4.6 Review

POLR3-Related Leukodystrophy: Exploring Potential Therapeutic Approaches

Journal

FRONTIERS IN CELLULAR NEUROSCIENCE
Volume 14, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fncel.2020.631802

Keywords

POLR3-related leukodystrophy; 4H leukodystrophy; hypomyelination; gene therapy; gene editing; cell therapy

Categories

Funding

  1. Canadian Institutes of Health Research [426534, 201610PJT-377869]
  2. Fondation Les Amis d'Elliot
  3. Fondation le Tout pour Loo
  4. Fonds de Recherche du Quebec en Sante (FRQS)
  5. Fondation du Grand defi Pierre Lavoie
  6. McGill Faculty of Medicine F.S.B. Miller Fellowship
  7. Research Institute of the McGill University Health Centre Desjardins Studentship in Child Health Research
  8. Vanier Canada Graduate Scholarship
  9. McGill University Faculty of Medicine MD/Ph.D. Program
  10. Canadian Institutes of Health Research (CIHR)

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Leukodystrophies are rare inherited CNS disorders that affect brain white matter, with hypomyelinating leukodystrophies characterized by abnormal myelin sheath formation. POLR3-related leukodystrophy is a common type within this category with no current cure. Therapeutic approaches discussed include stem cell transplantation, gene replacement therapy, and gene editing for potential treatment of POLR3-related leukodystrophy.
Leukodystrophies are a class of rare inherited central nervous system (CNS) disorders that affect the white matter of the brain, typically leading to progressive neurodegeneration and early death. Hypomyelinating leukodystrophies are characterized by the abnormal formation of the myelin sheath during development. POLR3-related or 4H (hypomyelination, hypodontia, and hypogonadotropic hypogonadism) leukodystrophy is one of the most common types of hypomyelinating leukodystrophy for which no curative treatment or disease-modifying therapy is available. This review aims to describe potential therapies that could be further studied for effectiveness in pre-clinical studies, for an eventual translation to the clinic to treat the neurological manifestations associated with POLR3-related leukodystrophy. Here, we discuss the therapeutic approaches that have shown promise in other leukodystrophies, as well as other genetic diseases, and consider their use in treating POLR3-related leukodystrophy. More specifically, we explore the approaches of using stem cell transplantation, gene replacement therapy, and gene editing as potential treatment options, and discuss their possible benefits and limitations as future therapeutic directions.

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