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Record W4404375050 · doi:10.1016/j.medj.2024.10.021

Multi-year enzyme expression in patients with mucopolysaccharidosis type VI after liver-directed gene therapy

2024· article· en· W4404375050 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueMed · 2024
Typearticle
Languageen
FieldMedicine
TopicLysosomal Storage Disorders Research
Canadian institutionsMcGill University Health CentreLondon Health Sciences CentreWestern University
FundersSeventh Framework ProgrammeInnovation FundFondazione TelethonMinistero dell’Istruzione, dell’Università e della RicercaEuropean Commission
KeywordsGenetic enhancementEnzyme replacement therapyMucopolysaccharidosisEnzymeGeneLiver enzymeMedicineInternal medicineBiologyEndocrinologyGeneticsBiochemistryDisease

Abstract

fetched live from OpenAlex

Background Mucopolysaccharidosis type VI (MPS VI) is due to a deficiency of the lysosomal enzyme arylsulfatase B (ARSB) that results in multi-organ accumulation of glycosaminoglycans (GAGs). Limitations of current treatments prompted the development of a liver-directed gene therapy clinical trial for MPS VI. Methods We report the long-term follow-up of patients with MPS VI who discontinued enzyme replacement therapy (ERT) and received a single intravenous infusion of high-dose (6 × 10 12 genome copies/kg) recombinant adeno-associated virus serotype 8 (AAV8) vector expressing ARSB under the control of a liver-specific promoter ( ClinicalTrials.gov : NCT03173521 ). Primary outcomes were safety and urinary GAG excretion. Secondary outcomes were endurance and respiratory function. Findings Median follow-up time was 45 months ( n = 4, three females and one male; age range: 5–10 years). No late-emergent safety events were observed. Patients showed sustained serum ARSB activity (38%–67% of mean healthy reference values), a modest increase in urinary GAG concentrations, and no relevant changes in endurance, cardiac, or pulmonary function. In one of the four patients, ERT was restarted because of elevated urinary GAGs without decreased serum ARSB activity up to about 2.5 years after gene transfer. Liver and spleen size remained within the reference ranges. Conclusions A single intravenous administration of AAV8.TBG.hARSB was safe and resulted in sustained ARSB expression and a modest increase in urinary GAGs in most patients, thus supporting liver-directed gene therapy for MPS VI. Funding This study was sponsored by the Telethon Foundation ETS, the European Union, the Isaac Foundation, and the Italian Ministry of University and Research. • Long-term data of AAV-mediated liver-directed gene therapy in patients with MPS VI • Sustained ARSB expression and modest increase in urine glycosaminoglycans • Endurance, pulmonary and cardiac function showed no changes despite ERT interruption Mucopolysaccharidosis type VI (MPS VI) is a rare lysosomal storage disease due to arylsulfatase B (ARSB) deficiency that leads to a multisystem accumulation of glycosaminoglycans (GAGs). Current treatment based on weekly infusions of enzyme replacement therapy (ERT) is unsatisfactory. In this study, after the discontinuation of ERT, MPS VI individuals received a single intravenous infusion of an AAV vector that delivered the gene encoding ARSB to the liver. AAV vector administration was safe and resulted in sustained ARSB expression for at least 3 years post-injection. Although a modest increase in urine GAGs was detected, no significant changes in endurance, liver and spleen sizes, or pulmonary and cardiac functions were observed. These findings support the safety and efficacy of AAV-mediated liver-directed gene therapy for MPS VI. Rossi et al. presented longitudinal data on mucopolysaccharidosis type VI individuals who discontinued enzyme replacement therapy and received AAV-mediated liver-directed gene therapy. Sustained serum ARSB expression and a modest increase in urine glycosaminoglycans were observed. No significant changes were detected in endurance, or pulmonary and cardiac function.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.090
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.020
GPT teacher head0.280
Teacher spread0.259 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it