Ikeda Yasuhiro, Yonemitsu Yoshikazu, Miyazaki Masanori, Kohno Ri-ichiro, Murakami Yusuke, Murata Toshinori, Goto Yoshinobu, Tabata Toshiaki, Ueda Yasuji, Ono Fumiko, Suzuki Toshimichi, Ageyama Naohide, Terao Keiji, Hasegawa Mamoru, Sueishi Katsuo, Ishibashi Tatsuro
Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Hum Gene Ther. 2009 Sep;20(9):943-54. doi: 10.1089/hum.2009.048.
A phase 1 clinical trial evaluating the safety of gene therapy for patients with wet age-related macular degeneration (AMD) or retinoblastoma has been completed without problems. The efficacy of gene therapy for Leber's congenital amaurosis (LCA) was reported by three groups. Gene therapy may thus hold promise as a therapeutic method for the treatment of intractable ocular diseases. However, it will first be important to precisely evaluate the efficiency and safety of alternative gene transfer vectors in a preclinical study using large animals. In the present study, we evaluated the acute local (ophthalmic) and systemic toxicity of our simian immunodeficiency virus from African green monkeys (SIVagm)-based lentiviral vectors carrying human pigment epithelium-derived factor (SIV-hPEDF) for transferring genes into nonhuman primate retinas. Transient inflammation and elevation of intraocular pressure were observed in some animals, but these effects were not dose dependent. Electroretinograms (ERGs), including multifocal ERGs, revealed no remarkable change in retinal function. Histopathologically, SIV-hPEDF administration resulted in a certain degree of inflammatory reaction and no apparent structural destruction in retinal tissue. Regarding systemic toxicity, none of the animals died, and none showed any serious side effects during the experimental course. No vector leakage was detected in serum or urine samples. We thus propose that SIVagm-mediated stable gene transfer might be useful and safe for ocular gene transfer in a clinical setting.
一项评估基因疗法对湿性年龄相关性黄斑变性(AMD)或视网膜母细胞瘤患者安全性的1期临床试验已顺利完成。三组研究报告了基因疗法对莱伯先天性黑蒙(LCA)的疗效。因此,基因疗法有望成为治疗难治性眼部疾病的一种治疗方法。然而,首先重要的是在使用大型动物的临床前研究中精确评估替代基因转移载体的效率和安全性。在本研究中,我们评估了携带人色素上皮衍生因子(SIV-hPEDF)的基于非洲绿猴猿猴免疫缺陷病毒(SIVagm)的慢病毒载体将基因导入非人灵长类动物视网膜的急性局部(眼部)和全身毒性。在一些动物中观察到短暂的炎症和眼压升高,但这些影响与剂量无关。视网膜电图(ERG),包括多焦ERG,显示视网膜功能无明显变化。组织病理学上,给予SIV-hPEDF导致一定程度的炎症反应,视网膜组织无明显结构破坏。关于全身毒性,在实验过程中没有动物死亡,也没有动物出现任何严重的副作用。在血清或尿液样本中未检测到载体泄漏。因此,我们认为SIVagm介导的稳定基因转移在临床环境中对眼部基因转移可能是有用且安全的。