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Aimiuwu OV, Fowler AM, Sah M, Teoh JJ, Kanber A, Pyne NK, Petri S, Rosenthal-Weiss C, Yang M, Harper SQ, Frankel WN. RNAi-Based Gene Therapy Rescues Developmental and Epileptic Encephalopathy in a Genetic Mouse Model. Mol Ther 2020; 28:1706-1716. [PMID: 32353324 PMCID: PMC7335739 DOI: 10.1016/j.ymthe.2020.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/19/2020] [Accepted: 04/08/2020] [Indexed: 01/23/2023] Open
Abstract
Developmental and epileptic encephalopathy (DEE) associated with de novo variants in the gene encoding dynamin-1 (DNM1) is a severe debilitating disease with no pharmacological remedy. Like most genetic DEEs, the majority of DNM1 patients suffer from therapy-resistant seizures and comorbidities such as intellectual disability, developmental delay, and hypotonia. We tested RNAi gene therapy in the Dnm1 fitful mouse model of DEE using a Dnm1-targeted therapeutic microRNA delivered by a self-complementary adeno-associated virus vector. Untreated or control-injected fitful mice have growth delay, severe ataxia, and lethal tonic-clonic seizures by 3 weeks of age. These major impairments are mitigated following a single treatment in newborn mice, along with key underlying cellular features including gliosis, cell death, and aberrant neuronal metabolic activity typically associated with recurrent seizures. Our results underscore the potential for RNAi gene therapy to treat DNM1 disease and other genetic DEEs where treatment would require inhibition of the pathogenic gene product.
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Affiliation(s)
- Osasumwen V Aimiuwu
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Allison M Fowler
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Megha Sah
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Jia Jie Teoh
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Ayla Kanber
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Nettie K Pyne
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
| | - Sabrina Petri
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Chana Rosenthal-Weiss
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Mu Yang
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Scott Q Harper
- Center for Gene Therapy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43205, USA
| | - Wayne N Frankel
- Institute for Genomic Medicine and Department of Genetics and Development, Columbia University Irving Medical Center, New York, NY 10032, USA.
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Amador A, Bostick CD, Olson H, Peters J, Camp CR, Krizay D, Chen W, Han W, Tang W, Kanber A, Kim S, Teoh J, Sah M, Petri S, Paek H, Kim A, Lutz CM, Yang M, Myers SJ, Bhattacharya S, Yuan H, Goldstein DB, Poduri A, Boland MJ, Traynelis SF, Frankel WN. Modelling and treating GRIN2A developmental and epileptic encephalopathy in mice. Brain 2020; 143:2039-2057. [PMID: 32577763 PMCID: PMC7363493 DOI: 10.1093/brain/awaa147] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 03/06/2020] [Accepted: 03/25/2020] [Indexed: 12/14/2022] Open
Abstract
NMDA receptors play crucial roles in excitatory synaptic transmission. Rare variants in GRIN2A encoding the GluN2A subunit are associated with a spectrum of disorders, ranging from mild speech and language delay to intractable neurodevelopmental disorders, including but not limited to developmental and epileptic encephalopathy. A de novo missense variant, p.Ser644Gly, was identified in a child with this disorder, and Grin2a knock-in mice were generated to model and extend understanding of this intractable childhood disease. Homozygous and heterozygous mutant mice exhibited altered hippocampal morphology at 2 weeks of age, and all homozygotes exhibited lethal tonic-clonic seizures by mid-third week. Heterozygous adults displayed susceptibility to induced generalized seizures, hyperactivity, repetitive and reduced anxiety behaviours, plus several unexpected features, including significant resistance to electrically-induced limbic seizures and to pentylenetetrazole induced tonic-clonic seizures. Multielectrode recordings of neuronal networks revealed hyperexcitability and altered bursting and synchronicity. In heterologous cells, mutant receptors had enhanced NMDA receptor agonist potency and slow deactivation following rapid removal of glutamate, as occurs at synapses. NMDA receptor-mediated synaptic currents in heterozygous hippocampal slices also showed a prolonged deactivation time course. Standard anti-epileptic drug monotherapy was ineffective in the patient. Introduction of NMDA receptor antagonists was correlated with a decrease in seizure burden. Chronic treatment of homozygous mouse pups with NMDA receptor antagonists significantly delayed the onset of lethal seizures but did not prevent them. These studies illustrate the power of using multiple experimental modalities to model and test therapies for severe neurodevelopmental disorders, while revealing significant biological complexities associated with GRIN2A developmental and epileptic encephalopathy.
