AAV2/9-mediated silencing of PMP22 prevents the development of pathological features in a rat model of Charcot-Marie-Tooth disease 1 A

Nat Commun. 2021 Apr 21;12(1):2356. doi: 10.1038/s41467-021-22593-3.

Abstract

Charcot-Marie-Tooth disease 1 A (CMT1A) results from a duplication of the PMP22 gene in Schwann cells and a deficit of myelination in peripheral nerves. Patients with CMT1A have reduced nerve conduction velocity, muscle wasting, hand and foot deformations and foot drop walking. Here, we evaluate the safety and efficacy of recombinant adeno-associated viral vector serotype 9 (AAV2/9) expressing GFP and shRNAs targeting Pmp22 mRNA in animal models of Charcot-Marie-Tooth disease 1 A. Intra-nerve delivery of AAV2/9 in the sciatic nerve allowed widespread transgene expression in resident myelinating Schwann cells in mice, rats and non-human primates. A bilateral treatment restore expression levels of PMP22 comparable to wild-type conditions, resulting in increased myelination and prevention of motor and sensory impairments over a twelve-months period in a rat model of CMT1A. We observed limited off-target transduction and immune response using the intra-nerve delivery route. A combination of previously characterized human skin biomarkers is able to discriminate between treated and untreated animals, indicating their potential use as part of outcome measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Charcot-Marie-Tooth Disease / genetics*
  • Charcot-Marie-Tooth Disease / pathology
  • Charcot-Marie-Tooth Disease / therapy*
  • Dependovirus / genetics
  • Disease Models, Animal
  • Female
  • Gene Silencing
  • Genetic Therapy / methods
  • Genetic Vectors
  • Humans
  • Macaca fascicularis
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Myelin Proteins / antagonists & inhibitors*
  • Myelin Proteins / genetics*
  • RNA, Small Interfering / genetics
  • Rats
  • Rats, Mutant Strains
  • Schwann Cells / metabolism
  • Schwann Cells / pathology
  • Sciatic Nerve / metabolism
  • Sciatic Nerve / pathology

Substances

  • Myelin Proteins
  • PMP22 protein, human
  • Pmp22 protein, mouse
  • Pmp22 protein, rat
  • RNA, Small Interfering