학술논문

Vector design influences hepatic genotoxicity after adeno-associated virus gene therapy
Document Type
Report
Source
Journal of Clinical Investigation. February 1, 2015, p870, 11 p.
Subject
Gene therapy -- Patient outcomes
Dependoviruses -- Usage
Genetic vectors -- Properties
Liver diseases -- Risk factors
Health care industry
Usage
Risk factors
Properties
Patient outcomes
Language
English
ISSN
0021-9738
Abstract
The use of adeno-associated virus (AAV) as a gene therapy vector has been approved recently for clinical use and has demonstrated efficacy in a growing number of clinical trials. However, the safety of AAV as a vector has been challenged by a single study that documented hepatocellular carcinoma (HCC) after AAV gene delivery in mice. Most studies have not noted genotoxicity following AAV-mediated gene delivery; therefore, the possibility that there is an association between AAV and HCC is controversial. Here, we performed a comprehensive study of HCC in a large number of mice following therapeutic AAV gene delivery. Using a sensitive high-throughput integration site-capture technique and global expressional analysis, we found that AAV integration into the RNA imprinted and accumulated in nucleus (Rian) locus, and the resulting overexpression of proximal microRNAs and retrotransposon-like 1 (Rtl1) were associated with HCC. In addition, we demonstrated that the AAV vector dose, enhancer/promoter selection, and the timing of gene delivery are all critical factors for determining HCC incidence after AAV gene delivery. Together, our results define aspects of AAV-mediated gene therapy that influence genotoxicity and suggest that these features should be considered for design of both safer AAV vectors and gene therapy studies.
Introduction Adeno-associated virus (AAV) is regarded as nonpathogenic (1) and, when configured for gene therapy applications, is devoid of an intrinsic capacity to replicate and integrate. AAVs have therefore emerged [...]