Borrás T, Gabelt B T, Klintworth G K, Peterson J C, Kaufman P L
Department of Ophthalmology, Duke University Medical Center, Durham, NC 27710, USA.
J Gene Med. 2001 Sep-Oct;3(5):437-49. doi: 10.1002/jgm.210.
Glaucoma is a group of chronic eye diseases often associated with an elevated intraocular pressure (IOP). If not controlled, the condition leads to blindness. The eye tissue responsible for maintaining aqueous humor resistance and thus normal IOP is the trabecular meshwork (TM). Adenoviral vectors are capable of transducing the TM in several rodent species. Because of the relevance of the non-human primate model in the study of glaucoma, gene transfer to the eyes of cynomolgus monkeys was investigated.
Four cynomolgus monkeys were injected with AdenoGFP into the anterior chamber: two monkeys received 10(9) pfu and the other two 10(7) pfu. One monkey received four consecutive injections into the same eye (10(7) pfu in each injection) over a 7-month period. In vivo gene transfer (fluorescence) and IOP were evaluated by standard clinical ophthalmic instruments (slit lamp biomicroscopy, gonioscopy and tonometry). Histopathology and cellular distribution were assessed postmortem.
The first injection of the lower viral dose resulted in marked TM-preferred gene transfer visible non-invasively by in vivo gonioscopy. The expression of the transgene lasted for 3-4 weeks with little or no signs of clinical inflammation. Gene transfer was achieved on three sequential occasions (3-4 weeks each) but failed and induced substantial, albeit reversible, corneal abnormalities on the fourth occasion.
Gene transfer to the TM and cornea can be monitored non-invasively in non-human primates, allowing correlation of gene transfer with physiological parameters. Because of ocular immune privilege, repeated anterior chamber administrations of adenoviral vectors expressing appropriate genes may have therapeutic potential for glaucoma.
青光眼是一组常与眼内压(IOP)升高相关的慢性眼病。若不加以控制,病情会导致失明。负责维持房水阻力从而保持正常眼内压的眼组织是小梁网(TM)。腺病毒载体能够在多种啮齿类动物物种中对小梁网进行转导。鉴于非人类灵长类动物模型在青光眼研究中的相关性,研究了向食蟹猴眼内进行基因转移。
将腺病毒绿色荧光蛋白(AdenoGFP)注入4只食蟹猴的前房:2只猴子接受10⁹ 个病毒颗粒(pfu),另外2只接受10⁷ 个pfu。1只猴子在7个月内对同一只眼连续进行4次注射(每次注射10⁷ 个pfu)。通过标准临床眼科仪器(裂隙灯生物显微镜检查、前房角镜检查和眼压测量)评估体内基因转移(荧光)和眼内压。死后评估组织病理学和细胞分布。
首次注射较低病毒剂量导致明显的小梁网优先基因转移,通过体内前房角镜检查可无创观察到。转基因表达持续3 - 4周,几乎没有或没有临床炎症迹象。连续3次成功实现基因转移(每次3 - 4周),但第4次失败并导致严重的、尽管可逆的角膜异常。
在非人类灵长类动物中可无创监测向小梁网和角膜的基因转移,从而使基因转移与生理参数相关联。由于眼的免疫赦免特性,向眼内前房重复给药表达适当基因的腺病毒载体可能对青光眼具有治疗潜力。