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Leclercq B, Mejlachowicz D, Behar-Cohen F. Ocular Barriers and Their Influence on Gene Therapy Products Delivery. Pharmaceutics 2022; 14:pharmaceutics14050998. [PMID: 35631584 PMCID: PMC9143174 DOI: 10.3390/pharmaceutics14050998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023] Open
Abstract
The eye is formed by tissues and cavities that contain liquids whose compositions are highly regulated to ensure their optical properties and their immune and metabolic functions. The integrity of the ocular barriers, composed of different elements that work in a coordinated fashion, is essential to maintain the ocular homeostasis. Specialized junctions between the cells of different tissues have specific features which guarantee sealing properties and selectively control the passage of drugs from the circulation or the outside into the tissues and within the different ocular compartments. Tissues structure also constitute selective obstacles and pathways for various molecules. Specific transporters control the passage of water, ions, and macromolecules, whilst efflux pumps reject and eliminate toxins, metabolites, or drugs. Ocular barriers, thus, limit the bioavailability of gene therapy products in ocular tissues and cells depending on the route chosen for their administration. On the other hand, ocular barriers allow a real local treatment, with limited systemic side-effects. Understanding the different barriers that limit the accessibility of different types of gene therapy products to the different target cells is a prerequisite for the development of efficient gene delivery systems. This review summarizes actual knowledge on the different ocular barriers that limit the penetration and distribution of gene therapy products using different routes of administration, and it provides a general overview of various methods used to bypass the ocular barriers.
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Affiliation(s)
- Bastien Leclercq
- Centre de Recherche des Cordeliers, From Physiopathology of Ocular Diseases to Clinical Development, Sorbonne University, Université de Paris Cité, Inserm, F-75006 Paris, France; (B.L.); (D.M.)
| | - Dan Mejlachowicz
- Centre de Recherche des Cordeliers, From Physiopathology of Ocular Diseases to Clinical Development, Sorbonne University, Université de Paris Cité, Inserm, F-75006 Paris, France; (B.L.); (D.M.)
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, From Physiopathology of Ocular Diseases to Clinical Development, Sorbonne University, Université de Paris Cité, Inserm, F-75006 Paris, France; (B.L.); (D.M.)
- Assistance Publique Hôpitaux de Paris, Ophtalmopole, Cochin Hospital, Université de Paris Cité, F-75015 Paris, France
- Department of Ophthalmology, Hôpital Foch, F-92150 Suresnes, France
- Correspondence:
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Hoogewoud F, Kowalczuk L, Bousquet E, Brézin A, Touchard E, Buggage R, Bordet T, Behar-Cohen F. [Anti-TNF-α in the treatment of non-infectious uveitis]. Med Sci (Paris) 2020; 36:893-899. [PMID: 33026332 DOI: 10.1051/medsci/2020160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Non-infectious uveitis is a heterogenous group of potentially blinding ocular autoimmune diseases that may represent a manifestation of a systemic condition or may affect the eyes only. A systemically administered anti-TNF has recently been approved for the treatment of non-infectious uveitis, broadening the therapeutic arsenal available to control intraocular inflammation and reduce uveitis complications that can lead to vision loss. When uveitis affects only the eyes, a local anti-TNF-α administration strategy could optimize the ocular therapeutic effect and reduce undesirable systemic side-effects. A new ocular method of non-viral gene therapy, currently in development, may broaden the indications for ocular anti-TNF-α agents, not only for uveitis but also for other diseases in which TNF-α-mediated neuro-inflammation has been demonstrated.
