title: Muscle as a target for supplementary factor IX gene transfer.
abstract: Immune responses to the factor IX (F.IX) transgene product are a concern in gene therapy for the X-linked bleeding disorder hemophilia B. The risk for such responses is determined by several factors, including the vector, target tissue, and others. Previously, we have demonstrated that hepatic gene transfer with adeno-associated viral (AAV) vectors can induce F.IX-specific immune tolerance. Muscle-derived F.IX expression, however, is limited by a local immune response. Here, skeletal muscle was investigated as a target for supplemental gene transfer. Given the low invasiveness of intramuscular injections, this route would be ideal for secondary gene transfer, thereby boosting levels of transgene expression. However, this is feasible only if immune tolerance established by compartmentalization of expression to the liver extends to other sites. Immune tolerance to human F.IX established by prior hepatic AAV-2 gene transfer was maintained after subsequent injection of AAV-1 or adenoviral vector into skeletal muscle, and tolerized mice failed to form antibodies or an interferon (IFN)-gamma(+) T cell response to human F.IX. A sustained increase in systemic transgene expression was obtained for AAV-1, whereas an increase after adenoviral gene transfer was transient. A CD8(+) T cell response specifically against adenovirus-transduced fibers was observed, suggesting that cytotoxic T cell responses against viral antigens were sufficient to eliminate expression in muscle. In summary, the data demonstrate that supplemental F.IX gene transfer to skeletal muscle does not break tolerance achieved by liver-derived expression. The approach is efficacious, if the vector for muscle gene transfer does not express immunogenic viral proteins.
authors.affiliation: Department of Pediatrics and Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL 32610, USA.
authors.forename: Brad E
authors.initials: BE
authors.lastname: Hoffman
authors.forename: Eric
authors.initials: E
authors.lastname: Dobrzynski
authors.forename: Lixin
authors.initials: L
authors.lastname: Wang
authors.forename: Lauren
authors.initials: L
authors.lastname: Hirao
authors.forename: Federico
authors.initials: F
authors.lastname: Mingozzi
authors.forename: Ou
authors.initials: O
authors.lastname: Cao
authors.forename: Roland W
authors.initials: RW
authors.lastname: Herzog
mesh_terms: D000818:Animals; D000906:Antibodies / Q000097:blood; D000229:Dependovirus / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005164:Factor IX / Q000235:genetics* / Q000276:immunology / Q000627:therapeutic use; D015870:Gene Expression; D015316:Genetic Therapy; D005822:Genetic Vectors / Q000008:administration & dosage / Q000627:therapeutic use*; D002836:Hemophilia B / Q000235:genetics*; D022781:Hepatocytes / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D007273:Injections, Intramuscular; D007371:Interferon-gamma / Q000097:blood; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D018482:Muscle, Skeletal / Q000378:metabolism / Q000821:virology
chemical_list: D000906:Antibodies; D007371:Interferon-gamma; D005164:Factor IX