Yuasa K, Yoshimura M, Urasawa N, Ohshima S, Howell J M, Nakamura A, Hijikata T, Miyagoe-Suzuki Y, Takeda S
Department of Molecular Therapy, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
Gene Ther. 2007 Sep;14(17):1249-60. doi: 10.1038/sj.gt.3302984. Epub 2007 Jun 21.
Using murine models, we have previously demonstrated that recombinant adeno-associated virus (rAAV)-mediated microdystrophin gene transfer is a promising approach to treatment of Duchenne muscular dystrophy (DMD). To examine further therapeutic effects and the safety issue of rAAV-mediated microdystrophin gene transfer using larger animal models, such as dystrophic dog models, we first investigated transduction efficiency of rAAV in wild-type canine muscle cells, and found that rAAV2 encoding beta-galactosidase effectively transduces canine primary myotubes in vitro. Subsequent rAAV2 transfer into skeletal muscles of normal dogs, however, resulted in low and transient expression of beta-galactosidase together with intense cellular infiltrations in vivo, where cellular and humoral immune responses were remarkably activated. In contrast, rAAV2 expressing no transgene elicited no cellular infiltrations. Co-administration of immunosuppressants, cyclosporine and mycophenolate mofetil could partially improve rAAV2 transduction. Collectively, these results suggest that immune responses against the transgene product caused cellular infiltration and eliminated transduced myofibers in dogs. Furthermore, in vitro interferon-gamma release assay showed that canine splenocytes respond to immunogens or mitogens more susceptibly than murine ones. Our results emphasize the importance to scrutinize the immune responses to AAV vectors in larger animal models before applying rAAV-mediated gene therapy to DMD patients.
利用小鼠模型,我们之前已经证明重组腺相关病毒(rAAV)介导的微肌营养不良蛋白基因转移是治疗杜氏肌营养不良症(DMD)的一种有前景的方法。为了使用更大的动物模型(如营养不良犬模型)进一步研究rAAV介导的微肌营养不良蛋白基因转移的治疗效果和安全性问题,我们首先研究了rAAV在野生型犬肌肉细胞中的转导效率,发现编码β-半乳糖苷酶的rAAV2在体外能有效地转导犬原代肌管。然而,随后将rAAV2转入正常犬的骨骼肌中,导致β-半乳糖苷酶在体内表达水平低且短暂,同时伴有强烈的细胞浸润,此时细胞免疫和体液免疫反应被显著激活。相比之下,不表达转基因的rAAV2未引发细胞浸润。联合使用免疫抑制剂环孢素和霉酚酸酯可部分改善rAAV2的转导。总体而言,这些结果表明针对转基因产物的免疫反应导致了细胞浸润,并清除了犬体内转导的肌纤维。此外体外干扰素-γ释放试验表明,犬脾细胞比小鼠脾细胞对免疫原或丝裂原更敏感。我们的结果强调了在将rAAV介导的基因治疗应用于DMD患者之前,在更大的动物模型中仔细研究对AAV载体免疫反应的重要性。