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Bainbridge JWB, Mehat MS, Sundaram V, Robbie SJ, Barker SE, Ripamonti C, Georgiadis A, Mowat FM, Beattie SG, Gardner PJ, Feathers KL, Luong VA, Yzer S, Balaggan K, Viswanathan A, de Ravel TJL, Casteels I, Holder GE, Tyler N, Fitzke FW, Weleber RG, Nardini M, Moore AT, Thompson DA, Petersen-Jones SM, Michaelides M, van den Born LI, Stockman A, Smith AJ, Rubin G, Ali RR. Long-term effect of gene therapy on Leber's congenital amaurosis. N Engl J Med 2015; 372:1887-97. [PMID: 25938638 PMCID: PMC4497809 DOI: 10.1056/nejmoa1414221] [Citation(s) in RCA: 525] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Mutations in RPE65 cause Leber's congenital amaurosis, a progressive retinal degenerative disease that severely impairs sight in children. Gene therapy can result in modest improvements in night vision, but knowledge of its efficacy in humans is limited. METHODS We performed a phase 1-2 open-label trial involving 12 participants to evaluate the safety and efficacy of gene therapy with a recombinant adeno-associated virus 2/2 (rAAV2/2) vector carrying the RPE65 complementary DNA, and measured visual function over the course of 3 years. Four participants were administered a lower dose of the vector, and 8 were administered a higher dose. In a parallel study in dogs, we investigated the relationship among vector dose, visual function, and electroretinography (ERG) findings. RESULTS Improvements in retinal sensitivity were evident, to varying extents, in six participants for up to 3 years, peaking at 6 to 12 months after treatment and then declining. No associated improvement in retinal function was detected by means of ERG. Three participants had intraocular inflammation, and two had clinically significant deterioration of visual acuity. The reduction in central retinal thickness varied among participants. In dogs, RPE65 gene therapy with the same vector at lower doses improved vision-guided behavior, but only higher doses resulted in improvements in retinal function that were detectable with the use of ERG. CONCLUSIONS Gene therapy with rAAV2/2 RPE65 vector improved retinal sensitivity, albeit modestly and temporarily. Comparison with the results obtained in the dog model indicates that there is a species difference in the amount of RPE65 required to drive the visual cycle and that the demand for RPE65 in affected persons was not met to the extent required for a durable, robust effect. (Funded by the National Institute for Health Research and others; ClinicalTrials.gov number, NCT00643747.).
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Affiliation(s)
- James W B Bainbridge
- From the UCL (University College London) Institute of Ophthalmology (J.W.B.B., M.S.M., V.S., S.J.R., S.E.B., C.R., A.G., F.M.M., S.G.B., P.J.G., V.A.L., K.B., A.V., G.E.H., F.W.F., M.N., A.T.M., M.M., A.S., A.J.S., G.R., R.R.A.) and the Department of Civil, Environmental, and Geomatic Engineering (N.T.), UCL, and Moorfields Eye Hospital (J.W.B.B., M.S.M., V.S., S.J.R., A.G., K.B., G.H., A.M., M.M.), London, and the Department of Psychology, Durham University, Durham (M.N.) - all in the United Kingdom; the College of Veterinary Medicine, Michigan State University, East Lansing (F.M.M., S.M.P.-J.), and the Kellogg Eye Center, University of Michigan Medical School, Ann Arbor (K.L.F., D.A.T., R.R.A.); the Center for Human Genetics, KU Leuven (T.J.L.R.), and the Department of Ophthalmology, UZ Leuven, Campus Sint-Rafaël (I.C.) - both in Leuven, Belgium; Rotterdam Eye Hospital, Rotterdam, the Netherlands (S.Y., L.I.B.); and the Oregon Retinal Degeneration Center, Ophthalmic Genetics Service, Casey Eye Institute, Oregon Health and Science University, Portland (R.G.W.)
