Selective Vulnerability of Neuronal Subtypes in ALS: A Fertile Ground for the Identification of Therapeutic Targets

It is well defined that subpopulations of motoneurons have different vulnerability to the pathology causing amyotrophic lateral sclerosis (ALS). In the spinal cord, the fast fatigable motoneurons have been shown to be the first to degenerate, followed by fatigue-resistant and slow motoneurons. In contrast motoneurons located in the Onuf’s and oculomotor nuclei appear to be resistant to disease. With a focus on research mainly done on mice overexpressing the mutated human superoxide dismutase (SOD1) protein, we review recent studies exploring the mechanisms that underlie the selective vulnerability of the various motoneuron subtypes. By comparing differences in gene expression between these populations, it has been possible to identify factors, which critically determine the survival of motoneurons and the neuromuscular function in the pathologic context of ALS. Furthermore, we discuss the contribution of non-cell autonomous processes, involving glial cells and the skeletal muscle, in the neurodegenerative process. Exploring the cause of neurodegeneration from the angle of the selective neuronal vulnerability has recently led to the identification of novel targets, which open opportunities for therapeutic intervention against ALS

AAV based gene therapy for rare diseases:targeting astrocytes for functional recovery in Amyotrophic Lateral Sclerosis

Of the seven thousand diseases that are described as rare, 80% of them have an identified genetic cause. With this in the mind, the development of technologies, such as gene therapy, to address the genetic factors involved in these pathologies, might be a game-changing therapeutic approach. Viral delivery of transgenes for RNA interference, DNA editing, or protein overexpression may offer opportunities for novel treatments. In this thesis, we developed adeno-associated virus (AAV) vector systems to tackle two rare diseases: Amyotrophic lateral sclerosis (ALS) caused by gain-of-function mutations in the superoxide dismutase 1 (SOD1) gene and inherited hearing loss disorder caused by mutation in the transmembrane channel-like 1 (TMC1) gene. ALS is a fatal neurodegenerative disease caused by the progressive degeneration of motoneurons (MN). Glial cells have been shown to importantly contribute to the disease. Silencing of the human pathogenic mutated SOD1 protein (SOD1G93A) in MN and/or astrocytes by AAV-mediated expression of microRNA targeting SOD1 has been shown to provide therapeutic benefits in a mouse model which is overexpressing SOD1G93A. However, in order to have an effective treatment, it is important to understand the influence of the therapy on several relevant ALS cell types. In this work, we determined the effects of lowering SOD1G93A expression in astrocytes using an AAV serotype 9, in combination with an astrocyte-specific promoter, in order to express a microRNA targeting SOD1. In the treated mice, we observed a significant improvement of the neuromuscular function and a partial protection of the vulnerable fast-fatigable MN. SOD1 silencing also induced a significant re-innervation of the neuromuscular junctions (NMJ) in the gastrocnemius muscle, observed after the initial phase of denervation, occurring around the age of 60 days. Re-innervation was associated with a grouping of the muscle fibers from the same type, consistent with enhanced axonal plasticity in the treated SOD1G93A mice. Overall, we demonstrated that silencing of SOD1 in astrocytes has an impact on MN plasticity at the level of NMJ, which translates into improved neuromuscular function towards the end stage of the disease. Mutations in the TMC1 gene lead to either complete deafness at birth, or to progressive hearing loss beginning in childhood, depending on the mode of inheritance (autosomal recessive or dominant, respectively). TMC1 is likely a component of the mechanotransduction channel, which is responsible for the transformation of mechanical sound-induced stimuli into electrical signals. This protein has been found to be expressed in the stereociliae of hair cells. In the second part of the thesis, we report on the development of viral tools to deliver a functional copy of the TMC1 gene, or its related paralog TMC2, into hair cells. We engineered several AAV vectors, in combination with different promoters, to identify a suitable combination able to restore TMC expression in the mouse cochlear hair cells, both in vitro and in vivo. We demonstrated, in collaboration with the lab of J. Holt, that when injected in TMC-null mice at birth, these vectors could partially restore loss of auditory function in this mouse model otherwise completely deaf. Overall we showed that AAV-based gene therapy is a promising approach to treat rare genetic disease

Bicistronic aav vector for rna interference in als

The present invention relates to a bicistronic expression vector for silencing a gene specifically in astrocytes and neurons, comprising two expression cassettes comprising a first and a second silencer sequence, respectively, wherein the expression of said first silencer sequence within astrocytes is regulated by an astrocyte-specific promoter and the expression of said second silencer sequence within neurons is regulated by a neuron-specific promoter. In a preferred embodiment, said first and second silencer sequences are SOD1 silencer sequences. Pharmaceutical composition comprising said bicistronic vector and the use of the same in the treatment of motoneuron diseases are further described

Astrocyte‐targeting RNA interference against mutated superoxide dismutase 1 induces motoneuron plasticity and protects fast‐fatigable motor units in a mouse model of amyotrophic lateral sclerosis

International audienc

Tmc gene therapy restores auditory function in deaf mice

Genetic hearing loss accounts for up to 50% of prelingual deafness worldwide, yet there are no biologic treatments currently available. To investigate gene therapy as a potential biologic strategy for restoration of auditory function in patients with genetic hearing loss, we tested a gene augmentation approach in mouse models of genetic deafness. We focused on DFNB7/11 and DFNA36, which are autosomal recessive and dominant deafnesses, respectively, caused by mutations in transmembrane channel-like 1 (TMC1). Mice that carry targeted deletion of Tmc1 or a dominant Tmc1 point mutation, known as Beethoven, are good models for human DFNB7/11 and DFNA36. We screened several adenoassociated viral (AAV) serotypes and promoters and identified AAV2/1 and the chicken beta-actin (Cba) promoter as an efficient combination for driving the expression of exogenous Tmc1 in inner hair cells in vivo. Exogenous Tmc1 or its closely related ortholog, Tmc2, were capable of restoring sensory transduction, auditory brainstem responses, and acoustic startle reflexes in otherwise deaf mice, suggesting that gene augmentation with Tmc1 or Tmc2 is well suited for further development as a strategy for restoration of auditory function in deaf patients who carry TMC1 mutations