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Immunoadsorption enables successful rAAV5-mediated repeated hepatic gene delivery in nonhuman primates.
Blood Adv 2019; 3(17):2632-2641BA

Abstract

Adeno-associated virus (AAV)-based liver gene therapy has been shown to be clinically successful. However, the presence of circulating neutralizing antibodies (NABs) against AAV vector capsids remains a major challenge as it may prevent successful transduction of the target cells. Therefore, there is a need to develop strategies that would enable AAV-mediated gene delivery to patients with preexisting anti-AAV NABs. In the current study, the feasibility of using an immunoadsorption (IA) procedure for repeated, liver-targeted gene delivery in nonhuman primates was explored. The animals were administered IV with recombinant AAV5 (rAAV5) carrying the reporter gene human secreted embryonic alkaline phosphatase (hSEAP). Seven weeks after the first rAAV treatment, all of the animals were readministered with rAAV5 carrying the therapeutic hemophilia B gene human factor IX (hFIX). Half of the animals administered with rAAV5-hSEAP underwent IA prior to the second rAAV5 exposure. The transduction efficacies of rAAV5-hSEAP and rAAV5-hFIX were assessed by measuring the levels of hSEAP and hFIX proteins. Although no hFIX was detected after rAAV5-hFIX readministration without prior IA, all animals submitted to IA showed therapeutic levels of hFIX expression, and a threshold of anti-AAV5 NAB levels compatible with successful readministration was demonstrated. In summary, our data demonstrate that the use of a clinically applicable IA procedure enables successful readministration of an rAAV5-based gene transfer in a clinically relevant animal model. Finally, the analysis of anti-AAV NAB levels in human subjects submitted to IA confirmed the safety and efficacy of the procedure to reduce anti-AAV NABs. Furthermore, clinical translation was assessed using an immunoglobulin G assay as surrogate.

Authors+Show Affiliations

Gene Therapy and Hepatology Department, Centro de Investigacion Medica Aplicada, University of Navarra, Pamplona, Spain; and.Research Department, uniQure BV, Amsterdam, The Netherlands.Gene Therapy and Hepatology Department, Centro de Investigacion Medica Aplicada, University of Navarra, Pamplona, Spain; and.Gene Therapy and Hepatology Department, Centro de Investigacion Medica Aplicada, University of Navarra, Pamplona, Spain; and.Research Department, uniQure BV, Amsterdam, The Netherlands.Research Department, uniQure BV, Amsterdam, The Netherlands.Gene Therapy and Hepatology Department, Centro de Investigacion Medica Aplicada, University of Navarra, Pamplona, Spain; and.Research Department, uniQure BV, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31501158

Citation

Salas, David, et al. "Immunoadsorption Enables Successful rAAV5-mediated Repeated Hepatic Gene Delivery in Nonhuman Primates." Blood Advances, vol. 3, no. 17, 2019, pp. 2632-2641.
Salas D, Kwikkers KL, Zabaleta N, et al. Immunoadsorption enables successful rAAV5-mediated repeated hepatic gene delivery in nonhuman primates. Blood Adv. 2019;3(17):2632-2641.
Salas, D., Kwikkers, K. L., Zabaleta, N., Bazo, A., Petry, H., van Deventer, S. J., ... Ferreira, V. (2019). Immunoadsorption enables successful rAAV5-mediated repeated hepatic gene delivery in nonhuman primates. Blood Advances, 3(17), pp. 2632-2641. doi:10.1182/bloodadvances.2019000380.
Salas D, et al. Immunoadsorption Enables Successful rAAV5-mediated Repeated Hepatic Gene Delivery in Nonhuman Primates. Blood Adv. 2019 Sep 10;3(17):2632-2641. PubMed PMID: 31501158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunoadsorption enables successful rAAV5-mediated repeated hepatic gene delivery in nonhuman primates. AU - Salas,David, AU - Kwikkers,Karin L, AU - Zabaleta,Nerea, AU - Bazo,Andrea, AU - Petry,Harald, AU - van Deventer,Sander J, AU - Aseguinolaza,Gloria Gonzalez, AU - Ferreira,Valerie, PY - 2019/04/29/received PY - 2019/07/28/accepted PY - 2019/9/11/entrez PY - 2019/9/11/pubmed PY - 2019/9/11/medline SP - 2632 EP - 2641 JF - Blood advances JO - Blood Adv VL - 3 IS - 17 N2 - Adeno-associated virus (AAV)-based liver gene therapy has been shown to be clinically successful. However, the presence of circulating neutralizing antibodies (NABs) against AAV vector capsids remains a major challenge as it may prevent successful transduction of the target cells. Therefore, there is a need to develop strategies that would enable AAV-mediated gene delivery to patients with preexisting anti-AAV NABs. In the current study, the feasibility of using an immunoadsorption (IA) procedure for repeated, liver-targeted gene delivery in nonhuman primates was explored. The animals were administered IV with recombinant AAV5 (rAAV5) carrying the reporter gene human secreted embryonic alkaline phosphatase (hSEAP). Seven weeks after the first rAAV treatment, all of the animals were readministered with rAAV5 carrying the therapeutic hemophilia B gene human factor IX (hFIX). Half of the animals administered with rAAV5-hSEAP underwent IA prior to the second rAAV5 exposure. The transduction efficacies of rAAV5-hSEAP and rAAV5-hFIX were assessed by measuring the levels of hSEAP and hFIX proteins. Although no hFIX was detected after rAAV5-hFIX readministration without prior IA, all animals submitted to IA showed therapeutic levels of hFIX expression, and a threshold of anti-AAV5 NAB levels compatible with successful readministration was demonstrated. In summary, our data demonstrate that the use of a clinically applicable IA procedure enables successful readministration of an rAAV5-based gene transfer in a clinically relevant animal model. Finally, the analysis of anti-AAV NAB levels in human subjects submitted to IA confirmed the safety and efficacy of the procedure to reduce anti-AAV NABs. Furthermore, clinical translation was assessed using an immunoglobulin G assay as surrogate. SN - 2473-9537 UR - https://www.unboundmedicine.com/medline/citation/31501158/Immunoadsorption_enables_successful_rAAV5-mediated_repeated_hepatic_gene_delivery_in_nonhuman_primates L2 - https://ashpublications.org/bloodadvances/article-lookup/doi/10.1182/bloodadvances.2019000380 DB - PRIME DP - Unbound Medicine ER -