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NeuroD1 gene therapy is an experimental **AAV-based in vivo neural reprogramming therapy** that delivers the **NeuroD1 transcription factor** to reactive astrocytes, typically using an **AAV9 vector under a GFAP promoter**, to convert astrocytes into functional neurons after central nervous system injury. The therapeutic concept has been developed primarily in academic settings and remains **preclinical**, with studies in rodent and non-human primate models of **ischemic stroke, ischemic brain injury, spinal cord injury, subarachnoid hemorrhage, and neonatal hypoxic-ischemic brain injury**. Its proposed mechanism is direct astrocyte-to-neuron conversion with associated neuronal replacement, neuroprotection, and circuit repair, leading in published preclinical work to recovery of neuronal populations and improvement in motor and cognitive outcomes.
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