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AAV-SHMT2 is an experimental gene therapy designed to deliver the Serine Hydroxymethyltransferase 2 (SHMT2) gene using an adeno-associated virus (AAV) vector. SHMT2 is a critical mitochondrial enzyme involved in the one-carbon metabolism pathway. Research indicates that SHMT2 is significantly downregulated in Huntington's disease (HD), leading to metabolic dysregulation, accumulation of homocysteine, and suppression of histone lactylation. By restoring SHMT2 expression, AAV-SHMT2 aims to normalize the metabolic-epigenetic axis, thereby attenuating the degeneration of medium spiny neurons (MSNs), reducing mutant huntingtin (mHTT) aggregation, and improving motor performance. It is currently being investigated in preclinical models of Huntington's disease, including human striatal organoids and transgenic mouse models.
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