Immune Responses to Muscle-Directed Adeno-Associated Viral Gene Transfer in Clinical Studies
Open accessAbstract
Muscle-directed gene therapy with adeno-associated viral (AAV) vectors is undergoing clinical development for treating neuromuscular disorders and for systemic delivery of therapeutic proteins. Although these approaches show considerable therapeutic benefits, they are also prone to induce potent immune responses against vector or transgene products owing to the immunogenic nature of the intramuscular delivery route, or the high doses required for systemic delivery to muscle. Major immunological concerns include antibody formation against viral capsid, complement activation, and cytotoxic T cell responses against capsid or transgene products. They can negate therapy and even lead to life-threatening immunotoxicities. Herein we review clinical observations and provide an outlook for how the field addresses these problems through a combination of vector engineering and immune modulation.
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The monoclonal antibody eculizumab, a C5 inhibitor, is currently used in attempts to reduce complement-related immunotoxicities.
“Currently, monoclonal antibody eculizumab (an inhibitor of C5) is being used in an attempt to lessen complementrelated immunotoxicities.13,95”
From Innate immune sensing of adeno-associated virus vectors (2024) · cites this paper as [95]
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Self-citation
- Authors
- Kumar, S. R. P., Duan, D., & Herzog, R. W.
- Affiliations
- Indiana University Indianapolis (US)
- University of Missouri (US)
- Corresponding author
- Herzog, Roland W.
- Venue
- Human Gene Therapy
- Publisher
- SAGE Publications
- Published
- 2023-05
- Volume
- 34
- Issue
- 9-10
- Pages
- 365-371
- ISSN
- 1043-0342 (ISSN-L)
- 1557-7422
- PMC
- PMC10210217
- OpenAlex
- W4375860305
- Cited by
- 28
- References
- 68
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 10 · 2023: 6
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Human Gene Therapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (P01HL160472, R01HL131093)
- National Institute of Allergy and Infectious Diseases (R01AI051390, R01AI177600)
- National Institute of Neurological Disorders and Stroke (R01NS090634)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR070517)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › RNA Interference and Gene Delivery
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Keywords
- adeno-associated virus vectors, immune response, neuromuscular disorders, complement activation, cytotoxic T lymphocytes, immunotoxicity, vector engineering, immunomodulation, clinical gene therapy
- MeSH terms
- Dependovirus, Genes, Viral, Genetic Vectors, Immunity, Injections, Intramuscular, Muscles, Gene Transfer Techniques, Transgenes
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