Abstract

Preclinical studies in mice and non-human primates showed that AAV serotype 5 provides efficient liver transduction and as such seems a promising vector for liver directed gene therapy. An advantage of AAV5 compared to serotype 8 already shown to provide efficient correction in a phase 1 trial in patients suffering from hemophilia B, is its lower seroprevalence in the general population. Our goal is liver directed gene therapy for Crigler-Najjar syndrome type I, inherited severe unconjugated hyperbilirubinemia caused by UGT1A1 deficiency. In a relevant animal model, the Gunn rat, we compared the efficacy of AAV 5 and 8 to that of AAV1 previously shown to be effective. Ferrying a construct driving hepatocyte specific expression of UGT1A1, both AAV8 and AAV1 provided an efficient correction of hyperbilirubinemia. In contrast to these two and to other animal models AAV5 failed to provide any correction. To clarify whether this unexpected finding was due to the rat model used or due to a problem with AAV5, the efficacy of this serotype was compared in a mouse and two additional rat strains. Administration of an AAV5 vector expressing luciferase under the control of a liver specific promoter confirmed that this serotype poorly performed in rat liver, rendering it not suitable for proof of concept studies in this species.

Highlights

  • Efficacy in patients demonstrates that adeno-associated viral (AAV) vectors can be used for in vivo correction of inherited disorders

  • In this study we evaluate the efficacy of scAAV5 and scAAV8 to that of scAAV1 in the Gunn rat

  • Serum billirubin levels were monitored for several months following an intraportal administration of 361011 gc/kg of scAAV-LP1-uridine diphospho-glucuronosyl transferase 1A1 (UGT1A1) vector pseudotyped with serotype 1, 5 and 8

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Summary

Introduction

Efficacy in patients demonstrates that adeno-associated viral (AAV) vectors can be used for in vivo correction of inherited disorders. The prevalence of these towards the different serotypes is highly relevant for their applicability as a gene therapy vector. Another study in healthy French donors revealed that the prevalence of NAb towards AAV8, 9 and especially AAV5 is the lowest [7]. The immune responses towards more than one serotype in an individual may in part be due to cross reaction because of the extensive homology between AAV capsid proteins. This seems a relevant mechanism since the amino-acid composition of the capsid of most serotypes differs only for 15% or less from that of AAV1 and 2, the two most prevalent serotypes. AAV5 is an exception since its capsid amino-acid composition differs by 40%

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