1
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Thomson SB, Stam A, Brouwers C, Fodale V, Bresciani A, Vermeulen M, Mostafavi S, Petkau TL, Hill A, Yung A, Russell-Schulz B, Kozlowski P, MacKay A, Ma D, Beg MF, Evers MM, Vallès A, Leavitt BR. AAV5-miHTT-mediated huntingtin lowering improves brain health in a Huntington's disease mouse model. Brain 2023; 146:2298-2315. [PMID: 36508327 PMCID: PMC10232253 DOI: 10.1093/brain/awac458] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/23/2022] [Accepted: 10/30/2022] [Indexed: 04/12/2024] Open
Abstract
Huntingtin (HTT)-lowering therapies show great promise in treating Huntington's disease. We have developed a microRNA targeting human HTT that is delivered in an adeno-associated serotype 5 viral vector (AAV5-miHTT), and here use animal behaviour, MRI, non-invasive proton magnetic resonance spectroscopy and striatal RNA sequencing as outcome measures in preclinical mouse studies of AAV5-miHTT. The effects of AAV5-miHTT treatment were evaluated in homozygous Q175FDN mice, a mouse model of Huntington's disease with severe neuropathological and behavioural phenotypes. Homozygous mice were used instead of the more commonly used heterozygous strain, which exhibit milder phenotypes. Three-month-old homozygous Q175FDN mice, which had developed acute phenotypes by the time of treatment, were injected bilaterally into the striatum with either formulation buffer (phosphate-buffered saline + 5% sucrose), low dose (5.2 × 109 genome copies/mouse) or high dose (1.3 × 1011 genome copies/mouse) AAV5-miHTT. Wild-type mice injected with formulation buffer served as controls. Behavioural assessments of cognition, T1-weighted structural MRI and striatal proton magnetic resonance spectroscopy were performed 3 months after injection, and shortly afterwards the animals were sacrificed to collect brain tissue for protein and RNA analysis. Motor coordination was assessed at 1-month intervals beginning at 2 months of age until sacrifice. Dose-dependent changes in AAV5 vector DNA level, miHTT expression and mutant HTT were observed in striatum and cortex of AAV5-miHTT-treated Huntington's disease model mice. This pattern of microRNA expression and mutant HTT lowering rescued weight loss in homozygous Q175FDN mice but did not affect motor or cognitive phenotypes. MRI volumetric analysis detected atrophy in four brain regions in homozygous Q175FDN mice, and treatment with high dose AAV5-miHTT rescued this effect in the hippocampus. Like previous magnetic resonance spectroscopy studies in Huntington's disease patients, decreased total N-acetyl aspartate and increased myo-inositol levels were found in the striatum of homozygous Q175FDN mice. These neurochemical findings were partially reversed with AAV5-miHTT treatment. Striatal transcriptional analysis using RNA sequencing revealed mutant HTT-induced changes that were partially reversed by HTT lowering with AAV5-miHTT. Striatal proton magnetic resonance spectroscopy analysis suggests a restoration of neuronal function, and striatal RNA sequencing analysis shows a reversal of transcriptional dysregulation following AAV5-miHTT in a homozygous Huntington's disease mouse model with severe pathology. The results of this study support the use of magnetic resonance spectroscopy in HTT-lowering clinical trials and strengthen the therapeutic potential of AAV5-miHTT in reversing severe striatal dysfunction in Huntington's disease.
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Affiliation(s)
- Sarah B Thomson
- Department of Medical Genetics, Centre for Molecular Medicine & Therapeutics, University of British Columbia and BC Children’s Hospital, Vancouver, BC V5Z4H4, Canada
| | - Anouk Stam
- Department of Research & Development, uniQure Biopharma B.V., 1105BP Amsterdam, The Netherlands
| | - Cynthia Brouwers
- Department of Research & Development, uniQure Biopharma B.V., 1105BP Amsterdam, The Netherlands
| | - Valentina Fodale
- Department of Translational Biology, IRBM S.p.A., Pomezia 00071, Italy
| | - Alberto Bresciani
- Department of Translational Biology, IRBM S.p.A., Pomezia 00071, Italy
| | - Michael Vermeulen
- Department of Medical Genetics, Centre for Molecular Medicine & Therapeutics, University of British Columbia and BC Children’s Hospital, Vancouver, BC V5Z4H4, Canada
| | - Sara Mostafavi
- Department of Medical Genetics, Centre for Molecular Medicine & Therapeutics, University of British Columbia and BC Children’s Hospital, Vancouver, BC V5Z4H4, Canada
| | - Terri L Petkau
- Department of Medical Genetics, Centre for Molecular Medicine & Therapeutics, University of British Columbia and BC Children’s Hospital, Vancouver, BC V5Z4H4, Canada
| | - Austin Hill
- Department of Medical Genetics, Centre for Molecular Medicine & Therapeutics, University of British Columbia and BC Children’s Hospital, Vancouver, BC V5Z4H4, Canada
| | - Andrew Yung
- UBC MRI Research Centre, Department of Radiology, University of British Columbia, Vancouver, BC V6T2B5, Canada
| | - Bretta Russell-Schulz
- UBC MRI Research Centre, Department of Radiology, University of British Columbia, Vancouver, BC V6T2B5, Canada
| | - Piotr Kozlowski
- UBC MRI Research Centre, Department of Radiology, University of British Columbia, Vancouver, BC V6T2B5, Canada
| | - Alex MacKay
- UBC MRI Research Centre, Department of Radiology, University of British Columbia, Vancouver, BC V6T2B5, Canada
| | - Da Ma
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27101, USA
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, BC V5A0A7, Canada
| | - Melvin M Evers
- Department of Research & Development, uniQure Biopharma B.V., 1105BP Amsterdam, The Netherlands
| | - Astrid Vallès
- Department of Research & Development, uniQure Biopharma B.V., 1105BP Amsterdam, The Netherlands
| | - Blair R Leavitt
- Department of Medical Genetics, Centre for Molecular Medicine & Therapeutics, University of British Columbia and BC Children’s Hospital, Vancouver, BC V5Z4H4, Canada
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2
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Sridhar A, Depla JA, Mulder LA, Karelehto E, Brouwer L, Kruiswijk L, Vieira de Sá R, Meijer A, Evers MM, van Kuppeveld FJM, Pajkrt D, Wolthers KC. Enterovirus D68 Infection in Human Primary Airway and Brain Organoids: No Additional Role for Heparan Sulfate Binding for Neurotropism. Microbiol Spectr 2022; 10:e0169422. [PMID: 36154279 PMCID: PMC9603061 DOI: 10.1128/spectrum.01694-22] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/09/2022] [Indexed: 12/31/2022] Open
Abstract
Enterovirus D68 (EV-D68) is an RNA virus that can cause outbreaks of acute flaccid paralysis (AFP), a polio-like disease. Before 2010, EV-D68 was a rare pathogen associated with mild respiratory symptoms, but the recent EV-D68 related increase in severe respiratory illness and outbreaks of AFP is not yet understood. An explanation for the rise in severe disease is that it may be due to changes in the viral genome resulting in neurotropism. In this regard, in addition to sialic acid, binding to heparan sulfate proteoglycans (HSPGs) has been identified as a feature for viral entry of some EV-D68 strains in cell lines. Studies in human primary organotypic cultures that recapitulate human physiology will address the relevance of these HSPG-binding mutations for EV-D68 infection in vivo. Therefore, in this work, we studied the replication and neurotropism of previously determined sialic acid-dependent and HSPG-dependent strains using primary human airway epithelial (HAE) cultures and induced human pluripotent stem cell (iPSC)-derived brain organoids. All three strains (B2/2042, B2/947, and A1/1348) used in this study infected HAE cultures and human brain organoids (shown for the first time). Receptor-blocking experiments in both cultures confirm that B2/2042 infection is solely dependent on sialic acid, while B2/947 and A1/1348 (HSPG to a lesser extent) binds to sialic acid and HSPG for cell entry. Our data suggest that HSPG-binding can be used by EV-D68 for entry in human physiological models but offers no advantage for EV-D68 infection of brain cells. IMPORTANCE Recent outbreaks of enterovirus D68, a nonpolio enterovirus, is associated with a serious neurological condition in young children, acute flaccid myelitis (AFM). As there is no antiviral treatment or vaccine available for EV-D68 it is important to better understand how EV-D68 causes AFM and why only recent outbreaks are associated with AFM. We investigated if a change in receptor usage of EV-D68 increases the virulence of EV-D68 in the airway or the central nervous system and thus could explain the increase in AFM cases. We studied this using physiologically relevant human airway epithelium and cerebral organoid cultures that are physiologically relevant human models. Our data suggest that heparan sulfate proteoglycans can be used by EV-D68 as an additional entry receptor in human physiological models but offers no advantage for EV-D68 infection of brain cells, and our data show the potential of these 46 innovative models for virology.