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Kaeppel C, Beattie SG, Fronza R, van Logtenstein R, Salmon F, Schmidt S, Wolf S, Nowrouzi A, Glimm H, von Kalle C, Petry H, Gaudet D, Schmidt M. Reply to: NGS library preparation may generate artifactual integration sites of AAV vectors. Nat Med 2014; 20:578-9. [PMID: 24901561 DOI: 10.1038/nm.3584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christine Kaeppel
- 1] National Center for Tumor Diseases, Heidelberg, Germany. [2] German Cancer Research Center, Heidelberg, Germany
| | | | - Raffaele Fronza
- 1] National Center for Tumor Diseases, Heidelberg, Germany. [2] German Cancer Research Center, Heidelberg, Germany
| | | | | | - Sabine Schmidt
- Genomics and Proteomics Core Facility, German Cancer Research Center, Heidelberg, Germany
| | - Stephan Wolf
- Genomics and Proteomics Core Facility, German Cancer Research Center, Heidelberg, Germany
| | - Ali Nowrouzi
- 1] National Center for Tumor Diseases, Heidelberg, Germany. [2] German Cancer Research Center, Heidelberg, Germany
| | - Hanno Glimm
- 1] National Center for Tumor Diseases, Heidelberg, Germany. [2] German Cancer Research Center, Heidelberg, Germany
| | - Christof von Kalle
- 1] National Center for Tumor Diseases, Heidelberg, Germany. [2] German Cancer Research Center, Heidelberg, Germany
| | | | - Daniel Gaudet
- ECOGENE-21 Clinical Research Center, Department of Medicine, Université de Montréal, Chicoutimi, Canada
| | - Manfred Schmidt
- 1] National Center for Tumor Diseases, Heidelberg, Germany. [2] German Cancer Research Center, Heidelberg, Germany
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Pañeda A, Lopez-Franco E, Kaeppel C, Unzu C, Gil-Royo AG, D'Avola D, Beattie SG, Olagüe C, Ferrero R, Sampedro A, Mauleon I, Hermening S, Salmon F, Benito A, Gavira JJ, Cornet ME, del Mar Municio M, von Kalle C, Petry H, Prieto J, Schmidt M, Fontanellas A, González-Aseguinolaza G. Safety and Liver Transduction Efficacy of rAAV5-cohPBGD in Nonhuman Primates: A Potential Therapy for Acute Intermittent Porphyria. Hum Gene Ther 2013; 24:1007-17. [DOI: 10.1089/hum.2013.166] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Astrid Pañeda
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
- DIGNA Biotech, 28020 Madrid, Spain
| | - Esperanza Lopez-Franco
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
| | - Christine Kaeppel
- National Center for Tumor Diseases and German Cancer Research Center, 69120 Heidelberg, Germany
| | - Carmen Unzu
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
| | - Ana Gloria Gil-Royo
- Department of Pharmacology and Toxicology, University of Navarra, (UNAV), 31008 Pamplona, Spain
| | - Delia D'Avola
- Department of Radiology, Department of Cardiology, University Clinic, UNAV, 31008 Pamplona, Spain
- Liver Unit and CIBERehd, 31008 Pamplona, Spain
| | | | - Cristina Olagüe
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
| | - Roberto Ferrero
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
| | - Ana Sampedro
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
| | - Itsaso Mauleon
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
| | | | | | - Alberto Benito
- Department of Radiology, Department of Cardiology, University Clinic, UNAV, 31008 Pamplona, Spain
| | - Juan Jose Gavira
- Department of Radiology, Department of Cardiology, University Clinic, UNAV, 31008 Pamplona, Spain
| | | | | | - Christof von Kalle
- National Center for Tumor Diseases and German Cancer Research Center, 69120 Heidelberg, Germany
| | | | - Jesus Prieto
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
- Department of Radiology, Department of Cardiology, University Clinic, UNAV, 31008 Pamplona, Spain
- Liver Unit and CIBERehd, 31008 Pamplona, Spain
| | - Manfred Schmidt
- National Center for Tumor Diseases and German Cancer Research Center, 69120 Heidelberg, Germany
| | - Antonio Fontanellas
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, 31008 Pamplona, Spain
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Nijmeijer BA, Petry H, Sonnemans MA, Beattie SG, Salmon LSF, Preusting H, Van Oorschot A, Twisk J. Safe and efficacious delivery of the human clotting factor IX gene to non human primates using a recombinant AAV vector produced in a fully-scalable GMP-compliant production system. Toxicol Lett 2013. [DOI: 10.1016/j.toxlet.2013.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kaeppel C, Beattie SG, Fronza R, van Logtenstein R, Salmon F, Schmidt S, Wolf S, Nowrouzi A, Glimm H, von Kalle C, Petry H, Gaudet D, Schmidt M. A largely random AAV integration profile after LPLD gene therapy. Nat Med 2013; 19:889-91. [PMID: 23770691 DOI: 10.1038/nm.3230] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 05/06/2013] [Indexed: 12/12/2022]
Abstract
The clinical application of adeno-associated virus vectors (AAVs) is limited because of concerns about AAV integration-mediated tumorigenicity. We performed integration-site analysis after AAV1-LPL(S447X) intramuscular injection in five lipoprotein lipase-deficient subjects, revealing random nuclear integration and hotspots in mitochondria. We conclude that AAV integration is potentially safe and that vector breakage and integration may occur from each position of the vector genome. Future viral integration-site analyses should include the mitochondrial genome.
