4.7 Review

Future Prospects of Gene Therapy for Friedreich's Ataxia

Journal

Publisher

MDPI
DOI: 10.3390/ijms22041815

Keywords

gene therapy; neurodegeneration; Friedreich’ s Ataxia; AAV; mouse models; preclinical studies; clinical trials

Funding

  1. Comunidad Autonoma de Madrid (NEUROMETAB-CM) [B2017/BMD-3700]
  2. Spanish Ministerio de Ciencia e Innovacion (MICINN) [PID2019-111338RB-I00]
  3. Agencia Estatal de Investigacion and Fondo Europeo de Desarrollo Regional (AEI/FEDER, EU)
  4. Fundacion Ramon Areces
  5. la Caixa Foundation [100010434, LCF/BQ/EU20/11810053]
  6. Contratos de atraccion de talento de la Comunidad de Madrid modalidad 2 [2017-T2/BMD-5323]

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Friedreich's ataxia is a genetic disease with no effective treatment currently available. Gene therapy appears to be a promising approach, although challenges such as immunotoxicity and phenotoxicity need to be addressed. Further research is needed to overcome these obstacles and evaluate the potential of gene therapy in treating the disease.
Friedreich's ataxia is an autosomal recessive neurogenetic disease that is mainly associated with atrophy of the spinal cord and progressive neurodegeneration in the cerebellum. The disease is caused by a GAA-expansion in the first intron of the frataxin gene leading to a decreased level of frataxin protein, which results in mitochondrial dysfunction. Currently, there is no effective treatment to delay neurodegeneration in Friedreich's ataxia. A plausible therapeutic approach is gene therapy. Indeed, Friedreich's ataxia mouse models have been treated with viral vectors en-coding for either FXN or neurotrophins, such as brain-derived neurotrophic factor showing promising results. Thus, gene therapy is increasingly consolidating as one of the most promising therapies. However, several hurdles have to be overcome, including immunotoxicity and pheno-toxicity. We review the state of the art of gene therapy in Friedreich's ataxia, addressing the main challenges and the most feasible solutions for them.

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