Journal
BLOOD
Volume 119, Issue 4, Pages 957-966Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2011-09-377630
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Funding
- Wellcome Trust, United Kingdom
- Department of Health's National Institute for Health Research (NIHR) Biomedical Research Centres
- NIHR, United Kingdom
- Katharine Dormandy Trust
- ASSISI Foundation of Memphis
- American Lebanese Syrian Associated Charities (ALSAC)
- National Heart, Lung, and Blood Institute (NHLBI) Center for Fetal Monkey Gene Transfer for Heart, Lung, and Blood Diseases [HL085794]
- California National Primate Research Center [RR00169]
- National Cancer Institute Cancer Center [CA027165]
- Great Ormond Street Hospital Childrens Charity [V1223] Funding Source: researchfish
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We explored adeno-associated viral vector (AAV) mediated gene transfer in the perinatal period in animal models of severe congenital factor VII (FVII) deficiency, a disease associated with early postnatal life-threatening hemorrhage. In young adult mice with plasma FVII < 1% of normal, a single tail vein administration of AAV (1 x 10(13) vector genomes [vg]/kg) resulted in expression of murine FVII at 266% +/- 34% of normal for >= 67 days, which mediated protection against fatal hemorrhage and significantly improved survival. Codon optimization of human FVII (hFVIIcoop) improved AAV transgene expression by 37-fold compared with the wild-type hFVII cDNA. In adult macaques, a single peripheral vein injection of 2 x 10(11) vg/kg of the hFVIIcoop AAV vector resulted in therapeutic levels of hFVII expression that were equivalent in males (10.7% +/- 3.1%) and females (12.3% +/- 0.8%). In utero delivery of this vector in the third trimester to fetal monkeys conferred expression of hFVII at birth of 20.4% +/- 3.7%, with a gradual decline to > 1% by 7 weeks. Re-administration of an alternative serotype at 12 months postnatal age increased hFVII levels to 165% +/- 6.2% of normal, which remained at therapeutic levels for a further 28 weeks without toxicity. Thus, perinatal AAV-mediated gene transfer shows promise for disorders with onset of pathology early after birth. (Blood. 2012; 119(4):957-966)
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