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A scalable human neuromuscular organoid platform enables lineage-specific analysis of drug responses in spinal muscular atrophy

Item Type:Preprint
Title:A scalable human neuromuscular organoid platform enables lineage-specific analysis of drug responses in spinal muscular atrophy
Creators: Lahmann, Ines ORCID logoORCID: https://orcid.org/0000-0003-0640-4519, García-Pérez, Angélica, El-Shimy, Ismail Amr ORCID logoORCID: https://orcid.org/0000-0003-0587-5140, Afonso Martins, Inês ORCID logoORCID: https://orcid.org/0009-0007-6147-2975, Nguyen, Lan Vi Ngoc, Moysidou, Chrysanthi-Maria ORCID logoORCID: https://orcid.org/0000-0001-9809-2764, Findeisen, Noelle, Rudolph, Ina-Maria ORCID logoORCID: https://orcid.org/0000-0002-3903-0755, Bukas, Christina, Cea, Donatella, Bassell, Gary J., Rossoll, Wilfried, Piraud, Marie, Diecke, Sebastian ORCID logoORCID: https://orcid.org/0000-0002-5219-5992 and Gouti, Mina ORCID logoORCID: https://orcid.org/0000-0001-7422-1605
Abstract:Scalable human models that capture interactions between distinct tissues remain limited, constraining mechanistic insight and therapeutic prediction. Here, we established a scalable, automation-compatible human neuromuscular organoid (NMO) platform that enables integrated analysis of neuronal and muscle lineages in spinal muscular atrophy (SMA). Patient-derived NMOs reproducibly self-organise into spinal cord and skeletal muscle compartments and form functional neuromuscular circuits. SMA NMOs recapitulate early disease features, including reduced survival motor neuron (SMN) protein levels and impaired neuromuscular junction (NMJ) maturation. Single-nucleus RNA sequencing identifies lineagespecific transcriptional changes across neuronal and muscle compartments preceding functional deficits. Using this platform, we compared two clinically relevant SMN2 splicing modulators and observed distinct, cell-type-dependent responses. While both compounds increased SMN levels and NMJ number, only one enhanced myofiber growth and improved contractile function. These findings highlight muscle maturation, rather than NMJ number alone, as a key determinant of functional recovery and establish NMOs as a scalable system for studying cell-type-specific therapeutic responses.
Source:bioRxiv
Publisher:Cold Spring Harbor Laboratory Press
Article Number:2026.08.23.745904
Date:24 August 2026
Official Publication:https://doi.org/10.64898/2026.08.23.745904

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