Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, USA.
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
J Inherit Metab Dis. 2021 Nov;44(6):1369-1381. doi: 10.1002/jimd.12392. Epub 2021 Aug 19.
Phenylketonuria (PKU) is the most common inborn error of metabolism of the liver, and results from mutations of both alleles of the phenylalanine hydroxylase gene (PAH). As such, it is a suitable target for gene therapy via gene delivery with a recombinant adeno-associated virus (AAV) vector. Here we use the synthetic AAV vector Anc80 via systemic administration to deliver a functional copy of a codon-optimized human PAH gene, with or without an intron spacer, to the Pah mouse model of PKU. Dose-dependent transduction of the liver and expression of PAH mRNA were present with both vectors, resulting in significant and durable reduction of circulating phenylalanine, reaching near control levels in males. Coat color of treated Pah mice reflected an increase in pigmentation from brown to the black color of control animals, further indicating functional restoration of phenylalanine metabolism and its byproduct melanin. There were no adverse effects associated with administration of AAV up to 5 × 10 VG/kg, the highest dose tested. Only minor and/or transient variations in some liver enzymes were observed in some of the AAV-dosed animals which were not associated with pathology findings in the liver. Finally, there was no impact on cell turnover or apoptosis as evaluated by Ki-67 and TUNEL staining, further supporting the safety of this approach. This study demonstrates the therapeutic potential of AAV Anc80 to safely and durably cure PKU in a mouse model, supporting development for clinical consideration.
苯丙酮尿症(PKU)是最常见的肝脏代谢性遗传病,由苯丙氨酸羟化酶基因(PAH)的两个等位基因突变引起。因此,它是通过携带重组腺相关病毒(AAV)载体的基因治疗的合适靶点。在这里,我们通过系统给药使用合成的 AAV 载体 Anc80 将经过密码子优化的人类 PAH 基因的功能拷贝递送至 PKU 的 Pah 小鼠模型,无论是否带有内含子间隔子。两种载体都能实现肝脏的剂量依赖性转导和 PAH mRNA 的表达,导致循环苯丙氨酸显著且持久地降低,达到接近对照水平的雄性。经处理的 Pah 小鼠的毛色反映了从棕色到对照动物的黑色的色素沉着增加,进一步表明苯丙氨酸代谢及其副产物黑色素的功能恢复。高达 5×10 VG/kg 的 AAV 给药没有副作用,这是测试的最高剂量。在一些接受 AAV 给药的动物中观察到一些肝脏酶的轻微和/或短暂变化,但与肝脏病理学发现无关。最后,Ki-67 和 TUNEL 染色评估的细胞更新或细胞凋亡没有影响,进一步支持了这种方法的安全性。这项研究证明了 AAV Anc80 在治疗 PKU 小鼠模型方面的治疗潜力,为临床考虑提供了支持。
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