AAV9/hGLA gene therapy reduces podocyte GL-3 accumulation in a Fabry disease mouse model

Fabry disease is a hereditary disorder caused by a deficiency of α-galactosidase A, leading to the accumulation of globotriaosylceramide (GL-3) in multiple cell types throughout the body. Terminally differentiated non-dividing cells, such as podocytes, are particularly susceptible to such accumulation and therefore require effective therapeutic intervention. Gene therapy is an ideal therapeutic intervention for replacing the deficient enzyme; however, one of the major challenges is maintaining long-term expression of episomal transgenes during cell division. In this regard, podocytes, as non-dividing cells, represent an ideal target for gene therapy in Fabry disease. Nevertheless, it has not been confirmed yet whether gene therapy vectors can transduce podocytes and reduce GL-3 accumulation especially in podocytes.

Male Fabry disease model mice (TgG3S/GLA knockout mice) received an intravenous injection of 2 × 10¹² vector genomes of AAV9 encoding human GLA at 6 weeks of age. Kidney tissues were analyzed 8 weeks after administration by electron microscopy (EM) and immunogold EM.

In AAV9/hGLA-treated mice, GL-3 accumulation was markedly reduced in most podocytes, endothelial cells, and tubular epithelial cells, whereas it was evident in untreated mice. Virus-like particles were detected only in treated mice. Furthermore, immunogold EM confirmed the presence of AAV9 particles in the podocytes of treated mice.

AAV9/hGLA gene therapy may reduce podocyte GL-3 accumulation in a Fabry disease mouse model, potentially through AAV9 transduction of podocytes; however, given the technical limitations of our approach, the precise cellular mechanisms remain to be determined.