Abstract

Numerous studies have demonstrated the efficacy of the Adeno-Associated Virus (AAV)-based gene delivery platform in vivo. The control of transgene expression in many protocols is highly desirable for therapeutic applications and/or safety reasons. To date, the tetracycline and the rapamycin dependent regulatory systems have been the most widely evaluated. While the long-term regulation of the transgene has been obtained in rodent models, the translation of these studies to larger animals, especially to nonhuman primates (NHP), has often resulted in an immune response against the recombinant regulator protein involved in transgene expression regulation. These immune responses were dependent on the target tissue and vector delivery route. Here, using AAV vectors, we evaluated a doxycyclin-inducible system in rodents and macaques in which the TetR protein is fused to the human Krüppel associated box (KRAB) protein. We demonstrated long term gene regulation efficiency in rodents after subretinal and intramuscular administration of AAV5 and AAV1 vectors, respectively. However, as previously described for other chimeric transactivators, the TetR-KRAB-based system failed to achieve long term regulation in the macaque after intramuscular vector delivery because of the development of an immune response. Thus, immunity against the chimeric transactivator TetR-KRAB emerged as the primary limitation for the clinical translation of the system when targeting the skeletal muscle, as previously described for other regulatory proteins. New developments in the field of chimeric drug-sensitive transactivators with the potential to not trigger the host immune system are still needed.

Highlights

  • Long-term expression of transgenes can be supported by recombinant Adeno-Associated Virus-derived vectors in a variety of target organs in mammals, including human patients, after a single administration [1,2]

  • We used recombinant Adeno-Associated Virus (rAAV) vectors in which the tetracycline-resistance operon of E. coli (TetR)-Kruppel associated box (KRAB) expression was driven by the ubiquitous CAG promoter and the d2GFP reporter gene was under the control of the Tet operator (TetO)-cytomegalovirus (CMV) entire natural promoter (CMVlg)

  • The clinical efficacy and safety of rAAV-based gene transfer will be improved with the use of systems able to turn ‘‘on’’ and ‘‘off’’ therapeutic gene expression

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Summary

Introduction

Long-term expression of transgenes can be supported by recombinant Adeno-Associated Virus (rAAV)-derived vectors in a variety of target organs in mammals, including human patients, after a single administration [1,2]. A limited number of clinically translatable regulatory systems are available All of these systems use chimeric transactivators, the activity of which is controlled by drugs, such as tetracycline and its derivative doxycycline (Dox) or rapamycin [7,8,9,10,11,12] for the two most developed systems. When the expression cassette was expressed from the skeletal muscle after intramuscular (IM) delivery of the vector, the majority (85%) of the NHP mounted an immune response against the Dox-sensitive rtTA transactivator, resulting in the rapid loss of reporter transgene regulation despite Dox administration to the macaques [13,14,19]. The rtTA epitope(s) - either originating from one of the two domains or both - recognized by the macaque immune system remains unknown, but if the transactivator domain of the molecule bears the dominant epitopes, using a less antigenic transactivator protein would potentially be beneficial to support long-term transgene regulation

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