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400 Investigation of a translational astrocyte-targeted AAV-mediated gene addition therapy in two models of Vanishing White Matter disease

Published online by Cambridge University Press:  03 April 2024

Jessica A. Herstine
Affiliation:
Center for Gene Therapy Abigail Wexner Research Institute at Nationwide Children’s Hospital Department of Pediatrics Center for Clinical and Translational Science The Ohio State University
Pi-Kai Chang
Affiliation:
Department of Pediatrics University of Utah School of Medicine
Sergiy Chornyy
Affiliation:
Center for Gene Therapy Abigail Wexner Research Institute at Nationwide Children’s Hospital
Tamara J. Stevenson
Affiliation:
Department of Pediatrics University of Utah School of Medicine
Jessica Rediger
Affiliation:
Center for Gene Therapy Abigail Wexner Research Institute at Nationwide Children’s Hospital
Julia Wentz
Affiliation:
Department of Pediatrics University of Utah School of Medicine
Nettie Pyne
Affiliation:
Center for Gene Therapy Abigail Wexner Research Institute at Nationwide Children’s Hospital
Joshua L. Bonkowsky
Affiliation:
Department of Pediatrics University of Utah School of Medicine Center for Personalized Medicine Primary Children’s Hospital
Allison M. Bradbury
Affiliation:
Center for Gene Therapy Abigail Wexner Research Institute at Nationwide Children’s Hospital Department of Pediatrics Center for Clinical and Translational Science The Ohio State University
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Abstract

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OBJECTIVES/GOALS: Vanishing White Matter Disease (VWM), is a childhood neurodegenerative leukodystrophy that presents with motor deficits, neurologic decline, and seizures leading to death.There are no treatments. Herein we investigate adeno-associated virus serotype 9 (AAV9) gene addition therapy for VWM. METHODS/STUDY POPULATION: To serve as a baseline for disease correction, we characterized the severe VWM Eif2b5I98M murine model with clinically relevant readouts including motor function, gait mapping and myelin loss through magnetic resonance imaging (MRI). Molecular characterization through the identification of biomarkers was also investigated. To provide targeted disease correction, we designed four gene replacement constructs to drive the rapeutic EIF2B5 expression in astrocytes—a critical cell type for VWM pathology. We are currently evaluating our AAV vectors in two murine VWM models, Eif2b5R191H and Eif2b5I98M, and are monitoring disease progression using traditional and clinically relevant readouts. RESULTS/ANTICIPATED RESULTS: The I98M mice display significant mobility loss, ataxic gait, and demyelination. Molecular characterization also indicates that the integrated stress response is significantly dysregulated, supporting the classic VWM phenotype. Our previous biodistribution study confirmed our ability to efficiently target astrocytes using varying iterations—including one novel—of the glial fibrillary acidic protein (GFAP) promoter. Our data suggests that targeting astrocytes with gene addition delays disease onset, partially rescues motor function, and attenuates myelin loss. Survival of the AAV9-gfaABC(1)D-EIF2B5 treated I98M mice is also significantly increased (p<0.0001), currently with a 2-fold extension in life expectancy. DISCUSSION/SIGNIFICANCE: Overall, we anticipate emergence of a lead astrocyte-targeted gene therapy candidate in which the data will be strengthened through the evaluation of clinically relevant measures in two murine models of disease, allowing fortimely translation to the clinic.

Type
Precision Medicine/Health
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2024. The Association for Clinical and Translational Science