INTRANASAL ADMINISTRATION OF ADENO-ASSOCIATED VIRUS TO TREAT CENTRAL NERVOUS SYSTEM DISORDERS
A method to prevent, inhibit or treat one or more symptoms associated with disease of the central nervous system by intranasally, intrathecally, intracerebrovascularly or intravenously administering a rAAV encoding a gene product associated with the disease, e.g., a mammal in which the gene product is absent or present at a reduced level relative to a mammal without the disease, in an amount effective, e.g., to provide for cross-correction.
1 . A method to enhance neurocognition or decrease neuropathology in the central nervous system of a mammal having a lysosomal storage disease, comprising: administering to the mammal a composition comprising an amount of a recombinant adeno-associated virus (rAAV) vector comprising an open reading frame encoding a lysosomal storage enzyme, effective to enhance neurocognition or decrease neuropathology throughout the brain relative to a mammal with mucopolysaccharidosis that is not administered the rAAV.
2 . A method to prevent or inhibit neurocognitive dysfunction or neuropathology in a mammal having a lysosomal storage disease, comprising: administering to the mammal a composition comprising an effective amount of a recombinant adeno-associated virus (rAAV) vector comprising an open reading frame encoding a lysosomal storage enzyme.
3 . A method to provide for cross-correction of a lysosomal storage enzyme deficiency in the central nervous system in a mammal in need thereof, comprising: administering to the mammal an effective amount of a composition comprising an effective amount of a recombinant adeno-associated virus (rAAV) vector comprising an open reading frame encoding a lysosomal storage enzyme, the expression of which in the mammal provides for cross-correction.
4 . The method of any one of claims 1 to 3 wherein the mammal is not treated with an immunosuppressant.
5 . The method of any one of claims 1 to 3 wherein the mammal is treated with an immunosuppressant.
6 . The method of claim 5 wherein the immune suppressant comprises cyclophosphamide.
7 . The method of claim 5 wherein the immune suppressant comprises a glucocorticoid, cytostatic agents including an alkylating agent, an anti-metabolite, a cytotoxic antibiotic, an antibody, or an agent active on immunophilin.
8 . The method of claim 5 wherein the immune suppressant comprises a nitrogen mustard, nitrosourea, platinum compound, methotrexate, azathioprine, mercaptopurine, fluorouracil, dactinomycin, an anthracycline, mitomycin C, bleomycin, mithramycin, IL-2 receptor- (CD25-) or CD3-directed antibodies, anti-IL-2 antibodies, ciclosporin, tacrolimus, sirolimus, IFN-β, IFN-γ, an opioid, or TNF-α (tumor necrosis factor-alpha) binding agent.
9 . The method of any one of claims 6 to 8 wherein the rAAV and the immune suppressant are co-administered or the immune suppressant is administered after the rAAV.
10 . The method of any one of claims 1 to 9 wherein the mammal is not immunotolerized prior to administration of rAAV.
11 . The method of any one of claims 1 to 9 wherein the mammal is immunotolerized prior to administration of rAAV.
12 . The method of any one of claims 1 to 3 wherein the mammal is an immunocompetent adult.
13 . The method of any one of claims 1 to 12 wherein the rAAV vector is a rAAV1, rAAV3, rAAV4, rAAV5, rAAVrh10, or rAAV9 vector.
14 . The method of any one of claims 1 to 13 wherein the gene product is alpha-L-iduronidase, iduronate-2-sulfatase, heparan sulfate sulfatase, N-acetyl-alpha-D-glucosaminidase, beta-hexosaminidase, alpha-galactosidase, betagalactosidase, beta-glucuronidase or glucocerebrosidase.
15 . The method of any one of claims 1 to 14 wherein the mammal is a human.
16 . The method of any one of claims 1 to 15 wherein the mammal is deficient in alpha-L-iduronidase.
17 . The method of any one of claims 1 to 15 wherein the mammal has mucopolysaccharidosis type I disorder, a mucopolysaccharidosis type II disorder, or a mucopolysaccharidosis type VII disorder.
18 . The method of any one of claims 1 to 17 wherein multiple doses are administered.
19 . The method of any one of claims 1 to 17 wherein the composition is administered weekly.
20 . The method of any one of claims 1 to 19 wherein the amount inhibits growth delay, inhibits hepatospenomegaly, inhibits cardiopulmonary disease, or inhibits skeletal dysplasia, or any combination thereof.
21 . The method of any one of claims 1 to 20 wherein the rAAV is rAAV9 or rAAVrh10.