Patients and animal models of CNGβ1-deficient retinitis pigmentosa support gene augmentation approach

J Clin Invest. 2018 Jan 2;128(1):190-206. doi: 10.1172/JCI95161. Epub 2017 Nov 20.

Abstract

Retinitis pigmentosa (RP) is a major cause of blindness that affects 1.5 million people worldwide. Mutations in cyclic nucleotide-gated channel β 1 (CNGB1) cause approximately 4% of autosomal recessive RP. Gene augmentation therapy shows promise for treating inherited retinal degenerations; however, relevant animal models and biomarkers of progression in patients with RP are needed to assess therapeutic outcomes. Here, we evaluated RP patients with CNGB1 mutations for potential biomarkers of progression and compared human phenotypes with those of mouse and dog models of the disease. Additionally, we used gene augmentation therapy in a CNGβ1-deficient dog model to evaluate potential translation to patients. CNGB1-deficient RP patients and mouse and dog models had a similar phenotype characterized by early loss of rod function and slow rod photoreceptor loss with a secondary decline in cone function. Advanced imaging showed promise for evaluating RP progression in human patients, and gene augmentation using adeno-associated virus vectors robustly sustained the rescue of rod function and preserved retinal structure in the dog model. Together, our results reveal an early loss of rod function in CNGB1-deficient patients and a wide window for therapeutic intervention. Moreover, the identification of potential biomarkers of outcome measures, availability of relevant animal models, and robust functional rescue from gene augmentation therapy support future work to move CNGB1-RP therapies toward clinical trials.

Keywords: Gene therapy; Genetic diseases; Ophthalmology; Retinopathy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cyclic Nucleotide-Gated Cation Channels / deficiency*
  • Cyclic Nucleotide-Gated Cation Channels / metabolism
  • Dependovirus
  • Disease Models, Animal
  • Dogs
  • Female
  • Humans
  • Male
  • Mice
  • Mice, Transgenic
  • Mutation*
  • Nerve Tissue Proteins / deficiency*
  • Nerve Tissue Proteins / metabolism
  • Retinitis Pigmentosa / genetics*
  • Retinitis Pigmentosa / metabolism*
  • Retinitis Pigmentosa / pathology
  • Retinitis Pigmentosa / therapy
  • Transduction, Genetic

Substances

  • CNGB1 protein, human
  • Cngb1 protein, mouse
  • Cyclic Nucleotide-Gated Cation Channels
  • Nerve Tissue Proteins