Abstract

Recent advances in recombinant adeno-associated virus (rAAV) gene therapy for choroideremia show gene replacement to be a promising approach. It is, however, well known that contact of vector solution with plastic materials in the surgical device may result in non-specific adsorption with resulting loss of physical titer and/or level of protein expression and activity. Here we assessed the biocompatibility and stability of rAAV2-REP1 (Rab Escort Protein-1) before and following passage through the injection device over a period of time to mimic the clinical scenario. Three identical devices were screened using two concentrations of vector: high (1E+12 DNase-resistant particles [DRP]/mL) and low (1E+11 DRP/mL), to mimic high- and low-dose administrations of vector product. The low dose was prepared using either formulation buffer that contained 0.001% of a non-ionic surfactant (PF68) or balanced salt solution (BSS). We observed significant losses in the genomic titer of samples diluted with BSS for all time points. The addition of 0.001% PF68 did not, however, affect rAAV physical titer, or REP1 protein expression and biological activity. Hence we observed that neither the genomic titer nor the biological activity of a rAAV2-REP1-containing solution was affected following passage through the surgical device when PF68 was present as a surfactant and this was maintained over a period up to 10 h.

Highlights

  • Inherited retinal diseases are degenerative disorders of the retina that affect 1:4,000 individuals worldwide.[1]

  • This study entailed three phases of work: (1) preparation of rAAV2REP1 solutions and passage through the drug delivery device under simulated clinical conditions, (2) measurement of recombinant adeno-associated virus serotype 2 (rAAV2)-REP1 titer to look for any adsorptive losses, and (3) assessment of the rAAV2REP1 biological activity to identify losses in vector potency

  • In this work, we show for the first time that both the biocompatibility and stability of rAAV2-REP1 are maintained following passage of the vector solution containing PF68 through the injection system used for human retinal gene therapy

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Summary

Introduction

Inherited retinal diseases are degenerative disorders of the retina that affect 1:4,000 individuals worldwide.[1]. The CHM gene encodes Rab Escort Protein[1] (REP1), a ubiquitously expressed protein that regulates intracellular trafficking pathways by prenylation of Rab GTPases.[3,4] The impairment of trafficking pathways in the retinal pigment epithelium (RPE) specialized cell layer disrupts cell homeostasis and causes retinal degeneration in choroideremia patients.[5]. Choroideremia is considered a prime candidate for gene augmentation therapy, where a working healthy copy of the CHM gene is delivered.[5] previous reports have shown that subretinal delivery of a recombinant adeno-associated virus serotype 2 (rAAV2) carrying the human CHM gene (rAAV2-REP1) is safe and can sustain and improve visual acuity in a cohort of predominantly late-stage patients.[6,7,8] An ongoing phase 3 clinical trial (ClinicalTrials.gov: NCT03496012) will look at efficacy in a wider range of disease manifestations

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