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Mao J, Wang Y, Zhang W, Shen Y, Zhang G, Xi W, Wang Q, Ruan Z, Wang J, Xi X. Long-term correction of hemorrhagic diathesis in hemophilia A mice by an AAV-delivered hybrid FVIII composed of the human heavy chain and the rat light chain. Front Med 2022; 16:584-595. [PMID: 35038106 DOI: 10.1007/s11684-021-0844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/29/2020] [Indexed: 12/01/2022]
Abstract
Conventional therapies for hemophilia A (HA) are prophylactic or on-demand intravenous FVIII infusions. However, they are expensive and inconvenient to perform. Thus, better strategies for HA treatment must be developed. In this study, a recombinant FVIII cDNA encoding a human/rat hybrid FVIII with an enhanced procoagulant potential for adeno-associated virus (AAV)-delivered gene therapy was developed. Plasmids containing human FVIII heavy chain (hHC), human light chain (hLC), and rat light chain (rLC) were transfected into cells and hydrodynamically injected into HA mice. Purified AAV viruses were intravenously injected into HA mice at two doses. Results showed that the hHC + rLC protein had a higher activity than the hHC + hLC protein at comparable expression levels. The specific activity of hHC + rLC was about 4- to 8-fold higher than that of their counterparts. Hydrodynamic injection experiments obtained consistent results. Notably, the HA mice undergoing the AAV-delivered hHC + rLC treatment exhibited a visibly higher activity than those treated with hHC + hLC, and the therapeutic effects lasted for up to 40 weeks. In conclusion, the application of the hybrid FVIII (hHC + rLC) via an AAV-delivered gene therapy substantially improved the hemorrhagic diathesis of the HA mice. These data might be of help to the development of optimized FVIII expression cassette for HA gene therapy.
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Affiliation(s)
- Jianhua Mao
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Collaborative Innovation Center of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Yun Wang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Collaborative Innovation Center of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.,Shanghai Institute of Hematology, State Key Laboratory for Medical Genomics and Department of Hematology, Collaborative Innovation Center of Systems Biomedicine, Pôle Sino-Français des Sciences du Vivant et Genomique, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Wei Zhang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Collaborative Innovation Center of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yan Shen
- Research Center for Experimental Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Guowei Zhang
- The School of Medicine, Hangzhou Normal University, Hangzhou, 310036, China
| | - Wenda Xi
- Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qiang Wang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Collaborative Innovation Center of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zheng Ruan
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Collaborative Innovation Center of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jin Wang
- Shanghai Institute of Hematology, State Key Laboratory for Medical Genomics and Department of Hematology, Collaborative Innovation Center of Systems Biomedicine, Pôle Sino-Français des Sciences du Vivant et Genomique, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaodong Xi
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Collaborative Innovation Center of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Cao W, Dong B, Horling F, Firrman JA, Lengler J, Klugmann M, de la Rosa M, Wu W, Wang Q, Wei H, Moore AR, Roberts SA, Booth CJ, Hoellriegl W, Li D, Konkle B, Miao C, Reipert BM, Scheiflinger F, Rottensteiner H, Xiao W. Minimal Essential Human Factor VIII Alterations Enhance Secretion and Gene Therapy Efficiency. Mol Ther Methods Clin Dev 2020; 19:486-495. [PMID: 33313336 PMCID: PMC7708868 DOI: 10.1016/j.omtm.2020.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
Abstract
One important limitation for achieving therapeutic expression of human factor VIII (FVIII) in hemophilia A gene therapy is inefficient secretion of the FVIII protein. Substitution of five amino acids in the A1 domain of human FVIII with the corresponding porcine FVIII residues generated a secretion-enhanced human FVIII variant termed B-domain-deleted (BDD)-FVIII-X5 that resulted in 8-fold higher FVIII activity levels in the supernatant of an in vitro cell-based assay system than seen with unmodified human BDD-FVIII. Analysis of purified recombinant BDD-FVIII-X5 and BDD-FVIII revealed similar specific activities for both proteins, indicating that the effect of the X5 alteration is confined to increased FVIII secretion. Intravenous delivery in FVIII-deficient mice of liver-targeted adeno-associated virus (AAV) vectors designed to express BDD-FVIII-X5 or BDD-FVIII achieved substantially higher plasma FVIII activity levels for BDD-FVIII-X5, even when highly efficient codon-optimized F8 nucleotide sequences were employed. A comprehensive immunogenicity assessment using in vitro stimulation assays and various in vivo preclinical models of hemophilia A demonstrated that the BDD-FVIII-X5 variant does not exhibit an increased immunogenicity risk compared to BDD-FVIII. In conclusion, BDD-FVIII-X5 is an effective FVIII variant molecule that can be further developed for use in gene- and protein-based therapeutics for patients with hemophilia A.
