Abstract

GM1 gangliosidosis is a rare neurodegenerative lysosomal storage disease caused by loss-of-function mutations in the gene encoding beta-galactosidase (β-gal). There are no approved treatments for GM1 gangliosidosis. Previous studies in animal models have demonstrated that adeno-associated viral (AAV) vector-mediated gene transfer to the brain can restore β-gal expression and prevent the onset of neurological signs. We developed an optimized AAV vector expressing human β-gal and evaluated the efficacy of a single intracerebroventricular injection of this vector into the cerebrospinal fluid (CSF) of a murine disease model. The AAV vector administration into the CSF increased β-gal activity in the brain, reduced neuronal lysosomal storage lesions, prevented the onset of neurological signs and gait abnormalities, and increased survival. These findings demonstrate the potential therapeutic activity of this vector and support its subsequent development for the treatment of GM1 gangliosidosis.

Highlights

  • GM1 GANGLIOSIDOSIS IS a rare genetic disorder caused by mutations in the GLB1 gene, which encodes lysosomal beta-galactosidase (b-gal)

  • We selected the AAVhu[68] capsid based on previous studies demonstrating that clade F associated viral (AAV) isolates are capable of efficient gene transfer to the brain and spinal cord after delivery into the cerebrospinal fluid (CSF).[13]

  • We designed transgene cassettes consisting of a codon-optimized human GLB1 cDNA driven by one of three ubiquitous promoters: chicken beta actin with a cytomegalovirus enhancer (CB7), elongation factor 1 alpha (EF1a) or ubiquitin C (UbC)

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Summary

Introduction

GM1 GANGLIOSIDOSIS IS a rare genetic disorder caused by mutations in the GLB1 gene, which encodes lysosomal beta-galactosidase (b-gal). In the absence of b-gal, cells are unable to catabolize polysaccharides with terminal galactose residues. A galactose-containing glycosaminoglycan, accumulates in a variety of tissues, causing skeletal dysplasia, hepatosplenomegaly, and cardiomyopathy.[1] In the central nervous system (CNS), the inability to catabolize GM1 ganglioside results in marked neuronal GM1 storage and subsequent neurodegeneration.[1]. The clinical presentation of GM1 gangliosidosis varies dramatically between patients depending on the underlying GLB1 mutations.[2] Patients expressing residual b-gal may present with neurological signs at any age and variable degrees of somatic disease. Patients present with peripheral manifestations of b-gal deficiency without CNS involvement, a disease termed mucopolysaccharidosis type IVB

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