03Jan 2023
OPA1 trans‐splicing: A gene therapy approach to treat OPA1‐related optic neuropathies

OPA1 trans‐splicing: A gene therapy approach to treat OPA1‐related optic neuropathies

Dominant Optic Atrophy is a blinding disease-related in 70% of cases to OPA1 variants. In addition, OPA1 variants lead to haplo‐insufficiency or dominant adverse effects, leading in 20% of cases to a syndromic presentation, with neurosensorial hearing loss as the most prevalent secondary symptom. Bi‐allelic OPA1 variants also lead to Behr syndrome, a severe polyneuropathy involving CNS and PNS symptoms. To generate a versatile ocular gene therapy for OPA1 patients, we designed a trans‐splicing strategy as a molecular process allowing to correct of all OPA1 mRNA transcripts with variants located in and downstream of the GTPase domain while respecting the normal expression pattern of the 8 OPA1 isoforms, related to alternative splicing occurring before exon 6. Notably, this strategy can theoretically correct most haploinsufficient and dominant‐negative variants. Furthermore, it should not result in OPA1 over‐expression, whatever the level of the therapeutic vector expression, as the trans‐splicing process uses the endogenous OPA1 pre‐mRNAs to generate a mature RNA (mRNA) devoid of the pathogenic variant. The present article provides the latest results concerning the feasibility of this approach and its possible transfer to a clinical trial.

  • #ophthalmology

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