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Affiliation(s)
- Christine Kaeppel
- National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
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Unzu C, Hervás-Stubbs S, Sampedro A, Mauleón I, Mancheño U, Alfaro C, de Salamanca RE, Benito A, Beattie SG, Petry H, Prieto J, Melero I, Fontanellas A. Transient and intensive pharmacological immunosuppression fails to improve AAV-based liver gene transfer in non-human primates. J Transl Med 2012; 10:122. [PMID: 22704060 PMCID: PMC3412719 DOI: 10.1186/1479-5876-10-122] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 06/15/2012] [Indexed: 11/28/2022] Open
Abstract
Background Adeno-associated vectors (rAAV) have been used to attain long-term liver gene expression. In humans, the cellular immune response poses a serious obstacle for transgene persistence while neutralizing humoral immunity curtails re-administration. Porphobilinogen deaminase (PBGD) haploinsufficiency (acute intermittent porphyria) benefits from liver gene transfer in mouse models and clinical trials are about to begin. In this work, we sought to study in non-human primates the feasibility of repeated gene-transfer with intravenous administration of rAAV5 vectors under the effects of an intensive immunosuppressive regimen and to analyze its ability to circumvent T-cell immunity and thereby prolong transgene expression. Methods Three female Macaca fascicularis were intravenously injected with 1x1013 genome copies/kg of rAAV5 encoding the human PBGD. Mycophenolate mofetil (MMF), anti-thymocyte immunoglobulin, methylprednisolone, tacrolimus and rituximab were given in combination during 12 weeks to block T- and B-cell mediated adaptive immune responses in two macaques. Immunodeficient and immunocompetent mice were intravenously injected with 5x1012 genome copies/kg of rAAV5-encoding luciferase protein. Forty days later MMF, tacrolimus and rituximab were daily administrated to ascertain whether the immunosuppressants or their metabolites could interfere with transgene expression. Results Macaques given a rAAV5 vector encoding human PBGD developed cellular and humoral immunity against viral capsids but not towards the transgene. Anti-AAV humoral responses were attenuated during 12 weeks but intensely rebounded following cessation of the immunosuppressants. Accordingly, subsequent gene transfer with a rAAV5 vector encoding green fluorescent protein was impossible. One macaque showed enhanced PBGD expression 25 weeks after rAAV5-pbgd administration but overexpression had not been detected while the animal was under immunosuppression. As a potential explanation, MMF decreases transgene expression in mouse livers that had been successfully transduced by a rAAV5 several weeks before MMF onset. Such a silencing effect was independent of AAV complementary strand synthesis and requires an adaptive immune system. Conclusions These results indicate that our transient and intensive pharmacological immunosuppression fails to improve AAV5-based liver gene transfer in non-human primates. The reasons include an incomplete restraint of humoral immune responses to viral capsids that interfere with repeated gene transfer in addition to an intriguing MMF-dependent drug-mediated interference with liver transgene expression.
