyloid mice, but E2Ch outperformed E2 in tau mice. In summary, while E2 is effective in suppressing amyloid pathology, the novel E2 variant E2Ch more effectively treats both the amyloid and tau pathology of murine AD in APOE4 background, supporting the development of AAVrh.10APOE2Ch as a therapy for APOE4-associated AD.
传统上,用于治疗遗传性疾病的基因疗法是传递正常等位基因以补偿功能丧失性突变。使用功能获得性变体可能会实现更有效的基因疗法。我们测试了这样一个假设:与未修饰的APOE2等位基因(E2)相比,经AAVrh.10介导将携带克赖斯特彻奇突变(R136S)的人类APOE2等位基因(E2Ch)递送至中枢神经系统,将能为小鼠提供针对APOE4相关阿尔茨海默病(AD)的更强保护。在两种携带人源化APOE4的小鼠品系中评估了这些载体:APP.PSEN1/TRE4“淀粉样蛋白小鼠”和P301S/TRE4“tau蛋白小鼠”。E2Ch和E2载体均能防止淀粉样蛋白小鼠中Aβ42和Aβ40的积累,并减少β淀粉样蛋白聚集体,但只有E2Ch载体能抑制tau蛋白小鼠中的tau缠结。在淀粉样蛋白小鼠中,两种载体均显著抑制了小胶质细胞激活和反应性星形胶质细胞,但在tau蛋白小鼠中,只有E2Ch载体介导了对Iba1和胶质纤维酸性蛋白(GFAP)的显著抑制。在四项行为学试验中,E2和E2Ch载体在淀粉样蛋白小鼠中具有相似的益处,但在tau蛋白小鼠中,E2Ch的表现优于E2。总之,虽然E2在抑制淀粉样蛋白病理方面有效,但新型E2变体E2Ch在APOE4背景下能更有效地治疗小鼠AD的淀粉样蛋白和tau蛋白病理,支持将AAVrh.10APOE2Ch开发为APOE4相关AD的一种疗法。