title: Stable gene transfer and expression of human blood coagulation factor IX after intramuscular injection of recombinant adeno-associated virus.
abstract: We sought to determine whether intramuscular injection of a recombinant adeno-associated virus (rAAV) vector expressing human factor IX (hF.IX) could direct expression of therapeutic levels of the transgene in experimental animals. High titer (10(12)-10(13) vector genomes/ml) rAAV expressing hF.IX was prepared, purified, and injected into hindlimb muscles of C57BL/6 mice and Rag 1 mice. In the immunocompetent C57BL/6 mice, immunofluorescence staining of muscle harvested 3 months after injection demonstrated the presence of hF.IX protein, and PCR analysis of muscle DNA was positive for AAV DNA, but no hF.IX was detected in mouse plasma. Further studies showed that these mice had developed circulating antibodies to hF.IX. In follow-up experiments in Rag 1 mice, which carry a mutation in the recombinase activating gene-1 and thus lack functional B and T cells, similar results were seen on DNA analysis of muscle, but these mice also demonstrated therapeutic levels (200-350 ng/ml) of F. IX in the plasma. The time course of F.IX expression demonstrates that levels gradually increase over a period of several weeks before reaching a plateau that is stable 6 months after injection. In other experiments we demonstrate colocalization of hF.IX and collagen IV in intersitial spaces between muscle fibers. Collagen IV has recently been identified as a F.IX-binding protein; this finding explains the unusual pattern of immunofluorescent staining for F.IX shown in these experiments. Thus rAAV can be used to direct stable expression of therapeutic levels of F.IX after intramuscular injection and is a feasible strategy for treatment of patients with hemophilia B.
authors.affiliation: Department of Pediatrics, University of Pennsylvania School of Medicine, and The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Herzog
authors.forename: J N
authors.initials: JN
authors.lastname: Hagstrom
authors.forename: S H
authors.initials: SH
authors.lastname: Kung
authors.forename: S J
authors.initials: SJ
authors.lastname: Tai
authors.forename: J M
authors.initials: JM
authors.lastname: Wilson
authors.forename: K J
authors.initials: KJ
authors.lastname: Fisher
authors.forename: K A
authors.initials: KA
authors.lastname: High
mesh_terms: D000818:Animals; D000910:Antibodies, Heterophile / Q000097:blood; D017931:DNA Primers; D000229:Dependovirus; D004797:Enzyme-Linked Immunosorbent Assay; D005164:Factor IX / Q000096:biosynthesis* / Q000235:genetics*; D005455:Fluorescent Antibody Technique; D018014:Gene Transfer Techniques; D015316:Genetic Therapy / Q000379:methods; D018398:Homeodomain Proteins; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000235:genetics / Q000276:immunology / Q000628:therapy; D007273:Injections, Intramuscular; D051379:Mice; D008810:Mice, Inbred C57BL; D008817:Mice, Mutant Strains; D018482:Muscle, Skeletal / Q000166:cytology / Q000378:metabolism*; D016133:Polymerase Chain Reaction; D014176:Protein Biosynthesis; D011506:Proteins / Q000235:genetics
chemical_list: D000910:Antibodies, Heterophile; D017931:DNA Primers; D018398:Homeodomain Proteins; D011506:Proteins; C064658:RAG-1 protein; D005164:Factor IX