Journal
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
Volume 113, Issue 34, Pages 9593-9598Publisher
NATL ACAD SCIENCES
DOI: 10.1073/pnas.1609291113
Keywords
alpha-synuclein; multiple system atrophy; caspase-1; truncation
Categories
Funding
- French Research Agency [ANR-14-RARE-0001-01]
- ERA-Net for Research on Rare Diseases
- NIH [1R21NS07988, 5R01GM111639]
- [LABEX BRAIN ANR-10-LABX-43]
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Multiple system atrophy (MSA) is a sporadic orphan neurodegenerative disorder. No treatment is currently available to slow down the aggressive neurodegenerative process, and patients die within a few years after disease onset. The cytopathological hallmark of MSA is the accumulation of alpha-synuclein (alpha-syn) aggregates in affected oligodendrocytes. Several studies point to alpha-syn oligomerization and aggregation as a mediator of neurotoxicity in synucleinopathies including MSA. C-terminal truncation by the inflammatory protease caspase-1 has recently been implicated in the mechanisms that promote aggregation of alpha-syn in vitro and in neuronal cell models of alpha-syn toxicity. We present here an in vivo proof of concept of the ability of the caspase-1 inhibitor prodrug VX-765 to mitigate alpha-syn pathology and to mediate neuroprotection in proteolipid protein alpha-syn (PLP-SYN) mice, a transgenic mouse model of MSA. PLP-SYN and age-matched wild-type mice were treated for a period of 11 wk with VX-765 or placebo. VX-765 prevented motor deficits in PLP-SYN mice compared with placebo controls. More importantly, VX-765 was able to limit the progressive toxicity of a-syn aggregation by reducing its load in the striatum of PLP-SYN mice. Not only did VX-765 reduce truncated alpha-syn, but it also decreased its monomeric and oligomeric forms. Finally, VX-765 showed neuroprotective effects by preserving tyrosine hydroxylase-positive neurons in the substantia nigra of PLP-SYN mice. In conclusion, our results suggest that VX-765, a drug that was well tolerated in a 6 wk-long phase II trial in patients with epilepsy, is a promising candidate to achieve disease modification in synucleinopathies by limiting alpha-syn accumulation.
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