Dopamine gene therapy for Parkinson's disease in a nonhuman primate without associated dyskinesia

B Jarraya, S Boulet, G Scott Ralph, C Jan… - Science translational …, 2009 - science.org
B Jarraya, S Boulet, G Scott Ralph, C Jan, G Bonvento, M Azzouz, JE Miskin, M Shin…
Science translational medicine, 2009science.org
In Parkinson's disease, degeneration of specific neurons in the midbrain can cause severe
motor deficits, including tremors and the inability to initiate movement. The standard
treatment is administration of pharmacological agents that transiently increase
concentrations of brain dopamine and thereby discontinuously modulate neuronal activity in
the striatum, the primary target of dopaminergic neurons. The resulting intermittent
dopamine alleviates parkinsonian symptoms but is also thought to cause abnormal …
In Parkinson’s disease, degeneration of specific neurons in the midbrain can cause severe motor deficits, including tremors and the inability to initiate movement. The standard treatment is administration of pharmacological agents that transiently increase concentrations of brain dopamine and thereby discontinuously modulate neuronal activity in the striatum, the primary target of dopaminergic neurons. The resulting intermittent dopamine alleviates parkinsonian symptoms but is also thought to cause abnormal involuntary movements, called dyskinesias. To investigate gene therapy for Parkinson’s disease, we simulated the disease in macaque monkeys by treating them with the complex I mitochondrial inhibitor 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, which induces selective degeneration of dopamine-producing neurons. In this model, we demonstrated that injection of a tricistronic lentiviral vector encoding the critical genes for dopamine synthesis (tyrosine hydroxylase, aromatic l-amino acid decarboxylase, and guanosine 5′-triphosphate cyclohydrolase 1) into the striatum safely restored extracellular concentrations of dopamine and corrected the motor deficits for 12 months without associated dyskinesias. Gene therapy–mediated dopamine replacement may be able to correct Parkinsonism in patients without the complications of dyskinesias.
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