Center for Nanomedicine at Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Extracell Vesicles. 2023 Jun;12(6):e12324. doi: 10.1002/jev2.12324.
Adeno-associated virus (AAV) vector has shown multiple clinical breakthroughs, but its clinical implementation in inhaled gene therapy remains elusive due to difficulty in transducing lung airway cells. We demonstrate here AAV serotype 6 (AAV6) associated with extracellular vesicles (EVs) and secreted from vector-producing HEK-293 cells during vector preparation (EVAAV6) as a safe and highly efficacious gene delivery platform for inhaled gene therapy applications. Specifically, we discovered that EVAAV6 provided markedly enhanced reporter transgene expression in mucus-covered air-liquid interface (ALI) cultures of primary human bronchial and nasal epithelial cells as well as in mouse lung airways compared to standard preparations of AAV6 alone. Of note, AAV6 has been previously shown to outperform other clinically tested AAV serotypes, including those approved by the FDA for treating non-lung diseases, in transducing ALI cultures of primary human airway cells. We provide compelling experimental evidence that the superior performance of EVAAV6 is attributed to the ability of EV to facilitate mucus penetration and cellular entry/transduction of AAV6. The tight and stable linkage between AAV6 and EVs appears essential to exploit the benefits of EVs given that a physical mixture of individually prepared EVs and AAV6 failed to mediate EV-AAV6 interactions or to enhance gene transfer efficacy.
腺相关病毒(AAV)载体已经取得了多项临床突破,但由于难以转导肺气道细胞,其在吸入基因治疗中的临床应用仍难以实现。我们在这里展示了腺相关病毒血清型 6(AAV6)与细胞外囊泡(EVs)相关,并在载体制备过程中从产生载体的 HEK-293 细胞中分泌出来(EVAAV6),作为吸入基因治疗应用的一种安全且高效的基因传递平台。具体来说,我们发现 EVAAV6 与单独的 AAV6 标准制剂相比,在覆盖有粘液的原代人支气管和鼻上皮细胞的气液界面(ALI)培养物以及小鼠肺气道中,显著增强了报告基因的转导表达。值得注意的是,先前已经表明,AAV6 在转导原代人气道细胞的 ALI 培养物方面优于其他经过临床测试的 AAV 血清型,包括那些被 FDA 批准用于治疗非肺部疾病的 AAV 血清型。我们提供了令人信服的实验证据,表明 EVAAV6 的优越性能归因于 EV 促进 AAV6 穿透粘液和细胞进入/转导的能力。鉴于单独制备的 EV 和 AAV6 的物理混合物未能介导 EV-AAV6 相互作用或增强基因转移效果,AAV6 与 EV 之间的紧密和稳定的联系对于利用 EV 的优势至关重要。
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