Hemophilia A is a defect in coagulation factor VIII, which is predominantly produced in liver and secreted into plasma at a level of 100-200 ng/ml. Hemophilia A is an attractive model for non-viral gene delivery since levels as low as 1-2% FVIII can affect bleeding. In addition, FVIII can be processed from non-liver cell types. While non-viral gene delivery has advantages of production and safety compared to viral gene therapy, the transient nature of gene expression makes re-administration necessary, therefore an oral route of administration highly desirable. We previously reported preliminary results in hemophilia A mice orally administered chitosan-FVIII DNA nanoparticles, including phenotypic bleeding correction in 4/5 mice given the highest DNA dose. Levels of functional FVIII by chromogenic assay were modest. However a thrombin assay revealed significantly greater thrombin generation in mice given chitosan-DNA nanoparticles as compared to naked DNA.
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