7. Lentiviral Vector-Mediated CFTR Gene Transfer to CF Pig Airways Corrects the Anion Transport Defect In Vivo

Abstract

Cystic fibrosis (CF) is the most common autosomal recessive disorder in Caucasian populations and is caused by mutations in CFTR. Complementation of CFTR rescues the anion transport defect in vitro, making this monogenetic disease a candidate for CF gene therapy. Lentiviral vector-mediated CFTR gene transfer has long been discussed as a promising strategy for gene therapy. Lentiviral vectors can efficiently transduce non-dividing cells and persistently express a therapeutic transgene. We previously demonstrated that the non-primate lentiviral vector derived from feline immunodeficiency virus (FIV) and pseudotyped with a GP64 envelope confers gene transfer to porcine airway epithelia both in well-differentiated primary cultures in vitro and in wild-type pig lungs in vivo. The CF pig model recapitulates many features of human disease and provides a new platform for preclinical gene therapy studies. Here, we show that lentiviral-mediated delivery of CFTR to nasal and lung epithelia corrects the anion channel defect in the CF pig model. We delivered GP64-FIV-pigCFTR to the nose and lung of 2-week old gut-corrected CF pigs using a MADgic atomizer. Two weeks post-transduction, we harvested sinus, trachea, and bronchus tissue to assay for gene correction. In freshly excised trachea and bronchus tissue explants, we observed a short-circuit current response to forskolin and IBMX (F&I) and inhibition by GlyH-101, consistent with CFTR function. Compared to non-transduced animals, cultured ethmoid sinus epithelia also showed evidence of correction by short-circuit current measurements. Loss of CFTR results in reduced bicarbonate transport and a lower ASL pH. A reduction in ASL pH impairs bacterial killing. Following gene transfer, we observed an increase in nasal and tracheal pH and rescue of bacterial killing. Together, these exciting results demonstrate the first evidence of functional in vivo correction of CFTR by a lentivirus in the CF pig model. These findings support the utility of a lentivirus for CF gene therapy.