Chronic cyclodextrin treatment of murine Niemann-Pick C disease ameliorates neuronal cholesterol and glycosphingolipid storage and disease progression

• Published in: PloS one 2009-09, Vol.4 (9), p.e6951
• Main Authors: Davidson, Cristin D, Ali, Nafeeza F, Micsenyi, Matthew C, Stephney, Gloria, Renault, Sophie, Dobrenis, Kostantin, Ory, Daniel S, Vanier, Marie T, Walkley, Steven U
• Format: Article
• Language: English
• Subjects: 1-Deoxynojirimycin - administration & dosage; 1-Deoxynojirimycin - analogs & derivatives; 2-Hydroxypropyl-beta-cyclodextrin; Accumulation; Animals; beta-Cyclodextrins - administration & dosage; Brain diseases; Brain research; Cell Biology/Neuronal and Glial Cell Biology; Cholesterol; Cholesterol - metabolism; Cyclodextrins; Cyclodextrins - administration & dosage; Development and progression; Disease; Disease Models, Animal; Disease Progression; Drug Synergism; Drugs; Enzyme Inhibitors - therapeutic use; Fibroblasts; Gangliosides; Gangliosidosis; Genetic disorders; Genetics and Genomics/Disease Models; Glycosphingolipids; Glycosphingolipids - metabolism; Homeostasis; Intellectual disabilities; Life span; Markers; Medical treatment; Medicine; Metabolic disorders; Metabolism; Mice; Mice, Transgenic; Mucopolysaccharidosis; Nervous system diseases; Neurodegeneration; Neurodegenerative diseases; Neurological diseases; Neurological Disorders; Neurological Disorders/Developmental and Pediatric Neurology; Neurons - metabolism; Neuroscience/Neuronal and Glial Cell Biology; Neurosciences; Niemann-Pick disease; Niemann-Pick Disease, Type C - drug therapy; Npc1 protein; Pathology/Cellular Pathology; Pathology/Neuropathology; Permeability; Potassium; Pregnanolone; Pregnanolone - administration & dosage; Proteins; Rodents; Sphingosine; Toxicology; Treatment Outcome; β-Cyclodextrin
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0006951

Niemann-Pick type C (NPC) disease is a fatal neurodegenerative disorder caused most commonly by a defect in the NPC1 protein and characterized by widespread intracellular accumulation of unesterified cholesterol and glycosphingolipids (GSLs). While current treatment therapies are limited, a few drugs tested in Npc1(-/-) mice have shown partial benefit. During a combination treatment trial using two such compounds, N-butyldeoxynojirimycin (NB-DNJ) and allopregnanolone, we noted increased lifespan for Npc1(-/-) mice receiving only 2-hydroxypropyl-beta-cyclodextrin (CD), the vehicle for allopregnanolone. This finding suggested that administration of CD alone, but with greater frequency, might provide additional benefit. Administration of CD to Npc1(-/-) mice beginning at either P7 or P21 and continuing every other day delayed clinical onset, reduced intraneuronal cholesterol and GSL storage as well as free sphingosine accumulation, reduced markers of neurodegeneration, and led to longer survival than any previous treatment regime. We reasoned that other lysosomal diseases characterized by cholesterol and GSL accumulation, including NPC disease due to NPC2 deficiency, GM1 gangliosidosis and mucopolysaccharidosis (MPS) type IIIA, might likewise benefit from CD treatment. Treated Npc2(-/-) mice showed benefits similar to NPC1 disease, however, mice with GM1 gangliosidosis or MPS IIIA failed to show reduction in storage. Treatment with CD delayed clinical disease onset, reduced intraneuronal storage and secondary markers of neurodegeneration, and significantly increased lifespan of both Npc1(-/-) and Npc2(-/-) mice. In contrast, CD failed to ameliorate cholesterol or glycosphingolipid storage in GM1 gangliosidosis and MPS IIIA disease. Understanding the mechanism(s) by which CD leads to reduced neuronal storage may provide important new opportunities for treatment of NPC and related neurodegenerative diseases characterized by cholesterol dyshomeostasis.