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Investigation of Gene and Cellular Therapies to Cure Maple Syrup Urine Disease (MSUD) in a Genetically Engineered Mouse Model

MSUD is a serious liver-based metabolic disorder caused by a deficiency in the branched-chain alpha-ketoacid dehydrogenase (BCKDH) complex. Resulting branched-chain amino acid (BCAA) accretion in the body mainly affects the brain, which in most cases results in permanent neurological dysfunction or death without life-long attentive care. Recently it was shown liver transplantation alone restored BCKDH to a level sufficient to correct MSUD. To test novel therapies, a mouse model of intermediate MSUD (iMSUD) was created (Homanics et al., 2006), which mimicked human iMSUD. Therefore, this dissertation focused on the investigation of liver-directed therapeutic approaches to correct MSUD.
In the first aim, iMSUD mice were further characterized and determined to closely mirror the human disease phenotype. iMSUD mice suffered from developmental delay, seizures, and altered brain amino acid and neurotransmitter concentration. iMSUD brains also displayed histological abnormalities while liver morphology was normal.
In the second aim, adeno-associated viral (AAV) vectors were used to deliver E2 to the liver. However, no significant improvement was determined in AAV-treated iMSUD mice compared to controls. The most likely reasons this study was unsuccessful were low treatment dose, a weak albumin promoter, and possible competition and interaction between AAV-derived and iMSUD transgene-derived E2.
The third aim focused on hepatocyte transplantation (HTx). iMSUD-HTx mice had a 75% reduction in BCAA/alanine levels compared to iMSUD controls. BCKDH activity was increased, and Real Time qPCR detected donor-derived E2 in the liver. Dopamine and serotonin, along with several related metabolites, were corrected to control levels. Body weight at weaning and survival were also significantly improved in iMSUD-HTx mice.
The fourth aim focused on differentiated embryonic stem cell (ESC) transplantation. Differentiated ESCs expressed liver-specific markers after 3 days in culture and BCKDH activity was significantly increased over undifferentiated ESC populations. Liver-like ESC engraftment was verified up to 1 month following transplantation into wildtype mouse liver.
In summary, iMSUD mice were determined to be a superior model to test novel liver-directed therapies. Our findings of partial metabolic correction of iMSUD in a mouse model by HTx were very encouraging. Therefore, liver-directed therapeutic intervention for human MSUD should be investigated further.

Identiferoai:union.ndltd.org:PITT/oai:PITTETD:etd-08112008-154554
Date27 August 2008
CreatorsSkvorak, Kristen J.
ContributorsPaula Clemens, Gerard Vockley, Gregg Homanics, Johnny Huard, Steven Strom, Harbhajan Paul
PublisherUniversity of Pittsburgh
Source SetsUniversity of Pittsburgh
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://etd.library.pitt.edu/ETD/available/etd-08112008-154554/
Rightsunrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report.

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