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DOI: 10.1055/a-2544-1530
Emerging Genetic Therapies in Epilepsy

Abstract
Advances in next-generation sequencing have allowed for genetic characterization of many epilepsies that previously had no known cause. Although having a precise diagnosis has been very helpful for management, counseling, and prognosis, until recently true precision medicine approaches that could have disease-modifying effects have been lacking. This review will highlight how preclinical animal models of Dravet syndrome have allowed some novel gene therapy approaches to be studied and further developed such that they are now entering into the clinics.
Publikationsverlauf
Accepted Manuscript online:
24. Februar 2025
Artikel online veröffentlicht:
24. März 2025
© 2025. Thieme. All rights reserved.
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References
- 1 Berg AT, Coryell J, Saneto RP. et al. Early-life epilepsies and the emerging role of genetic testing. JAMA Pediatr 2017; 171 (09) 863-871
- 2 Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989; 30 (04) 389-399
- 3 Claes L, Del-Favero J, Ceulemans B, Lagae L, Van Broeckhoven C, De Jonghe P. De novo mutations in the sodium-channel gene SCN1A cause severe myoclonic epilepsy of infancy. Am J Hum Genet 2001; 68 (06) 1327-1332
- 4 Li W, Schneider AL, Scheffer IE. Defining Dravet syndrome: an essential pre-requisite for precision medicine trials. Epilepsia 2021; 62 (09) 2205-2217
- 5 Cheah CS, Yu FH, Westenbroek RE. et al. Specific deletion of NaV1.1 sodium channels in inhibitory interneurons causes seizures and premature death in a mouse model of Dravet syndrome. Proc Natl Acad Sci U S A 2012; 109 (36) 14646-14651
- 6 Lersch R, Jannadi R, Grosse L. et al. Targeted molecular strategies for genetic neurodevelopmental disorders: emerging lessons from Dravet syndrome. Neuroscientist 2023; 29 (06) 732-750
- 7 Mavashov A, Brusel M, Liu J. et al. Heat-induced seizures, premature mortality, and hyperactivity in a novel Scn1a nonsense model for Dravet syndrome. Front Cell Neurosci 2023; 17: 1149391
- 8 Claes LR, Deprez L, Suls A. et al. The SCN1A variant database: a novel research and diagnostic tool. Hum Mutat 2009; 30 (10) E904-E920
- 9 Meng H, Xu HQ, Yu L. et al. The SCN1A mutation database: updating information and analysis of the relationships among genotype, functional alteration, and phenotype. Hum Mutat 2015; 36 (06) 573-580
- 10 Yu FH, Mantegazza M, Westenbroek RE. et al. Reduced sodium current in GABAergic interneurons in a mouse model of severe myoclonic epilepsy in infancy. Nat Neurosci 2006; 9 (09) 1142-1149
- 11 Martin MS, Dutt K, Papale LA. et al. Altered function of the SCN1A voltage-gated sodium channel leads to gamma-aminobutyric acid-ergic (GABAergic) interneuron abnormalities. J Biol Chem 2010; 285 (13) 9823-9834
- 12 Yamagata T, Raveau M, Kobayashi K. et al. CRISPR/dCas9-based Scn1a gene activation in inhibitory neurons ameliorates epileptic and behavioral phenotypes of Dravet syndrome model mice. Neurobiol Dis 2020; 141: 104954
- 13 Tanenhaus A, Stowe T, Young A. et al. Cell-selective adeno-associated virus-mediated SCN1A gene regulation therapy rescues mortality and seizure phenotypes in a Dravet syndrome mouse model and is well tolerated in nonhuman primates. Hum Gene Ther 2022; 33 (11-12): 579-597
- 14 Ricobaraza A, Bunuales M, Gonzalez-Aparicio M. et al. Preferential expression of SCN1A in GABAergic neurons improves survival and epileptic phenotype in a mouse model of Dravet syndrome. J Mol Med (Berl) 2023; 101 (12) 1587-1601
- 15 Mich JK, Ryu J, Wei AD. et al. AAV-mediated interneuron-specific gene replacement for Dravet syndrome. bioRxiv 2023