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Affiliation(s)
- Adithya Sridhar
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital Department of Pediatric Infectious Diseases, Amsterdam, The Netherlands
| | - Josse A. Depla
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital Department of Pediatric Infectious Diseases, Amsterdam, The Netherlands
- uniQure Biopharma B.V., Amsterdam, The Netherlands
| | - Lance A. Mulder
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital Department of Pediatric Infectious Diseases, Amsterdam, The Netherlands
| | - Eveliina Karelehto
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital Department of Pediatric Infectious Diseases, Amsterdam, The Netherlands
| | - Lieke Brouwer
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital Department of Pediatric Infectious Diseases, Amsterdam, The Netherlands
| | - Leonie Kruiswijk
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
| | | | - Adam Meijer
- National Institute for Public Health and Environment, Centre for Infectious Diseases Research and Laboratory Surveillance, Bilthoven, The Netherlands
| | | | - Frank J. M. van Kuppeveld
- Virology Division, Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Dasja Pajkrt
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children’s Hospital Department of Pediatric Infectious Diseases, Amsterdam, The Netherlands
| | - Katja C. Wolthers
- Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Department of Medical Microbiology, OrganoVIR Labs, Amsterdam, The Netherlands
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3
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van der Bent ML, Evers MM, Vallès A. Emerging Therapies for Huntington's Disease - Focus on N-Terminal Huntingtin and Huntingtin Exon 1. Biologics 2022; 16:141-160. [PMID: 36213816 PMCID: PMC9532260 DOI: 10.2147/btt.s270657] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/14/2022] [Indexed: 11/12/2022]
Abstract
Huntington's disease is a devastating heritable neurodegenerative disorder that is caused by the presence of a trinucleotide CAG repeat expansion in the Huntingtin gene, leading to a polyglutamine tract in the protein. Various mechanisms lead to the production of N-terminal Huntingtin protein fragments, which are reportedly more toxic than the full-length protein. In this review, we summarize the current knowledge on the production and toxicity of N-terminal Huntingtin protein fragments. Further, we expand on various therapeutic strategies targeting N-terminal Huntingtin on the protein, RNA and DNA level. Finally, we compare the therapeutic approaches that are clinically most advanced, including those that do not target N-terminal Huntingtin, discussing differences in mode of action and translational applicability.
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Affiliation(s)
| | - Melvin M Evers
- uniQure biopharma B.V., Department of Research and Development, Amsterdam, the Netherlands
| | - Astrid Vallès
- uniQure biopharma B.V., Department of Research and Development, Amsterdam, the Netherlands
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4
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Depla JA, Mulder LA, de Sá RV, Wartel M, Sridhar A, Evers MM, Wolthers KC, Pajkrt D. Human Brain Organoids as Models for Central Nervous System Viral Infection. Viruses 2022; 14:v14030634. [PMID: 35337041 PMCID: PMC8948955 DOI: 10.3390/v14030634] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 02/06/2023] Open
Abstract
Pathogenesis of viral infections of the central nervous system (CNS) is poorly understood, and this is partly due to the limitations of currently used preclinical models. Brain organoid models can overcome some of these limitations, as they are generated from human derived stem cells, differentiated in three dimensions (3D), and can mimic human neurodevelopmental characteristics. Therefore, brain organoids have been increasingly used as brain models in research on various viruses, such as Zika virus, severe acute respiratory syndrome coronavirus 2, human cytomegalovirus, and herpes simplex virus. Brain organoids allow for the study of viral tropism, the effect of infection on organoid function, size, and cytoarchitecture, as well as innate immune response; therefore, they provide valuable insight into the pathogenesis of neurotropic viral infections and testing of antivirals in a physiological model. In this review, we summarize the results of studies on viral CNS infection in brain organoids, and we demonstrate the broad application and benefits of using a human 3D model in virology research. At the same time, we describe the limitations of the studies in brain organoids, such as the heterogeneity in organoid generation protocols and age at infection, which result in differences in results between studies, as well as the lack of microglia and a blood brain barrier.
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Affiliation(s)
- Josse A. Depla
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC Location Academic Medical Center, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (L.A.M.); (A.S.); (K.C.W.); (D.P.)
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- UniQure Biopharma B.V., Department of Research & Development, Paasheuvelweg 25A, 1105 BE Amsterdam, The Netherlands; (R.V.d.S.); (M.W.); (M.M.E.)
- Correspondence:
| | - Lance A. Mulder
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC Location Academic Medical Center, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (L.A.M.); (A.S.); (K.C.W.); (D.P.)
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Renata Vieira de Sá
- UniQure Biopharma B.V., Department of Research & Development, Paasheuvelweg 25A, 1105 BE Amsterdam, The Netherlands; (R.V.d.S.); (M.W.); (M.M.E.)
| | - Morgane Wartel
- UniQure Biopharma B.V., Department of Research & Development, Paasheuvelweg 25A, 1105 BE Amsterdam, The Netherlands; (R.V.d.S.); (M.W.); (M.M.E.)
| | - Adithya Sridhar
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC Location Academic Medical Center, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (L.A.M.); (A.S.); (K.C.W.); (D.P.)
| | - Melvin M. Evers
- UniQure Biopharma B.V., Department of Research & Development, Paasheuvelweg 25A, 1105 BE Amsterdam, The Netherlands; (R.V.d.S.); (M.W.); (M.M.E.)
| | - Katja C. Wolthers
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC Location Academic Medical Center, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (L.A.M.); (A.S.); (K.C.W.); (D.P.)
| | - Dasja Pajkrt
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC Location Academic Medical Center, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (L.A.M.); (A.S.); (K.C.W.); (D.P.)
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC Location Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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5
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Nobre RJ, Lobo DD, Henriques C, Duarte SP, Lopes SM, Silva AC, Lopes MM, Mariet F, Schwarz LK, Baatje MS, Ferreira V, Vallès A, Pereira de Almeida L, Evers MM, Toonen LJA. MiRNA-Mediated Knockdown of ATXN3 Alleviates Molecular Disease Hallmarks in a Mouse Model for Spinocerebellar Ataxia Type 3. Nucleic Acid Ther 2021; 32:194-205. [PMID: 34878314 PMCID: PMC9221165 DOI: 10.1089/nat.2021.0020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Spinocerebellar ataxia type 3 (SCA3) is a neurodegenerative disorder caused by the expansion of a CAG repeat in the ATXN3 gene. This mutation leads to a toxic gain of function of the ataxin-3 protein, resulting in neuronal dysfunction and atrophy of specific brain regions over time. As ataxin-3 is a dispensable protein in rodents, ataxin-3 knockdown by gene therapy may be a powerful approach for the treatment of SCA3. In this study, we tested the feasibility of an adeno-associated viral (AAV) vector carrying a previously described artificial microRNA against ATXN3 in a striatal mouse model of SCA3. Striatal injection of the AAV resulted in good distribution throughout the striatum, with strong dose-dependent ataxin-3 knockdown. The hallmark intracellular ataxin-3 inclusions were almost completely alleviated by the microRNA-induced ATXN3 knockdown. In addition, the striatal lesion of dopamine- and cAMP-regulated neuronal phosphoprotein (DARPP-32) in the SCA3 mice was rescued by ATXN3 knockdown, indicating functional rescue of neuronal signaling and health upon AAV treatment. Together, these data suggest that microRNA-induced ataxin-3 knockdown is a promising therapeutic strategy in the treatment of SCA3.
