Safety of recombinant adeno-associated virus type 2-RPE65 vector delivered by ocular subretinal injection

Mol Ther. 2006 Jun;13(6):1074-84. doi: 10.1016/j.ymthe.2006.03.005. Epub 2006 Apr 27.

Abstract

AAV2 delivery of the RPE65 gene to the retina of blind RPE65-deficient animals restores vision. This strategy is being considered for human trials in RPE65-associated Leber congenital amaurosis (LCA), but toxicity and dose efficacy have not been defined. We studied ocular delivery of AAV-2/2.RPE65 in RPE65-mutant dogs. There was no systemic toxicity. Ocular examinations showed mild or moderate inflammation that resolved over 3 months. Retinal histopathology indicated that traumatic lesions from the injection were common, but thinning within the injection region occurred only at the two highest vector doses. Biodistribution studies at 3 months postinjection showed no vector in optic nerve or visual centers in the brain and only isolated non-dose-related detection in other organs. We also performed biodistribution studies in normal rats at about 2 weeks and 2 months postinjection and vector was not widespread outside the injected eye. Dose-response results in RPE65-mutant dogs indicated that the highest 1.5-log unit range of vector doses proved efficacious. The efficacy and toxicity limits defined in this study lead to suggestions for the design of a subretinal AAV-2/2.RPE65 human trial of RPE65-associated LCA.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Animals, Genetically Modified
  • Blindness / genetics
  • Blindness / therapy
  • Carrier Proteins
  • Dependovirus / genetics*
  • Dogs
  • Dose-Response Relationship, Drug
  • Drug-Related Side Effects and Adverse Reactions
  • Eye Proteins / administration & dosage
  • Eye Proteins / genetics*
  • Female
  • Genetic Therapy / methods
  • Genetic Vectors / administration & dosage*
  • Genetic Vectors / adverse effects*
  • Genetic Vectors / pharmacokinetics
  • Injections, Intralesional
  • Male
  • Optic Atrophy, Hereditary, Leber / genetics
  • Optic Atrophy, Hereditary, Leber / therapy
  • Rats
  • Rats, Sprague-Dawley
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / genetics
  • Retina / drug effects*
  • Retina / pathology
  • Tissue Distribution
  • cis-trans-Isomerases

Substances

  • Carrier Proteins
  • Eye Proteins
  • Recombinant Proteins
  • retinoid isomerohydrolase
  • cis-trans-Isomerases