54. Prevention of Sensory Ataxia in a Novel Mouse Model of Friedreich Ataxia Using Gene Therapy Approach

Friedreichu0027s ataxia (FRDA), the most common autosomal recessive ataxia, is characterized by a sensory and spinocerebellar ataxia, hypertrophic cardiomyopathy and increase incidence of diabetes. FRDA is caused by reduced levels of frataxin (FXN), an essential mitochondrial protein involved in the biosynthesis of iron-sulfur (Fe-S) clusters. Impaired mitochondrial oxidative phosphorylation, bioenergetics imbalance, deficit of Fe-S cluster enzymes and mitochondrial iron overload occur in individuals with FRDA. Proprioceptive neurons within the dorsal root ganglia (DRG) and cardiomyocytes are the most affected tissues in FRDA patients. To date there are not effective treatment for FRDA. We have previously established the primary proof-of-concept for developing gene therapy of FRDA cardiomyopathy and showed that adeno-associated virus (AAV) rh. 10 vector expressing human FXN injected intravenously not only prevented the onset of the cardiac disease in a faithful FRDA cardiac mouse model, but also, when administered at the time of heart failure, rapidly and completely reversed the cardiac disease. To date, there were unfortunately no adequate neuronal mouse model to address the possibility of gene therapy for the neuronal aspects of FRDA. We therefore recently generated a novel mouse model that recapitulates faithfully the sensory ataxia associated to FRDA using the conditional approach to delete frataxin specifically in the proprioceptive neurons of the DRG. By behavioural analysis, the mice exhibit an ataxic phenotype beginning at 3 weeks of age, which is rapidly progressive. Electrophysiological studies reveal a significant decrease of sensory wave already at 4.5 weeks and almost a complete loss at 8 weeks of age. A significant loss of sensory neurons within dorsal root ganglia is observed at 17.5 weeks of age compare to age matched controls. Ultrastructural analysis of sciatic and saphenous nerves showed abnormalities at early time points. Using this mouse model, we have developed an AAV gene therapy approach based on an intravenous delivery of AAV9-CAG-hFXN-HA vector at an early symptomatic stage of the disease. Mice displayed a complete prevention of the ataxic phenotype and electrophysiological analysis showed maintenance of the sensory wave in the treated animals. Histological studies revealed a complete prevention of neuronal loss in the DRG as well as a normal ultrastructure of saphenous and sciatic nerve. As results are encouraging, we plan to evaluate the potential therapeutical effect at a more advanced stage of the disease.