Gene Therapy for Mucopolysaccharidosis Type II-A Review of the Current Possibilities

Int J Mol Sci. 2021 May 23;22(11):5490. doi: 10.3390/ijms22115490.

Abstract

Mucopolysaccharidosis type II (MPS II) is a lysosomal storage disorder based on a mutation in the IDS gene that encodes iduronate 2-sulphatase. As a result, there is an accumulation of glycosaminoglycans-heparan sulphate and dermatan sulphate-in almost all body tissues, which leads to their dysfunction. Currently, the primary treatment is enzyme replacement therapy, which improves the course of the disease by reducing somatic symptoms, including hepatomegaly and splenomegaly. The enzyme, however, does not cross the blood-brain barrier, and no improvement in the function of the central nervous system has been observed in patients with the severe form of the disease. An alternative method of treatment that solves typical problems of enzyme replacement therapy is gene therapy, i.e., delivery of the correct gene to target cells through an appropriate vector. Much progress has been made in applying gene therapy for MPS II, from cellular models to human clinical trials. In this article, we briefly present the history and basics of gene therapy and discuss the current state of knowledge about the methods of this therapy in mucopolysaccharidosis type II.

Keywords: Hunter syndrome; adeno-associated viruses; gene editing; genetic therapy; mucopolysaccharidosis II; review.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Animals
  • Blood-Brain Barrier
  • CRISPR-Cas Systems
  • Child
  • Child, Preschool
  • Clinical Trials as Topic
  • Dependovirus / genetics
  • Disease Models, Animal
  • Drug Carriers
  • Electroporation
  • Enzyme Replacement Therapy / methods
  • Gene Editing
  • Genetic Therapy
  • Genetic Vectors / adverse effects
  • Genetic Vectors / therapeutic use
  • Glycoproteins / genetics*
  • Glycoproteins / pharmacokinetics
  • Glycoproteins / therapeutic use
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunoconjugates / administration & dosage
  • Immunoconjugates / therapeutic use
  • Infant
  • Injections, Intraventricular
  • Injections, Spinal
  • Lentivirus / genetics
  • Mice
  • Mucopolysaccharidosis II / genetics
  • Mucopolysaccharidosis II / therapy*
  • Multicenter Studies as Topic
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / therapeutic use
  • Retroviridae / genetics
  • Transcription Activator-Like Effector Nucleases

Substances

  • Drug Carriers
  • Glycoproteins
  • IDS protein, human
  • Immunoconjugates
  • Recombinant Proteins
  • Transcription Activator-Like Effector Nucleases