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Affiliation(s)
- Florence Hoogewoud
- Ophtalmopole Hôpital Cochin; Assistance Publique-Hôpitaux de Paris; Université de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France - Département d'ophtalmologie de l'université de Lausanne, Hôpital Ophtalmologique Jules-Gonin, Lausanne, Suisse
| | - Laura Kowalczuk
- Département d'ophtalmologie de l'université de Lausanne, Hôpital Ophtalmologique Jules-Gonin, Lausanne, Suisse - Centre de recherches des Cordeliers; Inserm UMR 1138, Physiopathologie des maladies oculaires : innovations thérapeutiques; Université de Paris, 15 rue de l'École de Médecine, 75006 Paris, France
| | - Elodie Bousquet
- Ophtalmopole Hôpital Cochin; Assistance Publique-Hôpitaux de Paris; Université de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France - Centre de recherches des Cordeliers; Inserm UMR 1138, Physiopathologie des maladies oculaires : innovations thérapeutiques; Université de Paris, 15 rue de l'École de Médecine, 75006 Paris, France
| | - Antoine Brézin
- Ophtalmopole Hôpital Cochin; Assistance Publique-Hôpitaux de Paris; Université de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France - Centre de recherches des Cordeliers; Inserm UMR 1138, Physiopathologie des maladies oculaires : innovations thérapeutiques; Université de Paris, 15 rue de l'École de Médecine, 75006 Paris, France
| | | | | | | | - Francine Behar-Cohen
- Ophtalmopole Hôpital Cochin; Assistance Publique-Hôpitaux de Paris; Université de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France - Centre de recherches des Cordeliers; Inserm UMR 1138, Physiopathologie des maladies oculaires : innovations thérapeutiques; Université de Paris, 15 rue de l'École de Médecine, 75006 Paris, France
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Bigot K, Gondouin P, Bénard R, Montagne P, Youale J, Piazza M, Picard E, Bordet T, Behar-Cohen F. Transferrin Non-Viral Gene Therapy for Treatment of Retinal Degeneration. Pharmaceutics 2020; 12:E836. [PMID: 32882879 PMCID: PMC7557784 DOI: 10.3390/pharmaceutics12090836] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023] Open
Abstract
Dysregulation of iron metabolism is observed in animal models of retinitis pigmentosa (RP) and in patients with age-related macular degeneration (AMD), possibly contributing to oxidative damage of the retina. Transferrin (TF), an endogenous iron chelator, was proposed as a therapeutic candidate. Here, the efficacy of TF non-viral gene therapy based on the electrotransfection of pEYS611, a plasmid encoding human TF, into the ciliary muscle was evaluated in several rat models of retinal degeneration. pEYS611 administration allowed for the sustained intraocular production of TF for at least 3 and 6 months in rats and rabbits, respectively. In the photo-oxidative damage model, pEYS611 protected both retinal structure and function more efficiently than carnosic acid, a natural antioxidant, reduced microglial infiltration in the outer retina and preserved the integrity of the outer retinal barrier. pEYS611 also protected photoreceptors from N-methyl-N-nitrosourea-induced apoptosis. Finally, pEYS611 delayed structural and functional degeneration in the RCS rat model of RP while malondialdehyde (MDA) ocular content, a biomarker of oxidative stress, was decreased. The neuroprotective benefits of TF non-viral gene delivery in retinal degenerative disease models further validates iron overload as a therapeutic target and supports the continued development of pEY611 for treatment of RP and dry AMD.
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Affiliation(s)
- Karine Bigot
- Eyevensys, Biopark, 11 rue Watt, 75013 Paris, France; (K.B.); (P.G.); (R.B.); (P.M.); (J.Y.); (M.P.)
| | - Pauline Gondouin
- Eyevensys, Biopark, 11 rue Watt, 75013 Paris, France; (K.B.); (P.G.); (R.B.); (P.M.); (J.Y.); (M.P.)
| | - Romain Bénard
- Eyevensys, Biopark, 11 rue Watt, 75013 Paris, France; (K.B.); (P.G.); (R.B.); (P.M.); (J.Y.); (M.P.)
| | - Pierrick Montagne
- Eyevensys, Biopark, 11 rue Watt, 75013 Paris, France; (K.B.); (P.G.); (R.B.); (P.M.); (J.Y.); (M.P.)
| | - Jenny Youale
- Eyevensys, Biopark, 11 rue Watt, 75013 Paris, France; (K.B.); (P.G.); (R.B.); (P.M.); (J.Y.); (M.P.)
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Team 17, 75006 Paris, France;
| | - Marie Piazza
- Eyevensys, Biopark, 11 rue Watt, 75013 Paris, France; (K.B.); (P.G.); (R.B.); (P.M.); (J.Y.); (M.P.)
| | - Emilie Picard
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Team 17, 75006 Paris, France;
| | - Thierry Bordet
- Eyevensys, Biopark, 11 rue Watt, 75013 Paris, France; (K.B.); (P.G.); (R.B.); (P.M.); (J.Y.); (M.P.)
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Team 17, 75006 Paris, France;
- Ophtalmopole, Cochin Hospital, AP-HP, Assistance Publique Hôpitaux de Paris, 24 rue du Faubourg Saint-Jacques, 75014 Paris, France
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Ocular gene therapies in clinical practice: viral vectors and nonviral alternatives. Drug Discov Today 2019; 24:1685-1693. [PMID: 31173914 DOI: 10.1016/j.drudis.2019.05.038] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 02/17/2019] [Accepted: 05/31/2019] [Indexed: 12/15/2022]
Abstract
Ocular gene therapy has entered into clinical practice. Although viral vectors are currently the best option to replace and/or correct genes, the optimal method to deliver these treatments to the retinal pigment epithelial (RPE) cells and/or photoreceptor cells remains to be improved to increase transduction efficacy and reduce iatrogenic risks. Beyond viral-mediated gene replacement therapies, nonviral gene delivery approaches offer the promise of sustained fine-tuned expression of secreted therapeutic proteins that can be adapted to the evolving stage of the disease course and can address more common nongenetic retinal diseases, such as age-related macular degeneration (AMD). Here, we review current gene therapy strategies for ocular diseases, with a focus on clinical stage products.
