Sun Baodong, Zhang Haoyue, Franco Luis M, Brown Talmage, Bird Andrew, Schneider Ayn, Koeberl Dwight D
Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
Mol Ther. 2005 Jun;11(6):889-98. doi: 10.1016/j.ymthe.2005.01.012.
Glycogen storage disease type II (Pompe disease) causes death in infancy from cardiorespiratory failure due to acid alpha-glucosidase (GAA; acid maltase) deficiency. An AAV2 vector pseudotyped as AAV6 (AAV2/6 vector) transiently expressed high-level human GAA in GAA-knockout (GAA-KO) mice without reducing glycogen storage; however, in immunodeficient GAA-KO/SCID mice the AAV2/6 vector expressed high-level GAA and reduced the glycogen content of the injected muscle for 24 weeks. A CD4+/CD8+ lymphocytic infiltrate was observed in response to the AAV2/6 vector in immunocompetent GAA-KO mice. When a muscle-specific creatine kinase promoter was substituted for the CB promoter (AAV-MCKhGAApA), that AAV2/6 vector expressed high-level GAA and reduced glycogen content in immunocompetent GAA-KO mice. Muscle-restricted expression of hGAA provoked only a humoral (not cellular) immune response. Intravenous administration of a high number of particles of AAV-MCKhGAApA as AAV2/7 reduced the glycogen content of the heart and skeletal muscle and corrected individual myofibers in immunocompetent GAA-KO mice 24 weeks postinjection. In summary, persistent correction of muscle glycogen content was achieved with an AAV vector containing a muscle-specific promoter in GAA-KO mice, and this approach should be considered for muscle-targeted gene therapy in Pompe disease.
II型糖原贮积病(庞贝病)可导致婴儿期因酸性α-葡萄糖苷酶(GAA;酸性麦芽糖酶)缺乏引起心肺功能衰竭而死亡。一种伪型为AAV6的AAV2载体(AAV2/6载体)在GAA基因敲除(GAA-KO)小鼠中短暂高水平表达人GAA,且不降低糖原贮积;然而,在免疫缺陷的GAA-KO/SCID小鼠中,AAV2/6载体表达高水平GAA,并在24周内降低了注射肌肉的糖原含量。在有免疫活性的GAA-KO小鼠中,观察到针对AAV2/6载体的CD4+/CD8+淋巴细胞浸润。当用肌肉特异性肌酸激酶启动子替代CB启动子(AAV-MCKhGAApA)时,该AAV2/6载体在有免疫活性的GAA-KO小鼠中表达高水平GAA并降低糖原含量。hGAA的肌肉限制性表达仅引发体液(而非细胞)免疫反应。静脉注射大量作为AAV2/7的AAV-MCKhGAApA颗粒可降低有免疫活性的GAA-KO小鼠心脏和骨骼肌的糖原含量,并在注射后24周纠正单个肌纤维。总之,在GAA-KO小鼠中,使用含有肌肉特异性启动子的AAV载体实现了肌肉糖原含量的持续纠正,这种方法应被考虑用于庞贝病的肌肉靶向基因治疗。