Codon-Optimized Npc1 mRNA corrects Niemann-Pick Type C1 disease phenotypes in vitro and in vivo [snRNA-Seq]

Despite its severity, therapeutic options remain limited. . Using codon-optimized Npc1 mRNA delivered by lipid nanoparticles (Co-Npc1:LNP), we achieved enhanced NPC1 protein expression and prolonged therapeutic activity in vitro, correcting both primary and secondary disease defects.

In an Npc1-/- mouse model, a single intravenous injection of Co-Npc1:LNP restored hepatic NPC1 protein levels, normalized autophagic flux, improved lipid abnormalities, and altered markers of liver injury. To interpret transcriptional changes post-Co-Npc1:LNP administration, we performed bulk RNA sequencing and applied MENTOR, a network-based clustering algorithm, and MENTOR-IA, an unbiased functional annotation tool, and identified restored pathways including cholesterol metabolism, lysosomal and mitochondrial function, and liver homeostasis.