Therapeutic Strategy for Fabry Disease by Intravenous Administration of Adeno-Associated Virus 9 in a Symptomatic Mouse Model

Hum Gene Ther. 2024 Mar;35(5-6):192-201. doi: 10.1089/hum.2023.106.

Abstract

Fabry disease (FD) is an inherited lysosomal storage disease caused by deficiency of α-galactosidase A (α-Gal A), an enzyme that hydrolyzes glycosphingolipids in lysosome. Accumulation of glycosphingolipids, mainly globotriaosylceramide (Gb3) in tissues, induces cellular dysfunction leading to multi-organ disorder. Gene therapy is a promising strategy that can overcome these problems, and virus vectors such as adeno-associated virus (AAV) have been used for study on gene therapy. We used human Gb3 synthetase-transgenic (TgG3S)/α-Gal A knockout (GLAko) mice. TgG3S/GLAko mice have elevated Gb3 accumulation in the major organs compared with GLAko mice, which have been widely used as a model for FD. At the age of 6 weeks, male TgG3S/GLAko were injected with 2 × 1012 vector genome AAV9 vectors containing human α-Gal A cDNA. Eight weeks after intravenous injection of AAV, α-Gal A enzymatic activity was elevated in the plasma, heart, and liver of TgG3S/GLAko mice to levels corresponding to 224%, 293%, and 105% of wild-type, respectively. Gb3 amount 8 weeks after AAV injection in the heart and liver of this group was successfully reduced to levels corresponding to 16% and 3% of untreated TgG3S/GLAko mice. Although the brain and kidney of AAV9-treated TgG3S/GLAko mice showed no significant increases in α-Gal A activity, Gb3 amount was smaller than untreated littermates (48% and 44%, respectively). In this study, systemic AAV administration did not show significant extension of the lifespan of TgG3S/GLAko mice compared with the untreated littermates. The timing of AAV injection, capsid choice, administration route, and injection volume may be important to achieve sufficient expression of α-Gal A in the whole body for the amelioration of lifespan.

Keywords: Fabry disease; adeno-associated virus vector; gene therapy; mouse; α-galactosidase A deficiency.

MeSH terms

  • Administration, Intravenous
  • Animals
  • Dependovirus / genetics
  • Dependovirus / metabolism
  • Disease Models, Animal
  • Fabry Disease* / genetics
  • Fabry Disease* / therapy
  • Glycosphingolipids / metabolism
  • Glycosphingolipids / therapeutic use
  • Humans
  • Infant
  • Male
  • Mice
  • Mice, Knockout
  • alpha-Galactosidase / genetics
  • alpha-Galactosidase / metabolism
  • alpha-Galactosidase / therapeutic use

Substances

  • alpha-Galactosidase
  • Glycosphingolipids