Skip to main content

Therapeutic Use of Interferon Gamma in Friedreich Ataxia

  • Chapter
  • First Online:
Trials for Cerebellar Ataxias

Abstract

Friedreich’s ataxia (FRDA) is a progressive neurodegenerative disorder caused by GAA triplet expansion in the FXN gene. At the cellular level, FRDA is associated with the deficiency of frataxin, a mitochondrial protein that plays a fundamental role in iron homeostasis and in the management of oxidative stress. The disease onset is usually in adolescence, leading to progressive disability. There is still no treatment to cure or halt the disease. Over the years an increasing number of drugs have been tested targeting different parts of the pathological cascade. One of the drugs tested has been interferon-gamma (IFN-γ). IFN-γ is currently approved for the treatment of chronic granulomatous disease and severe malignant osteopetrosis. In patients with FRDA, IFN-γ upregulated frataxin levels in cells from FRDA patients and increased frataxin expression in dorsal root ganglia neurons. In this chapter we review the basic science behind the proposal of IFN-γ as a potential treatment for FRDA and summarize the clinical studies related to the use of IFN-γ in FRDA, outlining critical lessons that have been learned in terms of drug efficacy and tolerability.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abreu R, Essler L, Giri P, Quinn F. Interferon-gamma promotes iron export in human macrophages to limit intracellular bacterial replication. PLoS One. 2020;15(12):e0240949.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Apolone G, Mosconi P. The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol. 1998;51(11):1025–36.

    Article  CAS  PubMed  Google Scholar 

  • Castro IH, Pignataro MF, Sewell KE, Espeche LD, Herrera MG, Noguera ME, Dain L, Nadra AD, Aran M, Smal C, Gallo M, Santos J. Frataxin structure and function. Subcell Biochem. 2019;93:393–438.

    Article  CAS  PubMed  Google Scholar 

  • Clay A, Hearle P, Schadt K, Lynch DR. New developments in pharmacotherapy for Friedreich ataxia. Expert Opin Pharmacother. 2019;20(15):1855–67. Epub 2019 Jul 16.

    Article  CAS  PubMed  Google Scholar 

  • Condò I, Ventura N, Malisan F, Rufini A, Tomassini B, Testi R. In vivo maturation of human frataxin. Hum Mol Genet. 2007;16(13):1534–40.

    Article  PubMed  Google Scholar 

  • Dag E, Ornek N, Ornek K, Erbahceci-Timur IE. Optical coherence tomography and visual field findings in patients with Friedreich ataxia. J Neuroophthalmol. 2014;34(2):118–21.

    Article  PubMed  Google Scholar 

  • Delatycki MB, Bidichandani SI. Friedreich ataxia- pathogenesis and implications for therapies. Neurobiol Dis. 2019;132:104606. Epub 2019 Sep 5.

    Article  CAS  PubMed  Google Scholar 

  • Deutsch EC, Santani AB, Perlman SL, Farmer JM, Stolle CA, Marusich MF, Lynch DR. A rapid, noninvasive immunoassay for frataxin: utility in assessment of Friedreich ataxia. Mol Genet Metab. 2010;101(2–3):238–45. https://doi.org/10.1016/j.ymgme.2010.07.001. Epub 2010 Jul 8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Harding IH, Chopra S, Arrigoni F, Boesch S, Brunetti A, Cocozza S, Corben LA, Deistung A, Delatycki M, Diciotti S, Dogan I, Evangelisti S, França MC Jr, Göricke SL, Georgiou-Karistianis N, Gramegna LL, Henry PG, Hernandez-Castillo CR, Hutter D, Jahanshad N, Joers JM, Lenglet C, Lodi R, Manners DN, Martinez ARM, Martinuzzi A, Marzi C, Mascalchi M, Nachbauer W, Pane C, Peruzzo D, Pisharady PK, Pontillo G, Reetz K, Rezende TJR, Romanzetti S, Saccà F, Scherfler C, Schulz JB, Stefani A, Testa C, Thomopoulos SI, Timmann D, Tirelli S, Tonon C, Vavla M, Egan GF, Thompson PM. Brain structure and degeneration staging in friedreich ataxia: magnetic resonance imaging volumetrics from the ENIGMA-Ataxia Working Group. Ann Neurol. 2021;90(4):570–83. https://doi.org/10.1002/ana.26200. Epub 2021 Sep 17. PMID: 34435700.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kak G, Raza M, Tiwari BK. Interferon-gamma (IFN-gamma): exploring its implications in infectious diseases. Biomol Concepts. 2018;9(1):64–79.

