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Cell and Gene Therapies for Mucopolysaccharidoses: Base Editing and Therapeutic Delivery to the CNS
Chloe L Christensen1, Rhea E Ashmead1, Francis Y M Choy2
1Department of Biology, Centre for Biomedical Research, University of Victoria, 3800 Finnerty Rd., Victoria, BC V8P 5C2, Canada.
Abstract:
Although individually uncommon, rare diseases collectively account for a considerable proportion of disease impact worldwide. A group of rare genetic diseases called the mucopolysaccharidoses (MPSs) are characterized by accumulation of partially degraded glycosaminoglycans cellularly. MPS results in varied systemic symptoms and in some forms of the disease, neurodegeneration. Lack of treatment options for MPS with neurological involvement necessitates new avenues of therapeutic investigation. Cell and gene therapies provide putative alternatives and when coupled with genome editing technologies may provide long term or curative treatment. Clustered regularly interspaced short palindromic repeats (CRISPR)-based genome editing technology and, more recently, advances in genome editing research, have allowed for the addition of base editors to the repertoire of CRISPR-based editing tools. The latest versions of base editors are highly efficient on-targeting deoxyribonucleic acid (DNA) editors. Here, we describe a number of putative guide ribonucleic acid (RNA) designs for precision correction of known causative mutations for 10 of the MPSs. In this review, we discuss advances in base editing technologies and current techniques for delivery of cell and gene therapies to the site of global degeneration in patients with severe neurological forms of MPS, the central nervous system, including ultrasound-mediated blood-brain barrier disruption.
Insights
Rare mucopolysaccharidoses (MPSs) cause neurodegeneration. This review explores base editing and gene therapy for precise DNA correction and central nervous system delivery, offering potential long-term treatments for these rare genetic diseases.
Area of Science:
- Biochemistry
- Genetics
- Neurology
Background:
- Rare diseases, including mucopolysaccharidoses (MPSs), collectively have a significant global health impact.
- MPSs are genetic disorders characterized by cellular glycosaminoglycan accumulation, leading to diverse systemic symptoms, including neurodegeneration in some forms.
- Current treatment options for MPS with neurological involvement are limited, highlighting the need for novel therapeutic strategies.
Purpose of the Study:
- To review advances in base editing technologies for precise genetic correction of MPS-causing mutations.
- To discuss cell and gene therapy delivery methods targeting the central nervous system for severe neurological MPS.
- To explore potential long-term or curative treatments for rare genetic MPS disorders.
Main Methods:
- Review of clustered regularly interspaced short palindromic repeats (CRISPR)-based genome editing technologies, focusing on base editors.
- Analysis of putative guide ribonucleic acid (RNA) designs for correcting known causative mutations in 10 MPS types.
- Examination of current cell and gene therapy delivery techniques, including ultrasound-mediated blood-brain barrier disruption.
Main Results:
- Base editors represent a highly efficient, on-target deoxyribonucleic acid (DNA) editing tool.
- Specific guide RNA designs show potential for precision correction of MPS-related mutations.
- Ultrasound-mediated blood-brain barrier disruption is a promising method for CNS-targeted therapy delivery.
Conclusions:
- Base editing and gene therapy offer promising avenues for treating rare genetic MPS diseases with neurological impact.
- Precision correction of causative mutations via advanced genome editing is feasible.
- Effective delivery of therapies to the central nervous system is critical for managing severe neurological MPS forms.
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