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ASM-AAV Gene Therapy as a Treatment for Limb Girdle Muscular Dystrophy 2B

LGMD2B is a progressive late adolescent onset disease with development of functional limitations in running and climbing stairs within 3 years of diagnosis, and requirement of wheel-chair assistance for mobility within 20 years, on average. These rates of disease progression are hastened by increased physical activity and exercise. The relationship between physical activity, muscle degeneration, and functional mobility deficits in LGMD2B, is thought to derive, in-part, from poor membrane repair and inadequate dysferlin-mediated ASM secretion in response to frequent myofiber membrane injury with activity and exercise. This deficit identifies extracellular ASM supplementation as a potential treatment to improve myofiber repair for LGMD2B and preserve functional mobility. ASM enzyme replacement therapy offers an alternative, but there are currently no approved drugs to address this or other disease etiology of dysferlinopathy. However, liver gene transfer with AAV vectors has successfully treated hemophilia B in humans, by inducing liver expression and secretion of therapeutic concentrations of circulating FIX protein. A similar treatment approach may be leveraged to bypass deficient injury triggered ASM secretion in LGMD2B, by providing myofibers with an increased pool of extracellular ASM for repair, derived from the transduced liver. Optimizing the pre-clinical efficacy and safety of a liver-targeted ASM-AAV treatment in LGMD2B is required for integration into the clinic.
https://doi.org/10.55762/pc.gr.157028
Grantee: Daniel Bittel, Ph.D., D.P.T.
Grant type: Development Grant
Award total: $209,811
Institution: Children's Research Institute (CNMC)
Country: DC, United States