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  • Proof-of-concept for multip...
    Suárez-Herrera, Nuria; Riswick, Iris B.; Vázquez-Domínguez, Irene; Duijkers, Lonneke; Karjosukarso, Dyah W.; Piccolo, Davide; Bauwens, Miriam; De Baere, Elfride; Cheetham, Michael E.; Garanto, Alejandro; Collin, Rob W.J.

    Molecular therapy, 03/2024, Letnik: 32, Številka: 3
    Journal Article

    The high allelic heterogeneity in Stargardt disease (STGD1) complicates the design of intervention strategies. A significant proportion of pathogenic intronic ABCA4 variants alters the pre-mRNA splicing process. Antisense oligonucleotides (AONs) are an attractive yet mutation-specific therapeutic strategy to restore these splicing defects. In this study, we experimentally assessed the potential of a splicing modulation therapy to target multiple intronic ABCA4 variants. AONs were inserted into U7snRNA gene cassettes and tested in midigene-based splice assays. Five potent antisense sequences were selected to generate a multiple U7snRNA cassette construct, and this combination vector showed substantial rescue of all of the splicing defects. Therefore, the combination cassette was used for viral synthesis and assessment in patient-derived photoreceptor precursor cells (PPCs). Simultaneous delivery of several modified U7snRNAs through a single AAV, however, did not show substantial splicing correction, probably due to suboptimal transduction efficiency in PPCs and/or a heterogeneous viral population containing incomplete AAV genomes. Overall, these data demonstrate the potential of the U7snRNA system to rescue multiple splicing defects, but also suggest that AAV-associated challenges are still a limiting step, underscoring the need for further optimization before implementing this strategy as a potential treatment for STGD1. Display omitted Suárez-Herrera and colleagues present a novel approach to address the high allelic heterogeneity in ABCA4, which significantly complicates the therapy design for Stargardt disease, a macular dystrophy with no available treatment. This approach showed potential to rescue several splicing defects in ABCA4 with a single therapeutic vector.