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Ramachandran PS, Lee V, Wei Z, Song JY, Casal G, Cronin T, Willett K, Huckfeldt R, Morgan JIW, Aleman TS, Maguire AM, Bennett J. Evaluation of Dose and Safety of AAV7m8 and AAV8BP2 in the Non-Human Primate Retina. Hum Gene Ther 2016; 28:154-167. [PMID: 27750461 DOI: 10.1089/hum.2016.111] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Within the next decade, we will see many gene therapy clinical trials for eye diseases, which may lead to treatments for thousands of visually impaired people around the world. To target retinal diseases that affect specific cell types, several recombinant adeno-associated virus (AAV) serotypes have been generated and used successfully in preclinical mouse studies. Because there are numerous anatomic and physiologic differences between the eyes of mice and "men" and because surgical delivery approaches and immunologic responses also differ between these species, this study evaluated the transduction characteristics of two promising new serotypes, AAV7m8 and AAV8BP2, in the retinas of animals that are most similar to those of humans: non-human primates (NHPs). We report that while AAV7m8 efficiently targets a variety of cell types by subretinal injection in NHPs, transduction after intravitreal delivery was mostly restricted to the inner retina at lower doses that did not induce an immune response. AAV8BP2 targets the cone photoreceptors efficiently but bipolar cells inefficiently by subretinal injection. Additionally, transduction by both serotypes in the anterior chamber of the eye and the optic pathway of the brain was observed post-intravitreal delivery. Finally, we assessed immunogenicity, keeping in mind that these AAV capsids may be used in future clinical trials. We found that AAV8BP2 had a better safety profile compared with AAV7m8, even at the highest doses administered. These studies underscore the differences in AAV transduction between mice and primates, highlighting the importance of careful evaluation of therapeutic vectors in NHPs prior to moving to clinical trials.
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Affiliation(s)
- Pavitra S Ramachandran
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Vivian Lee
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Zhangyong Wei
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Ji Yun Song
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Giulia Casal
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Therese Cronin
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Keirnan Willett
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Rachel Huckfeldt
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Jessica I W Morgan
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Tomas S Aleman
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Albert M Maguire
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Jean Bennett
- Center for Advanced Retinal and Ocular Therapeutics (CAROT) and F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
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Ophthalmic Drug Delivery. Drug Deliv 2016. [DOI: 10.1201/9781315382579-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Mining for genes related to choroidal neovascularization based on the shortest path algorithm and protein interaction information. Biochim Biophys Acta Gen Subj 2016; 1860:2740-9. [PMID: 26987808 DOI: 10.1016/j.bbagen.2016.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/05/2016] [Accepted: 03/10/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Choroidal neovascularization (CNV) is a serious eye disease that may cause visual loss, especially for older people. Many factors have been proven to induce this disease including age, gender, obesity, and so on. However, until now, we have had limited knowledge on CNV's pathogenic mechanism. Discovering the genes that underlie this disease and performing extensive studies on them can help us to understand how CNV occurs and design effective treatments. METHODS In this study, we designed a computational method to identify novel CNV-related genes in a large protein network constructed using the protein-protein interaction information in STRING. The candidate genes were first extracted from the shortest paths connecting any two known CNV-related genes and then filtered by a permutation test and using knowledge of their linkages to known CNV-related genes. RESULTS A list of putative CNV-related candidate genes was accessed by our method. These genes are deemed to have strong relationships with CNV. CONCLUSIONS Extensive analyses of several of the putative genes such as ANK1, ITGA4, CD44 and others indicate that they are related to specific biological processes involved in CNV, implying they may be novel CNV-related genes. GENERAL SIGNIFICANCE The newfound putative CNV-related genes may provide new insights into CNV and help design more effective treatments. This article is part of a Special Issue entitled "System Genetics" Guest Editor: Dr. Yudong Cai and Dr. Tao Huang.
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Pechan P, Wadsworth S, Scaria A. Gene Therapies for Neovascular Age-Related Macular Degeneration. Cold Spring Harb Perspect Med 2014; 5:a017335. [PMID: 25524721 DOI: 10.1101/cshperspect.a017335] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Pathological neovascularization is a key component of the neovascular form (also known as the wet form) of age-related macular degeneration (AMD) and proliferative diabetic retinopathy. Several preclinical studies have shown that antiangiogenesis strategies are effective for treating neovascular AMD in animal models. Vascular endothelial growth factor (VEGF) is one of the main inducers of ocular neovascularization, and several clinical trials have shown the benefits of neutralizing VEGF in patients with neovascular AMD or diabetic macular edema. In this review, we summarize several preclinical and early-stage clinical trials with intraocular gene therapies, which have the potential to reduce or eliminate the repeated intravitreal injections that are currently required for the treatment of neovascular AMD.
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Affiliation(s)
- Peter Pechan
- Gene Therapy, Sanofi-Genzyme R&D Center, Framingham, Massachusetts 01701
| | - Samuel Wadsworth
- Gene Therapy, Sanofi-Genzyme R&D Center, Framingham, Massachusetts 01701
| | - Abraham Scaria
- Gene Therapy, Sanofi-Genzyme R&D Center, Framingham, Massachusetts 01701
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