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Emerging Gene and Small Molecule Therapies for the Neurodevelopmental Disorder Angelman Syndrome

Journal

NEUROTHERAPEUTICS
Volume 18, Issue 3, Pages 1535-1547

Publisher

SPRINGER
DOI: 10.1007/s13311-021-01082-x

Keywords

Angelman syndrome; Seizures; Gene therapy; Animal models; Antisense oligonucleotides; Stem cells; Precision medicine; Delivery; Preclinical; Small molecules; Pharmacology; Treatment

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Angelman syndrome is a rare neurodevelopmental disorder characterized by severe developmental delay and intellectual disability. There is currently no cure, but advancements in small molecule drugs and gene therapies offer promise for treatment. Gene therapy could lead to precision medicine for Angelman syndrome and serve as a foundation for other single-gene neurodevelopmental disorders.
Angelman syndrome (AS) is a rare (similar to 1:15,000) neurodevelopmental disorder characterized by severe developmental delay and intellectual disability, impaired communication skills, and a high prevalence of seizures, sleep disturbances, ataxia, motor deficits, and microcephaly. AS is caused by loss-of-function of the maternally inherited UBE3A gene. UBE3A is located on chromosome 15q11-13 and is biallelically expressed throughout the body but only maternally expressed in the brain due to an RNA antisense transcript that silences the paternal copy. There is currently no cure for AS, but advancements in small molecule drugs and gene therapies offer a promising approach for the treatment of the disorder. Here, we review AS and how loss-of-function of the maternal UBE3A contributes to the disorder. We also discuss the strengths and limitations of current animal models of AS. Furthermore, we examine potential small molecule drug and gene therapies for the treatment of AS and associated challenges faced by the therapeutic design. Finally, gene therapy offers the opportunity for precision medicine in AS and advancements in the treatment of this disorder can serve as a foundation for other single-gene neurodevelopmental disorders.

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