Minimal hepatic glucose-6-phosphatase-α activity required to sustain survival and prevent hepatocellular adenoma formation in murine glycogen storage disease type Ia

Young Mok Lee; Goo-Young Kim; Chi-Jiunn Pan; Brian C Mansfield; Janice Y Chou

doi:10.1016/j.ymgmr.2015.03.001

Minimal hepatic glucose-6-phosphatase-α activity required to sustain survival and prevent hepatocellular adenoma formation in murine glycogen storage disease type Ia

Mol Genet Metab Rep. 2015 Mar 13:3:28-32. doi: 10.1016/j.ymgmr.2015.03.001. eCollection 2015 Jun.

Authors

Young Mok Lee¹, Goo-Young Kim¹, Chi-Jiunn Pan¹, Brian C Mansfield², Janice Y Chou¹

Affiliations

¹ Section on Cellular Differentiation, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, United States.
² Section on Cellular Differentiation, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, United States; Foundation Fighting Blindness, Columbia, MD 21046, United States.

Abstract

Glycogen storage disease type Ia (GSD-Ia), characterized by impaired glucose homeostasis and chronic risk of hepatocellular adenoma (HCA), is caused by a deficiency in glucose-6-phosphatase-α (G6Pase-α or G6PC) activity. In a previous 70-90 week-study, we showed that a recombinant adeno-associated virus (rAAV) vector-mediated gene transfer that restores more than 3% of wild-type hepatic G6Pase-α activity in G6pc (-/-) mice corrects hepatic G6Pase-α deficiency with no evidence of HCA. We now examine the minimal hepatic G6Pase-α activity required to confer therapeutic efficacy. We show that rAAV-treated G6pc (-/-) mice expressing 0.2% of wild-type hepatic G6Pase-α activity suffered from frequent hypoglycemic seizures at age 63-65 weeks but mice expressing 0.5-1.3% of wild-type hepatic G6Pase-α activity (AAV-LL mice) sustain 4-6 h of fast and grow normally to age 75-90 weeks. Despite marked increases in hepatic glycogen accumulation, the AAV-LL mice display no evidence of hepatic abnormalities, hepatic steatosis, or HCA. Interprandial glucose homeostasis is maintained by the G6Pase-α/glucose-6-phosphate transporter (G6PT) complex, and G6PT-mediated microsomal G6P uptake is the rate-limiting step in endogenous glucose production. We show that hepatic G6PT activity is increased in AAV-LL mice. These findings are encouraging for clinical studies of G6Pase-α gene-based therapy for GSD-Ia.

Keywords: AAV, adeno-associated virus; BW, body weight; ER, endoplasmic reticulum; G6P, glucose-6-phosphate; G6PC, glucose-6-phosphatase-α gene; G6PT, glucose-6-phosphate transporter; G6Pase-α, glucose-6-phosphatase-α; GPE, G6PC promoter and enhancer; GSD-Ia, glycogen storage disease type Ia; Gene therapy; Glucose homeostasis; Glucose-6-phosphate transporter; HCA, hepatocellular adenoma; Recombinant adeno-associated virus vector.