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Han JP, Lee Y, Lee JH, Chung HY, Lee GS, Nam YR, Choi M, Moon KS, Lee H, Lee H, Yeom SC. In vivo genome editing using 244- cis LNPs and low-dose AAV achieves therapeutic threshold in hemophilia A mice. MOLECULAR THERAPY. NUCLEIC ACIDS 2023; 34:102050. [PMID: 37916225 PMCID: PMC10616378 DOI: 10.1016/j.omtn.2023.102050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/04/2023] [Indexed: 11/03/2023]
Abstract
Gene therapy and rebalancing therapy have emerged as promising approaches for treating hemophilia A, but there are limitations, such as temporary efficacy due to individual differences. Genome editing for hemophilia has shown long-term therapeutic potential in preclinical trials. However, a cautious approach is necessary because genome editing is irreversible. Therefore, we attempted to induce low-level human factor 8 (hF8) gene knockin (KI) using 244-cis lipid nanoparticles and low-dose adeno-associated virus to minimize side effects and achieve a therapeutic threshold in hemophilia A mice. We selected the serpin family C member 1, SerpinC1, locus as a target to enable a combined rebalancing strategy with hF8 KI to augment efficacy. This strategy improved blood coagulation activity and reduced hemophilic complications without adverse effects. Furthermore, hemophilic mice with genome editing exhibit enhanced survival for 40 weeks. Here, we demonstrate an effective, safe, and sustainable treatment for hemophilia A. This study provides valuable information to establish safe and long-term genome-editing-mediated treatment strategies for treating hemophilia and other protein-deficient genetic diseases.
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Affiliation(s)
- Jeong Pil Han
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
| | - Yeji Lee
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seodaemun-gu, Seoul 03760, Korea
| | - Jeong Hyeon Lee
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
| | - Hye Yoon Chung
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
| | - Geon Seong Lee
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
| | - Yu Ri Nam
- Deartment of Chemistry, Korea Advanced Institute of Science and Technology (KAIST), Yuseong-gu, Daejeon 34141, Korea
| | - Myeongjin Choi
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, Yuseong-gu, Daejeon 34114, Korea
| | - Kyoung-Sik Moon
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, Yuseong-gu, Daejeon 34114, Korea
| | - Haeshin Lee
- Deartment of Chemistry, Korea Advanced Institute of Science and Technology (KAIST), Yuseong-gu, Daejeon 34141, Korea
| | - Hyukjin Lee
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seodaemun-gu, Seoul 03760, Korea
| | - Su Cheong Yeom
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
- WCU Biomodulation Major, Department of Agricultural Biotechnology, Seoul National University, Gwanank-gu, Seoul 08826, Korea
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Wu J, Zhang H, Lian T, Ding Y, Song C, Li D, Wu L, Lei T, Liang H. Biological activity of a new recombinant human coagulation factor VIII and its efficacy in a small animal model. Biochem Biophys Res Commun 2023; 640:80-87. [PMID: 36502635 DOI: 10.1016/j.bbrc.2022.12.005] [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: 11/17/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
Deficiency in human coagulation factor VIII (FVIII) causes hemophilia A (HA). Patients with HA may suffer from spontaneous bleeding, which can be life-threatening. Recombinant FVIII (rFVIII) is an established treatment and prevention agent for bleeding in patients with HA. Human plasma-derived FVIII (pdFVIII), commonly used in clinical practice, is relatively difficult to prepare. In this study, we developed a novel B-domain-deleted rFVIII, produced and formulated without the use of animal or human serum-derived components. rFVIII promoted the generation of activated factor X and downstream thrombin, and, similar to that of other available FVIII preparations, its activity was inhibited by FVIII inhibitors. In addition, rFVIII has ideal binding affinity to human von Willebrand factor. Activated FVIII (FVIIIa) could be degraded by activated protein C and lose its procoagulant activity. In vitro, commercially available recombinant FVIII (Xyntha) and pdFVIII were used as controls, and there were no statistical differences between rFVIII and commercial FVIII preparations, which demonstrates the satisfactory efficacy and potency of rFVIII. In vivo, HA mice showed that infusion of rFVIII rapidly corrected activated partial thromboplastin time, similar to Xyntha. Moreover, different batches of rFVIII were comparable. Overall, our results demonstrate the potential of rFVIII as an effective strategy for the treatment of FVIII deficiency.
