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Biffi A, Capotondo A, Fasano S, del Carro U, Marchesini S, Azuma H, Malaguti MC, Amadio S, Brambilla R, Grompe M, Bordignon C, Quattrini A, Naldini L. Gene therapy of metachromatic leukodystrophy reverses neurological damage and deficits in mice. J Clin Invest 2006; 116:3070-82. [PMID: 17080200 PMCID: PMC1626132 DOI: 10.1172/jci28873] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Accepted: 07/25/2006] [Indexed: 12/30/2022] Open
Abstract
Metachromatic leukodystrophy (MLD) is a demyelinating lysosomal storage disorder for which new treatments are urgently needed. We previously showed that transplantation of gene-corrected hematopoietic stem progenitor cells (HSPCs) in presymptomatic myeloablated MLD mice prevented disease manifestations. Here we show that HSC gene therapy can reverse neurological deficits and neuropathological damage in affected mice, thus correcting an overt neurological disease. The efficacy of gene therapy was dependent on and proportional to arylsulfatase A (ARSA) overexpression in the microglia progeny of transplanted HSPCs. We demonstrate a widespread enzyme distribution from these cells through the CNS and a robust cross-correction of neurons and glia in vivo. Conversely, a peripheral source of enzyme, established by transplanting ARSA-overexpressing hepatocytes from transgenic donors, failed to effectively deliver the enzyme to the CNS. These results indicate that the recruitment of gene-modified, enzyme-overexpressing microglia makes the enzyme bioavailable to the brain and makes therapeutic efficacy and disease correction attainable. Overall, our data provide a strong rationale for implementing HSPC gene therapy in MLD patients.
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Affiliation(s)
- Alessandra Biffi
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Alessia Capotondo
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Stefania Fasano
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Ubaldo del Carro
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Sergio Marchesini
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Hisaya Azuma
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Maria Chiara Malaguti
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Stefano Amadio
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Riccardo Brambilla
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Markus Grompe
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Claudio Bordignon
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Angelo Quattrini
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Luigi Naldini
- San Raffaele Telethon Institute for Gene Therapy,
Vita-Salute San Raffaele University,
Department of Molecular Biology and Functional Genomics, and
Neurology Unit, San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical Science and Biotechnology, University of Brescia, Brescia, Italy.
Department of Medical and Molecular Genetics, Oregon Health and Science University, Portland, Oregon, USA
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