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Suárez-Herrera N, Li CHZ, Leijsten N, Karjosukarso DW, Corradi Z, Bukkems F, Duijkers L, Cremers FPM, Hoyng CB, Garanto A, Collin RWJ. Preclinical Development of Antisense Oligonucleotides to Rescue Aberrant Splicing Caused by an Ultrarare ABCA4 Variant in a Child with Early-Onset Stargardt Disease. Cells 2024; 13:601. [PMID: 38607040 PMCID: PMC11011354 DOI: 10.3390/cells13070601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024] Open
Abstract
Precision medicine is rapidly gaining recognition in the field of (ultra)rare conditions, where only a few individuals in the world are affected. Clinical trial design for a small number of patients is extremely challenging, and for this reason, the development of N-of-1 strategies is explored to accelerate customized therapy design for rare cases. A strong candidate for this approach is Stargardt disease (STGD1), an autosomal recessive macular degeneration characterized by high genetic and phenotypic heterogeneity. STGD1 is caused by pathogenic variants in ABCA4, and amongst them, several deep-intronic variants alter the pre-mRNA splicing process, generally resulting in the insertion of pseudoexons (PEs) into the final transcript. In this study, we describe a 10-year-old girl harboring the unique deep-intronic ABCA4 variant c.6817-713A>G. Clinically, she presents with typical early-onset STGD1 with a high disease symmetry between her two eyes. Molecularly, we designed antisense oligonucleotides (AONs) to block the produced PE insertion. Splicing rescue was assessed in three different in vitro models: HEK293T cells, fibroblasts, and photoreceptor precursor cells, the last two being derived from the patient. Overall, our research is intended to serve as the basis for a personalized N-of-1 AON-based treatment to stop early vision loss in this patient.
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Affiliation(s)
- Nuria Suárez-Herrera
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
| | - Catherina H. Z. Li
- Department of Ophthalmology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.H.Z.L.); (C.B.H.)
| | - Nico Leijsten
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
| | - Dyah W. Karjosukarso
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
| | - Zelia Corradi
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
| | - Femke Bukkems
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
| | - Lonneke Duijkers
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
| | - Frans P. M. Cremers
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
| | - Carel B. Hoyng
- Department of Ophthalmology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (C.H.Z.L.); (C.B.H.)
- Dutch Center for RNA Therapeutics, 2311 EZ Leiden, The Netherlands
| | - Alejandro Garanto
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
- Dutch Center for RNA Therapeutics, 2311 EZ Leiden, The Netherlands
- Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Rob W. J. Collin
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (N.S.-H.); (N.L.); (D.W.K.); (Z.C.); (F.B.); (L.D.); (F.P.M.C.); (A.G.)
- Dutch Center for RNA Therapeutics, 2311 EZ Leiden, The Netherlands
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Karjosukarso DW, Bukkems F, Duijkers L, Leijsten N, Hoyng CB, Collin RWJ. Generation of iPSC lines from three Stargardt patients carrying bi-allelic ABCA4 variants. Stem Cell Res 2023; 71:103164. [PMID: 37441824 DOI: 10.1016/j.scr.2023.103164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Stargardt disease, a progressive retinal disorder, is associated with bi-allelic variants in ABCA4, a protein that is expressed in the retina. Induced pluripotent stem cell lines (RMCGENi005-A, SCTCi018-A, SCTCi017-A) were generated by lentivirus reprogramming of fibroblasts derived from Stargardt patients carrying different bi-allelic ABCA4 variants. All the generated lines showed pluripotent characteristics and no chromosomal aberrations. The availability of these lines will allow us to generate patient-derived photoreceptor precursor cells and retinal organoids to further study ABCA4 and thereby, Stargardt disease in relevant model systems carrying the patient's genetic background.
