Abstract

GM1-gangliosidosis is a lysosomal disease resulting from a deficiency in the hydrolase β-galactosidase (β-gal) and subsequent accumulation of gangliosides, primarily in neuronal tissue, leading to progressive neurological deterioration and eventually early death. Lysosomal diseases with neurological involvement have limited non-invasive therapies due to the inability of lysosomal enzymes to cross the blood-brain barrier (BBB). A novel fusion enzyme, labeled mTfR-GLB1, was designed to act as a ferry across the BBB by fusing β-gal to the mouse monoclonal antibody against the mouse transferrin receptor and tested in a murine model of GM1-gangliosidosis (β-gal−/−). Twelve hours following a single intravenous dose of mTfR-GLB1 (5.0 mg/kg) into adult β-gal−/− mice showed clearance of enzyme activity in the plasma and an increase in β-gal enzyme activity in the liver and spleen. Long-term efficacy of mTfR-GLB1 was assessed by treating β-gal−/− mice intravenously twice a week with a low (2.5 mg/kg) or high (5.0 mg/kg) dose of mTfR-GLB1 for 17 weeks. Long-term studies showed high dose mice gained weight normally compared to vehicle-treated β-gal−/− mice, which are significantly heavier than heterozygous controls. Behavioral assessment at six months of age using the pole test showed β-gal−/− mice treated with mTfR-GLB1 had improved motor function. Biochemical analysis showed an increase in β-gal enzyme activity in the high dose group from negligible levels to 20% and 11% of heterozygous levels in the liver and spleen, respectively. Together, these data show that mTfR-GLB1 is a catalytically active β-gal fusion enzyme in vivo that is readily taken up into tissues.Despite these indications of bioactivity, behavior tests other than the pole test, including the Barnes maze, inverted screen, and accelerating rotarod, showed limited or no improvement of treated mice compared to β-gal−/− mice receiving vehicle only. Further, administration of mTfR-GLB1 was insufficient to create measurable increases in β-gal enzyme activity in the brain or reduce ganglioside content (biochemically and morphologically).

Highlights

  • Lysosomal diseases are a group of rare, inherited, metabolic disor­ ders that are caused by deficiencies in lysosomal proteins, leading to the accumulation of their cellular substrates within the lysosome

  • Fusion enzymes have been developed, which allows for the enzyme to bind to a receptor that is present on the epithelial cells of the blood-brain barrier (BBB) and undergo receptor-mediated transcytosis

  • The present study describes the assessment of such a protein, mTfRGLB1, as a potential therapy for GM1-gangliosidosis. mTfR-GLB1 fuses the human β-gal enzyme to the carboxyl terminus of each heavy chain of a mouse chimeric monoclonal antibody against the mouse transferrin receptor, meaning there are two human β-gal enzymes present in each molecule

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Summary

Introduction

Lysosomal diseases are a group of rare, inherited, metabolic disor­ ders that are caused by deficiencies in lysosomal proteins, leading to the accumulation of their cellular substrates within the lysosome. Numerous therapeutics have been developed and tested for treating lysosomal diseases, including enzyme replacement therapy (ERT) Due to their size, lysosomal enzymes are unable to cross the blood-brain barrier (BBB), limiting their effect on the neurological pathology. For this reason, ERT has not been developed for many lysosomal diseases, including GM1-gangliosidosis, which has widespread neurological involvement. Patients with the most severe form of the disease, the infantile form, exhibit progressive neurodegeneration, including profound hypotonia and weakness, global developmental delay, and skeletal abnormalities. These patients typically never learn to ambulate by crawling or walking. There are no clini­ cally approved treatments for GM1-gangliosidosis

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