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Publication : Intracerebroventricular enzyme replacement therapy with β-galactosidase reverses brain pathologies due to GM1 gangliosidosis in mice.

First Author  Chen JC Year  2020
Journal  J Biol Chem Volume  295
Issue  39 Pages  13532-13555
PubMed ID  31481471 Mgi Jnum  J:298928
Mgi Id  MGI:6477827 Doi  10.1074/jbc.RA119.009811
Citation  Chen JC, et al. (2020) Intracerebroventricular enzyme replacement therapy with beta-galactosidase reverses brain pathologies due to GM1 gangliosidosis in mice. J Biol Chem 295(39):13532-13555
abstractText  Autosomal recessive mutations in the galactosidase beta1 (GLB1) gene cause lysosomal beta-gal deficiency, resulting in accumulation of galactose-containing substrates and onset of the progressive and fatal neurodegenerative lysosomal storage disease, GM1 gangliosidosis. Here, an enzyme replacement therapy (ERT) approach in fibroblasts from GM1 gangliosidosis patients with recombinant human beta-gal (rhbeta-gal) produced in Chinese hamster ovary cells enabled direct and precise rhbeta-gal delivery to acidified lysosomes. A single, low dose (3 nm) of rhbeta-gal was sufficient for normalizing beta-gal activity and mediating substrate clearance for several weeks. We found that rhbeta-gal uptake by the fibroblasts is dose-dependent and saturable and can be competitively inhibited by mannose 6-phosphate, suggesting cation-independent, mannose 6-phosphate receptor-mediated endocytosis from the cell surface. A single intracerebroventricularly (ICV) administered dose of rhbeta-gal (100 mug) resulted in broad bilateral biodistribution of rhbeta-gal to critical regions of pathology in a mouse model of GM1 gangliosidosis. Weekly ICV dosing of rhbeta-gal for 8 weeks substantially reduced brain levels of ganglioside and oligosaccharide substrates and reversed well-established secondary neuropathology. Of note, unlike with the ERT approach, chronic lentivirus-mediated GLB1 overexpression in the GM1 gangliosidosis patient fibroblasts caused accumulation of a prelysosomal pool of beta-gal, resulting in activation of the unfolded protein response and endoplasmic reticulum stress. This outcome was unsurprising in light of our in vitro biophysical findings for rhbeta-gal, which include pH-dependent and concentration-dependent stability and dynamic self-association. Collectively, our results highlight that ICV-ERT is an effective therapeutic intervention for managing GM1 gangliosidosis potentially more safely than with gene therapy approaches.
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