Intracerebral Administration of Adeno-Associated Viral Vector Serotype rh.10 Carrying Human SGSH and SUMF1 cDNAs in Children with Mucopolysaccharidosis Type IIIA Disease: Results of a Phase I/II Trial
Abstract
Mucopolysaccharidosis type IIIA is a severe degenerative disease caused by an autosomal recessive defect of a gene encoding a lysosomal heparan-N-sulfamidase, the N-sulfoglycosamine sulfohydrolase (SGSH), the catalytic site of which is activated by a sulfatase-modifying factor (SUMF1). Four children (Patients 1-3, aged between 5.5 and 6 years; Patient 4 aged 2 years 8 months) received intracerebral injections of an adeno-associated viral vector serotype rh.10-SGSH-IRES-SUMF1 vector in a phase I/II clinical trial. All children were able to walk, but their cognitive abilities were abnormal and had declined (Patients 1-3). Patients 1-3 presented with brain atrophy. The therapeutic vector was delivered in a frameless stereotaxic device, at a dose of 7.2×10(11) viral genomes/patient simultaneously via 12 needles as deposits of 60 μl over a period of 2 hr. The vector was delivered bilaterally to the white matter anterior, medial, and posterior to the basal ganglia. Immunosuppressive treatment (mycophenolate mofetil and tacrolimus) was initiated 15 days before surgery and maintained for 8 weeks (mycophenolate mofetil) or throughout follow-up (tacrolimus, with progressive dose reduction) to prevent elimination of transduced cells. Safety data collected from inclusion, during the neurosurgery period and over the year of follow-up, showed good tolerance, absence of adverse events related to the injected product, no increase in the number of infectious events, and no biological sign of toxicity related to immunosuppressive drugs. Efficacy analysis was necessarily preliminary in this phase I/II trial on four children, in the absence of validated surrogate markers. Brain atrophy evaluated by magnetic resonance imaging seemed to be stable in Patients 1 and 3 but tended to increase in Patients 2 and 4. Neuropsychological evaluations suggested a possible although moderate improvement in behavior, attention, and sleep in Patients 1-3. The youngest patient was the most likely to display neurocognitive benefit.
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AAV vector administration to the CNS has an excellent safety and efficacy profile.
“AAV vector administration to the CNS has an excellent safety and efficacy profile.”
From AAVrh.10-Mediated APOE2 Central Nervous System Gene Therapy for APOE4-Associated Alzheimer's Disease (2018) · cites this paper as [62]
LYSOGENE's AAVrh.10-hMPS3A administered to four children in a phase I first-in-human trial via intracerebral injections proved the method of administration to be safe for direct AAV vector delivery into the CNS.
“The results of the trial proved the method of administration to be safe for direct AAV vector delivery into the CNS.”
From Current clinical applications of in vivo gene therapy with AAVs (2021) · cites this paper as [258]
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- Authors
- Tardieu, M., Zérah, M., Husson, B., de Bournonville, S., Deiva, K., Adamsbaum, C., Vincent, F., Hocquemiller, M., Broissand, C., Furlan, V., Ballabio, A., Fraldi, A., Crystal, R. G., Baugnon, T., Roujeau, T., Heard, J.-M., & Danos, O.
- Affiliations
- Université Paris-Sud (FR)
- Hôpital Necker-Enfants Malades (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Pediatric Neurology, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin Bucêtre 94275, France.
- Inserm (FR)
- LYSOGENE SAS, Paris 75008, France.
- Baylor College of Medicine (US)
- Telethon Institute Of Genetics And Medicine (IT)
- Weill Cornell Medicine (US)
- Centre Hospitalier Universitaire de Montpellier (FR)
- Corresponding author
- Tardieu, Marc
- ORCID
- Venue
- Human Gene Therapy
- Publisher
- SAGE Publications
- Published
- 2014-06
- Volume
- 25
- Issue
- 6
- Pages
- 506-516
- ISSN
- 1043-0342 (ISSN-L)
- 1557-7422
- OpenAlex
- W1832822495
- Cited by
- 261
- References
- 33
- Citations by year
- 2026: 11 · 2025: 6 · 2024: 28 · 2023: 15 · 2022: 20 · 2021: 21 · 2020: 26 · 2019: 21 · 2018: 26 · 2017: 30 · 2016: 16 · 2015: 29 · 2014: 11
- FWCI
- 19.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Gene Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Lysosomal Storage Disorders Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
- Health Sciences › Medicine › Genetics › Neurogenetic and Muscular Disorders Research
- Keywords
- mucopolysaccharidosis type IIIA, SUMF1, lysosomal storage disease, children, brain atrophy, neuropsychological outcomes, immunosuppression, tacrolimus, mycophenolate mofetil, stereotactic injection
- MeSH terms
- Dependovirus, Cerebral Ventricles, Child, Child, Preschool, Female, Humans, Hydrolases, Injections, Intraventricular, Male, Mucopolysaccharidosis III, Sulfatases, Genetic Therapy, Treatment Outcome, Oxidoreductases Acting on Sulfur Group Donors
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