title: Liver-directed neonatal gene therapy prevents cardiac, bone, ear, and eye disease in mucopolysaccharidosis I mice.
abstract: Mucopolysaccharidosis I (MPS I) due to deficient alpha-L-iduronidase (IDUA) activity results in accumulation of glycosaminoglycans in many cells. Gene therapy could program liver to secrete enzyme with mannose 6-phosphate (M6P), and enzyme in blood could be taken up by other cells via the M6P receptor. Newborn MPS I mice were injected with 10(9) (high dose) or 10(8) (low dose) transducing units/kg of a retroviral vector (RV) expressing canine IDUA. Most animals achieved stable expression of IDUA in serum at 1240 +/- 147 and 110 +/- 31 units/ml, respectively. At 8 months, untreated MPS I mice had aortic insufficiency, increased bone mineral density (BMD), and reduced responses to sound and light. In contrast, MPS I mice that received high-dose RV had normal echocardiograms, BMD, auditory-evoked brain-stem responses, and electroretinograms. This is the first report of complete correction of these clinical manifestations in any model of mucopolysaccharidosis. Biochemical and pathologic evaluation confirmed that storage was reduced in these organs. Mice that received low-dose RV and achieved 30 units/ml of serum IDUA activity had no or only partial improvement. We conclude that high-dose neonatal gene therapy with an RV reduces some major clinical manifestations of MPS I in mice, but low dose is less effective.
authors.affiliation: Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Yuli
authors.initials: Y
authors.lastname: Liu
authors.forename: Lingfei
authors.initials: L
authors.lastname: Xu
authors.forename: Anne K
authors.initials: AK
authors.lastname: Hennig
authors.forename: Attila
authors.initials: A
authors.lastname: Kovacs
authors.forename: Annabel
authors.initials: A
authors.lastname: Fu
authors.forename: Sarah
authors.initials: S
authors.lastname: Chung
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Ramin S
authors.initials: RS
authors.lastname: Herati
authors.forename: Judith
authors.initials: J
authors.lastname: Mosinger Ogilvie
authors.forename: Shi-Rong
authors.initials: SR
authors.lastname: Cai
authors.forename: Katherine
authors.initials: K
authors.lastname: Parker Ponder
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001847:Bone Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000235:genetics / Q000517:prevention & control*; D004247:DNA / Q000008:administration & dosage / Q000378:metabolism; D004285:Dogs; D004427:Ear Diseases / Q000150:complications / Q000235:genetics / Q000503:physiopathology / Q000517:prevention & control*; D005128:Eye Diseases / Q000150:complications / Q000235:genetics / Q000503:physiopathology / Q000517:prevention & control*; D015316:Genetic Therapy; D006331:Heart Diseases / Q000150:complications / Q000235:genetics / Q000473:pathology / Q000517:prevention & control*; D007068:Iduronidase / Q000172:deficiency / Q000235:genetics / Q000378:metabolism; D008099:Liver / Q000201:enzymology*; D008358:Mannose / Q000378:metabolism; D051379:Mice; D018345:Mice, Knockout; D008059:Mucopolysaccharidosis I / Q000150:complications / Q000201:enzymology / Q000235:genetics* / Q000628:therapy*; D011859:Radiography; D012190:Retroviridae / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D004247:DNA; D007068:Iduronidase; D008358:Mannose