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Affiliation(s)
- Carmen Unzu
- Gene Therapy and Hepatology Area, Centre for Applied Medical Research (CIMA), University of Navarra, Navarra, Spain
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Pañeda A, Collantes M, Beattie SG, Otano I, Snapper J, Timmermans E, Guembe L, Petry H, Lanciego JL, Benito A, Prieto J, Rodriguez-Pena MS, Peñuelas I, Gonzalez-Aseguinolaza G. Adeno-Associated Virus Liver Transduction Efficiency Measured by in Vivo [18F]FHBG Positron Emission Tomography Imaging in Rodents and Nonhuman Primates. Hum Gene Ther 2011; 22:999-1009. [DOI: 10.1089/hum.2010.190] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Astrid Pañeda
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research (CIMA), 31008 Pamplona, Spain
| | - Maria Collantes
- Small Animal Imaging Research Unit, Center for Applied Medical Research, University Clinic of Navarra (CIMA-CUN), 31008 Pamplona, Spain
| | | | - Itzia Otano
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research (CIMA), 31008 Pamplona, Spain
| | - Jolanda Snapper
- Amsterdam Molecular Therapeutics, Amsterdam, 1100 The Netherlands
| | - Eric Timmermans
- Amsterdam Molecular Therapeutics, Amsterdam, 1100 The Netherlands
| | - Laura Guembe
- Morphology and Imaging Unit, CIMA, 31008 Pamplona, Spain
| | - Harald Petry
- Amsterdam Molecular Therapeutics, Amsterdam, 1100 The Netherlands
| | | | - Alberto Benito
- Department of Radiology, University Clinic of Navarra, University of Navarra (UNAV), 31008 Pamplona, Spain
| | - Jesus Prieto
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research (CIMA), 31008 Pamplona, Spain
- Liver Unit, and Center for Biomedical Research Network in Liver and Digestive Diseases (CIBERehd), University Clinic of Navarra, UNAV, 31008 Pamplona, Spain
| | | | - Iván Peñuelas
- Small Animal Imaging Research Unit, Center for Applied Medical Research, University Clinic of Navarra (CIMA-CUN), 31008 Pamplona, Spain
- Department of Nuclear Medicine, University Clinic of Navarra, UNAV, 31008 Pamplona, Spain
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Vanrell L, Di Scala M, Blanco L, Otano I, Gil-Farina I, Baldim V, Paneda A, Berraondo P, Beattie SG, Chtarto A, Tenenbaum L, Prieto J, Gonzalez-Aseguinolaza G. Development of a liver-specific Tet-on inducible system for AAV vectors and its application in the treatment of liver cancer. Mol Ther 2011; 19:1245-53. [PMID: 21364542 DOI: 10.1038/mt.2011.37] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Recombinant adeno-associated virus (rAAV) are effective gene delivery vehicles that can mediate long-lasting transgene expression. However, tight regulation and tissue-specific transgene expression is required for certain therapeutic applications. For regulatable expression from the liver we designed a hepatospecific bidirectional and autoregulatory tetracycline (Tet)-On system (Tet(bidir)Alb) flanked by AAV inverted terminal repeats (ITRs). We characterized the inducible hepatospecific system in comparison with an inducible ubiquitous expression system (Tet(bidir)CMV) using luciferase (luc). Although the ubiquitous system led to luc expression throughout the mouse, luc expression derived from the hepatospecific system was restricted to the liver. Interestingly, the induction rate of the Tet(bidir)Alb was significantly higher than that of Tet(bidir)CMV, whereas leakage of Tet(bidir)Alb was significantly lower. To evaluate the therapeutic potential of this vector, an AAV-Tet(bidir)-Alb-expressing interleukin-12 (IL-12) was tested in a murine model for hepatic colorectal metastasis. The vector induced dose-dependent levels of IL-12 and interferon-γ (IFN-γ), showing no significant toxicity. AAV-Tet(bidir)-Alb-IL-12 was highly efficient in preventing establishment of metastasis in the liver and induced an efficient T-cell memory response to tumor cells. Thus, we have demonstrated persistent, and inducible in vivo expression of a gene from a liver-specific Tet-On inducible construct delivered via an AAV vector and proved to be an efficient tool for treating liver cancer.
