Human Molecular Genetics Advance Access originally published online on November 25, 2005
Human Molecular Genetics 2006 15(1):53-64; doi:10.1093/hmg/ddi425
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Intracerebral adeno-associated virus-mediated gene transfer in rapidly progressive forms of metachromatic leukodystrophy
1Institut National de la Santé et de la Recherche Médicale U561, Université Paris V, 75014 Paris, France, 2Laboratory of Neurochemistry and Behavior at Institute Born-Bunge, Department of Biomedical Sciences, University of Antwerp 1, Antwerp B-2610, Belgium, 3National MS Centre, Vanheylenstraat 16, 1820 Melsbroek, Belgium, 4Department of Neurology, University Hospital, Edegem, Belgium, 5INSERM, Fondation Gillet-Mérieux, Hôpital Lyon-Sud, 69310 Pierre-Benite, France, 6Laboratoire de Génétique Moléculaire-UPRES EA 3618, Faculté des Sciences Pharmaceutiques, Université Paris V, 75014 Paris, France, 7Institute of Physiological Chemistry, Rheinische Friedrich-Wilhelms-Universität, 53115 Bonn, Germany and 8Department of Neurology and Memory Clinic, Middelheim General Hospital, B-2020 Antwerp, Belgium
* To whom correspondence should be addressed at: INSERM U561, 82 avenue Denfert Rochereau, Paris, France. Tel: +33 140488247; Fax: +33 10140488352; Email: cartier{at}paris5.inserm.fr
Received October 5, 2005; Accepted November 11, 2005
Metachromatic leukodystrophy (MLD) is a neurodegenerative lysosomal disease caused by a defect of the enzyme arylsulfatase A (ARSA) that disrupts the degradation of sulfatides (Sulf) in neurons and glial cells. Therapy for MLD requires active production of ARSA in the brain to prevent demyelination and neuronal damage, and efficient delivery of ARSA to act faster than disease progression, particularly in the rapidly progressive late infantile form. We used an adeno-associated virus serotype 5 (AAV5) vector to express the human ARSA gene in the brain of MLD mouse model. We achieved rapid, extensive and long-lasting expression of the recombinant ARSA in the brain, cerebellum and brainstem from at least 3 to 15 months post-injection. Analysis of the vector genome and ARSA distribution gave evidence for in vivo cross-correction of many untransduced neurons and astrocytes. ARSA delivery rapidly reversed Sulf storage and prevented neuropathological abnormalities and neuromotor impairment. We believe that AAV5-mediated brain delivery of ARSA is a potentially efficacious therapeutic strategy for MLD patients, especially for those with rapidly progressive form of the disease.
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