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AAV-mediated delivery of secreted acid α-glucosidase with enhanced uptake corrects neuromuscular pathology in Pompe mice
Naresh K. Meena, … , Nina Raben, Rosa Puertollano
Naresh K. Meena, … , Nina Raben, Rosa Puertollano
Published July 18, 2023
Citation Information: JCI Insight. 2023;8(16):e170199. https://doi.org/10.1172/jci.insight.170199.
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Research Article Muscle biology

AAV-mediated delivery of secreted acid α-glucosidase with enhanced uptake corrects neuromuscular pathology in Pompe mice

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Abstract

Gene therapy is under advanced clinical development for several lysosomal storage disorders. Pompe disease, a debilitating neuromuscular illness affecting infants, children, and adults with different severity, is caused by a deficiency of lysosomal glycogen-degrading enzyme acid α-glucosidase (GAA). Here, we demonstrated that adeno-associated virus–mediated (AAV-mediated) systemic gene transfer reversed glycogen storage in all key therapeutic targets — skeletal and cardiac muscles, the diaphragm, and the central nervous system — in both young and severely affected old Gaa-knockout mice. Furthermore, the therapy reversed secondary cellular abnormalities in skeletal muscle, such as those in autophagy and mTORC1/AMPK signaling. We used an AAV9 vector encoding a chimeric human GAA protein with enhanced uptake and secretion to facilitate efficient spread of the expressed protein among multiple target tissues. These results lay the groundwork for a future clinical development strategy in Pompe disease.

Authors

Naresh K. Meena, Davide Randazzo, Nina Raben, Rosa Puertollano

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Figure 1

Systemic gene transfer fails to rescue muscle pathology after short-term treatment at a low vector dose.

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Systemic gene transfer fails to rescue muscle pathology after short-term...
(A) Experimental design: 3.5-month-old KO mice received a single injection of systemic vector (SYS; n = 5) at a dose of 0.5 × 1013 vg/kg. Age-matched wild-type (WT) and untreated Gaa–/– (KO) mice were used as controls. Muscle samples were collected 1 month (mo) after dosing. (B) Western blot analyses of whole muscle lysates with anti-human GAA antibody. Gapdh was used as a loading control. Graph shows GAA activity in muscle tissues from WT, KO, and SYS-treated KO mice. (C) Glycogen content in muscle tissues across the groups. (D) PAS-stained sections of gastrocnemius muscle; PAS-positive material (small dots) is seen in all fibers from KO mice; some fibers (or parts of a fiber) from SYS-treated KO mice appear normal (asterisks). Bars: 50 μm. (E) Western blot analyses of whole muscle lysates with the indicated antibodies. No significant decrease in the levels of lysosomal/autophagosomal markers is seen in treated compared to untreated KO. Statistical significance was determined by 1-way ANOVA and unpaired 2-tailed Student’s t test. Graphs represent mean ± SD. *P < 0.05; **P < 0.01; ****P < 0.0001.

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