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Affiliation(s)
- Lucia Vanrell
- Division of Hepatology and Gene Therapy, Center for Applied Medical Research, Pamplona, Spain
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Unzu C, Sampedro A, Mauleón I, Alegre M, Beattie SG, de Salamanca RE, Snapper J, Twisk J, Petry H, González-Aseguinolaza G, Artieda J, Rodríguez-Pena MS, Prieto J, Fontanellas A. Sustained enzymatic correction by rAAV-mediated liver gene therapy protects against induced motor neuropathy in acute porphyria mice. Mol Ther 2010; 19:243-50. [PMID: 20877347 DOI: 10.1038/mt.2010.210] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Acute intermittent porphyria (AIP) is characterized by a hereditary deficiency of hepatic porphobilinogen deaminase (PBGD) activity. Clinical features are acute neurovisceral attacks accompanied by overproduction of porphyrin precursors in the liver. Recurrent life-threatening attacks can be cured only by liver transplantation. We developed recombinant adeno-associated virus (rAAV) vectors expressing human PBGD protein driven by a liver-specific promoter to provide sustained protection against induced attacks in a predictive model for AIP. Phenobarbital injections in AIP mice induced porphyrin precursor accumulation, functional block of nerve conduction, and progressive loss of large-caliber axons in the sciatic nerve. Hepatocyte transduction showed no gender variation after rAAV2/8 injection, while rAAV2/5 showed lower transduction efficiency in females than males. Full protection against induced phenobarbital-attacks was achieved in animals showing over 10% of hepatocytes expressing high amounts of PBGD. More importantly, sustained hepatic expression of hPBGD protected against loss of large-caliber axons in the sciatic nerve and disturbances in nerve conduction velocity as induced by recurrent phenobarbital administrations. These data show for the first time that porphyrin precursors generated in the liver interfere with motor function. rAAV2/5-hPBGD vector can be produced in sufficient quantity for an intended gene therapy trial in patients with recurrent life-threatening porphyria attacks.
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Affiliation(s)
- Carmen Unzu
- Gene Therapy and Hepatology Area, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain
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Vaessen SFC, Veldman RJ, Comijn EM, Snapper J, Sierts JA, van den Oever K, Beattie SG, Twisk J, Kuivenhoven JA. AAV gene therapy as a means to increase apolipoprotein (Apo) A-I and high-density lipoprotein-cholesterol levels: correction of murine ApoA-I deficiency. J Gene Med 2009; 11:697-707. [PMID: 19431216 DOI: 10.1002/jgm.1344] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Inherited apolipoprotein (Apo) A-I deficiency is an orphan disorder characterized by high-density lipoprotein (HDL)-cholesterol deficiency and premature atherosclerosis. Constitutive over-expression of ApoA-I might provide a means to treat this disease. The present study provides a comprehensive evaluation of adeno-associated virus (AAV)-mediated ApoA-I gene delivery to express human (h)ApoA-I and correct the low HDL-cholesterol phenotype associated with ApoA-I deficiency. METHODS In an effort to maximize AAV-mediated gene expression, we performed head-to-head comparisons of recombinant AAVs with pseudotype capsids 1, 2, 6 and 8 administered by different routes with the use of five different liver-specific promoters in addition to cytomegalovirus as single-stranded or as self-complementary (sc) AAV vectors. RESULTS Intravenous administration of 1 x 10(13) gc/kg scAAV8, in combination with the liver-specific promoter LP1, in female ApoA-I(-/-) mice resulted in hApoA-I expression levels of 634 +/- 69 mg/l, which persisted for the duration of the study (15 weeks). This treatment resulted in full recovery of HDL-cholesterol levels with correction of HDL particle size and apolipoprotein composition. In addition, we observed increased adrenal cholesterol content and a significant increase in bodyweight in treated mice. CONCLUSIONS The present study demonstrates that systemic delivery of a scAAV8 vector provides a means for efficient liver expression of hApoA-I, thereby correcting the lipid abnormalities associated with murine ApoA-I deficiency. Importantly, the study demonstrates that AAV-based gene therapy can be used to express therapeutic proteins at a high level for a prolonged period of time and, as such, provides a basis for further development of this strategy to treat hApoA-I deficiency.
