Scientists have developed a gene therapy that blocks axonal degeneration, preventing axon destruction in mice and suggesting a therapeutic strategy that could help prevent the loss of peripheral nerves in multiple conditions. Nerve axons serve as the wiring of the nervous system, sending electrical signals that control movement and sense of touch. Now, scientists have developed a gene therapy that blocks this process, preventing axon destruction, suggesting a therapeutic strategy that could help prevent the loss of peripheral nerves in multiple conditions. The study appears in the Journal of Experimental Medicine.

Peripheral neuropathies: the most common neurodegenerative diseases

"Peripheral neuropathies are the most common neurodegenerative diseases in the world," said first author Stefanie Geisler, MD, an assistant professor of neurology. "Many peripheral neuropathies are caused by breakdown of nerve fibers, but we currently don't have therapies that can directly block this process. For many neuropathies, we can't halt progression of the disease and are limited to trying to treat the symptoms. They are somewhat successful decreasing neuropathic pain, but it is very difficult to alleviate numbness.

"I see many patients with chemotherapy-induced neuropathy, and it can severely impact their quality of life," she said. "To benefit patients, we will need to test this treatment in human clinical trials, but our current finding is significant because we have shown for the first time that we can effectively block nerve fiber breakdown in mice with a standard viral gene therapy."

When an axon is injured, whether cut or crushed by injury or damaged by drugs, a protein called SARM1 becomes active. In healthy nerves, this protein is switched off. Past studies by this research team have shown that activated SARM1 triggers axons to self-destruct, kicking off a chain of events that quickly consumes all of a nerve cell's energy supply. The axons of such cells break into pieces.

"For a long time, viral gene therapy was a pipe dream"

"With our viral gene therapy, we delivered a mutated form of SARM1 that is not only inactive itself but also blocks normal SARM1 proteins that have become activated in mice with nerve injuries," said senior author Jeffrey D. Milbrandt, MD, PhD, the James S. McDonnell Professor and head of the Department of Genetics. "For a long time, viral gene therapy was a pipe dream, but there are now a number of ongoing clinical trials in other disorders that suggest we are on a promising track."

"This has the potential to be transformative because it cuts across so many diseases," said co-senior author Aaron DiAntonio, MD, PhD, the Alan A. and Edith L. Wolff Professor of Developmental Biology. "Rather than addressing a single disease, it is potentially a treatment for a disease process that is shared among many different neurodegenerative disorders."In addition to this viral gene therapy, the researchers are studying other possible ways to block SARM1, including small molecules for drug development.