Changes in Cerebrospinal Fluid Concentrations of Selenium Species Induced by Tofersen Administration in Subjects with Amyotrophic Lateral Sclerosis Carrying SOD1 Gene Mutations Changes in Cerebrospinal Fluid Concentrations of Selenium Species Induced by Tofersen Administration in Subjects with Amyotrophic Lateral Sclerosis Carrying SOD1 Gene Mutations

• Published in: Biological trace element research Vol. 203; no. 4; pp. 2355 - 2364
• Main Authors: Vinceti, Marco, Urbano, Teresa, Filippini, Tommaso, Bedin, Roberta, Simonini, Cecilia, Sorarù, Gianni, Trojsi, Francesca, Michalke, Bernhard, Mandrioli, Jessica
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2025; Springer Nature B.V
• Subjects: Adult; Aetiology; Aged; Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - cerebrospinal fluid; Amyotrophic Lateral Sclerosis - drug therapy; Amyotrophic Lateral Sclerosis - genetics; Anion exchange; anion exchange chromatography; Anion exchanging; Anions; Antisense oligonucleotides; Antisense therapy; Biochemistry; Biomedical and Life Sciences; Biotechnology; Blood-brain barrier; Brain; Central nervous system; Cerebrospinal fluid; Chromatography; disease progression; Drugs; etiology; Female; Food and Drug Administration; genes; Health services; Humans; Inductively coupled plasma; Life Sciences; Male; Mass spectrometry; Mass spectroscopy; Middle Aged; Motor neurons; Mutation; Neurodegenerative diseases; Neurons; Nutrition; oligonucleotides; Oligonucleotides - administration & dosage; Oncology; Point mutation; Scientific imaging; Selenium; Selenium - cerebrospinal fluid; Selenomethionine; species; Spinal cord; Superoxide dismutase; Superoxide Dismutase-1 - genetics; toxicology; Selenium compounds; Amyotrophic lateral sclerosis; Selenium; Tofersen; SOD1
• ISSN: 0163-4984; 1559-0720; 1559-0720
• DOI: 10.1007/s12011-024-04311-4

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease affecting the brain and spinal cord motor neurons. On 25 April 2023, the drug tofersen, an antisense oligonucleotide, received the US Food and Drug Administration approval for treating ALS in adults carrying mutations of the SOD1 gene. We aimed at assessing whether cerebrospinal fluid concentrations of selenium, an element of both toxicological and nutritional interest possibly involved in disease etiology and progression, are modified by tofersen administration. We determined concentrations of selenium species by anion exchange chromatography hyphenated to inductively coupled plasma-dynamic reaction cell-mass spectrometry and overall selenium by using inductively coupled plasma sector-field mass spectrometry, at baseline and 6 months after active tofersen treatment in ten Italian ALS patients carrying the SOD1 gene mutation. Concentrations of total selenium and many selenium species substantially increased after the intervention, particularly of inorganic (tetravalent and hexavalent) selenium and of the organic species selenomethionine and a compound co-eluting with the selenocystine standard. Overall, these findings suggest that tofersen treatment markedly alters selenium status and probably the redox status within the central nervous system, possibly due to a direct effect on neurons and/or the blood–brain barrier. Further studies are required to investigate the biological and clinical relevance of these findings and how they might relate to the pharmacological effects of the drug and to disease progression.