Preclinical dose-escalation study of intravitreal AAV-RS1 gene therapy in a mouse model of X-linked retinoschisis: dose-dependent expression and improved retinal structure and function
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Gene therapy for inherited retinal diseases has been shown to ameliorate functional and structural defects in both animal models and in human clinical trials. X-linked retinoschisis (XLRS) is an early-age onset macular dystrophy resulting from loss of an extracellular matrix protein (RS1). In preparation for a human clinical gene therapy trial, we conducted a dose-range efficacy study of the clinical vector, a self-complementary AAV delivering a human retinoschisin (RS1) gene under control of the RS1 promoter and an interphotoreceptor binding protein enhancer (AAV8-scRS/IRBPhRS), in the retinoschisin knockout (Rs1-KO) mouse. The therapeutic vector at 1 × 10(6) to 2.5 × 10(9) (1E6-2.5E9) vector genomes (vg)/eye or vehicle was administered to one eye of 229 male Rs1-KO mice by intravitreal injection at 22 ± 3 days postnatal age (PN). Analysis of retinal function (dark-adapted electroretinogram, ERG), structure (cavities and outer nuclear layer thickness) by in vivo retinal imaging using optical coherence tomography, and retinal immunohistochemistry (IHC) for RS1 was done 3-4 months and/or 6-9 months postinjection (PI). RS1 IHC staining was dose dependent across doses ≥1E7 vg/eye, and the threshold for significant improvement in all measures of retinal structure and function was 1E8 vg/eye. Higher doses, however, did not produce additional improvement. At all doses showing efficacy, RS1 staining in Rs1-KO mouse was less than that in wild-type mice. Improvement in the ERG and RS1 staining was unchanged or greater at 6-9 months than at 3-4 months PI. This study demonstrates that vitreal administration of AAV8 scRS/IRBPhRS produces significant improvement in retinal structure and function in the mouse model of XLRS over a vector dose range that can be extended to a human trial. It indicates that a fully normal level of RS1 expression is not necessary for a therapeutic effect.
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AAV-mediated RS1 expression in the Rs1-knockout mouse improved retinal structure, with fewer cavities, and function, as measured by electroretinogram.
“AAV-mediated augmentation of human RS1 expression in the Rs1-knockout mouse led to improved retinal structure (reduced retinal cavities) and function (electroretinogram response)”
From Correcting visual loss by genetics and prosthetics (2020) · cites this paper as Bush 2016
Early results from a phase I human trial of RS1 gene therapy showed possible closure of parafoveal schisis cavities in at least one patient.
“while early results from a phase I human trial has demonstrated potential closure of parafoveal schisis cavities in at least one patient [Bush 2016, Cukras 2018].”
From Correcting visual loss by genetics and prosthetics (2020) · cites this paper as Bush 2016
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- Authors
- Bush, R. A., Zeng, Y., Colosi, P., Kjellstrom, S., Hiriyanna, S., Vijayasarathy, C., Santos, M., Li, J., Wu, Z., & Sieving, P. A.
- Affiliations
- National Institutes of Health (US)
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland.
- National Eye Institute, National Institutes of Health, Bethesda, Maryland.
- Venue
- Human Gene Therapy
- Publisher
- SAGE Publications
- Published
- 2016-05
- Volume
- 27
- Issue
- 5
- Pages
- 376-389
- ISSN
- 1043-0342 (ISSN-L)
- 1557-7422
- PMC
- PMC4840830
- OpenAlex
- W2318885789
- Cited by
- 86
- References
- 43
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 15 · 2023: 6 · 2022: 12 · 2021: 11 · 2020: 9 · 2019: 4 · 2018: 9 · 2017: 3 · 2016: 1
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Human Gene Therapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- National Institutes of Health
- National Eye Institute
- National Institute on Deafness and Other Communication Disorders
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Keywords
- X-linked retinoschisis, retinoschisin, intravitreal gene therapy, dose escalation, retinal function, electroretinogram, retinal structure, outer nuclear layer thickness, macular dystrophy
- MeSH terms
- Dependovirus, Animals, Disease Models, Animal, Electroretinography, Eye Proteins, Genetic Vectors, Immunohistochemistry, Male, Retina, Time Factors, Transduction, Genetic, Genetic Therapy, Cell Adhesion Molecules, Gene Expression, Mice, Knockout, Retinoschisis, Tomography, Optical Coherence, Genes, X-Linked, Mice, Intravitreal Injections
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