Xu L, Daly T, Gao C, Flotte T R, Song S, Byrne B J, Sands M S, Parker Ponder K
Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Hum Gene Ther. 2001 Mar 20;12(5):563-73. doi: 10.1089/104303401300042500.
Although AAV vectors show promise for hepatic gene therapy, the optimal transcriptional regulatory elements have not yet been identified. In this study, we show that an AAV vector with the CMV enhancer/chicken beta-actin promoter results in 9.5-fold higher expression after portal vein injection than an AAV vector with the EF1 alpha promoter, and 137-fold higher expression than an AAV vector with the CMV promoter/enhancer. Although induction of the acute-phase response with the administration of lipopolysaccharide (LPS) activated the CMV promoter/enhancer from the context of an adenoviral vector in a previous study, LPS resulted in only a modest induction of this promoter from an AAV vector in vivo. An AAV vector with the CMV-beta-actin promoter upstream of the coagulation protein human factor X (hFX) was injected intravenously into neonatal mice. This resulted in expression of hFX at 548 ng/ml (6.8% of normal) for up to 1.2 years, and 0.6 copies of AAV vector per diploid genome in the liver at the time of sacrifice. Neonatal intramuscular injection resulted in expression of hFX at 248 ng/ml (3.1% of normal), which derived from both liver and muscle. We conclude that neonatal gene therapy with an AAV vector with the CMV-beta-actin promoter might correct hemophilia due to hFX deficiency.
尽管腺相关病毒(AAV)载体在肝脏基因治疗方面显示出前景,但尚未确定最佳的转录调控元件。在本研究中,我们发现,与携带EF1α启动子的AAV载体相比,携带巨细胞病毒(CMV)增强子/鸡β-肌动蛋白启动子的AAV载体在门静脉注射后表达水平高9.5倍,与携带CMV启动子/增强子的AAV载体相比则高137倍。尽管在先前的一项研究中,给予脂多糖(LPS)诱导急性期反应可激活腺病毒载体背景下的CMV启动子/增强子,但在体内LPS仅能适度诱导AAV载体中的该启动子。将携带凝血蛋白人凝血因子X(hFX)上游CMV-β-肌动蛋白启动子的AAV载体静脉注射到新生小鼠体内。这导致hFX表达水平在长达1.2年的时间里达到548 ng/ml(为正常水平的6.8%),在处死时肝脏中每个二倍体基因组有0.6个AAV载体拷贝。新生小鼠肌肉注射导致hFX表达水平为248 ng/ml(为正常水平的3.1%),表达来源于肝脏和肌肉。我们得出结论,用携带CMV-β-肌动蛋白启动子的AAV载体进行新生小鼠基因治疗可能纠正因hFX缺乏导致的血友病。