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Affiliation(s)
- Rui Jorge Nobre
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,ViraVector-Viral Vector for Gene Transfer Core Facility and University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research (III), University of Coimbra, Coimbra, Portugal
| | - Diana D Lobo
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research (III), University of Coimbra, Coimbra, Portugal
| | - Carina Henriques
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,ViraVector-Viral Vector for Gene Transfer Core Facility and University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Sonia P Duarte
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research (III), University of Coimbra, Coimbra, Portugal
| | - Sara M Lopes
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research (III), University of Coimbra, Coimbra, Portugal
| | - Ana C Silva
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research (III), University of Coimbra, Coimbra, Portugal
| | - Miguel M Lopes
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,Institute for Interdisciplinary Research (III), University of Coimbra, Coimbra, Portugal
| | - Fanny Mariet
- uniQure Biopharma b.v., Amsterdam, the Netherlands
| | | | - M S Baatje
- uniQure Biopharma b.v., Amsterdam, the Netherlands
| | | | | | - Luis Pereira de Almeida
- Center for Neuroscience and Cell Biology (CNC), Molecular Therapy of Brain Disorders Group, University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), Vectors, Gene and Cell Therapy Group, University of Coimbra, Coimbra, Portugal.,ViraVector-Viral Vector for Gene Transfer Core Facility and University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
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6
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Sogorb-Gonzalez M, Vendrell-Tornero C, Snapper J, Stam A, Keskin S, Miniarikova J, Spronck EA, de Haan M, Nieuwland R, Konstantinova P, van Deventer SJ, Evers MM, Vallès A. Secreted therapeutics: monitoring durability of microRNA-based gene therapies in the central nervous system. Brain Commun 2021; 3:fcab054. [PMID: 34704020 PMCID: PMC8093922 DOI: 10.1093/braincomms/fcab054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/20/2021] [Accepted: 02/11/2021] [Indexed: 01/08/2023] Open
Abstract
The preclinical development of microRNA-based gene therapies for inherited neurodegenerative diseases is accompanied by translational challenges. Due to the inaccessibility of the brain to periodically evaluate therapy effects, accessible and reliable biomarkers indicative of dosing, durability and therapeutic efficacy in the central nervous system are very much needed. This is particularly important for viral vector-based gene therapies, in which a one-time administration results in long-term expression of active therapeutic molecules in the brain. Recently, extracellular vesicles have been identified as carriers of RNA species, including microRNAs, and proteins in all biological fluids, whilst becoming potential sources of biomarkers for diagnosis. In this study, we investigated the secretion and potential use of circulating miRNAs associated with extracellular vesicles as suitable sources to monitor the expression and durability of gene therapies in the brain. Neuronal cells derived from induced pluripotent stem cells were treated with adeno-associated viral vector serotype 5 carrying an engineered microRNA targeting huntingtin or ataxin3 gene sequences, the diseases-causing genes of Huntington disease and spinocerebellar ataxia type 3, respectively. After treatment, the secretion of mature engineered microRNA molecules was confirmed, with extracellular microRNA levels correlating with viral dose and cellular microRNA expression in neurons. We further investigated the detection of engineered microRNAs over time in the CSF of non-human primates after a single intrastriatal injection of adeno-associated viral vector serotype 5 carrying a huntingtin-targeting engineered microRNA. Quantifiable engineered microRNA levels enriched in extracellular vesicles were detected in the CSF up to two years after brain infusion. Altogether, these results confirm the long-term expression of adeno-associated viral vector serotype 5-delivered microRNAs and support the use of extracellular vesicle-associated microRNAs as novel translational pharmacokinetic markers in ongoing clinical trials of gene therapies for neurodegenerative diseases.
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Affiliation(s)
- Marina Sogorb-Gonzalez
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Carlos Vendrell-Tornero
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Jolanda Snapper
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Anouk Stam
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Sonay Keskin
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Jana Miniarikova
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Elisabeth A Spronck
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Martin de Haan
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Rienk Nieuwland
- Laboratory of Experimental Clinical Chemistry, and Vesicles Observation Center, Amsterdam UMC, University of Amsterdam, Amsterdam, 1105 AZ, The Netherlands
| | - Pavlina Konstantinova
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Sander J van Deventer
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, 2333 ZA, The Netherlands
| | - Melvin M Evers
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
| | - Astrid Vallès
- Department of Research and Development, uniQure Biopharma N.V., Amsterdam, 1105 BP, The Netherlands
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7
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Vallès A, Evers MM, Stam A, Sogorb-Gonzalez M, Brouwers C, Vendrell-Tornero C, Acar-Broekmans S, Paerels L, Klima J, Bohuslavova B, Pintauro R, Fodale V, Bresciani A, Liscak R, Urgosik D, Starek Z, Crha M, Blits B, Petry H, Ellederova Z, Motlik J, van Deventer S, Konstantinova P. Widespread and sustained target engagement in Huntington's disease minipigs upon intrastriatal microRNA-based gene therapy. Sci Transl Med 2021; 13:13/588/eabb8920. [PMID: 33827977 DOI: 10.1126/scitranslmed.abb8920] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 01/09/2021] [Indexed: 12/12/2022]
Abstract
Huntingtin (HTT)-lowering therapies hold promise to slow down neurodegeneration in Huntington's disease (HD). Here, we assessed the translatability and long-term durability of recombinant adeno-associated viral vector serotype 5 expressing a microRNA targeting human HTT (rAAV5-miHTT) administered by magnetic resonance imaging-guided convention-enhanced delivery in transgenic HD minipigs. rAAV5-miHTT (1.2 × 1013 vector genome (VG) copies per brain) was successfully administered into the striatum (bilaterally in caudate and putamen), using age-matched untreated animals as controls. Widespread brain biodistribution of vector DNA was observed, with the highest concentration in target (striatal) regions, thalamus, and cortical regions. Vector DNA presence and transgene expression were similar at 6 and 12 months after administration. Expression of miHTT strongly correlated with vector DNA, with a corresponding reduction of mutant HTT (mHTT) protein of more than 75% in injected areas, and 30 to 50% lowering in distal regions. Translational pharmacokinetic and pharmacodynamic measures in cerebrospinal fluid (CSF) were largely in line with the effects observed in the brain. CSF miHTT expression was detected up to 12 months, with CSF mHTT protein lowering of 25 to 30% at 6 and 12 months after dosing. This study demonstrates widespread biodistribution, strong and durable efficiency of rAAV5-miHTT in disease-relevant regions in a large brain, and the potential of using CSF analysis to determine vector expression and efficacy in the clinic.
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Affiliation(s)
- Astrid Vallès
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands.
| | - Melvin M Evers
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands.
| | - Anouk Stam
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Marina Sogorb-Gonzalez
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Cynthia Brouwers
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Carlos Vendrell-Tornero
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Seyda Acar-Broekmans
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Lieke Paerels
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Jiri Klima
- Institute of Animal Physiology and Genetics, Rumburská 89, 277 21 Libechov, Czech Republic
| | - Bozena Bohuslavova
- Institute of Animal Physiology and Genetics, Rumburská 89, 277 21 Libechov, Czech Republic
| | - Roberta Pintauro
- Department of Translational Biology, IRBM Science Park S.p.A., Via Pontina km 30,600, 00071 Pomezia, Italy
| | - Valentina Fodale
- Department of Translational Biology, IRBM Science Park S.p.A., Via Pontina km 30,600, 00071 Pomezia, Italy
| | - Alberto Bresciani
- Department of Translational Biology, IRBM Science Park S.p.A., Via Pontina km 30,600, 00071 Pomezia, Italy
| | - Roman Liscak
- Department of Stereotactic Radioneurosurgery, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Dusan Urgosik
- Department of Stereotactic Radioneurosurgery, Na Homolce Hospital, Roentgenova 37/2, 150 30, Prague 5, Czech Republic
| | - Zdenek Starek
- Interventional Cardiac Electrophysiology, St. Anne's University Hospital, Pekařská 53, 656 91 Brno, Czech Republic
| | - Michal Crha
- Small Animal Clinic, Veterinary and Pharmaceutical University, Palackého třída 1946/1, 612 42 Brno, Czech Republic
| | - Bas Blits
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Harald Petry
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Zdenka Ellederova
- Institute of Animal Physiology and Genetics, Rumburská 89, 277 21 Libechov, Czech Republic
| | - Jan Motlik
- Institute of Animal Physiology and Genetics, Rumburská 89, 277 21 Libechov, Czech Republic
| | - Sander van Deventer
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
| | - Pavlina Konstantinova
- Department of Research and Development, uniQure biopharma B.V., Paasheuvelweg 25a, 1105 BP Amsterdam, Netherlands
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Spronck EA, Vallès A, Lampen MH, Montenegro-Miranda PS, Keskin S, Heijink L, Evers MM, Petry H, van Deventer SJ, Konstantinova P, de Haan M. Intrastriatal Administration of AAV5-miHTT in Non-Human Primates and Rats Is Well Tolerated and Results in miHTT Transgene Expression in Key Areas of Huntington Disease Pathology. Brain Sci 2021; 11:brainsci11020129. [PMID: 33498212 PMCID: PMC7908995 DOI: 10.3390/brainsci11020129] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/10/2021] [Accepted: 01/17/2021] [Indexed: 02/04/2023] Open
Abstract
Huntington disease (HD) is a fatal, neurodegenerative genetic disorder with aggregation of mutant Huntingtin protein (mutHTT) in the brain as a key pathological mechanism. There are currently no disease modifying therapies for HD; however, HTT-lowering therapies hold promise. Recombinant adeno-associated virus serotype 5 expressing a microRNA that targets HTT mRNA (AAV5-miHTT) is in development for the treatment of HD with promising results in rodent and minipig HD models. To support a clinical trial, toxicity studies were performed in non-human primates (NHP, Macaca fascicularis) and Sprague-Dawley rats to evaluate the safety of AAV5-miHTT, the neurosurgical administration procedure, vector delivery and expression of the miHTT transgene during a 6-month observation period. For accurate delivery of AAV5-miHTT to the striatum, real-time magnetic resonance imaging (MRI) with convection-enhanced delivery (CED) was used in NHP. Catheters were successfully implanted in 24 NHP, without neurological symptoms, and resulted in tracer signal in the target areas. Widespread vector DNA and miHTT transgene distribution in the brain was found, particularly in areas associated with HD pathology. Intrastriatal administration of AAV5-miHTT was well tolerated with no clinically relevant changes in either species. These studies demonstrate the excellent safety profile of AAV5-miHTT, the reproducibility and tolerability of intrastriatal administration, and the delivery of AAV5-miHTT to the brain, which support the transition of AAV5-miHTT into clinical studies.
