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AAV gene therapy for hereditary spastic paraplegia type 50: a phase 1 trial in a single patient.
Dowling, James J; Pirovolakis, Terry; Devakandan, Keshini; Stosic, Ana; Pidsadny, Mia; Nigro, Elisa; Sahin, Mustafa; Ebrahimi-Fakhari, Darius; Messahel, Souad; Varadarajan, Ganapathy; Greenberg, Benjamin M; Chen, Xin; Minassian, Berge A; Cohn, Ronald; Bonnemann, Carsten G; Gray, Steven J.
Afiliación
  • Dowling JJ; Precision Child Health, Hospital for Sick Children, Toronto, Ontario, Canada. james.dowling@sickkids.ca.
  • Pirovolakis T; Division of Neurology and Program for Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada. james.dowling@sickkids.ca.
  • Devakandan K; Departments of Paediatrics and Molecular Genetics, University of Toronto, Toronto, Ontario, Canada. james.dowling@sickkids.ca.
  • Stosic A; CureSPG50 Foundation, Toronto, Ontario, Canada.
  • Pidsadny M; Precision Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.
  • Nigro E; Precision Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.
  • Sahin M; Division of Neurology and Program for Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada.
  • Ebrahimi-Fakhari D; Precision Child Health, Hospital for Sick Children, Toronto, Ontario, Canada.
  • Messahel S; Division of Neurology and Program for Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada.
  • Varadarajan G; Department of Neurology, Boston Children's Hospital, Boston, MA, USA.
  • Greenberg BM; Department of Neurology, Boston Children's Hospital, Boston, MA, USA.
  • Chen X; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Minassian BA; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Cohn R; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Bonnemann CG; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Gray SJ; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Nat Med ; 30(7): 1882-1887, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38942994
ABSTRACT
There are more than 10,000 individual rare diseases and most are without therapy. Personalized genetic therapy represents one promising approach for their treatment. We present a road map for individualized treatment of an ultra-rare disease by establishing a gene replacement therapy developed for a single patient with hereditary spastic paraplegia type 50 (SPG50). Through a multicenter collaboration, an adeno-associated virus-based gene therapy product carrying the AP4M1 gene was created and successfully administered intrathecally to a 4-year-old patient within 3 years of diagnosis as part of a single-patient phase 1 trial. Primary endpoints were safety and tolerability, and secondary endpoints evaluated efficacy. At 12 months after dosing, the therapy was well tolerated. No serious adverse events were observed, with minor events, including transient neutropenia and Clostridioides difficile gastroenteritis, experienced but resolved. Preliminary efficacy measures suggest a stabilization of the disease course. Longer follow-up is needed to confirm the safety and provide additional insights on the efficacy of the therapy. Overall, this report supports the safety of gene therapy for SPG50 and provides insights into precision therapy development for rare diseases. Clinical trial registration NCT06069687 .
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Genética / Paraplejía Espástica Hereditaria / Dependovirus Límite: Child, preschool / Humans / Male Idioma: En Revista: Nat Med Asunto de la revista: BIOLOGIA MOLECULAR / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Genética / Paraplejía Espástica Hereditaria / Dependovirus Límite: Child, preschool / Humans / Male Idioma: En Revista: Nat Med Asunto de la revista: BIOLOGIA MOLECULAR / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos