用于乙型血友病肝靶向基因治疗的优化人凝血因子IX表达盒
Optimized human factor IX expression cassettes for hepatic-directed gene therapy of hemophilia B.
作者信息
Zhang Ru, Wang Qiang, Zhang Lin, Chen Saijuan
机构信息
State Key Laboratory for Medical Genomics, Shanghai Institute of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
出版信息
Front Med. 2015 Mar;9(1):90-9. doi: 10.1007/s11684-015-0390-2. Epub 2015 Feb 7.
Gene therapy provides a potential cure for hemophilia B, and significant progress has been achieved in liver-directed gene transfer mediated by adeno-associated viral vectors. Recent clinical trials involving the use of a self-complementary adeno-associated virus serotype 8-human codon-optimized factor IX (AAV8-hFIXco) vector demonstrated encouraging efficacy with hFIX expression stabilized at 1% to 6% of normal level in patients, but safety concerns related to high vector doses are still present. Thus, further improvement of AAV vectors and hFIX expression cassette may positively contribute to the ultimate success of hemophilia B gene therapy. In this study, to obtain a higher expression level of hFIX that potentiates the coagulant capacity of recipients, human FIX expression vector was optimized by upgrading the codon adaption index and adjusting the GC content, inserting a Kozak sequence (GCCACC), and introducing a gain-of-function mutation, R338L (FIX Padua). The efficiency of the published and the presently constructed cassettes was compared through in vivo screening. In addition, the regulatory elements that control the FIX gene expression in these cassettes were screened for liver-specific effectiveness. Among all the constructed cassettes, scAAV-Pre-hFIXco-SIH-R338L, which was the construct under the control of the prothrombin enhancer and prealbumin promoter, resulted in the highest level of coagulant activity, and the expression levels of two constructed cassettes (scAAV-Chi-hFIXco-SIH-R338L and scAAV-Pre-hFIXco-SIH-R338L) were also higher than that of the published cassette (scAAV-LP1-hFIXco-SJ). In summary, our strategies led to a substantial increase in hFIX expression at the protein level or a remarkably elevated coagulant activity. Thus, these reconstructs of hFIX with AAV vector may potentially contribute to the creation of an efficacious gene therapy of hemophilia B.
基因治疗为B型血友病提供了一种潜在的治愈方法,并且在腺相关病毒载体介导的肝脏定向基因转移方面已经取得了重大进展。最近涉及使用自我互补腺相关病毒血清型8-人密码子优化因子IX(AAV8-hFIXco)载体的临床试验显示出令人鼓舞的疗效,患者体内hFIX表达稳定在正常水平的1%至6%,但与高载体剂量相关的安全问题仍然存在。因此,进一步改进腺相关病毒载体和hFIX表达盒可能会对B型血友病基因治疗的最终成功产生积极贡献。在本研究中,为了获得更高水平的hFIX表达以增强受体的凝血能力,通过提高密码子适应指数和调整GC含量、插入Kozak序列(GCCACC)以及引入功能获得性突变R338L(FIX Padua)来优化人FIX表达载体。通过体内筛选比较了已发表的和当前构建的表达盒的效率。此外,还筛选了这些表达盒中控制FIX基因表达的调控元件的肝脏特异性有效性。在所有构建的表达盒中,由凝血酶原增强子和前白蛋白启动子控制的构建体scAAV-Pre-hFIXco-SIH-R338L产生了最高水平的凝血活性,并且两个构建的表达盒(scAAV-Chi-hFIXco-SIH-R338L和scAAV-Pre-hFIXco-SIH-R338L)的表达水平也高于已发表的表达盒(scAAV-LP1-hFIXco-SJ)。总之,我们的策略导致hFIX在蛋白质水平上的表达大幅增加或凝血活性显著提高。因此,这些采用腺相关病毒载体的hFIX重建可能有助于创建一种有效的B型血友病基因治疗方法。