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Affiliation(s)
- Dyah W Karjosukarso
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Femke Bukkems
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lonneke Duijkers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nico Leijsten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carel B Hoyng
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob W J Collin
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
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Karjosukarso DW, Bukkems F, Duijkers L, Leijsten N, Collin RWJ. Generation of three isogenic control lines from patient-derived iPSCs carrying bi-allelic ABCA4 variants underlying Stargardt disease. Stem Cell Res 2023; 71:103169. [PMID: 37480818 DOI: 10.1016/j.scr.2023.103169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023] Open
Abstract
Stargardt disease, a progressive retinal disorder, is associated with bi-allelic variants in ABCA4. Employing the CRISPR/Cas9 approach, we generated isogenic control lines (RMCGENi005-A-1, RMCGENi018-A-1, RMCGENi017-A-1) for each of three induced pluripotent stem cell lines (RMCGENi005-A, RMCGENi018-A, RMCGENi017-A) derived from Stargardt patients carrying compound heterozygous ABCA4 variants. All of the generated lines showed pluripotent characteristics, no chromosomal aberrations and no indication of off-targets. The availability of these isogenic control lines will allow us to have a fair comparison between health and disease state within our studies on Stargardt disease.
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Affiliation(s)
- Dyah W Karjosukarso
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Femke Bukkems
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lonneke Duijkers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nico Leijsten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rob W J Collin
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.
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Klück V, Cabău G, Mies L, Bukkems F, van Emst L, Bakker R, van Caam A, Crişan TO, Joosten LAB. TGF-β is elevated in hyperuricemic individuals and mediates urate-induced hyperinflammatory phenotype in human mononuclear cells. Arthritis Res Ther 2023; 25:30. [PMID: 36850003 PMCID: PMC9969669 DOI: 10.1186/s13075-023-03001-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 01/29/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Soluble urate leads to a pro-inflammatory phenotype in human monocytes characterized by increased production of IL-1β and downregulation of IL-1 receptor antagonist, the mechanism of which remains to be fully elucidated. Previous transcriptomic data identified differential expression of genes in the transforming growth factor (TGF)-β pathway in monocytes exposed to urate in vitro. In this study, we explore the role of TGF-β in urate-induced hyperinflammation in peripheral blood mononuclear cells (PBMCs). METHODS TGF-β mRNA in unstimulated PBMCs and protein levels in plasma were measured in individuals with normouricemia, hyperuricemia and gout. For in vitro validation, PBMCs of healthy volunteers were isolated and treated with a dose ranging concentration of urate for assessment of mRNA and pSMAD2. Urate and TGF-β priming experiments were performed with three inhibitors of TGF-β signalling: SB-505124, 5Z-7-oxozeaenol and a blocking antibody against TGF-β receptor II. RESULTS TGF-β mRNA levels were elevated in gout patients compared to healthy controls. TGF-β-LAP levels in serum were significantly higher in individuals with hyperuricemia compared to controls. In both cases, TGF-β correlated positively to serum urate levels. In vitro, urate exposure of PBMCs did not directly induce TGF-β but did enhance SMAD2 phosphorylation. The urate-induced pro-inflammatory phenotype of monocytes was partly reversed by blocking TGF-β. CONCLUSIONS TGF-β is elevated in individuals with hyperuricemia and correlated to serum urate concentrations. In addition, the urate-induced pro-inflammatory phenotype in human monocytes is mediated by TGF-β signalling. Future studies are warranted to explore the intracellular pathways involved and to assess the clinical significance of urate-TGF-β relation.
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Affiliation(s)
- Viola Klück
- Department of Internal Medicine, Radboud UMC, Nijmegen, The Netherlands.,Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, The Netherlands
| | - Georgiana Cabău
- Department of Medical Genetics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Linda Mies
- Department of Internal Medicine, Radboud UMC, Nijmegen, The Netherlands
| | - Femke Bukkems
- Departement of Rheumatology, Radboud UMC, Nijmegen, The Netherlands
| | - Liesbeth van Emst
- Department of Internal Medicine, Radboud UMC, Nijmegen, The Netherlands
| | - René Bakker
- Departement of Rheumatology, Radboud UMC, Nijmegen, The Netherlands
| | - Arjan van Caam
- Departement of Rheumatology, Radboud UMC, Nijmegen, The Netherlands
| | | | - Tania O Crişan
- Department of Medical Genetics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud UMC, Nijmegen, The Netherlands. .,Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, The Netherlands. .,Department of Medical Genetics, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania.
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