Polynucleotides encoding branched-chain alpha-ketoacid dehydrogenase complex E1-α, E1-β, and E2 subunits for the treatment of maple syrup urine disease
This disclosure relates to mRNA therapy for the treatment of maple syrup urine disease (MSUD). mRNAs for use in the invention, when administered in vivo, encode branched chain α-ketoacid dehydrogenase complex (BCKDC) E1α, E1β, or E2mRNA therapies of the disclosure increase and/or restore deficient levels of E1α, E1β, or E2 expression and/or BCKDC activity in subjects. mRNA therapies of the invention further decrease abnormal accumulation of branched chain amino acids associated with deficient BCKDC activity in subjects.
1 . A pharmaceutical composition comprising a lipid nanoparticle, a first mRNA, a second mRNA, and a third mRNA, wherein the first mRNA comprises a first open reading frame (ORF) encoding a branched-chain α-ketoacid dehydrogenase complex (BCKDC) Ela polypeptide comprising the amino acid sequence set forth in SEQ ID NO: 1 or 19, wherein the second mRNA comprises a second ORF encoding a BCKDC E1β polypeptide comprising the amino acid sequence set forth in SEQ ID NO:9, wherein the third mRNA comprises a third ORF encoding a BCKDC E2 polypeptide comprising the amino acid sequence set forth in SEQ ID NO:14, and wherein all of the uracils in the first mRNA, the second mRNA, and the third mRNA are N1-methylpseudouracils.
2 . The pharmaceutical composition of claim 1 , wherein the lipid nanoparticle comprises:
(i)
(ii) cholesterol, and (iii) PEG-DMG or
(i) Compound II, (ii) 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC) or 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE), (iii) cholesterol, and (iv) PEG-DMG or Compound I;
(i) Compound II, (ii) cholesterol, and (iii) Compound I; or
(i) Compound II, (ii) DSPC or DOPE, (iii) cholesterol, and (iv) Compound I.
3 . A method of expressing a branched-chain α-ketoacid dehydrogenase complex (BCKDC) Ela polypeptide, Elβ polypeptide, and E2 polypeptide in a human subject in need thereof, comprising administering intravenously to the subject a therapeutically effective amount of the pharmaceutical composition of claim 1 .
4 . A method of treating maple syrup urine disease (MSUD) in a human subject in need thereof, comprising administering intravenously to the subject a therapeutically effective amount of the pharmaceutical composition of claim 1 .
5 . The method of claim 4 , wherein the administration to the subject is about once a week or about once every two weeks.
6 . A method of reducing leucine, isoleucine, and/or valine blood levels in a human subject in need thereof, comprising administering intravenously to the subject a therapeutically effective amount of the pharmaceutical composition of claim 1 .
7 . A method of reducing leucine, isoleucine, and/or valine urine level in a human subject in need thereof, comprising administering intravenously to the subject a therapeutically effective amount of the pharmaceutical composition of claim 1 .
8 . A method of increasing branched chain α-ketoacid dehydrogenase complex (BCKDC) activity in a human subject in need thereof, comprising administering intravenously to the subject a therapeutically effective amount of the pharmaceutical composition of claim 1 .
9 . The method of claim 8 , wherein the BCKDC activity is increased in the liver of the subject.