Department of Medicine, Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA.
Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
J Gene Med. 2018 Sep;20(9):e3049. doi: 10.1002/jgm.3049. Epub 2018 Sep 4.
Following systemic delivery, AAV9-mediated gene expression is significantly increased in ischemic versus non-ischemic muscle, suggesting that AAV9 is an attractive vector for treating peripheral arterial disease. Potential mechanisms underlying ischemia-augmented expression include: (i) increased vascular permeability and (ii) "unmasking" of endogenous AAV9 receptors. In the present study, we aimed to reconstitute the ischemic induction of AAV9 in vivo, using local injection of histamine (to increase vascular permeability) and neuraminidase (to desialylate cell surface glycans).
Bioassays were performed to optimize the effects of histamine and neuraminidase after intramuscular injection. Histamine and/or neuraminidase were then injected intramuscularly shortly before intravenous injection of an AAV9 vector expressing luciferase. Luciferase expression was serially assessed with bioluminescence imaging. At the end of the study, tissues were harvested for assays of luciferase activity and AAV9 genome copy number aiming to assess AAV-mediated gene expression and transduction, respectively.
Intramuscular injection of either neuraminidase or neuraminidase plus histamine significantly increased both transduction and gene expression, whereas histamine alone had little effect. Pre-injection with neuraminidase increased AAV9-mediated gene delivery by four- to nine-fold and luciferase activity by 60-100-fold. Luciferase activity in neuraminidase-injected muscle was > 100-fold higher than in any off-target tissue (including heart, liver and brain).
The ischemic induction of AAV9-mediated gene expression in muscle can largely be reconstituted by pre-injecting neuraminidase intranmuscularly. This strategy may prove useful in future human gene therapy protocols as a quick and efficient means to selectively target systemically injected AAV9 to localized regions of muscle, thus decreasing the potential for adverse effects in off-target tissues.
在全身给药后,与非缺血肌肉相比,AAV9 介导的基因表达在缺血肌肉中显著增加,这表明 AAV9 是治疗外周动脉疾病的有吸引力的载体。缺血增强表达的潜在机制包括:(i)增加血管通透性和(ii)“揭示”内源性 AAV9 受体。在本研究中,我们旨在通过局部注射组氨酸(增加血管通透性)和神经氨酸酶(脱唾液酸细胞表面聚糖)在体内重建 AAV9 的缺血诱导。
进行生物测定以优化组氨酸和神经氨酸酶在肌肉内注射后的作用。然后,在静脉注射表达荧光素酶的 AAV9 载体之前,将组氨酸和/或神经氨酸酶肌肉内注射。用生物发光成像连续评估荧光素酶表达。在研究结束时,收获组织进行荧光素酶活性和 AAV9 基因组拷贝数的测定,旨在分别评估 AAV 介导的基因表达和转导。
肌肉内注射神经氨酸酶或神经氨酸酶加组氨酸均显著增加转导和基因表达,而单独注射组氨酸则效果甚微。预先注射神经氨酸酶使 AAV9 介导的基因传递增加了四到九倍,荧光素酶活性增加了 60-100 倍。神经氨酸酶注射肌肉中的荧光素酶活性比任何非靶组织(包括心脏、肝脏和大脑)都高 100 倍以上。
肌肉中 AAV9 介导的基因表达的缺血诱导可以通过肌肉内预先注射神经氨酸酶来很大程度上重建。这种策略可能在未来的人类基因治疗方案中很有用,作为一种快速有效的方法将全身注射的 AAV9 选择性地靶向肌肉的局部区域,从而减少对非靶组织的不良反应的可能性。