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Affiliation(s)
- Junzheng Wu
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China
| | - Hang Zhang
- Beijing Tiantan Biological Products Co. Ltd., 100024, Beijing, China
| | - Tong Lian
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China
| | - Yaling Ding
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China
| | - Chunlei Song
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China
| | - Dekuan Li
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China
| | - Liheng Wu
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China
| | - Tao Lei
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China.
| | - Hong Liang
- Chengdu Rongsheng Pharmaceuticals Co. Ltd., 610041, Chengdu, China; Beijing Tiantan Biological Products Co. Ltd., 100024, Beijing, China.
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Ashfaq J, Ahmed R, Tariq F, Abedin QU, Abid M, Borhany M. Frequency of Intron 22 Inversion in Severe Hemophilia A Patients. Cureus 2022; 14:e28247. [PMID: 36158401 PMCID: PMC9490293 DOI: 10.7759/cureus.28247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/05/2022] Open
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Han JP, Kim M, Choi BS, Lee JH, Lee GS, Jeong M, Lee Y, Kim EA, Oh HK, Go N, Lee H, Lee KJ, Kim UG, Lee JY, Kim S, Chang J, Lee H, Song DW, Yeom SC. In vivo delivery of CRISPR-Cas9 using lipid nanoparticles enables antithrombin gene editing for sustainable hemophilia A and B therapy. SCIENCE ADVANCES 2022; 8:eabj6901. [PMID: 35061543 PMCID: PMC8782450 DOI: 10.1126/sciadv.abj6901] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/30/2021] [Indexed: 05/24/2023]
Abstract
Hemophilia is a hereditary disease that remains incurable. Although innovative treatments such as gene therapy or bispecific antibody therapy have been introduced, substantial unmet needs still exist with respect to achieving long-lasting therapeutic effects and treatment options for inhibitor patients. Antithrombin (AT), an endogenous negative regulator of thrombin generation, is a potent genome editing target for sustainable treatment of patients with hemophilia A and B. In this study, we developed and optimized lipid nanoparticles (LNPs) to deliver Cas9 mRNA along with single guide RNA that targeted AT in the mouse liver. The LNP-mediated CRISPR-Cas9 delivery resulted in the inhibition of AT that led to improvement in thrombin generation. Bleeding-associated phenotypes were recovered in both hemophilia A and B mice. No active off-targets, liver-induced toxicity, and substantial anti-Cas9 immune responses were detected, indicating that the LNP-mediated CRISPR-Cas9 delivery was a safe and efficient approach for hemophilia therapy.
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Affiliation(s)
- Jeong Pil Han
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
| | - MinJeong Kim
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Woman’s University, Seodaemun-gu, Seoul 03760, Korea
| | | | - Jeong Hyeon Lee
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
| | - Geon Seong Lee
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
| | - Michaela Jeong
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Woman’s University, Seodaemun-gu, Seoul 03760, Korea
| | - Yeji Lee
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Woman’s University, Seodaemun-gu, Seoul 03760, Korea
| | - Eun-Ah Kim
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Woman’s University, Seodaemun-gu, Seoul 03760, Korea
| | | | - Nanyeong Go
- Toolgen Inc., Geumcheon-gu, Seoul 08501, Korea
| | - Hyerim Lee
- Toolgen Inc., Geumcheon-gu, Seoul 08501, Korea
| | - Kyu Jun Lee
- Toolgen Inc., Geumcheon-gu, Seoul 08501, Korea
| | - Un Gi Kim
- Toolgen Inc., Geumcheon-gu, Seoul 08501, Korea
| | | | | | - Jun Chang
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Woman’s University, Seodaemun-gu, Seoul 03760, Korea
| | - Hyukjin Lee
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Woman’s University, Seodaemun-gu, Seoul 03760, Korea
| | | | - Su Cheong Yeom
- Graduate School of International Agricultural Technology and Institute of Green BioScience and Technology, Seoul National University, Pyeongchang, Gangwon 25354, Korea
- WCU Biomodulation Major, Department of Agricultural Biotechnology, Seoul National University, Gwanank-gu, Seoul 08826, Korea
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