Enhanced secretion and uptake of beta-glucuronidase improves adeno-associated viral-mediated gene therapy of mucopolysaccharidosis type VII mice.

Previous treatment of mucopolysaccharidosis type VII mice (Sly syndrome) with AAV vectors has resulted in increased levels of beta-glucuronidase (GUS) enzyme in some tissues with reduction of glycosaminoglycan storage granules and improved health. By adding coding sequences for secretion (Igkappa) and uptake (HIV-1 TAT) signals to the GUS gene delivered by AAV, and treating mice both intrathecally and intravenously as newborns, we have increased the GUS enzyme levels in more tissues and have improved the health of the mice so much that they are able to breed. The levels of GUS in the serum were above normal in some mice, which caused reduction of storage in the spleen, a nontransduced tissue. The heart and aorta showed therapeutic levels of GUS enzyme. AAV GUS DNA was found in brain and liver, which showed no storage. Phenotypically the treated mice were more active and showed less stunted skeletal growth. The pups born to these mice were not affected by the gene therapy, as shown by mutant levels of GUS enzyme in their tissues and the absence of AAV GUS DNA. However, they were resistant to intravenous treatment with AAV GUS due to the mother's antibodies, but not to intrathecal treatment.