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Affiliation(s)
- Ariadna Amador
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
| | | | - Heather Olson
- Epilepsy Genetics Program, Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Jurrian Peters
- Epilepsy Genetics Program, Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Chad R Camp
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
| | - Daniel Krizay
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
- Department of Genetics and Development, Columbia University, New York, NY, USA
| | - Wenjuan Chen
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Wei Han
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
- Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Weiting Tang
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Ayla Kanber
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
| | - Sukhan Kim
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
| | - JiaJie Teoh
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
| | - Megha Sah
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
| | - Sabrina Petri
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
| | - Hunki Paek
- Department of Otolaryngology and Head and Neck Surgery, Columbia University, New York, NY, USA
| | - Ana Kim
- Department of Otolaryngology and Head and Neck Surgery, Columbia University, New York, NY, USA
| | - Cathleen M Lutz
- Department of Otolaryngology and Head and Neck Surgery, Columbia University, New York, NY, USA
| | - Mu Yang
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Scott J Myers
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
- Center for Functional Evaluation of Rare Variants (CFERV), Emory University School of Medicine, Atlanta, GA, 30322, USA
| | | | - Hongjie Yuan
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
- Center for Functional Evaluation of Rare Variants (CFERV), Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - David B Goldstein
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
- Department of Genetics and Development, Columbia University, New York, NY, USA
| | - Annapurna Poduri
- Epilepsy Genetics Program, Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Michael J Boland
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Stephen F Traynelis
- Department of Pharmacology and Chemical Biology, Emory University, Atlanta, GA, USA
- Center for Functional Evaluation of Rare Variants (CFERV), Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Wayne N Frankel
- Institute for Genomic Medicine, Columbia University, New York, NY, USA
- Department of Genetics and Development, Columbia University, New York, NY, USA
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Teoh J, Subramanian N, Pero ME, Bartolini F, Amador A, Kanber A, Williams D, Petri S, Yang M, Allen AS, Beal J, Haut SR, Frankel WN. Arfgef1 haploinsufficiency in mice alters neuronal endosome composition and decreases membrane surface postsynaptic GABA A receptors. Neurobiol Dis 2019; 134:104632. [PMID: 31678406 DOI: 10.1016/j.nbd.2019.104632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 12/23/2022] Open
Abstract
ARFGEF1 encodes a guanine exchange factor involved in intracellular vesicle trafficking, and is a candidate gene for childhood genetic epilepsies. To model ARFGEF1 haploinsufficiency observed in a recent Lennox Gastaut Syndrome patient, we studied a frameshift mutation (Arfgef1fs) in mice. Arfgef1fs/+ pups exhibit signs of developmental delay, and Arfgef1fs/+ adults have a significantly decreased threshold to induced seizures but do not experience spontaneous seizures. Histologically, the Arfgef1fs/+ brain exhibits a disruption in the apical lining of the dentate gyrus and altered spine morphology of deep layer neurons. In primary hippocampal neuron culture, dendritic surface and synaptic but not total GABAA receptors (GABAAR) are reduced in Arfgef1fs/+ neurons with an accompanying decrease in the number of GABAAR-containing recycling endosomes in cell body. Arfgef1fs/+ neurons also display differences in the relative ratio of Arf6+:Rab11+:TrfR+ recycling endosomes. Although the GABAAR-containing early endosomes in Arfgef1fs/+ neurons are comparable to wildtype, Arfgef1fs/+ neurons show an increase in the number of GABAAR-containing lysosomes in dendrite and cell body. Together, the altered endosome composition and decreased neuronal surface GABAAR results suggests a mechanism whereby impaired neuronal inhibition leads to seizure susceptibility.
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Affiliation(s)
- JiaJie Teoh
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America.
| | - Narayan Subramanian
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Maria Elena Pero
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York, NY, United States of America; Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Francesca Bartolini
- Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Ariadna Amador
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Ayla Kanber
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Damian Williams
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Sabrina Petri
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Mu Yang
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Andrew S Allen
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, United States of America
| | - Jules Beal
- The Saul R. Korey Department of Neurology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Sheryl R Haut
- The Saul R. Korey Department of Neurology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Wayne N Frankel
- Institute for Genomic Medicine, Columbia University Irving Medical Center, New York, NY, United States of America; Department of Genetic and Development, Columbia University Irving Medical Center, New York, NY, United States of America
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