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Affiliation(s)
- Elisabeth A. Spronck
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
- Correspondence: ; Tel.: +31-(0)20-240-6091
| | - Astrid Vallès
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Margit H. Lampen
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Paula S. Montenegro-Miranda
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Sonay Keskin
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Liesbeth Heijink
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Melvin M. Evers
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Harald Petry
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Sander J. van Deventer
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
| | - Pavlina Konstantinova
- uniQure biopharma B.V., 1105 BP Amsterdam, The Netherlands; (A.V.); (M.H.L.); (P.S.M.-M.); (S.K.); (L.H.); (M.M.E.); (H.P.); (P.K.)
| | - Martin de Haan
- Madeha Management & Consultancy, 1222 LM Nederhorst den Berg, The Netherlands;
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Sridhar A, Simmini S, Ribeiro CMS, Tapparel C, Evers MM, Pajkrt D, Wolthers K. A Perspective on Organoids for Virology Research. Viruses 2020; 12:v12111341. [PMID: 33238561 PMCID: PMC7700289 DOI: 10.3390/v12111341] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/12/2020] [Accepted: 11/22/2020] [Indexed: 12/27/2022] Open
Abstract
Animal models and cell lines are invaluable for virology research and host-pathogen interaction studies. However, it is increasingly evident that these models are not sufficient to fully understand human viral diseases. With the advent of three-dimensional organotypic cultures, it is now possible to study viral infections in the human context. This perspective explores the potential of these organotypic cultures, also known as organoids, for virology research, antiviral testing, and shaping the virology landscape.
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Affiliation(s)
- Adithya Sridhar
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands; (A.S.); (D.P.)
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands
| | - Salvatore Simmini
- Gastrointestinal Biology Group, STEMCELL Technologies UK Ltd., Cambridge CB28 9TL, UK;
| | - Carla M. S. Ribeiro
- Department of Experimental Immunology, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands;
| | - Caroline Tapparel
- Department of Microbiology and Molecular Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland;
- Division of Infectious Diseases, Geneva University Hospital, 1205 Geneva, Switzerland
| | - Melvin M. Evers
- Department of Research and Development, uniQure Biopharma B.V., 1105 BE Amsterdam, The Netherlands;
| | - Dasja Pajkrt
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands; (A.S.); (D.P.)
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands
| | - Katja Wolthers
- OrganoVIR Labs, Department of Medical Microbiology, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, 1100 AZ Amsterdam, The Netherlands; (A.S.); (D.P.)
- Correspondence:
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10
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Affiliation(s)
- Melvin M Evers
- Research, uniQure biopharma B.V , Amsterdam, The Netherlands
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11
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Caron NS, Southwell AL, Brouwers CC, Cengio LD, Xie Y, Black HF, Anderson LM, Ko S, Zhu X, van Deventer SJ, Evers MM, Konstantinova P, Hayden MR. Potent and sustained huntingtin lowering via AAV5 encoding miRNA preserves striatal volume and cognitive function in a humanized mouse model of Huntington disease. Nucleic Acids Res 2020; 48:36-54. [PMID: 31745548 PMCID: PMC7145682 DOI: 10.1093/nar/gkz976] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 11/13/2022] Open
Abstract
Huntington disease (HD) is a fatal neurodegenerative disease caused by a pathogenic expansion of a CAG repeat in the huntingtin (HTT) gene. There are no disease-modifying therapies for HD. Artificial microRNAs targeting HTT transcripts for degradation have shown preclinical promise and will soon enter human clinical trials. Here, we examine the tolerability and efficacy of non-selective HTT lowering with an AAV5 encoded miRNA targeting human HTT (AAV5-miHTT) in the humanized Hu128/21 mouse model of HD. We show that intrastriatal administration of AAV5-miHTT results in potent and sustained HTT suppression for at least 7 months post-injection. Importantly, non-selective suppression of huntingtin was generally tolerated, however high dose AAV5-miHTT did induce astrogliosis. We observed an improvement of select behavioural and modest neuropathological HD-like phenotypes in Hu128/21 mice, suggesting a potential therapeutic benefit of miRNA-mediated non-selective HTT lowering. Finally, we also observed that potent reduction of wild type HTT (wtHTT) in Hu21 control mice was tolerated up to 7 months post-injection but may induce impairment of motor coordination and striatal atrophy. Taken together, our data suggests that in the context of HD, the therapeutic benefits of mHTT reduction may outweigh the potentially detrimental effects of wtHTT loss following non-selective HTT lowering.
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Affiliation(s)
- Nicholas S Caron
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Amber L Southwell
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Cynthia C Brouwers
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Louisa Dal Cengio
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Yuanyun Xie
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada.,Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Hailey Findlay Black
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Lisa M Anderson
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Seunghyun Ko
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Xiang Zhu
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Sander J van Deventer
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Melvin M Evers
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Pavlina Konstantinova
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Michael R Hayden
- Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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12
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Martier R, Sogorb-Gonzalez M, Stricker-Shaver J, Hübener-Schmid J, Keskin S, Klima J, Toonen LJ, Juhas S, Juhasova J, Ellederova Z, Motlik J, Haas E, van Deventer S, Konstantinova P, Nguyen HP, Evers MM. Development of an AAV-Based MicroRNA Gene Therapy to Treat Machado-Joseph Disease. Mol Ther Methods Clin Dev 2019; 15:343-358. [PMID: 31828177 PMCID: PMC6889651 DOI: 10.1016/j.omtm.2019.10.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/22/2019] [Indexed: 01/06/2023]
Abstract
Spinocerebellar ataxia type 3 (SCA3), or Machado-Joseph disease (MJD), is a progressive neurodegenerative disorder caused by a CAG expansion in the ATXN3 gene. The expanded CAG repeat is translated into a prolonged polyglutamine repeat in the ataxin-3 protein and accumulates within inclusions, acquiring toxic properties, which results in degeneration of the cerebellum and brain stem. In the current study, a non-allele-specific ATXN3 silencing approach was investigated using artificial microRNAs engineered to target various regions of the ATXN3 gene (miATXN3). The miATXN3 candidates were screened in vitro based on their silencing efficacy on a luciferase (Luc) reporter co-expressing ATXN3. The three best miATXN3 candidates were further tested for target engagement and potential off-target activity in induced pluripotent stem cells (iPSCs) differentiated into frontal brain-like neurons and in a SCA3 knockin mouse model. Besides a strong reduction of ATXN3 mRNA and protein, small RNA sequencing revealed efficient guide strand processing without passenger strands being produced. We used different methods to predict alteration of off-target genes upon AAV5-miATXN3 treatment and found no evidence for unwanted effects. Furthermore, we demonstrated in a large animal model, the minipig, that intrathecal delivery of AAV5 can transduce the main areas affected in SCA3 patients. These results proved a strong basis to move forward to investigate distribution, efficacy, and safety of AAV5-miATXN3 in large animals.