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Affiliation(s)
- Wenjing Cao
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Biao Dong
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Franziska Horling
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Jenni A. Firrman
- Dairy and Functional Foods Research Unit, ARS, USDA, 600 East Mermaid Lane, Wyndmoor, PA 19038, USA
| | - Johannes Lengler
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Matthias Klugmann
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Maurus de la Rosa
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Wenman Wu
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Qizhao Wang
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Hongying Wei
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Andrea R. Moore
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Sean A. Roberts
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Carmen J. Booth
- Department of Comparative Medicine, Yale University School of Medicine, 310 Cedar St., BML 330, New Haven, CT 06510, USA
| | - Werner Hoellriegl
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Dong Li
- Sol Sherry Thrombosis Research Center, Temple University Medical School, 3400 North Broad Street, Philadelphia, PA, 19140, USA
| | - Barbara Konkle
- Seattle Children’s Research Institute, University of Washington, 1900 9 Ave, Seattle, WA 98195, USA
| | - Carol Miao
- Department of Medicine/Hematology, University of Washington, 1900 9 Ave, Seattle, WA 98195, USA
| | - Birgit M. Reipert
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Friedrich Scheiflinger
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Hanspeter Rottensteiner
- Drug Discovery Austria, Baxalta Innovations GmbH (now part of Takeda), Donau-City Str. 7, Vienna 1220, Austria
| | - Weidong Xiao
- Herman B Wells Center for Pediatric Research, Indiana University, Indianapolis, IN 46202, USA
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Carestia A, Kim SJ, Horling F, Rottensteiner H, Lubich C, Reipert BM, Crowe BA, Jenne CN. Modulation of the liver immune microenvironment by the adeno-associated virus serotype 8 gene therapy vector. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2020; 20:95-108. [PMID: 33376758 PMCID: PMC7750493 DOI: 10.1016/j.omtm.2020.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022]
Abstract
Adeno-associated viruses (AAVs) are emerging as one of the vehicles of choice for gene therapy. However, the potential immunogenicity of these vectors is a major limitation of their use, leading to the necessity of a better understanding of how viral vectors engage the innate immune system. In this study, we demonstrate the immune response mediated by an AAV vector in a mouse model. Mice were infected intravenously with 4 × 1012 copies (cp)/kg of AAV8, and the ensuing immune response was analyzed using intravital microscopy during a period of weeks. Administration of AAV8 resulted in the infection of hepatocytes, and this infection led to a moderate, but significant, activation of the immune system in the liver. This host immune response involved platelet aggregation, neutrophil extracellular trap (NET) formation, and the recruitment of monocytes, B cells, and T cells. The resident liver macrophage population, Kupffer cells, was necessary to initiate this immune response, as its depletion abrogated platelet aggregation and NET formation and delayed the recruitment of immune cells. Moreover, the death of liver cells produced by this AAV was moderate and failed to result in a robust, sustained inflammatory response. Altogether, these data suggest that AAV8 is a suitable vector for gene therapy approaches.
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Affiliation(s)
- Agostina Carestia
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Seok-Joo Kim
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, AB T2N 4N1, Canada
| | | | | | - Christian Lubich
- Institute Krems Bioanalytics, IMC FH Krems, University of Applied Sciences, Krems, Austria
| | - Birgit M Reipert
- Drug Discovery Austria, Baxalta Innovations GmbH, Vienna, Austria
| | - Brian A Crowe
- Drug Discovery Austria, Baxalta Innovations GmbH, Vienna, Austria
| | - Craig N Jenne
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, AB T2N 4N1, Canada
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