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However, some LSDs, such as mucopolysaccharidosis type III (MPSIII) diseases or Sanfilippo syndrome, represent a difficult challenge because patients suffer severe neurodegeneration with mild somatic alterations. The disease's main target is the central nervous system (CNS) and enzymes do not efficiently cross the blood\u2013brain barrier (BBB) even if present at very high concentration in circulation. No specific treatment has been approved for MPSIII. In this study, we discuss the adeno-associated virus (AAV) vector-mediated gene transfer strategies currently being developed for MPSIII disease. These strategies rely on local delivery of AAV vectors to the CNS either through direct intraparenchymal injection at several sites or through delivery to the cerebrospinal fluid (CSF), which bathes the whole CNS, or exploit the properties of certain AAV serotypes capable of crossing the BBB upon systemic administration. Although studies in small and large animal models of MPSIII diseases have provided evidence supporting the efficacy and safety of all these strategies, there are considerable differences between the different routes of administration in terms of procedure-associated risks, vector dose requirements, sensitivity to the effect of circulating neutralizing antibodies that block AAV transduction, and potential toxicity. Ongoing clinical studies should shed light on which gene transfer strategy leads to highest clinical benefits while minimizing risks. The development of all these strategies opens a new horizon for treatment of not only MPSIII and other LSDs but also of a wide range of neurological diseases.<\/jats:p>","DOI":"10.1089\/hum.2019.217","type":"journal-article","created":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T07:37:41Z","timestamp":1567582661000},"page":"1211-1221","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["<i>In Vivo<\/i>\n                    Gene Therapy for Mucopolysaccharidosis Type III (Sanfilippo Syndrome): A New Treatment Horizon"],"prefix":"10.1177","volume":"30","author":[{"given":"Sara","family":"Marc\u00f3","sequence":"first","affiliation":[{"name":"Center of Animal Biotechnology and Gene Therapy and Department of Biochemistry and Molecular Biology, Universitat Aut\u00f2noma de Barcelona (UAB), Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Haurigot","sequence":"additional","affiliation":[{"name":"Center of Animal Biotechnology and Gene Therapy and Department of Biochemistry and Molecular Biology, Universitat Aut\u00f2noma de Barcelona (UAB), Bellaterra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Bosch","sequence":"additional","affiliation":[{"name":"Center of Animal Biotechnology and Gene Therapy and Department of Biochemistry and Molecular Biology, Universitat Aut\u00f2noma de Barcelona (UAB), Bellaterra, Spain"},{"name":"CIBER de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,9,24]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Neufeld EF Muenzer J. 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