Efficient motor neuron targeting in adult mice by a single lumbar intrathecal r AAV 9‐e GFP administration: application for motor neuron diseases

Abstract

Spinal muscular atrophy (SMA) the second most common autosomal recessive disorder causes of childhood mortality affecting between 1/6000 to 1/10000 live births. SMA is due to deletion/mutations in the Survival Motor Neuron 1 (SMN1) gene. The disease is characterized by degeneration of spinal motor neurons (MNs), atrophy of skeletal muscles, and generalized weakness. SMA is clinically classified into four main types (I, II, III and IV) based on the age of onset and clinical severity. Currently, no curative treatment exists for SMA type II/III SMA patients representing the majority currently awaiting treatment. Gene therapy, restoring SMN1 activity in MNs, is a promising therapeutic strategy for SMA. In the moderate forms (type II/III) of the disease, no lesion is found in peripheral organs. Thus, a targeted therapy directly into the CNS should be more appropriate. We have, recently, demonstrated that a single administration of an rAAV9 vector into the cerebrospinal fluid leads to an efficient transduction of MNs in non‐human primates. In order to treat our mouse model that can mimick the human pathology of type II/III SMA, the first main challenge was to develop an efficient and safety route of delivery that can target whole spinal cord and brain. In this context, we develop the lumbar intrathecal delivery (itlumb), by single percutaneous lumbar puncture. We demonstrate that a single lumbar intrathecal injection of rAAV9‐eGFP vector using specific neuronal promoter can efficiently and specifically target MNs from proximal to distal part of the spinal cord in adult mice, wherease, using rAAV9‐eGFP ubiquitous promoter, we observe both glial cells and MNs targeting (figure a, b and c) . Surprisingly, by lumbar administration, we efficiently reach the brain and target neurons and glial cells using rAAV9 ubiquitous promoter (figure g) . Then, we compared the serotypes 9 and 10 of AAV vector in order to demonstrate which serotype is the most efficient to target MNs after intrathecal delivery. We used the Synapsin 1 (SYN1) promoter, that lead to specific expression in neuron cells population, in adult mice, by lumbar intrathecal administration. We observed a spectacular and specific MNs expression with the serotype 9 around 50% and 10 % in the lumbar and cervical spinal cord respectively. Wherease the serotype 10 transduce less significantly MNs cells (30% and 5 % in the lumbar and cervical spinal cord respectively). This results, offer new perspectives for the treatment of motor neuron diseases such as moderate forms of spinal muscular atrophy.