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Ahmad A, Mandwie M, Dreismann AK, Smyth CM, Doyle H, Malik TH, Pickering MC, Lachmann PJ, Alexander IE, Logan GJ. Adeno-Associated Virus Vector Gene Delivery Elevates Factor I Levels and Downregulates the Complement Alternative Pathway In Vivo. Hum Gene Ther 2021; 32:1370-1381. [PMID: 34238030 DOI: 10.1089/hum.2021.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The complement system is a key component of innate immunity, but impaired regulation influences disease susceptibility, including age-related macular degeneration and some kidney diseases. While complete complement inhibition has been used successfully to treat acute kidney disease, key unresolved challenges include strategies to modulate rather than completely inhibit the system and to deliver therapy potentially over decades. Elevating concentrations of complement factor I (CFI) restricts complement activation in vitro and this approach was extended in the current study to modulate complement activation in vivo. Sustained increases in CFI levels were achieved using an adeno-associated virus (AAV) vector to target the liver, inducing a 4- to 5-fold increase in circulating CFI levels. This led to decreased activity of the alternative pathway as demonstrated by a reduction in the rate of inactive C3b (iC3b) deposition and more rapid formation of C3 degradation products. In addition, vector application in a mouse model of systemic lupus erythematosus (NZBWF1), where tissue injury is, in part, complement dependent, resulted in reduced complement C3 and IgG renal deposition. Collectively, these data demonstrate that sustained elevation of CFI reduces complement activation in vivo providing proof-of-principle support for the therapeutic application of AAV gene delivery to modulate complement activation.
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Affiliation(s)
- Amina Ahmad
- Gene Therapy Research Unit, Children's Medical Research Institute and Sydney Children's Hospitals Network, University of Sydney, Westmead, Australia
| | - Mawj Mandwie
- Gene Therapy Research Unit, Children's Medical Research Institute and Sydney Children's Hospitals Network, University of Sydney, Westmead, Australia
| | - Anna K Dreismann
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Christine M Smyth
- Gene Therapy Research Unit, Children's Medical Research Institute and Sydney Children's Hospitals Network, University of Sydney, Westmead, Australia
| | - Helen Doyle
- Pathology, Sydney Children's Hospitals Network, Westmead, Australia
| | - Talat H Malik
- Centre for Inflammatory Disease, Imperial College London, United Kingdom; and
| | - Matthew C Pickering
- Centre for Inflammatory Disease, Imperial College London, United Kingdom; and
| | - Peter J Lachmann
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Ian E Alexander
- Gene Therapy Research Unit, Children's Medical Research Institute and Sydney Children's Hospitals Network, University of Sydney, Westmead, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Westmead, Australia
| | - Grant J Logan
- Gene Therapy Research Unit, Children's Medical Research Institute and Sydney Children's Hospitals Network, University of Sydney, Westmead, Australia
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Grossman TR, Hettrick LA, Johnson RB, Hung G, Peralta R, Watt A, Henry SP, Adamson P, Monia BP, McCaleb ML. Inhibition of the alternative complement pathway by antisense oligonucleotides targeting complement factor B improves lupus nephritis in mice. Immunobiology 2015; 221:701-8. [PMID: 26307001 DOI: 10.1016/j.imbio.2015.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/03/2015] [Accepted: 08/06/2015] [Indexed: 11/16/2022]
Abstract
Systemic lupus erythematosus is an autoimmune disease that manifests in widespread complement activation and deposition of complement fragments in the kidney. The complement pathway is believed to play a significant role in the pathogenesis and in the development of lupus nephritis. Complement factor B is an important activator of the alternative complement pathway and increasing evidence supports reducing factor B as a potential novel therapy to lupus nephritis. Here we investigated whether pharmacological reduction of factor B expression using antisense oligonucleotides could be an effective approach for the treatment of lupus nephritis. We identified potent and well tolerated factor B antisense oligonucleotides that resulted in significant reductions in hepatic and plasma factor B levels when administered to normal mice. To test the effects of factor B antisense oligonucleotides on lupus nephritis, we used two different mouse models, NZB/W F1 and MRL/lpr mice, that exhibit lupus nephritis like renal pathology. Antisense oligonucleotides mediated reductions in circulating factor B levels were associated with significant improvements in renal pathology, reduced glomerular C3 deposition and proteinuria, and improved survival. These data support the strategy of using factor B antisense oligonucleotides for treatment of lupus nephritis in humans.
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Affiliation(s)
- Tamar R Grossman
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA.
| | - Lisa A Hettrick
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
| | - Robert B Johnson
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
| | - Gene Hung
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
| | - Raechel Peralta
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
| | - Andrew Watt
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
| | - Scott P Henry
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
| | - Peter Adamson
- GSK Ophthalmology, GlaxoSmithKline, Stevenage, Hertfordshire, United Kingdom
| | - Brett P Monia
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
| | - Michael L McCaleb
- Department of Antisense Drug Discovery, Isis Pharmaceuticals, Carlsbad, California, USA
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Truedsson L. Classical pathway deficiencies - A short analytical review. Mol Immunol 2015; 68:14-9. [PMID: 26038300 DOI: 10.1016/j.molimm.2015.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/04/2015] [Accepted: 05/07/2015] [Indexed: 01/05/2023]
Abstract
Deficiencies in the classical pathway of complement activation have some common features but show also great differences. Deficiencies of each of the components (C1q, C1s, C1r, C4 and C2) imply increased susceptibility to bacterial infections. They are also associated with increased risk to develop systemic lupus erythematosus where deficiency of C1q is strongly associated to the disease while C4 less and C2 much less. Deficiency of C1q affects only activation of the classical pathway while deficiency of C4 and C2 also prevent activation of the lectin pathway. Bypass mechanisms may result in complement activation also in absence of C2 but not in absence of C1q or C4. The genes for C2 and C4 isotypes are closely located within the MHC class III region on chromosome 6p and the genes for the 3 C1q chains are on chromosome 1p. Deficiencies of C1q and of C4 show genetic heterogeneity while deficiency of C2 in the great majority of cases is caused by a specific deletion. The production of C4 and C2 is mainly by the hepatocytes in the liver while C1q is produced by monocytic bone marrow derived cells. This has implications for the possibility to treat the deficiency and hematopoietic stem cell transplantation has been tried in C1q deficiency.
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Affiliation(s)
- Lennart Truedsson
- Department of Laboratory Medicine, Section of Microbiology, Immunology and Glycobiology, Lund University, University Hospital of Skåne, 22185 Lund, Sweden.
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