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Affiliation(s)
- Raygene Martier
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marina Sogorb-Gonzalez
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Janice Stricker-Shaver
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | | | - Sonay Keskin
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Jiri Klima
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Lodewijk J Toonen
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Jana Juhasova
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Zdenka Ellederova
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Jan Motlik
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Eva Haas
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Sander van Deventer
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pavlina Konstantinova
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Huu Phuc Nguyen
- Department of Human Genetics, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Melvin M Evers
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
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13
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Spronck EA, Brouwers CC, Vallès A, de Haan M, Petry H, van Deventer SJ, Konstantinova P, Evers MM. AAV5-miHTT Gene Therapy Demonstrates Sustained Huntingtin Lowering and Functional Improvement in Huntington Disease Mouse Models. Mol Ther Methods Clin Dev 2019; 13:334-343. [PMID: 30984798 PMCID: PMC6446047 DOI: 10.1016/j.omtm.2019.03.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/07/2019] [Indexed: 12/19/2022]
Abstract
Huntington disease (HD) is a fatal neurodegenerative disorder caused by an autosomal dominant CAG repeat expansion in the huntingtin (HTT) gene. The translated expanded polyglutamine repeat in the HTT protein is known to cause toxic gain of function. We showed previously that strong HTT lowering prevented neuronal dysfunction in HD rodents and minipigs after single intracranial injection of adeno-associated viral vector serotype 5 expressing a microRNA targeting human HTT (AAV5-miHTT). To evaluate long-term efficacy, AAV5-miHTT was injected into the striatum of knockin Q175 HD mice, and the mice were sacrificed 12 months post-injection. AAV5-miHTT caused a dose-dependent and sustained HTT protein reduction with subsequent suppression of mutant HTT aggregate formation in the striatum and cortex. Functional proof of concept was shown in transgenic R6/2 HD mice. Eight weeks after AAV5-miHTT treatment, a significant improvement in motor coordination on the rotarod was observed. Survival analysis showed that a single AAV5-miHTT treatment resulted in a significant 4-week increase in median survival compared with vehicle-treated R6/2 HD mice. The combination of long-term HTT lowering, reduction in aggregation, prevention of neuronal dysfunction, alleviation of HD-like symptoms, and beneficial survival observed in HD rodents treated with AAV5-miHTT supports the continued development of HTT-lowering gene therapies for HD.
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Affiliation(s)
- Elisabeth A Spronck
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Cynthia C Brouwers
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Astrid Vallès
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Martin de Haan
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Harald Petry
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Sander J van Deventer
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pavlina Konstantinova
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Melvin M Evers
- Department of Research and Development, uniQure biopharma B.V., Amsterdam, the Netherlands
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14
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Martier R, Liefhebber JM, Miniarikova J, van der Zon T, Snapper J, Kolder I, Petry H, van Deventer SJ, Evers MM, Konstantinova P. Artificial MicroRNAs Targeting C9orf72 Can Reduce Accumulation of Intra-nuclear Transcripts in ALS and FTD Patients. Mol Ther Nucleic Acids 2019; 14:593-608. [PMID: 30776581 PMCID: PMC6378669 DOI: 10.1016/j.omtn.2019.01.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 12/13/2022]
Abstract
The most common pathogenic mutation in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) is an intronic GGGGCC (G4C2) repeat in the chromosome 9 open reading frame 72 (C9orf72) gene. Cellular toxicity due to RNA foci and dipeptide repeat (DPR) proteins produced by the sense and antisense repeat-containing transcripts is thought to underlie the pathogenesis of both diseases. RNA sequencing (RNA-seq) data of C9orf72-ALS patients and controls were analyzed to better understand the sequence conservation of C9orf72 in patients. MicroRNAs were developed in conserved regions to silence C9orf72 (miC), and the feasibility of different silencing approaches was demonstrated in reporter overexpression systems. In addition, we demonstrated the feasibility of a bidirectional targeting approach by expressing two concatenated miC hairpins. The efficacy of miC was confirmed by the reduction of endogenously expressed C9orf72 mRNA, in both nucleus and cytoplasm, and an ∼50% reduction of nuclear RNA foci in (G4C2)44-expressing cells. Ultimately, two miC candidates were incorporated in adeno-associated virus vector serotype 5 (AAV5), and silencing of C9orf72 was demonstrated in HEK293T cells and induced pluripotent stem cell (iPSC)-derived neurons. These data support the feasibility of microRNA (miRNA)-based and AAV-delivered gene therapy that could alleviate the gain of toxicity seen in ALS and FTD patients.
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Affiliation(s)
- Raygene Martier
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jolanda M Liefhebber
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Jana Miniarikova
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Tom van der Zon
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Jolanda Snapper
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Iris Kolder
- BaseClear B.V., Sylviusweg 74, 2333 BE, Leiden, the Netherlands
| | - Harald Petry
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Sander J van Deventer
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Melvin M Evers
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands
| | - Pavlina Konstantinova
- Department of Research & Development, uniQure Biopharma B.V., Amsterdam, the Netherlands.
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15
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Evers MM, Miniarikova J, Juhas S, Vallès A, Bohuslavova B, Juhasova J, Skalnikova HK, Vodicka P, Valekova I, Brouwers C, Blits B, Lubelski J, Kovarova H, Ellederova Z, van Deventer SJ, Petry H, Motlik J, Konstantinova P. AAV5-miHTT Gene Therapy Demonstrates Broad Distribution and Strong Human Mutant Huntingtin Lowering in a Huntington's Disease Minipig Model. Mol Ther 2018; 26:2163-2177. [PMID: 30007561 PMCID: PMC6127509 DOI: 10.1016/j.ymthe.2018.06.021] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/18/2018] [Accepted: 06/20/2018] [Indexed: 02/07/2023] Open
Abstract
Huntington’s disease (HD) is a fatal neurodegenerative disorder caused by a CAG trinucleotide repeat expansion in the huntingtin gene. Previously, we showed strong huntingtin reduction and prevention of neuronal dysfunction in HD rodents using an engineered microRNA targeting human huntingtin, delivered via adeno-associated virus (AAV) serotype 5 vector with a transgene encoding an engineered miRNA against HTT mRNA (AAV5-miHTT). One of the challenges of rodents as a model of neurodegenerative diseases is their relatively small brain, making successful translation to the HD patient difficult. This is particularly relevant for gene therapy approaches, where distribution achieved upon local administration into the parenchyma is likely dependent on brain size and structure. Here, we aimed to demonstrate the translation of huntingtin-lowering gene therapy to a large-animal brain. We investigated the feasibility, efficacy, and tolerability of one-time intracranial administration of AAV5-miHTT in the transgenic HD (tgHD) minipig model. We detected widespread dose-dependent distribution of AAV5-miHTT throughout the tgHD minipig brain that correlated with the engineered microRNA expression. Both human mutant huntingtin mRNA and protein were significantly reduced in all brain regions transduced by AAV5-miHTT. The combination of widespread vector distribution and extensive huntingtin lowering observed with AAV5-miHTT supports the translation of a huntingtin-lowering gene therapy for HD from preclinical studies into the clinic.
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Affiliation(s)
- Melvin M Evers
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands.
