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December 14, 1998
New Gene Therapy Strategy
Keeps Muscles Strong in Old Age: Possibilities Seen
for Disease Treatment, But Also for Athletic or
Cosmetic Enhancements
Scientists at the University
of Pennsylvania Medical Center have developed a
novel gene therapy treatment that permanently
blocks the age-related loss of muscle size and
strength in mice. Mice, like humans and all
mammals, lose up to a third of their muscle mass
and power with age. In humans, the result is an
advancing weakness in the elderly that can lead to
unsteadiness and impaired mobility, increased
susceptibility to falls and injury, and joint
stress and degeneration.
Even in young adult mice, the new treatment
increased muscle strength by a dramatic 15 percent
over untreated muscle. But in older mice, the
improvement was even more remarkable: The
researchers documented a 27 percent increase in
strength over untreated muscle in these mice -
fully restoring their strength to what it was in
young adulthood.
The technique suggests human therapies that
could reverse the feebleness associated with old
age or counter the muscle-wasting effects of
muscular dystrophies and related diseases. It also
raises the possibility, however, that the technique
could be used - or abused - for athletic or
cosmetic enhancements.
Results from the experimental study were
presented at the 38th annual meeting of the
American Society for Cell Biology in San Francisco
on December 14 and will be published in the
December 22 issue of the Proceedings of the
National Academy of Sciences. (Copies of the paper
are available to reporters through the journal's
news office, reachable by telephone at 202-334-2138
or by e-mail at pnasnews@nas.edu.)
"Our results show that it may be possible to
preserve muscle size and strength in old age using
this approach," says H. Lee Sweeney, Ph.D.,
professor of physiology and senior investigator on
the study. "We're now looking to see whether the
technique might also be used to increase muscle
strength in diseases such as muscular
dystrophy."
To develop the new treatment, the researchers
took advantage of the ability of some viruses to
integrate their genetic material into the cells
they infect. For these experiments, they selected
an adeno-associated virus, or AAV, known to be
highly efficient at introducing its genes into
target cells. They then stripped the AAV of its own
disease-causing - and immune-system provoking -
genes and reloaded it with a normally occurring
gene called insulin-like growth factor I, or IGF-I,
as well as a muscle-specific promoter to drive high
production levels of the growth factor. The
investigators then injected the engineered virus
into the muscles of the mice.
IGF-I is a growth factor critical in the process
of muscle repair. Under normal circumstances,
damaged muscles release quantities of IGF-I as an
activation signal to neighboring cells known as
satellite cells. Satellite cells are muscle stem
cells - progenitor cells - that become functional
muscle cells after activation and then migrate into
the muscle to repair it.
The researchers theorized that age-related
muscle loss might be the result of a declining
efficiency in the satellite-cell activation process
due to a decreased IGF-I signaling capability with
age on the part of muscles in need of repair. They
hypothesized that using gene therapy to command
high levels of IGF-I production in aging muscle
might stimulate more effective repair and
regeneration by the satellite cells, which proved
to be the case.
If this work is to be extended into humans, a
number of ethical considerations will need to be
addressed, according to senior author Sweeney.
"The beneficial effects of this gene therapy
could easily be used in humans for athletic or even
cosmetic enhancements and not only for limiting
age-related muscle loss or for treating diseases of
the muscle," Sweeney notes.
Elisabeth R. Barton-Davis, Ph.D., is the lead
author on the study, and Daria I. Shoturma is a
coauthor. The remaining coauthors are Antonio
Musaro, Ph.D., and Nadia Rosenthal, Ph.D., both
based at Massachusetts General Hospital. This work
was supported by grants from the National
Institutes of Health and the Muscular Dystrophy
Association.
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