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Affiliation(s)
- Stefan F C Vaessen
- Department of Experimental Vascular Medicine, Academic Medical Centre, Amsterdam, the Netherlands
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Pañeda A, Vanrell L, Mauleon I, Crettaz JS, Berraondo P, Timmermans EJ, Beattie SG, Twisk J, van Deventer S, Prieto J, Fontanellas A, Rodriguez-Pena MS, Gonzalez-Aseguinolaza G. Effect of Adeno-Associated Virus Serotype and Genomic Structure on Liver Transduction and Biodistribution in Mice of Both Genders. Hum Gene Ther 2009; 20:908-17. [DOI: 10.1089/hum.2009.031] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Astrid Pañeda
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Lucia Vanrell
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Itsaso Mauleon
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Julien S. Crettaz
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | - Pedro Berraondo
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | | | | | - Jaap Twisk
- AMT BV, 1105 BA Amsterdam, The Netherlands
| | | | - Jesus Prieto
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
- Liver Unit, University Clinic, University of Navarra, 31008 Pamplona, Spain
| | - Antonio Fontanellas
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
| | | | - Gloria Gonzalez-Aseguinolaza
- Division Gene Therapy and Hepatology, Center for Applied Medical Research (CIMA), University of Navarra, 31008 Pamplona, Spain
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Beattie SG, Goetzman E, Tang Q, Conlon T, Campbell-Thompson M, Matern D, Vockley J, Flotte TR. Recombinant adeno-associated virus-mediated gene delivery of long chain acyl coenzyme A dehydrogenase (LCAD) into LCAD-deficient mice. J Gene Med 2008; 10:1113-23. [PMID: 18720429 DOI: 10.1002/jgm.1242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Very long chain acyl coenzyme A (CoA) dehydrogenase (VLCAD) deficiency is a relatively common mitochondrial beta-oxidation disorder. The most severe form of VLCAD deficiency presents with neonatal cardiomyopathy and hepatic failure and is generally fatal within the first year of life. Mice deficient for long chain acyl CoA dehydrogenase (LCAD) closely resemble the clinical syndrome observed in VLCAD-deficient humans. Recombinant adeno-associated viral (rAAV) vectors with pseudotype capsids were investigated for their potential towards correcting the phenotype observed in mice heterozygous (+/-) for LCAD (i.e. liver and muscle steatosis). METHODS rAAV containing the mouse LCAD cDNA (mLCAD) under the transcriptional control of the CMV/chicken beta-actin hybrid promoter were injected intramuscularly into the tibialis anterior (TA) muscle of LCAD(+/-) mice or injected into the portal vein to transduce hepatocytes. RESULTS Ten weeks post-injection of rAAV1-mLCAD into the TA muscle, significantly increased levels of mLCAD within mitochondria were demonstrated by immunostaining of TA sections, immunoblotting of mitochondrial isolates and by the electron transfer flavoprotein (ETF) fluorescence reduction enzyme activity assay. Magnetic resonance spectroscopy of vector-injected TA muscle demonstrated a reduction in the lipid content compared to phosphate-buffered saline-injected mice, whereas a systemic effect was observed as a reduction in liver macrosteatosis. Eight weeks after portal vein injection of rAAV8-mLCAD into LCAD(+/-) mice, increased levels of mLCAD within hepatocyte mitochondria were demonstrated by immunostaining and also by the ETF assay. Scoring of the hepatosteatosis observed in partially deficient LCAD mice indicated a reduction in the lipid content within livers of vector-treated mice. CONCLUSIONS These studies show that rAAV-mediated delivery of mLCAD was efficient and led to an amelioration of local and systemic pathologies observed in partially deficient LCAD mice.