| | - Jana Miniarikova
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Stefan Juhas
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Astrid Vallès
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | | | - Jana Juhasova
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | | | - Petr Vodicka
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Ivona Valekova
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Cynthia Brouwers
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Bas Blits
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Jacek Lubelski
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Hana Kovarova
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Zdenka Ellederova
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Sander J van Deventer
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Harald Petry
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
| | - Jan Motlik
- Institute of Animal Physiology and Genetics, Libechov, Czech Republic
| | - Pavlina Konstantinova
- Department of Research & Development, uniQure biopharma B.V., Amsterdam, the Netherlands
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16
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Toonen LJA, Overzier M, Evers MM, Leon LG, van der Zeeuw SAJ, Mei H, Kielbasa SM, Goeman JJ, Hettne KM, Magnusson OT, Poirel M, Seyer A, 't Hoen PAC, van Roon-Mom WMC. Transcriptional profiling and biomarker identification reveal tissue specific effects of expanded ataxin-3 in a spinocerebellar ataxia type 3 mouse model. Mol Neurodegener 2018; 13:31. [PMID: 29929540 PMCID: PMC6013885 DOI: 10.1186/s13024-018-0261-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 05/23/2018] [Indexed: 12/12/2022] Open
Abstract
Background Spinocerebellar ataxia type 3 (SCA3) is a progressive neurodegenerative disorder caused by expansion of the polyglutamine repeat in the ataxin-3 protein. Expression of mutant ataxin-3 is known to result in transcriptional dysregulation, which can contribute to the cellular toxicity and neurodegeneration. Since the exact causative mechanisms underlying this process have not been fully elucidated, gene expression analyses in brains of transgenic SCA3 mouse models may provide useful insights. Methods Here we characterised the MJD84.2 SCA3 mouse model expressing the mutant human ataxin-3 gene using a multi-omics approach on brain and blood. Gene expression changes in brainstem, cerebellum, striatum and cortex were used to study pathological changes in brain, while blood gene expression and metabolites/lipids levels were examined as potential biomarkers for disease. Results Despite normal motor performance at 17.5 months of age, transcriptional changes in brain tissue of the SCA3 mice were observed. Most transcriptional changes occurred in brainstem and striatum, whilst cerebellum and cortex were only modestly affected. The most significantly altered genes in SCA3 mouse brain were Tmc3, Zfp488, Car2, and Chdh. Based on the transcriptional changes, α-adrenergic and CREB pathways were most consistently altered for combined analysis of the four brain regions. When examining individual brain regions, axon guidance and synaptic transmission pathways were most strongly altered in striatum, whilst brainstem presented with strongest alterations in the pi-3 k cascade and cholesterol biosynthesis pathways. Similar to other neurodegenerative diseases, reduced levels of tryptophan and increased levels of ceramides, di- and triglycerides were observed in SCA3 mouse blood. Conclusions The observed transcriptional changes in SCA3 mouse brain reveal parallels with previous reported neuropathology in patients, but also shows brain region specific effects as well as involvement of adrenergic signalling and CREB pathway changes in SCA3. Importantly, the transcriptional changes occur prior to onset of motor- and coordination deficits. Electronic supplementary material The online version of this article (10.1186/s13024-018-0261-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lodewijk J A Toonen
- Department of Human Genetics, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - Maurice Overzier
- Department of Human Genetics, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - Melvin M Evers
- Department of Research & Development, uniQure, Amsterdam, The Netherlands
| | - Leticia G Leon
- Cancer Pharmacology Lab, University of Pisa, Ospedale di Cisanello, Edificio 6 via Paradisa, 2, 56124, Pisa, Italy
| | - Sander A J van der Zeeuw
- Sequencing Analysis Support Core, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - Hailiang Mei
- Sequencing Analysis Support Core, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - Szymon M Kielbasa
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - Jelle J Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - Kristina M Hettne
- Department of Human Genetics, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | | | | | | | - Peter A C 't Hoen
- Department of Human Genetics, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands.,Centre for Molecular and Biomolecular Informatics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands
| | - Willeke M C van Roon-Mom
- Department of Human Genetics, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands.
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17
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Miniarikova J, Evers MM, Konstantinova P. Translation of MicroRNA-Based Huntingtin-Lowering Therapies from Preclinical Studies to the Clinic. Mol Ther 2018; 26:947-962. [PMID: 29503201 DOI: 10.1016/j.ymthe.2018.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/30/2018] [Accepted: 02/05/2018] [Indexed: 12/21/2022] Open
Abstract
The single mutation underlying the fatal neuropathology of Huntington's disease (HD) is a CAG triplet expansion in exon 1 of the huntingtin (HTT) gene, which gives rise to a toxic mutant HTT protein. There have been a number of not yet successful therapeutic advances in the treatment of HD. The current excitement in the HD field is due to the recent development of therapies targeting the culprit of HD either at the DNA or RNA level to reduce the overall mutant HTT protein. In this review, we briefly describe short-term and long-term HTT-lowering strategies targeting HTT transcripts. One of the most advanced HTT-lowering strategies is a microRNA (miRNA)-based gene therapy delivered by a single administration of an adeno-associated viral (AAV) vector to the HD patient. We outline the outcome measures for the miRNA-based HTT-lowering therapy in the context of preclinical evaluation in HD animal and cell models. We highlight the strengths and ongoing queries of the HTT-lowering gene therapy as an HD intervention with a potential disease-modifying effect. This review provides a perspective on the fast-developing HTT-lowering therapies for HD and their translation to the clinic based on existing knowledge in preclinical models.
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Affiliation(s)
- Jana Miniarikova
- Department of Research and Development, uniQure, Amsterdam, the Netherlands; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Melvin M Evers
- Department of Research and Development, uniQure, Amsterdam, the Netherlands
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18
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Miniarikova J, Zimmer V, Martier R, Brouwers CC, Pythoud C, Richetin K, Rey M, Lubelski J, Evers MM, van Deventer SJ, Petry H, Déglon N, Konstantinova P. AAV5-miHTT gene therapy demonstrates suppression of mutant huntingtin aggregation and neuronal dysfunction in a rat model of Huntington's disease. Gene Ther 2017; 24:630-639. [PMID: 28771234 PMCID: PMC5658675 DOI: 10.1038/gt.2017.71] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 06/16/2017] [Accepted: 07/25/2017] [Indexed: 12/21/2022]
Abstract
Huntington’s disease (HD) is a fatal progressive neurodegenerative disorder caused by a mutation in the huntingtin (HTT) gene. To date, there is no treatment to halt or reverse the course of HD. Lowering of either total or only the mutant HTT expression is expected to have therapeutic benefit. This can be achieved by engineered micro (mi)RNAs targeting HTT transcripts and delivered by an adeno-associated viral (AAV) vector. We have previously showed a miHTT construct to induce total HTT knock-down in Hu128/21 HD mice, while miSNP50T and miSNP67T constructs induced allele-selective HTT knock-down in vitro. In the current preclinical study, the mechanistic efficacy and gene specificity of these selected constructs delivered by an AAV serotype 5 (AAV5) vector was addressed using an acute HD rat model. Our data demonstrated suppression of mutant HTT messenger RNA, which almost completely prevented mutant HTT aggregate formation, and ultimately resulted in suppression of DARPP-32-associated neuronal dysfunction. The AAV5-miHTT construct was found to be the most efficient, although AAV5-miSNP50T demonstrated the anticipated mutant HTT allele selectivity and no passenger strand expression. Ultimately, AAV5-delivered-miRNA-mediated HTT lowering did not cause activation of microglia or astrocytes suggesting no immune response to the AAV5 vector or therapeutic precursor sequences. These preclinical results suggest that using gene therapy to knock-down HTT may provide important therapeutic benefit for HD patients and raised no safety concerns, which supports our ongoing efforts for the development of an RNA interference-based gene therapy product for HD.
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Affiliation(s)
- J Miniarikova
- Department of Research & Development, uniQure N.V., Amsterdam, The Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - V Zimmer
- Neurosciences Research Center (CRN), Laboratory of Cellular and Molecular Neurotherapies (LCMN), Lausanne University Hospital, Lausanne, Switzerland.,Department of Clinical Neurosciences, LCMN, Lausanne University Hospital, Lausanne, Switzerland
| | - R Martier
- Department of Research & Development, uniQure N.V., Amsterdam, The Netherlands.,Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - C C Brouwers
- Department of Research & Development, uniQure N.V., Amsterdam, The Netherlands
| | - C Pythoud
- Neurosciences Research Center (CRN), Laboratory of Cellular and Molecular Neurotherapies (LCMN), Lausanne University Hospital, Lausanne, Switzerland.,Department of Clinical Neurosciences, LCMN, Lausanne University Hospital, Lausanne, Switzerland
| | - K Richetin
- Neurosciences Research Center (CRN), Laboratory of Cellular and Molecular Neurotherapies (LCMN), Lausanne University Hospital, Lausanne, Switzerland.,Department of Clinical Neurosciences, LCMN, Lausanne University Hospital, Lausanne, Switzerland
| | - M Rey
- Neurosciences Research Center (CRN), Laboratory of Cellular and Molecular Neurotherapies (LCMN), Lausanne University Hospital, Lausanne, Switzerland.,Department of Clinical Neurosciences, LCMN, Lausanne University Hospital, Lausanne, Switzerland
| | - J Lubelski
- Department of Research & Development, uniQure N.V., Amsterdam, The Netherlands
| | - M M Evers
- Department of Research & Development, uniQure N.V., Amsterdam, The Netherlands
| | - S J van Deventer
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - H Petry
- Department of Research & Development, uniQure N.V., Amsterdam, The Netherlands
| | - N Déglon
- Neurosciences Research Center (CRN), Laboratory of Cellular and Molecular Neurotherapies (LCMN), Lausanne University Hospital, Lausanne, Switzerland.,Department of Clinical Neurosciences, LCMN, Lausanne University Hospital, Lausanne, Switzerland
| | - P Konstantinova
- Department of Research & Development, uniQure N.V., Amsterdam, The Netherlands
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19
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Casaca-Carreira J, Toonen LJ, Evers MM, Jahanshahi A, van-Roon-Mom WM, Temel Y. In vivo proof-of-concept of removal of the huntingtin caspase cleavage motif-encoding exon 12 approach in the YAC128 mouse model of Huntington’s disease. Biomed Pharmacother 2016; 84:93-96. [DOI: 10.1016/j.biopha.2016.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 08/25/2016] [Accepted: 09/05/2016] [Indexed: 12/17/2022] Open
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20
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Evers MM, Toonen LJ, van Roon-Mom WM. Antisense oligonucleotides in therapy for neurodegenerative disorders. Adv Drug Deliv Rev 2015; 87:90-103. [PMID: 25797014 DOI: 10.1016/j.addr.2015.03.008] [Citation(s) in RCA: 204] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 03/02/2015] [Accepted: 03/12/2015] [Indexed: 12/14/2022]
Abstract
Antisense oligonucleotides are synthetic single stranded strings of nucleic acids that bind to RNA and thereby alter or reduce expression of the target RNA. They can not only reduce expression of mutant proteins by breakdown of the targeted transcript, but also restore protein expression or modify proteins through interference with pre-mRNA splicing. There has been a recent revival of interest in the use of antisense oligonucleotides to treat several neurodegenerative disorders using different approaches to prevent disease onset or halt disease progression and the first clinical trials for spinal muscular atrophy and amyotrophic lateral sclerosis showing promising results. For these trials, intrathecal delivery is being used but direct infusion into the brain ventricles and several methods of passing the blood brain barrier after peripheral administration are also under investigation.
