BioMarin Pharmaceutical Inc., Novato, California, USA.
Sana Biotechnology, Seattle, Washington, USA.
Toxicol Pathol. 2023 Jul;51(5):246-256. doi: 10.1177/01926233231202995. Epub 2023 Nov 3.
Replication-incompetent adeno-associated virus (AAV)-based vectors are nonpathogenic viral particles used to deliver therapeutic genes to treat multiple monogenic disorders. AAVs can elicit immune responses; thus, one challenge in AAV-based gene therapy is the presence of neutralizing antibodies against vector capsids that may prevent transduction of target cells or elicit adverse findings. We present safety findings from two 12-week studies in nonhuman primates (NHPs) with pre-existing or treatment-emergent antibodies. In the first study, NHPs with varying levels of naturally acquired anti-AAV5 antibodies were dosed with an AAV5-based vector encoding human factor VIII (hFVIII). In the second study, NHPs with no pre-existing anti-AAV antibodies were dosed with an AAV5-based vector carrying the beta subunit of choriogonadotropic hormone (bCG); this led to the induction of high-titer antibodies against the AAV5 capsid. Four weeks later, the same NHPs received an equivalent dose of an AAV5-based vector carrying human factor IX (hFIX). In both of these studies, the administration of vectors carrying hFVIII, bCG, and hFIX was well-tolerated in NHPs with no adverse clinical pathology or microscopic findings. These two studies demonstrate the safety of AAV-based vector administration in NHPs with either low-titer pre-existing anti-AAV5 antibodies or re-administration, even in the presence of high-titer antibodies.
复制缺陷型腺相关病毒 (AAV) 载体是一种非致病性病毒颗粒,用于递送治疗基因以治疗多种单基因疾病。AAV 可引起免疫反应;因此,AAV 为基础的基因治疗的一个挑战是存在针对载体衣壳的中和抗体,这可能会阻止靶细胞的转导或引起不良发现。我们介绍了两项在具有预先存在或治疗后出现的抗体的非人类灵长类动物 (NHP) 中进行的 12 周安全性研究的结果。在第一项研究中,具有不同水平天然获得性抗 AAV5 抗体的 NHP 接受了编码人凝血因子 VIII (hFVIII) 的 AAV5 载体给药。在第二项研究中,没有预先存在的抗 AAV 抗体的 NHP 接受了携带绒毛膜促性腺激素 β 亚基 (bCG) 的 AAV5 载体给药;这导致了针对 AAV5 衣壳的高滴度抗体的诱导。四周后,相同的 NHP 接受了携带人凝血因子 IX (hFIX) 的 AAV5 载体的等效剂量给药。在这两项研究中,在具有低滴度预先存在的抗 AAV5 抗体或重新给药的 NHP 中,载体携带 hFVIII、bCG 和 hFIX 的给药均耐受良好,没有临床病理学或显微镜下发现的不良反应。这两项研究表明,即使存在高滴度抗体,AAV 为基础的载体给药在具有低滴度预先存在的抗 AAV5 抗体或再次给药的 NHP 中是安全的。
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