[HTML][HTML] Long-term safety and efficacy following systemic administration of a self-complementary AAV vector encoding human FIX pseudotyped with serotype 5 and 8 …

AC Nathwani, C Rosales, J McIntosh, G Rastegarlari… - Molecular therapy, 2011 - cell.com
AC Nathwani, C Rosales, J McIntosh, G Rastegarlari, D Nathwani, D Raj, S Nawathe…
Molecular therapy, 2011cell.com
Adeno-associated virus vectors (AAV) show promise for liver-targeted gene therapy. In this
study, we examined the long-term consequences of a single intravenous administration of a
self-complementary AAV vector (scAAV2/8-LP1-hFIXco) encoding a codon optimized human
factor IX (hFIX) gene in 24 nonhuman primates (NHPs). A dose–response relationship
between vector titer and transgene expression was observed. Peak hFIX expression
following the highest dose of vector (2× 10 12 pcr-vector genomes (vg)/kg) was 21±3 µg/ml …
Adeno-associated virus vectors (AAV) show promise for liver-targeted gene therapy. In this study, we examined the long-term consequences of a single intravenous administration of a self-complementary AAV vector (scAAV2/ 8-LP1-hFIXco) encoding a codon optimized human factor IX (hFIX) gene in 24 nonhuman primates (NHPs). A dose–response relationship between vector titer and transgene expression was observed. Peak hFIX expression following the highest dose of vector (2 × 1012 pcr-vector genomes (vg)/kg) was 21 ± 3 µg/ml (∼420% of normal). Fluorescent in-situ hybridization demonstrated scAAV provirus in almost 100% of hepatocytes at that dose. No perturbations of clinical or laboratory parameters were noted and vector genomes were cleared from bodily fluids by 10 days. Macaques transduced with 2 × 1011 pcr-vg/kg were followed for the longest period (∼5 years), during which time expression of hFIX remained >10% of normal level, despite a gradual decline in transgene copy number and the proportion of transduced hepatocytes. All macaques developed serotype-specific antibodies but no capsid-specific cytotoxic T lymphocytes were detected. The liver was preferentially transduced with 300-fold more proviral copies than extrahepatic tissues. Long-term biochemical, ultrasound imaging, and histologic follow-up of this large cohort of NHP revealed no toxicity. These data support further evaluation of this vector in hemophilia B patients.
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