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AAV-mediated delivery of secreted acid α-glucosidase with enhanced uptake corrects neuromuscular pathology in Pompe mice
Naresh K. Meena, Davide Randazzo, Nina Raben, Rosa Puertollano
Naresh K. Meena, Davide Randazzo, Nina Raben, Rosa Puertollano
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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 2

Systemic gene transfer rescues muscle pathology after short-term treatment at a high vector dose.

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Systemic gene transfer rescues muscle pathology after short-term treatme...
(A) Experimental design: 3.5-month-old KO mice received a single injection of systemic vector (SYS; n = 3) at a dose of 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 and E) Western blot analyses of whole muscle lysates with the indicated antibodies. Gapdh was used as a loading control. The treatment normalized the levels of lysosomal/autophagosomal markers (D) and AMPK activity (E). A significant decrease in both nonphosphorylated 4EBP1 (non-p4EBP1) and total 4EBP1 indicates an improvement in the mTORC1 signaling. (F) Top panel: Immunostaining of single fibers with markers for lysosomes (LAMP1; green), autophagosomes (LC3; red), and nuclei (Hoechst dye; blue); enlarged lysosomes and autophagic buildup (multicolored area in the core of the fiber) are seen in virtually all fibers from KO mice; lysosomes and autophagosomes appear as abundant dot-like LAMP1/LC3-positive structures (often located adjacent to each other; inset) in fibers from WT and SYS-treated KO mice. Bottom panel: Differential interference contrast images of the fibers shown on the top panel; ordered sarcomeric organization is fully restored after treatment. Statistical significance was determined by 1-way ANOVA. Graphs represent mean ± SD. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001. Bars: 20 μm. 4EBP1, eukaryotic translation initiation factor 4E-binding protein 1.

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