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Engineered tRNAs efficiently suppress CDKL5 premature termination codons
Stefano Pezzini1, Aurora Mustaccia2, Pierre Aboa1
1Department of Medical Biotechnology and Translational Medicine, University of Milan, Segrate (Milan), 20054, Italy.
Abstract:
The CDKL5 deficiency disorder (CDD) is a severe neurodevelopmental disorder characterized by early-onset epilepsy, intellectual disability, motor and visual dysfunctions. The causative gene is CDKL5, which codes for a kinase required for brain development. There is no cure for CDD patients; treatments are symptomatic and focus mainly on seizure control. Several pathogenic variants are loss-of-function, but recent studies suggest that the CDD phenotype is sensitive to the CDKL5 gene dosage. Therefore, mRNA-targeted correction strategies that respect the physiological regulation of CDKL5 could be a valid alternative to augmentative gene therapy. Nonsense mutations cause ~ 11% of CDD cases, and these patients might benefit from readthrough therapies. We proved that drug-mediated readthrough efficiently suppresses premature CDKL5 nonsense codons, but the recoded kinase remained highly hypomorphic, curtailing the translational value of this pharmacological approach. In this study we explored if the recently developed Anticodon-edited tRNAs (ACE-tRNAs) offer an alternative readthrough strategy for CDD. Transfecting cells expressing different CDKL5 nonsense variants, we demonstrated that ACE-tRNAs efficiently restore full-length kinase synthesis. The recoded CDKL5 is correctly localized and catalytically active, thereby bringing tRNA-based therapy back into the spotlight for future investigations to assess the efficacy of this approach in correcting the pathological phenotype of CDD.
Insights
Anticodon-edited tRNAs (ACE-tRNAs) offer a promising new strategy for CDKL5 deficiency disorder (CDD). This approach effectively restores full-length CDKL5 kinase synthesis in cells with nonsense mutations, unlike previous drug-mediated therapies.
Area of Science:
- Genetics
- Molecular Biology
- Neuroscience
Background:
- CDKL5 deficiency disorder (CDD) is a severe neurodevelopmental disorder with no cure, primarily managed through seizure control.
- Pathogenic variants in the CDKL5 gene, crucial for brain development, cause CDD.
- Nonsense mutations account for a significant portion of CDD cases, presenting an opportunity for readthrough therapies.
Purpose of the Study:
- To investigate Anticodon-edited tRNAs (ACE-tRNAs) as a novel readthrough strategy for CDKL5 deficiency disorder (CDD).
- To evaluate the efficacy of ACE-tRNAs in restoring functional CDKL5 protein synthesis from nonsense variants.
- To compare ACE-tRNA therapy with previous drug-mediated readthrough approaches.
Main Methods:
- Utilized cell transfection models expressing various CDKL5 nonsense variants.
- Employed ACE-tRNAs designed to target and correct premature nonsense codons in CDKL5 mRNA.
- Assessed the synthesis, localization, and catalytic activity of the recoded CDKL5 kinase.
Main Results:
- ACE-tRNAs efficiently restored the synthesis of full-length CDKL5 kinase in cells with nonsense mutations.
- The recoded CDKL5 protein exhibited correct cellular localization and retained catalytic activity.
- Drug-mediated readthrough, while suppressing nonsense codons, resulted in a hypomorphic kinase, limiting its therapeutic value.
Conclusions:
- ACE-tRNAs represent a viable alternative readthrough strategy for CDD caused by nonsense mutations.
- This tRNA-based approach successfully restores functional CDKL5 protein, unlike previous pharmacological methods.
- Further investigation is warranted to assess the therapeutic potential of ACE-tRNAs for correcting the CDD phenotype.
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