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基于腺相关病毒的基因治疗产品在心肌细胞中导致的蛋白质过表达会诱发小鼠内质网应激和心肌变性。

Protein overexpression by adeno-associated virus-based gene therapy products in cardiomyocytes induces endoplasmic reticulum stress and myocardial degeneration in mice.

作者信息

Yasuno Kyohei, Watanabe Ryo, Ishida Rumiko, Okado Keiko, Kondo Hirofumi, Iguchi Takuma, Imaoka Masako, Tsuchiya Yoshimi

机构信息

Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., 1-16-13 Kita-Kasai, Edogawa-ku, Tokyo 134-8630, Japan.

Department of Translational Research, Daiichi Sankyo RD Novare Co., Ltd., 1-16-13 Kita-Kasai, Edogawa-ku, Tokyo 134-8630, Japan.

出版信息

J Toxicol Pathol. 2024 Oct;37(4):139-149. doi: 10.1293/tox.2024-0011. Epub 2024 Jun 7.

Abstract

Gene therapy (GT) products created using adeno-associated virus (AAV) vectors tend to exhibit toxicity via immune reactions, but other mechanisms of toxicity remain incompletely understood. We examined the cardiotoxicity of an overexpressed transgenic protein. Male C57BL/6J mice were treated with a single intravenous dose of product X, an AAV-based GT product, at 2.6 × 10 vg/kg. Necropsies were performed at 24 h, 7 days, and 14 days after dosing. Pathological examination and gene expression analysis were performed on the heart. Histopathologically, hypertrophy and vacuolar degeneration of cardiomyocytes and fibrosis were observed 14 days after dosing. Immunohistochemistry for endoplasmic reticulum (ER) stress-related proteins revealed increased positive reactions for glucose-regulated protein 78 and C/EBPR homologous protein in cardiomyocytes 7 days after dosing, without histopathological abnormalities. Fourteen days after dosing, some cardiomyocytes showed positivity for PKR-like endoplasmic reticulum kinase and activating transcription factor 4 expression. Ultrastructurally, increases in the ER and cytosol were observed in cardiomyocytes 7 days after dosing, along with an increase in the number of Golgi apparatus compartments 14 days after dosing. The tissue concentration of the transgene product protein increased 7 days after dosing. Gene expression analysis showed upregulation of ER stress-related genes 7 days after dosing, suggesting activation of the PKR-like ER kinase pathway of the unfolded protein reaction (UPR). Thus, the cardiotoxicity induced by product X was considered to involve cell damage caused by the overexpression of the product protein accompanied by UPR. Marked UPR activation may also cause toxicity of AAV-based GT products.

摘要

使用腺相关病毒(AAV)载体制造的基因治疗(GT)产品往往会通过免疫反应表现出毒性,但其他毒性机制仍未完全了解。我们研究了一种过表达转基因蛋白的心脏毒性。雄性C57BL/6J小鼠静脉内单次注射剂量为2.6×10 vg/kg的产品X(一种基于AAV的GT产品)。给药后24小时、7天和14天进行尸检。对心脏进行病理检查和基因表达分析。组织病理学上,给药后14天观察到心肌细胞肥大、空泡变性和纤维化。内质网(ER)应激相关蛋白的免疫组织化学显示,给药后7天心肌细胞中葡萄糖调节蛋白78和C/EBPR同源蛋白的阳性反应增加,无组织病理学异常。给药后14天,一些心肌细胞显示PKR样内质网激酶和激活转录因子4表达呈阳性。超微结构上,给药后7天心肌细胞内质网和胞质溶胶增加,给药后14天高尔基体隔室数量增加。给药后7天转基因产物蛋白的组织浓度增加。基因表达分析显示给药后7天ER应激相关基因上调,提示未折叠蛋白反应(UPR)的PKR样内质网激酶途径被激活。因此,产品X诱导的心脏毒性被认为涉及产品蛋白过表达伴随UPR引起的细胞损伤。明显的UPR激活也可能导致基于AAV的GT产品的毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b73/11442262/c0f578687888/tox-37-139-g001.jpg

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