Transgene expression levels and kinetics determine risk of humoral immune response modeled in factor IX knockout and missense mutant mice

Gene Ther. 2007 Mar;14(5):429-40. doi: 10.1038/sj.gt.3302881. Epub 2006 Oct 26.

Abstract

Immune responses leading to antibody-mediated elimination of the transgenic protein are a concern in gene replacement for congenital protein deficiencies, for which hemophilia is an important model. Although most hemophilia B patients have circulating non-functional but immunologically crossreactive factor IX (FIX) protein (CRM+ phenotype), inciting factors for FIX neutralizing antibody (inhibitor) development have been studied in crossreactive material-negative (CRM-) animal models. For this study, determinants of FIX inhibitor development were compared in hemophilia B mice, in which circulating FIX protein is absent (CRM- factor IX knockout (FIXKO) model) or present (CRM+ missense R333Q-hFIX model) modeling multiple potential therapies. The investigations compare for the first time different serotypes of adeno-associated virus (AAV) vectors (AAV2 and AAV1), each at multiple doses, in the setting of two different FIX mutations. The comparisons demonstrate in the FIXKO background (CRM- phenotype) that neither vector serotype nor vector particle number independently determine the inhibitor trigger, which is influenced primarily by the level and kinetics of transgene expression. In the CRM+ missense background, inhibitor development was never stimulated by AAV gene therapy or protein therapy, despite the persistence of lymphocytes capable of responding to FIX with non-inhibitory antibodies. This genotype/phenotype is strongly protective against antibody formation in response to FIX therapy.

Publication types

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

MeSH terms

  • Animals
  • Autoantibodies / immunology*
  • Cross Reactions
  • Factor IX / genetics*
  • Factor IX / immunology
  • Gene Expression
  • Genetic Therapy / adverse effects*
  • Genetic Therapy / methods
  • Genetic Vectors / genetics*
  • Hemophilia A / blood
  • Hemophilia A / immunology
  • Hemophilia A / therapy
  • Humans
  • Kinetics
  • Mice
  • Mice, Knockout
  • Mice, Mutant Strains
  • Models, Biological
  • Mutation, Missense
  • Risk
  • Transduction, Genetic / methods
  • Transgenes

Substances

  • Autoantibodies
  • Factor IX