Cited by 81Virus-based gene therapy researchLysosomal Storage Disorders ResearchRNA Interference and Gene Delivery

Toxicology Study of Intra-Cisterna Magna Adeno-Associated Virus 9 Expressing Iduronate-2-Sulfatase in Rhesus Macaques

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Hordeaux, Juliette, Hinderer, Christian, Goode, Tamara, Buza, Elizabeth L., Bell, Peter, Calcedo, Roberto, Richman, Laura K., Wilson, James M.·2018·Molecular Therapy - Methods & Clinical Development

Abstract

Hunter syndrome is an X-linked recessive disease caused by deficiency of the lysosomal enzyme iduronate-2-sulfatase. The severe form of this progressive, systemic, and neurodegenerative disease results in loss of cognitive skills and early death. Several clinical trials are evaluating adeno-associated virus 9 for the treatment of neurodegenerative diseases using systemic or intrathecal lumbar administration. In large animals, administration via suboccipital puncture gives better brain transduction than lumbar administration. Here, we conducted a good laboratory practice-compliant investigational new drug-enabling study to determine the safety of suboccipital adeno-associated virus 9 gene transfer of human iduronate-2-sulfatase into nonhuman primates. Thirteen rhesus macaques received vehicle or one of two doses of vector with or without immunosuppression. We assessed in-life safety and immune responses. Animals were euthanized 90 days post-administration and sampled for histopathology and biodistribution. The procedure was well tolerated in all animals. Minimal mononuclear cerebrospinal fluid pleocytosis occurred in some animals. Asymptomatic minimal-to-moderate toxicity to some dorsal root ganglia sensory neurons and their associated axons occurred in all vector-treated animals. This study supports the clinical development of suboccipital adeno-associated virus 9 delivery for severe Hunter syndrome and highlights a potential toxicity that warrants monitoring in first-in-human studies.

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  1. [2]Neufeld E.F. Muenzer J. The mucopolysaccharidoses Scriver C. Beaudet A. Sly W. The Metabolic & Molecular Bases of Inherited Disease 2001 McGraw-Hill 3421 3452

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Authors
Hordeaux, J., Hinderer, C., Goode, T., Buza, E. L., Bell, P., Calcedo, R., Richman, L. K., & Wilson, J. M.
Affiliations
University of Pennsylvania (US)
Corresponding author
Wilson, James M.
Venue
Molecular Therapy - Methods & Clinical Development
Publisher
Elsevier BV
Published
2018-09
Volume
10
Pages
68-78
ISSN
2329-0501 (ISSN-L)
OpenAlex
W2883795982
Cited by
81
References
26
Citations by year
2026: 7 · 2025: 7 · 2024: 15 · 2023: 13 · 2022: 11 · 2021: 11 · 2020: 14 · 2019: 3
FWCI
4.28
Type
journal article
Language
en
Open access
Locations
  • Molecular Therapy — Methods & Clinical Development (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
University of Pennsylvania
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
  • Health Sciences › Medicine › Physiology › Lysosomal Storage Disorders Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Interference and Gene Delivery
Keywords
Hunter syndrome, iduronate-2-sulfatase, AAV9, gene therapy, rhesus monkeys, neurodegenerative diseases, immunosuppression, cerebrospinal fluid pleocytosis, tissue distribution, vector safety

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