運動ニューロン疾患に対する塩基編集治療の可能性を実証 ―患者さん由来神経筋オルガノイドとマウスで効果―

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2026-09-18 京都大学iPS細胞研究所

HMSN-Pの原因となるTFG遺伝子のP285L変異を、DNAを切断せず一塩基単位で修正するアデニン塩基編集治療を開発した。研究では、患者由来iPS細胞で最適なABE8eを選定し、AAVベクターに搭載してHMSN-Pモデルマウスへ投与。運動神経軸索の変性抑制、運動機能改善、生存期間延長が確認された。さらに患者由来神経筋オルガノイドでも、異常なTFGタンパク質凝集と神経細胞死が減少した。動物・ヒト細胞モデル双方で効果を示した概念実証であり、HMSN-Pだけでなく、一塩基変異を原因とする遺伝性神経疾患への応用可能性が示された。一方、臨床応用には安全性、投与法、長期効果などの検証が必要である。

運動ニューロン疾患に対する塩基編集治療の可能性を実証 ―患者さん由来神経筋オルガノイドとマウスで効果―
図1 塩基編集の模式図

<関連情報>

Base editing rescues a hereditary motor neuron disease in mouse and patient-derived iPSC organoid model

Keiko Imamura ∙ Shin Yoshioka ∙ Kota Kamizato ∙ … ∙ Keiji Nishida ∙ Yuishin Izumi ∙ Haruhisa Inoue
Molecular Therapy Advances  Published:August 21, 2026
DOI:https://doi.org/10.1016/j.omta.2026.201835

Abstract

In hereditary motor neuron diseases (MNDs), including forms of amyotrophic lateral sclerosis (ALS) caused by single-nucleotide variants, effective therapeutic strategies need to address both gain- and loss-of-function mechanisms. Genome editing-based gene therapy represents a promising approach for simultaneously targeting these mechanisms. To establish proof-of-concept for base editing in a hereditary MND, we targeted the P285L variant in the TRK-fused gene (TFG), which causes hereditary motor and sensory neuropathy with proximal dominant involvement (HMSN-P), a disorder that shares clinical and histopathological features with ALS. We identified the optimal adenine base editor by comparing candidate editors in HMSN-P patient-derived induced pluripotent stem cells (iPSCs). We then generated a transgenic mouse model expressing human TFG P285L and evaluated the selected editor by subpial delivery of adeno-associated virus (AAV) vectors to the spinal cord. AAV-mediated base editing prolonged survival, preserved motor neurons, and attenuated axon loss in ventral nerve roots. Treatment with the selected base editing vector reduced TFG aggregation and suppressed neuronal death in HMSN-P iPSC-derived neuromuscular organoids. Collectively, these findings support the therapeutic potential of base editing for hereditary MNDs.

細胞遺伝子工学
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