학술논문

First-in-human in vivogenome editing via AAV-zinc-finger nucleases for mucopolysaccharidosis I/II and hemophilia B
Document Type
Article
Source
Molecular Therapy; December 2022, Vol. 30 Issue: 12 p3587-3600, 14p
Subject
Language
ISSN
15250016; 15250024
Abstract
Zinc-finger nuclease (ZFN)-based in vivogenome editing is a novel treatment that can potentially provide lifelong protein replacement with single intravenous administration. Three first-in-human open-label ascending single-dose phase 1/2 studies were performed in parallel (starting November 2017) primarily to assess safety and tolerability of ZFN in vivoediting therapy in mucopolysaccharidosis I (MPS I) (n = 3), MPS II (n = 9), and hemophilia B (n = 1). Treatment was well tolerated with no serious treatment-related adverse events. At the 1e13 vg/kg dose, evidence of genome editing was detected through albumin-transgene fusion transcripts in liver for MPS II (n = 2) and MPS I (n = 1) subjects. The MPS I subject also had a transient increase in leukocyte iduronidase activity to the lower normal range. At the 5e13 vg/kg dose, one MPS II subject had a transient increase in plasma iduronate-2-sulfatase approaching normal levels and one MPS I subject approached mid-normal levels of leukocyte iduronidase activity with no evidence of genome editing. The hemophilia B subject was not able to decrease use of factor IX concentrate; genome editing could not be assessed. Overall, ZFN in vivoediting therapy had a favorable safety profile with evidence of targeted genome editing in liver, but no long-term enzyme expression in blood.