    Article  CAS  PubMed  Google Scholar 

  • Li K. Iron pathophysiology in Friedreich’s ataxia. Adv Exp Med Biol. 2019;1173:125–43.

    Article  CAS  PubMed  Google Scholar 

  • Lynch DR, Hauser L, McCormick A, Wells M, Dong YN, McCormack S, Schadt K, Perlman S, Subramony SH, Mathews KD, Brocht A, Ball J, Perdok R, Grahn A, Vescio T, Sherman JW. Farmer randomized, double-blind, placebo-controlled study of interferon-γ 1b in Friedreich ataxia. Ann Clin Transl Neurol. 2019;6(3):546–53. https://doi.org/10.1002/acn3.731. eCollection 2019 Mar. PMID: 30911578.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Marcotulli C, Fortuni S, Arcuri G, Tomassini B, Leonardi L, Pierelli F, Testi R, Casali C. GIFT-1, a phase IIa clinical trial to test the safety and efficacy of IFNγ administration in FRDA patients. Neurol Sci. 2016;37(3):361–4. https://doi.org/10.1007/s10072-015-2427-3. Epub 2015 Nov 30. PMID: 26621361 Clinical Trial.

    Article  PubMed  Google Scholar 

  • Nairz M, Weiss G. Iron in infection and immunity. Mol Asp Med. 2020;75:100864. Epub 2020 May 24.

    Article  CAS  Google Scholar 

  • Nairz M, Haschka D, Demetz E, Weiss G. Iron at the interface of immunity and infection. Front Pharmacol. 2014;5:152.

    Article  PubMed  PubMed Central  Google Scholar 

  • Neumann H, Schmidt H, Wilharm E, Behrens L, Wekerle H. Interferon gamma gene expression in sensory neurons: evidence for autocrine gene regulation. J Exp Med. 1997;186(12):2023–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ocana-Santero G, Díaz-Nido J, Herranz-Martín S. Future prospects of gene therapy for Friedreich’s ataxia. Int J Mol Sci. 2021;22(4):1815.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Patel M, Jsaacs CJ, Seyer L, et al. Progression of Friedreich ataxia: quantitative characterization over 5 years. Ann Clin Transl Neurol. 2016;3(9):684–94. https://doi.org/10.1002/acn3.332. eCollection 2016 Sep.

    Article  PubMed  PubMed Central  Google Scholar 

  • Prosperini L, Sacca F, Cordioli C, et al. Real-world effectiveness of natalizumab and fingolimod compared with selfinjectable drugs in non-responders and in treatment-naive patients with multiple sclerosis. J Neurol 2017; 264(2):284–94.

    Google Scholar 

  • Reetz K, Dogan I, Hilgers RD, et al. Progression characteristics of the European Friedreich’s Ataxia Consortium for Translational Study (EFACTS): a 2 year cohort study. Lancet Neurol. 2016;15:1346–54.

    Article  PubMed  Google Scholar 

  • Reetz K, Dogan I, Hilgers RD, et al. Progression characteristics of the European Friedreich’s Ataxia Consortium for Translational Studies (EFACTS): a 4-year cohort study. Lancet Neurol. 2021;20(5):362–72. https://doi.org/10.1016/S1474-4422(21)00027-2. Epub 2021 Mar 23.

    Article  PubMed  Google Scholar 

  • Schmitz-Hubsch T, du Montcel ST, Baliko L, et al. Scale for the assessment and rating of ataxia: development of a new clinical scale. Neurology. 2006;66(11):1717–20.

    Article  CAS  PubMed  Google Scholar 

  • Schroder K, Hertzog PJ, Ravasi T, Hume DA. Interferon-gamma: an overview of signals, mechanisms and functions. J Leukoc Biol. 2004;75(2):163–89. Epub 2003 Oct 2.

