Long-Term Improvement of Neurological Signs and Metabolic Dysfunction in a Mouse Model of Krabbe's Disease after Global Gene Therapy

Michael S. Marshall, Yazan Issa, Benas Jakubauskas, Monika Stoskute, Vince Elackattu, Jeffrey N. Marshall, Wil Bogue, Duc Nguyen, Zane Hauck, Emily Rue, Subha Karumuthil-Melethil, Violeta Zaric, Maarten Bosland, Richard B. van Breemen, Maria I. Givogri, Steven J. Gray, Stephen J. Crocker, Ernesto R. Bongarzone

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We report a global adeno-associated virus (AAV)9-based gene therapy protocol to deliver therapeutic galactosylceramidase (GALC), a lysosomal enzyme that is deficient in Krabbe's disease. When globally administered via intrathecal, intracranial, and intravenous injections to newborn mice affected with GALC deficiency (twitcher mice), this approach largely surpassed prior published benchmarks of survival and metabolic correction, showing long-term protection of demyelination, neuroinflammation, and motor function. Bone marrow transplantation, performed in this protocol without immunosuppressive preconditioning, added minimal benefits to the AAV9 gene therapy. Contrasting with other proposed pre-clinical therapies, these results demonstrate that achieving nearly complete correction of GALC's metabolic deficiencies across the entire nervous system via gene therapy can have a significant improvement to behavioral deficits, pathophysiological changes, and survival. These results are an important consideration for determining the safest and most effective manner for adapting gene therapy to treat this leukodystrophy in the clinic. Advances in adeno-associated virus (AAV)-based gene therapy have improved the ability to correct for genetic deficiencies in the nervous system. Marshall et al. show that a combination of intrathecal, intravenous, and intracranial delivery of AAV9 carrying the cDNA for galactosylceramidase (GALC) globally corrected GALC deficiency in a mouse model of Krabbe's disease, preventing the progression of neurological disease for almost the entire lifespan of the animals.

Original languageEnglish (US)
JournalMolecular Therapy
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Globoid Cell Leukodystrophy
Galactosylceramidase
Genetic Therapy
Dependovirus
Nervous System
Benchmarking
Spinal Injections
Demyelinating Diseases
Immunosuppressive Agents
Bone Marrow Transplantation
Intravenous Injections
Disease Progression
Complementary DNA
Enzymes
Therapeutics

Keywords

  • AAV
  • Demyelination
  • Galactosylceramidase
  • Gene therapy
  • Krabbe's disease
  • Leukodystrophy
  • Microglia
  • Myelin
  • Oligodendrocytes
  • Psychosine

ASJC Scopus subject areas

  • Molecular Medicine
  • Molecular Biology
  • Genetics
  • Pharmacology
  • Drug Discovery

Cite this

Marshall, M. S., Issa, Y., Jakubauskas, B., Stoskute, M., Elackattu, V., Marshall, J. N., ... Bongarzone, E. R. (Accepted/In press). Long-Term Improvement of Neurological Signs and Metabolic Dysfunction in a Mouse Model of Krabbe's Disease after Global Gene Therapy. Molecular Therapy. https://doi.org/10.1016/j.ymthe.2018.01.009

Long-Term Improvement of Neurological Signs and Metabolic Dysfunction in a Mouse Model of Krabbe's Disease after Global Gene Therapy. / Marshall, Michael S.; Issa, Yazan; Jakubauskas, Benas; Stoskute, Monika; Elackattu, Vince; Marshall, Jeffrey N.; Bogue, Wil; Nguyen, Duc; Hauck, Zane; Rue, Emily; Karumuthil-Melethil, Subha; Zaric, Violeta; Bosland, Maarten; van Breemen, Richard B.; Givogri, Maria I.; Gray, Steven J.; Crocker, Stephen J.; Bongarzone, Ernesto R.

In: Molecular Therapy, 01.01.2018.

Research output: Contribution to journalArticle

Marshall, MS, Issa, Y, Jakubauskas, B, Stoskute, M, Elackattu, V, Marshall, JN, Bogue, W, Nguyen, D, Hauck, Z, Rue, E, Karumuthil-Melethil, S, Zaric, V, Bosland, M, van Breemen, RB, Givogri, MI, Gray, SJ, Crocker, SJ & Bongarzone, ER 2018, 'Long-Term Improvement of Neurological Signs and Metabolic Dysfunction in a Mouse Model of Krabbe's Disease after Global Gene Therapy', Molecular Therapy. https://doi.org/10.1016/j.ymthe.2018.01.009
Marshall, Michael S. ; Issa, Yazan ; Jakubauskas, Benas ; Stoskute, Monika ; Elackattu, Vince ; Marshall, Jeffrey N. ; Bogue, Wil ; Nguyen, Duc ; Hauck, Zane ; Rue, Emily ; Karumuthil-Melethil, Subha ; Zaric, Violeta ; Bosland, Maarten ; van Breemen, Richard B. ; Givogri, Maria I. ; Gray, Steven J. ; Crocker, Stephen J. ; Bongarzone, Ernesto R. / Long-Term Improvement of Neurological Signs and Metabolic Dysfunction in a Mouse Model of Krabbe's Disease after Global Gene Therapy. In: Molecular Therapy. 2018.
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abstract = "We report a global adeno-associated virus (AAV)9-based gene therapy protocol to deliver therapeutic galactosylceramidase (GALC), a lysosomal enzyme that is deficient in Krabbe's disease. When globally administered via intrathecal, intracranial, and intravenous injections to newborn mice affected with GALC deficiency (twitcher mice), this approach largely surpassed prior published benchmarks of survival and metabolic correction, showing long-term protection of demyelination, neuroinflammation, and motor function. Bone marrow transplantation, performed in this protocol without immunosuppressive preconditioning, added minimal benefits to the AAV9 gene therapy. Contrasting with other proposed pre-clinical therapies, these results demonstrate that achieving nearly complete correction of GALC's metabolic deficiencies across the entire nervous system via gene therapy can have a significant improvement to behavioral deficits, pathophysiological changes, and survival. These results are an important consideration for determining the safest and most effective manner for adapting gene therapy to treat this leukodystrophy in the clinic. Advances in adeno-associated virus (AAV)-based gene therapy have improved the ability to correct for genetic deficiencies in the nervous system. Marshall et al. show that a combination of intrathecal, intravenous, and intracranial delivery of AAV9 carrying the cDNA for galactosylceramidase (GALC) globally corrected GALC deficiency in a mouse model of Krabbe's disease, preventing the progression of neurological disease for almost the entire lifespan of the animals.",
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