Long-Term Improvement of Neurological Signs and Metabolic Dysfunction in a Mouse Model of Krabbe's Disease after Global Gene Therapy

Mol Ther. 2018 Mar 7;26(3):874-889. doi: 10.1016/j.ymthe.2018.01.009. Epub 2018 Jan 17.


We report a global adeno-associated virus (AAV)9-based gene therapy protocol to deliver therapeutic galactosylceramidase (GALC), a lysosomal enzyme that is deficient in Krabbe's disease. When globally administered via intrathecal, intracranial, and intravenous injections to newborn mice affected with GALC deficiency (twitcher mice), this approach largely surpassed prior published benchmarks of survival and metabolic correction, showing long-term protection of demyelination, neuroinflammation, and motor function. Bone marrow transplantation, performed in this protocol without immunosuppressive preconditioning, added minimal benefits to the AAV9 gene therapy. Contrasting with other proposed pre-clinical therapies, these results demonstrate that achieving nearly complete correction of GALC's metabolic deficiencies across the entire nervous system via gene therapy can have a significant improvement to behavioral deficits, pathophysiological changes, and survival. These results are an important consideration for determining the safest and most effective manner for adapting gene therapy to treat this leukodystrophy in the clinic.

Keywords: AAV; Krabbe’s disease; demyelination; galactosylceramidase; gene therapy; leukodystrophy; microglia; myelin; oligodendrocytes; psychosine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autonomic Pathways / metabolism
  • Autonomic Pathways / pathology
  • Autonomic Pathways / ultrastructure
  • Axons / metabolism
  • Axons / pathology
  • Axons / ultrastructure
  • Behavior, Animal
  • Brain / metabolism
  • Carbohydrate Metabolism*
  • Dependovirus / genetics
  • Disease Models, Animal
  • Female
  • Galactosylceramidase / genetics*
  • Galactosylceramidase / metabolism*
  • Gene Expression
  • Genetic Therapy*
  • Genetic Vectors / administration & dosage
  • Genetic Vectors / genetics
  • Genetic Vectors / pharmacokinetics
  • Leukodystrophy, Globoid Cell / diagnosis
  • Leukodystrophy, Globoid Cell / genetics*
  • Leukodystrophy, Globoid Cell / metabolism*
  • Leukodystrophy, Globoid Cell / therapy
  • Male
  • Mice
  • Myelin Sheath / metabolism
  • Myelin Sheath / pathology
  • Myelin Sheath / ultrastructure
  • Phenotype*
  • Tissue Distribution
  • Transduction, Genetic
  • Treatment Outcome


  • Galactosylceramidase