Recent progress and considerations for AAV gene therapies targeting the central nervous system

J Neurodev Disord. 2018 May 18;10(1):16. doi: 10.1186/s11689-018-9234-0.

Abstract

Background: Neurodevelopmental disorders, as a class of diseases, have been particularly difficult to treat even when the underlying cause(s), such as genetic alterations, are understood. What treatments do exist are generally not curative and instead seek to improve quality of life for affected individuals. The advent of gene therapy via gene replacement offers the potential for transformative therapies to slow or even stop disease progression for current patients and perhaps minimize or prevent the appearance of symptoms in future patients.

Main body: This review focuses on adeno-associated virus (AAV) gene therapies for diseases of the central nervous system. An overview of advances in AAV vector design for therapy is provided, along with a description of current strategies to develop AAV vectors with tailored tropism. Next, progress towards treatment of neurodegenerative diseases is presented at both the pre-clinical and clinical stages, focusing on a few select diseases to highlight broad categories of therapeutic parameters. Special considerations for more challenging cases are then discussed in addition to the immunological aspects of gene therapy.

Conclusion: With the promising clinical trial results that have been observed for the latest AAV gene therapies and continued pre-clinical successes, the question is no longer whether a therapy can be developed for certain neurodevelopmental disorders, but rather, how quickly.

Keywords: AAV9; Adeno-associated virus; Cellular immunity; Central nervous system; Clinical trial; Gene therapy; Neutralizing antibody.

Publication types

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

MeSH terms

  • Animals
  • Dependovirus / genetics*
  • Genetic Therapy / methods*
  • Genetic Vectors / genetics*
  • Humans
  • Neurodevelopmental Disorders / genetics
  • Neurodevelopmental Disorders / therapy*
  • Translational Medical Research