Novel Coagulation Factor VIII Gene Therapy in a Mouse Model of Hemophilia A by Lipid-Coated FeO Nanoparticles.

Hemophilia A is a bleeding disease caused by loss of coagulation factor VIII (FVIII) function. Although prophylactic FVIII infusion prevents abnormal bleeding, disability and joint damage in hemophilia patients are common. The cost of treatment is among the highest for a single disease, and the adverse effects of repeated infusion are still an issue that has not been addressed. In this study, we established a nonviral gene therapy strategy to treat knockout ( KO) mice. A novel gene therapy approach was developed using dipalmitoylphosphatidylcholine formulated with iron oxide (DPPC-FeO) to carry the B-domain-deleted (BDD)- plasmid, which was delivered into the KO mice via tail vein injection. Here, a liver-specific albumin promoter-driven BDD- plasmid was constructed, and the binding ability of circular DNA was confirmed to be more stable than that of linear DNA when combined with DPPC-FeO nanoparticles. The KO mice that received the DPPC-FeO plasmid complex were assessed by staining the ferric ion of DPPC-FeO nanoparticles with Prussian blue in liver tissue. The bleeding of the KO mice was improved in a few weeks, as shown by assessing the activated partial thromboplastin time (aPTT). Furthermore, no liver toxicity, thromboses, deaths, or persistent changes after nonviral gene therapy were found, as shown by serum liver indices and histopathology. The results suggest that this novel gene therapy can successfully improve hemostasis disorder in KO mice and might be a promising approach to treating hemophilia A patients in clinical settings.