- 16 Favero M, Sotuyo NP, Lopez E, Kearney JA, Goldberg EM. A transient developmental window of fast-spiking interneuron dysfunction in a mouse model of Dravet syndrome. J Neurosci 2018; 38 (36) 7912-7927
- 17 Goff KM, Goldberg EM. Vasoactive intestinal peptide-expressing interneurons are impaired in a mouse model of Dravet syndrome. eLife 2019; 8: 8
- 18 Mattis J, Somarowthu A, Goff KM. et al. Corticohippocampal circuit dysfunction in a mouse model of Dravet syndrome. eLife 2022; 11: 11
- 19 Goff KM, Liebergall SR, Jiang E, Somarowthu A, Goldberg EM. VIP interneuron impairment promotes in vivo circuit dysfunction and autism-related behaviors in Dravet syndrome. Cell Rep 2023; 42 (06) 112628
- 20 Mora-Jimenez L, Valencia M, Sanchez-Carpintero R. et al. Transfer of SCN1A to the brain of adolescent mouse model of Dravet syndrome improves epileptic, motor, and behavioral manifestations. Mol Ther Nucleic Acids 2021; 25: 585-602
- 21 Fadila S, Beucher B, Dopeso-Reyes IG. et al. Viral vector-mediated expression of NaV1.1, after seizure onset, reduces epilepsy in mice with Dravet syndrome. J Clin Invest 2023; 133 (12) 133
- 22 Lim KH, Han Z, Jeon HY. et al. Antisense oligonucleotide modulation of non-productive alternative splicing upregulates gene expression. Nat Commun 2020; 11 (01) 3501
- 23 Kaneko K, Currin CB, Goff KM. et al. Developmentally regulated impairment of parvalbumin interneuron synaptic transmission in an experimental model of Dravet syndrome. Cell Rep 2022; 38 (13) 110580
- 24 Jones SP, O'Neill N, Carpenter JC. et al. Early developmental alterations of CA1 pyramidal cells in Dravet syndrome. Neurobiol Dis 2024; 201: 106688
- 25 Di Berardino C, Mainardi M, Brusco S, Benvenuto E, Broccoli V, Colasante G. Temporal manipulation of the Scn1a gene reveals its essential role in adult brain function. Brain 2024; 147 (04) 1216-1230
- 26 Valassina N, Brusco S, Salamone A. et al. Scn1a gene reactivation after symptom onset rescues pathological phenotypes in a mouse model of Dravet syndrome. Nat Commun 2022; 13 (01) 161
- 27 Han Z, Chen C, Christiansen A. et al. Antisense oligonucleotides increase Scn1a expression and reduce seizures and SUDEP incidence in a mouse model of Dravet syndrome. Sci Transl Med 2020; 12 (558) 12
- 28 Wengert ER, Wagley PK, Strohm SM. et al. Targeted Augmentation of Nuclear Gene Output (TANGO) of Scn1a rescues parvalbumin interneuron excitability and reduces seizures in a mouse model of Dravet syndrome. Brain Res 2022; 1775: 147743
- 29 Meena M, Ticho B, Mohapatra S, Barriere O, Gosselin N. A pharmacokinetic (PK) model for STK-001, an antisense oligonucleotide (ASO), based on data from non-human primates (NHP) enables dose selection in patients with Dravet syndrome (DS). 2021
- 30 Laux LCJ, Sullivan J, Desurkar A, Roberts CM, Schreiber JM, Knupp KG, Perry MS, Wheless JM, Wirrell EC, Brathwaite C, Condon C, Dandurand A, Lynch J, Stutely J, Wang F, Parkerson KA, Ticho B. Zorevunersen (STK-001) demonstrates potential for disease modification including reductions in seizures and improvements in cognition and behavior in children and adolescents with Dravet syndrome. 2024
- 31 Sullivan J, Brunklaus A, Cross JH. et al. Patients with Dravet Syndrome in Open-label Extension Studies of Zorevunersen (STK-001) Have Durable Reductions in Seizure Frequency and Clinically Meaningful Improvements in Cognition and Behavior. 2024
- 32 Condon CParkerson K, Dandurand A. et al. Small Changes on the vineland-3 are meaningful to caregivers of patients with Dravet syndrome. 2023
- 33 Sullivan J, Deighton AM, Vila MC. et al. The clinical, economic, and humanistic burden of Dravet syndrome—a systematic literature review. Epilepsy Behav 2022; 130: 108661