Boyce Sara, James Izabela, Rangarajan Savita, Curry Nicola, Bagot Catherine, Austin Steven, Laffan Mike, Mangles Sarah, Chandrakumaran Kandiah, Mundy Carina
Southampton Haemophilia Comprehensive Care Centre University Hospital Southampton NHS Foundation Trust Southampton UK.
University of Southampton Southampton UK.
Res Pract Thromb Haemost. 2022 Jun 3;6(4):e12705. doi: 10.1002/rth2.12705. eCollection 2022 May.
BACKGROUND: Gene therapy shows promise as a potential "cure" for hemophilia A and B. Adeno-associated virus (AAV) vectors are the leading platform to deliver modified genetic code of factor VIII or IX to the liver effecting endogenous production. Patient exposure to wild-type AAV leads to the formation of neutralizing factors, which can prevent successful transduction. It is thus important to establish the seroprevalence of the AAV serotypes in people with hemophilia to aid prediction of successful gene transfer. The seroprevalence of AAV6 in UK people with hemophilia B is not yet reported. OBJECTIVES: We studied the prevalence of anti-AAV6 neutralizing factors in UK people with hemophilia B ( = 49). We collected data on people's hepatitis C exposure and treatment with plasma-derived factor IX (FIX) to identify if there was correlation with AAV6 exposure. METHODS: Serum samples and patient data were collected from 49 people with hemophilia B registered at UK hemophilia comprehensive care centers. The samples were tested for neutralizing factors to AAV6 using a cell-based transduction inhibition assay. RESULTS: Thirty-one percent of patients had serum neutralization against AAV6. There was no correlation between AAV6 seropositivity and previous treatment with plasma-derived FIX products or hepatitis C exposure. CONCLUSION: Based on limited data, there is no evidence of association between the presence of AAV6 neutralizing factors in people with hemophilia B and exposure to contaminated plasma derivatives. The frequency of AAV6 neutralizing factors in our hemophilia B cohort is similar to UK people with hemophilia A and non-hemophilia populations.
背景:基因治疗有望成为治疗甲型和乙型血友病的潜在“治愈”方法。腺相关病毒(AAV)载体是将因子VIII或IX的修饰遗传密码传递至肝脏以实现内源性产生的主要平台。患者接触野生型AAV会导致中和因子的形成,这可能会阻碍成功转导。因此,确定血友病患者中AAV血清型的血清流行率对于预测基因转移的成功与否很重要。英国乙型血友病患者中AAV6的血清流行率尚未见报道。 目的:我们研究了英国乙型血友病患者(n = 49)中抗AAV6中和因子的流行情况。我们收集了有关丙型肝炎暴露和血浆源性因子IX(FIX)治疗的数据,以确定是否与AAV6暴露存在相关性。 方法:从英国血友病综合护理中心登记的49例乙型血友病患者中收集血清样本和患者数据。使用基于细胞的转导抑制试验检测样本中针对AAV6的中和因子。 结果:31%的患者血清对AAV6具有中和作用。AAV6血清阳性与既往使用血浆源性FIX产品治疗或丙型肝炎暴露之间无相关性。 结论:基于有限的数据,没有证据表明乙型血友病患者中AAV6中和因子的存在与接触受污染的血浆衍生物之间存在关联。我们乙型血友病队列中AAV6中和因子的频率与英国甲型血友病患者和非血友病人群相似。
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