Intraventricular Enzyme Replacement Improves Disease Phenotypes in a Mouse Model of Late Infantile Neuronal Ceroid Lipofuscinosis

Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, Iowa 52242, USA.
Molecular Therapy (Impact Factor: 6.23). 05/2008; 16(4):649-56. DOI: 10.1038/mt.2008.9
Source: PubMed


Late infantile neuronal ceroid lipofuscinosis (LINCL) is an autosomal recessive neurodegenerative disease caused by mutations in CLN2, which encodes the lysosomal protease tripeptidyl peptidase 1 (TPP1). LINCL is characterized clinically by progressive motor and cognitive decline, and premature death. Enzyme-replacement therapy (ERT) is currently available for lysosomal storage diseases affecting peripheral tissues, but has not been used in patients with central nervous system (CNS) involvement. Enzyme delivery through the cerebrospinal fluid is a potential alternative route to the CNS, but has not been studied for LINCL. In this study, we identified relevant neuropathological and behavioral hallmarks of disease in a mouse model of LINCL and correlated those findings with tissues from LINCL patients. Subsequently, we tested if intraventricular delivery of TPP1 to the LINCL mouse was efficacious. We found that infusion of recombinant human TPP1 through an intraventricular cannula led to enzyme distribution in several regions of the brain of treated mice. In vitro activity assays confirm increased TPP1 activity throughout the rostral-caudal extent of the brain. Importantly, treated mice showed attenuated neuropathology, and decreased resting tremor relative to vehicle-treated mice. This data demonstrates that intraventricular enzyme delivery to the CNS is feasible and may be of therapeutic value.

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Available from: Seng H. Cheng
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    • "Therefore, CLN2 disease is amenable to TPP1 enzyme replacement therapy (ERT). Because large molecules such as TPP1 cannot cross the bloodebrain barrier, delivery of the enzyme to the brain has been achieved through administration of TPP1 pro-enzyme by infusion into the cerebrospinal fluid (CSF) in mouse and dog (Chang et al., 2008; Vuillemenot et al., 2011). In the Dachshund CLN2 disease model, we have previously shown that this route of TPP1 administration results in widespread distribution of the active enzyme in many structures of the brain and in reduction in the accumulation of neuronal lysosomal storage material that is characteristic of this disease (Vuillemenot et al., 2011). "
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    ABSTRACT: Late-infantile neuronal ceroid lipofuscinosis (CLN2 disease) is a hereditary neurological disorder characterized by progressive retinal degeneration and vision loss, cognitive and motor decline, seizures, and pronounced brain atrophy. This fatal pediatric disease is caused by mutations in the CLN2 gene which encodes the lysosomal enzyme tripeptidyl peptidase-1 (TPP1). Utilizing a TAP1-/- Dachshund model of CLN2 disease, studies were conducted to assess the effects of TPP1 enzyme replacement administered directly to the CNS on disease progression. Recombinant human TPP1 (rhTPP1) or artificial cerebrospinal fluid vehicle was administered to CLN2-affected dogs via infusion into the CSF. Untreated and vehicle treated affected dogs exhibited progressive declines in pupillary light reflexes (PLRs) and electroretinographic (ERG) responses to light stimuli. Studies were undertaken to determine whether CSF administration of rhTPP1 alters progression of the PLR and ERG deficits in the canine model. rhTPP1 administration did not inhibit the decline in ERG responses, as rhTPP1 treated, vehicle treated, and untreated dogs all exhibited similar progressive and profound declines in ERG amplitudes. However, in some of the dogs treated with rhTPP1 there were substantial delays in the appearance and progression of PLR deficits compared with untreated or vehicle treated affected dogs. These findings indicate that CSF administration of TPP1 can attenuate functional impairment of neural pathways involved in mediating the PLR but does not prevent loss of retinal responses detectable with ERG. (C) 2014 The Authors. Published by Elsevier Ltd.
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    • "Recently, ERT have also been developed for the treatment of Late Infantile Neuronal Ceroid Lipofuscinosis (NCL) [52] [53]. "
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    • "Studies in mouse and dog models of mucopolysaccharidosis IIIA also revealed that the strategy was effective in ameliorating neuropathology and improving clinical signs in affected animals.23,24 Other studies in mice with the LSDs Krabbe disease and late infantile neuronal ceroid lipofuscinosis demonstrated that delivery of recombinant lysosomal enzymes into the CSF was efficacious in reducing disease pathology and neurological signs and symptoms.25,26 Thus, the principle that provision of enzyme into the CSF is beneficial for LSDs is gaining considerable traction. "
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