Approaches to Gene Modulation Therapy for ALS

Neurotherapeutics. 2022 Jul;19(4):1159-1179. doi: 10.1007/s13311-022-01285-w. Epub 2022 Sep 6.

Abstract

Amyotrophic lateral sclerosis (ALS) is a devastating motor neuron disease for which there is currently no robust therapy. Recent progress in understanding ALS disease mechanisms and genetics in combination with innovations in gene modulation strategies creates promising new options for the development of ALS therapies. In recent years, six gene modulation therapies have been tested in ALS patients. These target gain-of-function pathology of the most common ALS genes, SOD1, C9ORF72, FUS, and ATXN2, using adeno-associated virus (AAV)-mediated microRNAs and antisense oligonucleotides (ASOs). Here, we review the latest clinical and preclinical advances in gene modulation approaches for ALS, including gene silencing, gene correction, and gene augmentation. These techniques have the potential to positively impact the direction of future research trials and transform ALS treatments for this grave disease.

Keywords: Adeno-associated virus (AAV); Amyotrophic lateral sclerosis (ALS); Antisense oligonucleotides (ASOs); CRISPR/Cas9; Gene therapy; MicroRNA.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Amyotrophic Lateral Sclerosis* / genetics
  • Amyotrophic Lateral Sclerosis* / therapy
  • C9orf72 Protein / genetics
  • Humans
  • MicroRNAs*
  • Oligonucleotides, Antisense / genetics
  • Oligonucleotides, Antisense / therapeutic use
  • Superoxide Dismutase-1 / genetics

Substances

  • Superoxide Dismutase-1
  • C9orf72 Protein
  • Oligonucleotides, Antisense
  • MicroRNAs