Custom adeno-associated virus capsids: The next generation of recombinant vectors with novel tropism

Recombinant gene delivery vehicles based on adeno-associated virus (rAAV) have emerged as promising vectors for the correction of genetic and acquired human disease states. These vectors possess many characteristics, including low pathogenicity and immunogenicity, and long-term gene expression after a single administered dose, that make them leading candidates for clinical gene therapy applications. Yet, the broad tissue tropism of the available AAV serotypes remains a disadvantage for the safest, most effective in vivo delivery of transgenes to target tissues. In addition, clinically relevant cell types exist that are poorly transduced by current rAAV vectors. As a result, increased efforts are now being made to tailor the tropism of rAAV to improve their transduction and selectivity profiles. Flexible, diverse methodologies have emerged that allow more control over the cell surface receptors rAAV employs for cell entry. These novel rAAV production strategies have resulted in unique vectors characterized by unique capsid protein sequences that employ alternative receptors, and have provided a better understanding of many basic aspects of the rAAV life cycle. This review aims to summarize the genetic methods currently being employed to customize rAAV capsids.