Gene therapy for neurodegenerative disorders
Compositions and methods for treating disorders affecting motor function, such as motor function affected by disease or injury to the brain and/or spinal cord, are disclosed.
1. A method of treating spinal muscular atrophy (SMA) comprising administering to a subject in need thereof a therapeutically effective amount of recombinant adeno-associated virus (rAAV) virions comprising a self-complementary adeno-associated virus (scAAV) vector comprising a heterologous nucleic acid construct, wherein the heterologous nucleic acid construct comprises:
a. a first AAV2 inverted terminal repeat (ITR);
b. cytomegalovirus enhancer/chicken-β actin (CBA) promoter;
c. a polynucleotide encoding a survival motor neuron (SMN) protein comprising an amino acid sequence that is at least 90% identical to SEQ ID NO: 2; and
d. a second AAV2 ITR, and wherein the rAAV virions comprise an AAV8 or AAV9 capsid;
and wherein the rAAV virions are administered (i) into at least one region of the deep cerebellar nuclei of the cerebellum, (ii) via direct spinal cord injection, (iii) via intracerebroventricular injection, and/or (iv) via intrathecal injection.
2. The method of claim 1 , wherein the polynucleotide encodes a SMN protein comprising an amino acid sequence that is at least 95% identical to SEQ ID NO: 2.
3. The method of claim 1 , wherein the second ITR is mutated.
4. The method of claim 3 , wherein the second ITR comprises a mutation in a terminal resolution sequence.
5. The method of claim 1 , wherein about 10 6 to about 10 15 rAAV virions are administered.
6. The method of claim 1 , wherein the rAAV virions are administered in a single-dose.
7. A method of treating spinal muscular atrophy (SMA) comprising administering to a subject in need thereof about 10 6 to about 10 15 recombinant AAV (rAAV) virions, wherein the rAAV virions comprise a self-complementary heterologous nucleic acid construct comprising:
a. a first AAV2 inverted terminal repeat (ITR);
b. cytomegalovirus enhancer/chicken-β actin (CBA) promoter;
c. a polynucleotide encoding a survival motor neuron (SMN) protein comprising the amino acid sequence that is at least 90% identical to SEQ ID NO: 2; and
d. a second AAV2 ITR, wherein the second ITR comprises a mutation in a terminal resolution sequence, and wherein the rAAV virions comprise an AAV8 or AAV9 capsid;
and wherein the rAAV virions are administered (i) into at least one region of the deep cerebellar nuclei of the cerebellum, (ii) via direct spinal cord injection, (iii) via intracerebroventricular injection, and/or (iv) via intrathecal injection.
8. The method of claim 7 , wherein the polynucleotide encodes a SMN protein comprising an amino acid sequence that is identical to SEQ ID NO: 2.
9. The method according to claim 7 , wherein the rAAV virions are administered in a single-dose.
10. A method of treating spinal muscular atrophy (SMA) comprising administering to a subject in need thereof a therapeutically effective amount of recombinant AAV (rAAV) virions, wherein the rAAV virions comprise a self-complementary heterologous nucleic acid construct comprising, in 5′ to 3′ order, a wild-type AAV2 ITR; a cytomegalovirus enhancer/chicken-β actin (CBA) promoter; a polynucleotide encoding a survival motor neuron (SMN) protein comprising an amino acid sequence that is at least 90% identical to SEQ ID NO: 2; a mutated AAV2 ITR comprising a mutation in a terminal resolution sequence; an inverted polynucleotide encoding a survival motor neuron (SMN) protein comprising an amino acid sequence that is at least 90% identical to SEQ ID NO: 2; an inverted cytomegalovirus enhancer/chicken-β actin (CBA) promoter; and an inverted wild-type AAV2 ITR, wherein the rAAV virions comprise an AAV8 or AAV9 capsid, and wherein the rAAV virions are administered (i) into at least one region of the deep cerebellar nuclei of the cerebellum, (ii) via direct spinal cord injection, (iii) via intracerebroventricular injection, and/or (iv) via intrathecal injection.
11. The method of claim 10 , wherein the polynucleotide encodes a SMN protein comprising an amino acid sequence that is identical to SEQ ID NO: 2.
12. The method of claim 10 , wherein the inverted polynucleotide encodes a SMN protein comprising an amino acid sequence that is identical to SEQ ID NO: 2.
13. The method of claim 10 , wherein the polynucleotide encodes a SMN protein comprising an amino acid sequence that is identical to SEQ ID NO: 2, and wherein the inverted polynucleotide encodes a SMN protein comprising an amino acid sequence that is identical to SEQ ID NO: 2.
14. The method according to claim 10 , wherein the rAAV virions are administered in a single-dose.
15. The method according to claim 10 , wherein about 10 6 to about 10 15 rAAV virions are administered.
16. The method of claim 10 , wherein the rAAV virions are administered in a single-dose, and wherein about 10 6 to about 10 15 rAAV virions are administered.
17. The method according to claim 1 , wherein the polynucleotide encodes a SMN protein comprising SEQ ID NO: 2.
18. The method of claim 7 , wherein the polynucleotide encodes a SMN protein comprising an amino acid sequence that is at least 95% identical to SEQ ID NO: 2.
19. The method of claim 10 , wherein the polynucleotide encodes a SMN protein comprising an amino acid sequence that is at least 95% identical to SEQ ID NO: 2.
20. The method of claim 10 , wherein the inverted polynucleotide encodes a SMN protein comprising an amino acid sequence that is at least 95% identical to SEQ ID NO: 2.
21. The method of claim 10 , wherein the polynucleotide encodes a SMN protein comprising an amino acid sequence that is at least 95% identical to SEQ ID NO: 2, and wherein the inverted polynucleotide encodes a SMN protein comprising an amino acid sequence that is at least 95% identical to SEQ ID NO: 2.
22. The method of claim 1 , wherein the scAAV virions are administered into at least one region of the deep cerebellar nuclei of the cerebellum.
23. The method of claim 1 , wherein the scAAV virions are administered via direct spinal cord injection.
24. The method of claim 1 , wherein the scAAV virions are administered via intracerebroventricular injection.
25. The method of claim 1 , wherein the scAAV virions are administered via intrathecal injection.
26. The method of claim 7 , wherein the scAAV virions are administered into at least one region of the deep cerebellar nuclei of the cerebellum.
27. The method of claim 7 , wherein the scAAV virions are administered via direct spinal cord injection.
28. The method of claim 7 , wherein the scAAV virions are administered via intracerebroventricular injection.
29. The method of claim 7 , wherein the scAAV virions are administered via intrathecal injection.
30. The method of claim 10 , wherein the scAAV virions are administered into at least one region of the deep cerebellar nuclei of the cerebellum.
31. The method of claim 10 , wherein the scAAV virions are administered via direct spinal cord injection.
32. The method of claim 10 , wherein the scAAV virions are administered via intracerebroventricular injection.
33. The method of claim 10 , wherein the scAAV virions are administered via intrathecal injection.