Chen Zhan, Yang Luzi, Zhang Yueyang, Li Jiting, Yang Yuhan, Li Yue, Fan Linwei, Chen Wei, Miao Lei, Liu Jin, Chen Gonglie, Wang Ze, Li Yifei, Gao Fei, Zhou Jing, Zheng Lemin, Zhang Yan, Zhao Dongyu, Pu William T, Yang Ke, Dong Erdan, Guo Yuxuan
Institute of Cardiovascular Sciences, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
Nat Cardiovasc Res. 2025 Jun 13. doi: 10.1038/s44161-025-00665-7.
Adeno-associated viruses (AAVs) are commonly used for gene therapy, but a clinically relevant method to fine-tune AAV expression is lacking, restricting their therapeutic efficacy and safety. Here we develop the drug-elicitable alternative splicing module (DreAM), which is responsive to risdiplam, a Food and Drug Administration-approved alternative splicing modulator. Risdiplam activated DreAM-regulated AAV expression in a dose-dependent manner with a 2,000-fold inducible change, depending on the dose of risdiplam and the organ of interest. With a temporal resolution of 2 days, DreAM could transiently, reversibly and repeatedly activate AAV expression according to the frequency and duration of risdiplam administration. In this proof-of-concept study, we incorporated DreAM into the cardiomyocyte-specific, liver-detargeted AAV9-Tnnt2-miR122TS vector to transiently activate the cardiomyocyte regeneration factor YAP. A dedifferentiation-proliferation-redifferentiation cycle was established in adult cardiomyocytes, improving cardiac regeneration after myocardial infarction while limiting animal death, AAV9-Tnnt2 expression in the liver and hepatic tumorigenesis. Therefore, DreAM may enhance the efficacy, safety and scope of gene therapy.
腺相关病毒(AAV)常用于基因治疗,但缺乏一种临床上适用的微调AAV表达的方法,这限制了它们的治疗效果和安全性。在此,我们开发了药物诱导可变剪接模块(DreAM),它对美国食品药品监督管理局批准的可变剪接调节剂利司扑兰有反应。利司扑兰以剂量依赖性方式激活DreAM调控的AAV表达,诱导变化可达2000倍,这取决于利司扑兰的剂量和目标器官。DreAM具有2天的时间分辨率,可根据利司扑兰给药的频率和持续时间,瞬时、可逆且反复地激活AAV表达。在这项概念验证研究中,我们将DreAM整合到心肌细胞特异性、肝脏脱靶的AAV9-Tnnt2-miR122TS载体中,以瞬时激活心肌细胞再生因子YAP。在成年心肌细胞中建立了去分化-增殖-再分化循环,改善了心肌梗死后的心脏再生,同时限制了动物死亡、肝脏中AAV9-Tnnt2的表达以及肝脏肿瘤发生。因此,DreAM可能会提高基因治疗的疗效、安全性和适用范围。