In vivo intranasal delivery of coagulation factor IX: a proof-of-concept study

J Thromb Haemost. 2023 Nov;21(11):3117-3123. doi: 10.1016/j.jtha.2023.08.019. Epub 2023 Aug 25.

Abstract

Background: Hemophilia B (HB) is a bleeding disorder characterized by coagulation factor (F) IX (FIX) deficiency. The current standard-of-care for severe HB is prophylaxis with long-term repetitive intravenous (i.v.) infusions of recombinant FIX (rFIX) with standard half-life or extended half-life. Unmet needs remain regarding the development of non-invasive administration routes for coagulation factors. The aim of this study was to evaluate the effectiveness of intranasal delivery (IND) of rFIX and rFIX fused to Fc fragment (rFIX-Fc) in mice.

Methods: Drops of rFIX and rFIX-Fc were deposited in the nostrils of wild-type, FcRn knock-out, FcRn humanized, and FIX knock-out mice. rFIX mucosal uptake was evaluated by measuring plasma FIX antigen and FIX activity (FIX:C) levels, and by performing histologic analysis of the nasal mucosa following IND.

Results: After IND, both rFIX and rFIX-Fc were equally delivered to the blood compartment, irrespective of the mouse strain studied, mostly through a passive mechanism of transportation across the mucosal barrier, independent of FcRn receptor. Both plasma FIX antigen and FIX:C activity levels increased following IND in FIX knock-out mice.

Conclusion: This proof-of-concept study describes evidence supporting the nasal route as an alternative to FIX i.v. infusion for the treatment of HB.

Keywords: Fc receptor; administration; factor IX; hemophilia B; intranasal; mice; neonatal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Factor IX / therapeutic use
  • Hemophilia A* / drug therapy
  • Hemophilia B* / drug therapy
  • Hemophilia B* / genetics
  • Mice
  • Mice, Knockout
  • Recombinant Fusion Proteins / therapeutic use
  • Recombinant Proteins / therapeutic use

Substances

  • Factor IX
  • Recombinant Fusion Proteins
  • Recombinant Proteins