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Current Neuropharmacology

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ISSN (Print): 1570-159X
ISSN (Online): 1875-6190

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Research Article

Does Patisiran Reduce Ocular Transthyretin Synthesis? A Pilot Study of Two Cases

Author(s): Chiara Cambieri, Marco Marenco, Tania Colasanti, Carmine Mancone, Alessandro Corsi, Mara Riminucci, Laura Libonati, Federica Moret, Cristina Chimenti, Alessandro Lambiase, Fabrizio Conti, Matteo Garibaldi, Maurizio Inghilleri and Marco Ceccanti*

Volume 21, Issue 12, 2023

Published on: 03 July, 2023

Page: [2543 - 2549] Pages: 7

DOI: 10.2174/1570159X21666230623094710

Price: $65

Abstract

Background: Variant transthyretin-mediated amyloidosis (ATTR-v) is a well-characterized disease affecting the neurologic and cardiovascular systems. Patisiran has been approved for neurologic involvement as it reduces hepatic synthesis of transthyretin (TTR). Eye involvement is a lateonset feature increasing the risk of glaucoma and cataracts in patients.

Aims: The aim of this case series was to assess whether patisiran can effectively reduce TTR synthesis in such a barrier-protected organ as the eye.

Methods: Two patisiran-treated ATTR-v patients underwent serum and aqueous humor sampling to measure TTR levels detected by SDS-PAGE and immunoblotting. Serum samples were compared to healthy control (HC), whereas aqueous humor samples were compared to non-amyloidotic subjects affected by cataracts and glaucoma.

Results: Serum TTR levels representative of hepatic synthesis were sharply lower in treated patients if compared to the HC (-87.5% and -93.75%, respectively). Aqueous humor TTR levels showed mild-tono reduction in treated patients compared to non-amyloidotic subjects with cataracts (-34.9% and +8.1%, respectively) and glaucoma (-41.1% and -2.1%).

Conclusion: Patisiran does not seem to be as effective in inhibiting ocular TTR synthesis as it is in inhibiting hepatic synthesis. Re-engineering the envelope could allow the drug to target RPE cells thus avoiding any ocular involvement.

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Graphical Abstract

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