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21
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Evers MM, Schut MH, Pepers BA, Atalar M, van Belzen MJ, Faull RL, Roos RA, van Roon-Mom WMC. Making (anti-) sense out of huntingtin levels in Huntington disease. Mol Neurodegener 2015; 10:21. [PMID: 25928884 PMCID: PMC4411791 DOI: 10.1186/s13024-015-0018-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/17/2015] [Indexed: 01/27/2023] Open
Abstract
Background Huntington disease (HD) is an autosomal dominant neurodegenerative disorder, characterized by motor, psychiatric and cognitive symptoms. HD is caused by a CAG repeat expansion in the first exon of the HTT gene, resulting in an expanded polyglutamine tract at the N-terminus of the huntingtin protein. Typical disease onset is around mid-life (adult-onset HD) whereas onset below 21 years is classified as juvenile HD. While much research has been done on the underlying HD disease mechanisms, little is known about regulation and expression levels of huntingtin RNA and protein. Results In this study we used 15 human post-mortem HD brain samples to investigate the expression of wild-type and mutant huntingtin mRNA and protein. In adult-onset HD brain samples, there was a small but significantly lower expression of mutant huntingtin mRNA compared to wild-type huntingtin mRNA, while wild-type and mutant huntingtin protein expression levels did not differ significantly. Juvenile HD subjects did show a lower expression of mutant huntingtin protein compared to wild-type huntingtin protein. Our results in HD brain and fibroblasts suggest that protein aggregation does not affect levels of huntingtin RNA and protein. Additionally, we did not find any evidence for a reduced expression of huntingtin antisense in fibroblasts derived from a homozygous HD patient. Conclusions We found small differences in allelic huntingtin mRNA levels in adult-onset HD brain, with significantly lower mutant huntingtin mRNA levels. Wild-type and mutant huntingtin protein were not significantly different in adult-onset HD brain samples. Conversely, in juvenile HD brain samples mutant huntingtin protein levels were lower compared with wild-type huntingtin, showing subtle differences between juvenile HD and adult-onset HD. Since most HD model systems harbor juvenile repeat expansions, our results suggest caution with the interpretation of huntingtin mRNA and protein studies using HD cell and animal models with such long repeats. Furthermore, our huntingtin antisense results in homozygous HD cells do not support reduced huntingtin antisense expression due to an expanded CAG repeat.
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Affiliation(s)
- Melvin M Evers
- Department of Human Genetics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands.
| | - Menno H Schut
- Department of Human Genetics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands.
| | - Barry A Pepers
- Department of Human Genetics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands.
| | | | - Martine J van Belzen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands.
| | - Richard Lm Faull
- Centre for Brain Research and Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand.
| | - Raymund Ac Roos
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Willeke M C van Roon-Mom
- Department of Human Genetics, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands.
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22
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Evers MM, Toonen LJA, van Roon-Mom WMC. Ataxin-3 protein and RNA toxicity in spinocerebellar ataxia type 3: current insights and emerging therapeutic strategies. Mol Neurobiol 2014; 49:1513-31. [PMID: 24293103 PMCID: PMC4012159 DOI: 10.1007/s12035-013-8596-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 11/14/2013] [Indexed: 01/10/2023]
Abstract
Ataxin-3 is a ubiquitously expressed deubiqutinating enzyme with important functions in the proteasomal protein degradation pathway and regulation of transcription. The C-terminus of the ataxin-3 protein contains a polyglutamine (PolyQ) region that, when mutationally expanded to over 52 glutamines, causes the neurodegenerative disease spinocerebellar ataxia 3 (SCA3). In spite of extensive research, the molecular mechanisms underlying the cellular toxicity resulting from mutant ataxin-3 remain elusive and no preventive treatment is currently available. It has become clear over the last decade that the hallmark intracellular ataxin-3 aggregates are likely not the main toxic entity in SCA3. Instead, the soluble PolyQ containing fragments arising from proteolytic cleavage of ataxin-3 by caspases and calpains are now regarded to be of greater influence in pathogenesis. In addition, recent evidence suggests potential involvement of a RNA toxicity component in SCA3 and other PolyQ expansion disorders, increasing the pathogenic complexity. Herein, we review the functioning of ataxin-3 and the involvement of known protein and RNA toxicity mechanisms of mutant ataxin-3 that have been discovered, as well as future opportunities for therapeutic intervention.
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Affiliation(s)
- Melvin M. Evers
- Department of Human Genetics, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
| | - Lodewijk J. A. Toonen
- Department of Human Genetics, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
| | - Willeke M. C. van Roon-Mom
- Department of Human Genetics, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, The Netherlands
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23
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Evers MM, Tran HD, Zalachoras I, Meijer OC, den Dunnen JT, van Ommen GJB, Aartsma-Rus A, van Roon-Mom WMC. Preventing formation of toxic N-terminal huntingtin fragments through antisense oligonucleotide-mediated protein modification. Nucleic Acid Ther 2013; 24:4-12. [PMID: 24380395 DOI: 10.1089/nat.2013.0452] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Huntington's disease (HD) is a progressive autosomal dominant disorder, caused by a CAG repeat expansion in the HTT gene, which results in expansion of a polyglutamine stretch at the N-terminal end of the huntingtin protein. Several studies have implicated the importance of proteolytic cleavage of mutant huntingtin in HD pathogenesis and it is generally accepted that N-terminal huntingtin fragments are more toxic than full-length protein. Important cleavage sites are encoded by exon 12 of HTT. Here we report proof of concept using antisense oligonucleotides to induce skipping of exon 12 in huntingtin pre-mRNA, thereby preventing the formation of a 586 amino acid N-terminal huntingtin fragment implicated in HD toxicity. In vitro studies showed successful exon skipping and appearance of a shorter huntingtin protein. Cleavage assays showed reduced 586 amino acid N-terminal huntingtin fragments in the treated samples. In vivo studies revealed exon skipping after a single injection of antisense oligonucleotides in the mouse striatum. Recent advances to inhibit the formation of mutant huntingtin using oligonucleotides seem promising therapeutic strategies for HD. Nevertheless, huntingtin is an essential protein and total removal has been shown to result in progressive neurodegeneration in vivo. Our proof of concept shows a completely novel approach to reduce mutant huntingtin toxicity not by reducing its expressing levels, but by modifying the huntingtin protein.
