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Skeletal phenotype amelioration in mucopolysaccharidosis VI requires intervention at the earliest stages of postnatal development
Elizabeth Hwang-Wong, … , Aris N. Economides, Katherine D. Cygnar
Elizabeth Hwang-Wong, … , Aris N. Economides, Katherine D. Cygnar
Published September 26, 2023
Citation Information: JCI Insight. 2023;8(21):e171312. https://doi.org/10.1172/jci.insight.171312.
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Research Article Bone biology

Skeletal phenotype amelioration in mucopolysaccharidosis VI requires intervention at the earliest stages of postnatal development

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Abstract

Mucopolysaccharidosis VI (MPS VI) is a rare lysosomal disease arising from impaired function of the enzyme arylsulfatase B (ARSB). This impairment causes aberrant accumulation of dermatan sulfate, a glycosaminoglycan (GAG) abundant in cartilage. While clinical severity varies along with age at first symptom manifestation, MPS VI usually presents early and strongly affects the skeleton. Current enzyme replacement therapy (ERT) does not provide effective treatment for the skeletal manifestations of MPS VI. This lack of efficacy may be due to an inability of ERT to reach affected cells or to the irreversibility of the disease. To address the question of reversibility of skeletal phenotypes, we generated a conditional by inversion (COIN) mouse model of MPS VI, ArsbCOIN/COIN, wherein Arsb is initially null and can be restored to WT using Cre. We restored Arsb at different times during postnatal development, using a tamoxifen-dependent global Cre driver. By restoring Arsb at P7, P21, and P56–P70, we determined that skeletal phenotypes can be fully rescued if Arsb restoration occurs at P7, while only achieving partial rescue at P21 and no significant rescue at P56–P70. This work has highlighted the importance of early intervention in patients with MPS VI to maximize therapeutic impact.

Authors

Elizabeth Hwang-Wong, Gabrielle Amar, Nanditha Das, Xiaoli Zhang, Nina Aaron, Kirsten Gale, Nyanza Rothman, Massimo Fante, Andrew Baik, Ajay Bhargava, Arun Fricker, Michelle McAlister, Jeremy Rabinowitz, John Lees-Shepard, Kalyan Nannuru, Aris N. Economides, Katherine D. Cygnar

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Figure 2

Arsb COIN allele recombination rates and transcript abundance in peripheral organs when tamoxifen is delivered at P7.

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Arsb COIN allele recombination rates and transcript abundance in periphe...
(A–C) Percentage recombination of the liver, heart, and kidney is assessed as ΔCT of Arsb Lox71–specific sequence compared with a serial standard, with GAPDH as a reference. Transcript abundance is assessed as ΔΔCT against WT samples as references. n = 4–17 mice. Data represent mean ± SD. Statistical significance was determined by 2-way ANOVA with Tukey’s multiple-comparison test. ***P < 0.001, ****P < 0.0001.

Copyright © 2023 American Society for Clinical Investigation
ISSN 2379-3708

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