Division of Cell and Molecular Therapy, Department of Pediatrics, University of Florida, Gainesville, FL 32610, USA.
Division of Cell and Molecular Therapy, Department of Pediatrics, University of Florida, Gainesville, FL 32610, USA; Department of Neuroscience, University of Florida, Gainesville, FL 32610, USA.
Mol Ther. 2018 Jan 3;26(1):173-183. doi: 10.1016/j.ymthe.2017.09.001. Epub 2017 Sep 21.
The devastating neurodegenerative disease multiple sclerosis (MS) could substantially benefit from an adeno-associated virus (AAV) immunotherapy designed to restore a robust and durable antigen-specific tolerance. However, developing a sufficiently potent and lasting immune-regulatory therapy that can intervene in ongoing disease is a major challenge and has thus been elusive. We addressed this problem by developing a highly effective and robust tolerance-inducing in vivo gene therapy. Using a pre-clinical animal model, we designed a liver-targeting gene transfer vector that expresses full-length myelin oligodendrocyte glycoprotein (MOG) in hepatocytes. We show that by harnessing the tolerogenic nature of the liver, this powerful gene immunotherapy restores immune tolerance by inducing functional MOG-specific regulatory T cells (Tregs) in vivo, independent of major histocompatibility complex (MHC) restrictions. We demonstrate that mice treated prophylactically are protected from developing disease and neurological deficits. More importantly, we demonstrate that when given to mice with preexisting disease, ranging from mild neurological deficits to severe paralysis, the gene immunotherapy abrogated CNS inflammation and significantly reversed clinical symptoms of disease. This specialized approach for inducing antigen-specific immune tolerance has significant therapeutic potential for treating MS and other autoimmune disorders.
破坏性神经退行性疾病多发性硬化症 (MS) 可以从腺相关病毒 (AAV) 免疫疗法中显著受益,该疗法旨在恢复强大和持久的抗原特异性耐受。然而,开发一种足够有效和持久的免疫调节疗法,以干预正在进行的疾病是一个主要挑战,因此一直难以实现。我们通过开发一种高效和强大的诱导耐受的体内基因治疗来解决这个问题。使用临床前动物模型,我们设计了一种肝脏靶向基因转移载体,该载体在肝细胞中表达全长髓鞘少突胶质细胞糖蛋白 (MOG)。我们表明,通过利用肝脏的耐受性,这种强大的基因免疫疗法通过在体内诱导功能性 MOG 特异性调节性 T 细胞 (Treg) 来恢复免疫耐受,而不受主要组织相容性复合体 (MHC) 的限制。我们证明,预防性治疗的小鼠免受疾病和神经功能缺损的影响。更重要的是,我们证明,当给予患有预先存在疾病的小鼠时,从轻度神经功能缺损到严重瘫痪,基因免疫疗法消除了中枢神经系统炎症并显著逆转了疾病的临床症状。这种诱导抗原特异性免疫耐受的特殊方法具有治疗多发性硬化症和其他自身免疫性疾病的巨大治疗潜力。
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