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Updated: Apr 14, 2026
Author Spotlight: Deciphering the Role of ATM in Ataxia-Telangiectasia and the Associated Cerebellar Degeneration
Published on: December 27, 2024
Positive effect of erythrocyte-delivered dexamethasone in ataxia-telangiectasia
Vincenzo Leuzzi1, Roberto Micheli1, Daniela D'Agnano1
1Department of Pediatrics, Child Neurology and Psychiatry (V.L., D.D., T.V.), Department of Molecular Medicine (I.Q.), and Department of Clinical and Molecular Medicine (L.C.), Sapienza University of Rome, Italy; Unit of Child Neurology and Psychiatry (R.M., E.F.), Department of Clinical and Experimental Sciences, Pediatrics Clinic (A.P., A.S., M. Marini, P.F.L.), and Institute of Molecular Medicine A. Nocivelli (A.P., A.S., M. Marini, P.F.L.), Spedali Civili and University of Brescia, Brescia, Italy; School in Reproductive and Developmental Science (A.M.), University of Trieste and University of Brescia, Brescia, Italy; Department of Pediatrics (M.C.P.), University of Milan, Fondazione IRCCS Ca' Granda, Milan, Italy; Department of Pediatrics (A.F.), Bambino Gesù Children's Hospital and University of Tor Vergata, Rome, Italy; Department of Biomolecular Sciences (M. Magnani), University of Urbino "Carlo Bo," Urbino, Italy; and EryDel SpA (M. Magnani), Urbino, Italy.
Objective:
Ataxia-telangiectasia (AT) is a rare, devastating neurodegenerative disease presenting with early-onset ataxia, oculocutaneous telangiectasia, immunodeficiency, radiosensitivity, and proneness to cancer. In a previous phase 2 study, we showed that 6 monthly infusions of autologous erythrocytes loaded with dexamethasone (EryDex; EryDel, Urbino, Italy) were effective in improving neurologic impairment in young patients with AT. The present article reports the results of the extension of this study for an additional 24-month period.
Methods:
After the end of the first trial, 4 patients continued to be treated with monthly EryDex infusions for an additional 24 months, and their clinical outcome was compared with that of 7 age-matched patients who stopped the treatment after the first 6 infusions. The protocol included serial assessment of ataxia (by International Cooperative Ataxia Rating Scale) and adaptive behavior (by Vineland Adaptive Behavior Scales) and clinical and laboratory tests revealing treatment- and steroid-dependent adverse effects, if present.
Results:
Patients in the extended study experienced a continuous neurologic improvement with respect to their pretreatment status, whereas controls showed a progressive neurologic deterioration (according to the natural history of the disease) after the discontinuation of the treatment. The delivery system we adopted proved to be safe and well-tolerated, and none of the side effects usually associated with the chronic administration of corticosteroids were observed during the entire trial.
Conclusions:
These promising preliminary results call for a large-scale controlled study on protracted treatment of patients with AT with dexamethasone-loaded erythrocytes.
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