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Affiliation(s)
- Stuart G Beattie
- University of Massachusetts Medical School, Worcester, MA 01655, USA
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Beattie SG, Goetzman E, Conlon T, Germain S, Walter G, Campbell-Thompson M, Matern D, Vockley J, Flotte TR. Biochemical correction of short-chain acyl-coenzyme A dehydrogenase deficiency after portal vein injection of rAAV8-SCAD. Hum Gene Ther 2008; 19:579-88. [PMID: 18500942 DOI: 10.1089/hum.2007.168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Recombinant adeno-associated viral vectors pseudotyped with serotype 5 and 8 capsids (AAV5 and AAV8) have been shown to be efficient gene transfer reagents for the liver. We have produced AAV5 and AAV8 vectors that express mouse short-chain acyl-CoA dehydrogenase (mSCAD) cDNA under the transcriptional control of the cytomegalovirus-chicken beta-actin hybrid promoter. We hypothesized that these vectors would produce sufficient hepatocyte transduction (after administration via the portal vein) and thus sufficient SCAD enzyme to correct the phenotype observed in the SCAD-deficient (BALB/cByJ) mouse, which includes elevated blood butyrylcarnitine and hepatic steatosis. Ten weeks after portal vein injection into 8-week-old mice, AAV8-treated livers contained acyl-CoA dehydrogenase activity (14.3 mU/mg) toward butyryl-CoA, compared with 7.6 mU/mg in mice that received phosphate-buffered saline. Immunohistochemistry showed expression of mSCAD within rAAV8-mSCAD-transduced hepatocytes, as seen by light microscopy. A significant reduction of circulating butyrylcarnitine was seen in AAV5-mSCAD- and AAV8-mSCAD-injected mice. Magnetic resonance spectroscopy of fasted mice demonstrated a significant reduction in relative lipid content within the livers of AAV8-mSCAD-treated mice. These results demonstrate biochemical correction of SCAD deficiency after AAV8-mediated SCAD gene delivery.
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Affiliation(s)
- Stuart G Beattie
- University of Massachusetts Medical School, Worcester, MA 01655, USA
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14
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Cruz PE, Mueller C, Cossette TL, Golant A, Tang Q, Beattie SG, Brantly M, Campbell-Thompson M, Blomenkamp KS, Teckman JH, Flotte TR. In vivo post-transcriptional gene silencing of alpha-1 antitrypsin by adeno-associated virus vectors expressing siRNA. J Transl Med 2007; 87:893-902. [PMID: 17592477 DOI: 10.1038/labinvest.3700629] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
alpha-1 Antitrypsin (AAT) deficiency is one of the most common genetic diseases in North America, with a carrier frequency of approximately 4% in the US population. Homozygosity for the most common mutation (Glu342Lys, PI(*)Z) leads to the synthesis of a mutant protein, which accumulates and polymerizes within hepatocytes rather than being efficiently secreted. This lack of secretion causes severe serum deficiency predisposing to chronic lung disease. Twelve to fifteen percent of patients with PI(*)ZZ also develop liver disease, which can be severe, even in infancy. This is thought to be due to toxic effects of the accumulated mutant Z-AAT within the hepatocyte. Thus, an approach to reduce AAT-deficient liver disease will likely require some mechanism to decrease the amount of Z-AAT within hepatocytes. In this report, we describe studies of small-interfering RNAs (siRNAs) designed to downregulate endogenous AAT within hepatocytes. Three different siRNA sequences were identified and cloned into a recombinant adeno-associated virus (rAAV) backbone, either singly or as a trifunctional (3X) construct. Each had activity independently, but the levels of AAT expression in cell culture models showed the greatest decrease with the 3X construct, resulting in levels that were five-fold lower than controls. The rAAV-3X-siRNA was then packaged into AAV8 capsids and used in vivo to transduce the livers of human Z-AAT overexpressing transgenic mice. Those studies showed a decrease in total human AAT, a clearing of Z-AAT accumulation by immunohistochemistry, and a decrease in monomer Z-AAT within the liver within 3 weeks after vector injection. The rAAV8-3X-siRNA vector may hold promise as a potential therapy for patients with AAT liver disease.