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Affiliation(s)
- Melvin M Evers
- 1 Department of Human Genetics, Leiden University Medical Center , The Netherlands
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24
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Evers MM, Tran HD, Zalachoras I, Pepers BA, Meijer OC, den Dunnen JT, van Ommen GJB, Aartsma-Rus A, van Roon-Mom WMC. Ataxin-3 protein modification as a treatment strategy for spinocerebellar ataxia type 3: removal of the CAG containing exon. Neurobiol Dis 2013; 58:49-56. [PMID: 23659897 DOI: 10.1016/j.nbd.2013.04.019] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/17/2013] [Accepted: 04/21/2013] [Indexed: 11/17/2022] Open
Abstract
Spinocerebellar ataxia type 3 is caused by a polyglutamine expansion in the ataxin-3 protein, resulting in gain of toxic function of the mutant protein. The expanded glutamine stretch in the protein is the result of a CAG triplet repeat expansion in the penultimate exon of the ATXN3 gene. Several gene silencing approaches to reduce mutant ataxin-3 toxicity in this disease aim to lower ataxin-3 protein levels, but since this protein is involved in deubiquitination and proteasomal protein degradation, its long-term silencing might not be desirable. Here, we propose a novel protein modification approach to reduce mutant ataxin-3 toxicity by removing the toxic polyglutamine repeat from the ataxin-3 protein through antisense oligonucleotide-mediated exon skipping while maintaining important wild type functions of the protein. In vitro studies showed that exon skipping did not negatively impact the ubiquitin binding capacity of ataxin-3. Our in vivo studies showed no toxic properties of the novel truncated ataxin-3 protein. These results suggest that exon skipping may be a novel therapeutic approach to reduce polyglutamine-induced toxicity in spinocerebellar ataxia type 3.
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Affiliation(s)
- Melvin M Evers
- Department of Human Genetics, Leiden University Medical Center, The Netherlands.
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25
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Evers MM, Tran HD, Zalachoras L, den Dunnen JT, van Ommen GJB, Meijer OC, Aartsma-Rus A, van Roon-Mom WMC. P03 Reducing toxic N-terminal huntingtin fragments in HD using exon skipping. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van Roon-Mom WMC, Evers MM, Tran HD, van Deutekom JCT, Mulders SAM, Aartsma-Rus AM, den Dunnen JT, van Ommen GJB. P01 Antisense oligonucleotide mediated transcript reduction and modulation—the European approach to develop a therapy for Huntington disease. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Na(v)1.5, the pore forming α-subunit of the voltage-dependent cardiac Na(+) channel, is an integral membrane protein involved in the initiation and conduction of action potentials. Mutations in the gene-encoding Na(v)1.5, SCN5A, have been associated with a variety of arrhythmic disorders, including long QT, Brugada, and sick sinus syndromes as well as progressive cardiac conduction defect and atrial standstill. Moreover, alterations in the Na(v)1.5 expression level and/or sodium current density have been frequently noticed in acquired cardiac disorders, such as heart failure. The molecular mechanisms underlying these alterations are poorly understood, but are considered essential for conception of arrhythmogenesis and the development of therapeutic strategies for prevention or treatment of arrhythmias. The unravelling of such mechanisms requires critical molecular insight into the biology of Na(v)1.5 expression and function. Therefore, the aim of this review is to provide an up-to-date account of molecular determinants of normal Na(v)1.5 expression and function. The parts of the Na(v)1.5 life cycle that are discussed include (i) regulatory aspects of the SCN5A gene and transcript structure, (ii) the nature, molecular determinants, and functional consequences of Na(v)1.5 post-translational modifications, and (iii) the role of Na(v)1.5 interacting proteins in cellular trafficking. The reviewed studies have provided valuable information on how the Na(v)1.5 expression level, localization, and biophysical properties are regulated, but also revealed that our understanding of the underlying mechanisms is still limited.
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Affiliation(s)
- Martin B Rook
- Department of Medical Physiology, Division Heart & Lungs, University Medical Center Utrecht, The Netherlands
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Evers MM, Pepers BA, van Deutekom JCT, Mulders SAM, den Dunnen JT, Aartsma-Rus A, van Ommen GJB, van Roon-Mom WMC. Targeting several CAG expansion diseases by a single antisense oligonucleotide. PLoS One 2011; 6:e24308. [PMID: 21909428 PMCID: PMC3164722 DOI: 10.1371/journal.pone.0024308] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 08/04/2011] [Indexed: 12/16/2022] Open
Abstract
To date there are 9 known diseases caused by an expanded polyglutamine repeat, with the most prevalent being Huntington's disease. Huntington's disease is a progressive autosomal dominant neurodegenerative disorder for which currently no therapy is available. It is caused by a CAG repeat expansion in the HTT gene, which results in an expansion of a glutamine stretch at the N-terminal end of the huntingtin protein. This polyglutamine expansion plays a central role in the disease and results in the accumulation of cytoplasmic and nuclear aggregates. Here, we make use of modified 2'-O-methyl phosphorothioate (CUG)n triplet-repeat antisense oligonucleotides to effectively reduce mutant huntingtin transcript and protein levels in patient-derived Huntington's disease fibroblasts and lymphoblasts. The most effective antisense oligonucleotide, (CUG)(7), also reduced mutant ataxin-1 and ataxin-3 mRNA levels in spinocerebellar ataxia 1 and 3, respectively, and atrophin-1 in dentatorubral-pallidoluysian atrophy patient derived fibroblasts. This antisense oligonucleotide is not only a promising therapeutic tool to reduce mutant huntingtin levels in Huntington's disease but our results in spinocerebellar ataxia and dentatorubral-pallidoluysian atrophy cells suggest that this could also be applicable to other polyglutamine expansion disorders as well.
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Affiliation(s)
- Melvin M. Evers
- Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Barry A. Pepers
- Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Johan T. den Dunnen
- Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Genome Technology Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemieke Aartsma-Rus
- Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Gert-Jan B. van Ommen
- Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
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Zalachoras I, Evers MM, van Roon-Mom WMC, Aartsma-Rus AM, Meijer OC. Antisense-mediated RNA targeting: versatile and expedient genetic manipulation in the brain. Front Mol Neurosci 2011; 4:10. [PMID: 21811437 PMCID: PMC3142880 DOI: 10.3389/fnmol.2011.00010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 07/08/2011] [Indexed: 12/28/2022] Open
Abstract
A limiting factor in brain research still is the difficulty to evaluate in vivo the role of the increasing number of proteins implicated in neuronal processes. We discuss here the potential of antisense-mediated RNA targeting approaches. We mainly focus on those that manipulate splicing (exon skipping and exon inclusion), but will also briefly discuss mRNA targeting. Classic knockdown of expression by mRNA targeting is only one possible application of antisense oligonucleotides (AON) in the control of gene function. Exon skipping and inclusion are based on the interference of AONs with splicing of pre-mRNAs. These are powerful, specific and particularly versatile techniques, which can be used to circumvent pathogenic mutations, shift splice variant expression, knock down proteins, or to create molecular models using in-frame deletions. Pre-mRNA targeting is currently used both as a research tool, e.g., in models for motor neuron disease, and in clinical trials for Duchenne muscular dystrophy and amyotrophic lateral sclerosis. AONs are particularly promising in relation to brain research, as the modified AONs are taken up extremely fast in neurons and glial cells with a long residence, and without the need for viral vectors or other delivery tools, once inside the blood brain barrier. In this review we cover (1). The principles of antisense-mediated techniques, chemistry, and efficacy. (2) The pros and cons of AON approaches in the brain compared to other techniques of interfering with gene function, such as transgenesis and short hairpin RNAs, in terms of specificity of the manipulation, spatial, and temporal control over gene expression, toxicity, and delivery issues. (3) The potential applications for Neuroscience. We conclude that there is good evidence from animal studies that the central nervous system can be successfully targeted, but the potential of the diverse AON-based approaches appears to be under-recognized.
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Affiliation(s)
- Ioannis Zalachoras
- Division of Medical Pharmacology, Leiden/Amsterdam Center for Drug Research Leiden, Netherlands
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van Roon-Mom WMC, Evers MM, van Deutekom JCT, Mulders SAM, Aartsma-Rus AM, den Dunnen JT, van Ommen GJB. B09 One antisense oligonucleotide as a potential therapy for polyglutamine disorders. J Neurol Neurosurg Psychiatry 2010. [DOI: 10.1136/jnnp.2010.222596.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Evers MM, van Deutekom JCT, Mulders SAM, Aartsma-Rus AM, Weiss A, Roscic A, den Dunnen JT, van Ommen GJB, van Roon-Mom WMC. B08 Reduction of prolonged cag repeat containing alleles in Huntington's disease using antisense oligonucleotides. J Neurol Neurosurg Psychiatry 2010. [DOI: 10.1136/jnnp.2010.222596.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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