Free University of Brussels, Brussels, Belgium.
Hepatology. 2011 May;53(5):1696-707. doi: 10.1002/hep.24230.
Lentiviral vectors are attractive tools for liver-directed gene therapy because of their capacity for stable gene expression and the lack of preexisting immunity in most human subjects. However, the use of integrating vectors may raise some concerns about the potential risk of insertional mutagenesis. Here we investigated liver gene transfer by integrase-defective lentiviral vectors (IDLVs) containing an inactivating mutation in the integrase (D64V). Hepatocyte-targeted expression using IDLVs resulted in the sustained and robust induction of immune tolerance to both intracellular and secreted proteins, despite the reduced transgene expression levels in comparison with their integrase-competent vector counterparts. IDLV-mediated and hepatocyte-targeted coagulation factor IX (FIX) expression prevented the induction of neutralizing antibodies to FIX even after antigen rechallenge in hemophilia B mice and accounted for relatively prolonged therapeutic FIX expression levels. Upon the delivery of intracellular model antigens, hepatocyte-targeted IDLVs induced transgene-specific regulatory T cells that contributed to the observed immune tolerance. Deep sequencing of IDLV-transduced livers showed only rare genomic integrations that had no preference for gene coding regions and occurred mostly by a mechanism inconsistent with residual integrase activity.
IDLVs provide an attractive platform for the tolerogenic expression of intracellular or secreted proteins in the liver with a substantially reduced risk of insertional mutagenesis.
慢病毒载体因其稳定的基因表达能力和大多数人类受试者中缺乏预先存在的免疫性而成为肝脏定向基因治疗的有吸引力的工具。然而,整合载体的使用可能会引起对插入突变潜在风险的一些关注。在这里,我们研究了含有整合酶失活突变(D64V)的整合酶缺陷型慢病毒载体(IDLV)对肝脏的基因转移。尽管与具有整合酶功能的载体相比,其转基因表达水平降低,但 IDLV 介导的肝细胞靶向表达导致了对内源和分泌蛋白的持续和强烈的免疫耐受诱导。IDLV 介导的和肝细胞靶向的凝血因子 IX(FIX)表达即使在乙型血友病小鼠中抗原再挑战后也能防止中和抗体对 FIX 的诱导,并导致相对延长的治疗性 FIX 表达水平。在递送细胞内模型抗原后,肝细胞靶向的 IDLV 诱导了转基因特异性调节性 T 细胞,这有助于观察到的免疫耐受。IDLV 转导的肝脏的深度测序显示只有少数基因组整合,这些整合没有对基因编码区的偏好,并且主要通过与残留整合酶活性不一致的机制发生。
IDLV 为肝脏中内源性或分泌性蛋白的耐受性表达提供了一个有吸引力的平台,其插入突变的风险大大降低。