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Affiliation(s)
- Pedro E Cruz
- Department of Pediatrics, University of Florida, Gainesville, FL, USA
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15
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Kanadia RN, Shin J, Yuan Y, Beattie SG, Wheeler TM, Thornton CA, Swanson MS. Reversal of RNA missplicing and myotonia after muscleblind overexpression in a mouse poly(CUG) model for myotonic dystrophy. Proc Natl Acad Sci U S A 2006; 103:11748-53. [PMID: 16864772 PMCID: PMC1544241 DOI: 10.1073/pnas.0604970103] [Citation(s) in RCA: 282] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Indexed: 01/19/2023] Open
Abstract
RNA-mediated pathogenesis is a recently developed disease model that proposes that certain types of mutant genes produce toxic transcripts that inhibit the activities of specific proteins. This pathogenesis model was proposed first for the neuromuscular disease myotonic dystrophy (DM), which is associated with the expansion of structurally related (CTG)(n) and (CCTG)(n) microsatellites in two unrelated genes. At the RNA level, these expansions form stable hairpins that alter the pre-mRNA splicing activities of two antagonistic factor families, the MBNL and CELF proteins. It is unclear which altered activity is primarily responsible for disease pathogenesis and whether other factors and biochemical pathways are involved. Here, we show that overexpression of Mbnl1 in vivo mediated by transduction of skeletal muscle with a recombinant adeno-associated viral vector rescues disease-associated muscle hyperexcitability, or myotonia, in the HSA(LR) poly(CUG) mouse model for DM. Myotonia reversal occurs concurrently with restoration of the normal adult-splicing patterns of four pre-mRNAs that are misspliced during postnatal development in DM muscle. Our results support the hypothesis that the loss of MBNL1 activity is a primary pathogenic event in the development of RNA missplicing and myotonia in DM and provide a rationale for therapeutic strategies designed either to overexpress MBNL1 or inhibit MBNL1 interactions with CUG and CCUG repeat expansions.
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Affiliation(s)
- Rahul N. Kanadia
- Department of Molecular Genetics and Microbiology
- Genetics Institute, University of Florida College of Medicine, 1600 Southwest Archer Road, Gainesville, FL 32610; and
| | - Jihae Shin
- Department of Molecular Genetics and Microbiology
- Genetics Institute, University of Florida College of Medicine, 1600 Southwest Archer Road, Gainesville, FL 32610; and
| | - Yuan Yuan
- Department of Molecular Genetics and Microbiology
- Genetics Institute, University of Florida College of Medicine, 1600 Southwest Archer Road, Gainesville, FL 32610; and
| | - Stuart G. Beattie
- Department of Molecular Genetics and Microbiology
- Genetics Institute, University of Florida College of Medicine, 1600 Southwest Archer Road, Gainesville, FL 32610; and
| | - Thurman M. Wheeler
- Department of Neurology, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642
| | - Charles A. Thornton
- Department of Neurology, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642
| | - Maurice S. Swanson
- Department of Molecular Genetics and Microbiology
- Genetics Institute, University of Florida College of Medicine, 1600 Southwest Archer Road, Gainesville, FL 32610; and
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16
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Harris JD, Beattie SG, Dickson JG. Novel tools for production and purification of recombinant adeno-associated viral vectors. Methods Mol Med 2003; 76:255-67. [PMID: 12526168 DOI: 10.1385/1-59259-304-6:255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Julian D Harris
- Division of Biochemistry, School of Biological Sciences, Royal Holloway University of London, United Kingdom
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17
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Graham IR, Beattie SG, Hill VJ, Dickson G. Oligonucleotide-based gene correction strategies: applications to neuromuscular and cardiovascular diseases. Croat Med J 2001; 42:467-72. [PMID: 11471201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Gene augmentation is an attractive and viable approach in treatment of inherited diseases, despite its limitations, ie, the amount of viral genome in replication-defective viral vectors is often too small for larger copy DNAs to be inserted. In addition, most viral vectors, when assessed in vivo, can elicit a host immune response, especially in cases of introduction of a gene copy where protein is completely absent, may have potential mutagenic effect on the host genome, or may be down-regulated. Therefore, alternative therapeutic approaches are being investigated, such as chimeraplasty, in which a mutated allele that already exists in an affected individual can be corrected. Although the only gene defects that can be corrected by chimeraplasty are point mutations, and the correction frequencies are variable, it has been observed that intracellular delivery of oligonucleotides is likely to be more efficient than that of plasmid DNA or viral vectors, because corrected genes are expressed from their autologous promoters, ensuring thus correct spatial and temporal expression, and host immune response is not elicited. Another strategy in the therapy of inherited diseases, such as Duchenne muscular dystrophy, is the application of antisense RNA oligonucleotides, or splicomers, to the exclusion of exons whose mutation leads to production of deficient essential proteins. Here we report the recent progress made and problems encountered in each of these fields, and discuss the potential of nucleotide-based gene correction strategies in treatment of neuromuscular and cardiovascular diseases.
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Affiliation(s)
- I R Graham
- Centre for Biomedical Research, School of Biological Sciences, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, United Kingdom
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