    Article  CAS  PubMed  Google Scholar 

  • Selvadurai LP, Harding IH, Corben LA, Georgiou-Karistianis N. Cerebral abnormalities in Friedreich ataxia: a review. Neurosci Biobehav Rev. 2018;84:394–406.

    Article  PubMed  Google Scholar 

  • Seyer L, Galetta K, Wilson J, et al. Analysis of the visual system in Friedreich ataxia. J Neurol. 2013;260(9):2362–9. https://doi.org/10.1007/s00415-013-6978-z. Epub 2013 Jun 18.

    Article  PubMed  Google Scholar 

  • Seyer L, Greeley N, Foerster D, Strawser C, Gelbard S, Dong Y, Schadt K, Cotticelli MG, Brocht A, Farmer J, Wilson RB, Lynch DR. Open-label pilot study of interferon gamma-1b in Friedreich ataxia. Acta Neurol Scand. 2015;132(1):7–15. https://doi.org/10.1111/ane.12337. Epub 2014 Oct 21. PMID: 25335475 Clinical Trial.

    Article  CAS  PubMed  Google Scholar 

  • Tomassini B, Arcuri G, Fortuni S, et al. Interferon gamma upregulates frataxin and corrects the functional deficits in a Friedreich ataxia model. Hum Mol Genet 2012; 21(13): 2855–61.

    Google Scholar 

  • Ustun TB, Chatterji S, Kostanjsek N, et al. Developing the World Health Organization Disability Assessment Schedule 2.0. Bull World Health Organ. 2010;88(11):815–23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vavla M, D’Angelo MG, Arrigoni F, Toschi N, Peruzzo D, Gandossini S, Russo A, Diella E, Tirelli S, Salati R, Scarpazza P, Luffarelli R, Fortuni S, Rufini A, Condò I, Testi R, Martinuzzi A. Safety and efficacy of interferon γ in Friedreich’s ataxia. Mov Disord. 2020a;35(2):370–1. https://doi.org/10.1002/mds.27979. Epub 2020 Jan 13. PMID: 31930551.

    Article  PubMed  Google Scholar 

  • Vavla M, Arrigoni F, Toschi N, Peruzzo D, D’Angelo MG, Gandossini S, Russo A, Diella E, Tirelli S, Salati R, Rufini A, Condo I, Testi R, Martinuzzi A. Sensitivity of neuroimaging indicators in monitoring the effects of interferon gamma treatment in Friedreich’s ataxia. Front Neurosci. 2020b;14:872. https://doi.org/10.3389/fnins.2020.00872. eCollection 2020. PMID: 33162876.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weidemann F, Rummey C, Bijnens B, et al. The heart in Friedreich ataxia: definition of cardiomyopathy, disease severity, and correlation with neurological symptoms. Circulation 2012; 125(13):1626–34.

    Google Scholar 

  • Wyller VB, Jacobsen K, Dahl MB, Nilsen H, Proske S, Horter T. Brun Interferon gamma may improve cardiac function in Friedreich’s ataxia cardiomyopathy. Int J Cardiol. 2016;221:376–8. https://doi.org/10.1016/j.ijcard.2016.06.288. Epub 2016 Jun 29. PMID: 27404709.

    Article  PubMed  Google Scholar 

  • Yetkİn MF, GÜltekİn M. Efficacy and tolerability of interferon gamma in treatment of Friedreich’s ataxia: retrospective study. Noro Psikiyatr Ars. 2020;57(4):270–3. https://doi.org/10.29399/npa.25047. eCollection 2020 Dec. PMID: 33354116.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrea Martinuzzi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Martinuzzi, A., Paparella, G., Vavla, M., D’Angelo, M.G., Arrigoni, F., Testi, R. (2023). Therapeutic Use of Interferon Gamma in Friedreich Ataxia. In: Soong, Bw., Manto, M., Brice, A., Pulst, S.M. (eds) Trials for Cerebellar Ataxias. Contemporary Clinical Neuroscience. Springer, Cham. https://doi.org/10.1007/978-3-031-24345-5_24

Download citation

Publish with us

Policies and ethics