Products and Methods for Treatment of Familial Amyotrophic Lateral Sclerosis
The present invention relates to RNA-based methods for inhibiting the expression of the superoxide dismutase 1 (SOD-1) gene. Recombinant adeno-associated viruses of the invention deliver DNAs encoding RNAs that knock down the expression of SOD-1. The methods have application in the treatment of amyotrophic lateral sclerosis.
The present application is a continuation of U.S. patent application Ser. No. 16/041,381, filed Jul. 20, 2018, which is a continuation of U.S. patent application Ser. No. 14/914,861, filed on Feb. 26, 2016, now abandoned, which is a national phase filing of U.S. International Patent Application No. PCT/US14/52753, filed on Aug. 26, 2014, which claims priority benefit of U.S. Provisional Application No. 61/870,585, filed Aug. 27, 2013, all of which are incorporated by reference herein in their entirety.
STATEMENT OF GOVERNMENT INTERESTThis invention was made with government support under U.S. National Institutes of Health R21-NS067238, NS027036, ROI NS064492 and RC2 NS69476-01. The Government has certain rights in the invention.
INCORPORATION BY REFERENCE OF MATERIAL SUBMITTED ELECTRONICALLYIncorporated by reference in its entirety is a computer-readable nucleotide/amino acid sequence listing submitted concurrently herewith and identified as follows: 14,350 byte ACII (Text) file named “47886PCT_SeqListing.txt,” created on Aug. 26, 2014.
FIELD OF THE INVENTIONThe present invention relates to RNA-based methods for inhibiting the expression of the superoxide dismutase 1 (SOD-1) gene. Recombinant adeno-associated viruses of the invention deliver DNAs encoding RNAs that knock down the expression of SOD-1. The methods have application in the treatment of amyotrophic lateral sclerosis (ALS).
BACKGROUNDALS is an adult-onset, rapidly progressive and fatal neurodegenerative disease, characterized by selective degeneration of both upper and lower motor neurons. First characterized by Charcot in 1869, ALS is responsible for one in every 2000 deaths, affecting nearly 5 out of 100,000 individuals. ALS occurs when specific nerve cells in the brain and spinal cord that control voluntary movement degenerate. Within two to five years after clinical onset, the loss of these motor neurons leads to progressive atrophy of skeletal muscles, which results in loss of muscular function resulting in paralysis, speech deficits, and death due to respiratory failure.
Most ALS cases have no clear genetic linkage and are referred to as sporadic, but in 10% of instances disease is familial with dominant inheritance. Twenty percent of familial cases are caused by mutations in the enzyme superoxide dismutase 1 (SOD1), with over 140 distinct mutations identified to date1, 2. Many efforts to identify how mutations alter the function of SOD1 have produced a consensus view that SOD1 mutants acquire one or more toxicities, whose nature still remains controversial3, but there is clear evidence that a proportion of mutant SOD1 is misfolded and subsequently aggregates4, 5. SOD1 aggregates are, in fact, one of the histological hallmarks of SOD1-related ALS cases4.
In the past 20 years, multiple animal models expressing mutant forms of human SOD1 have been generated. These models recapitulate the hallmarks of ALS, developing age-dependent motor axon degeneration and accompanying muscle denervation, glial inflammation and subsequent motor neuron loss. Selective gene excision experiments have determined that mutant SOD1 expression within motor neurons themselves contributes to disease onset and early disease progression6, as does mutant synthesis in NG2+ cells7 that are precursors to oligodendrocytes. However, mutant SOD1 protein expression in microglia and astrocytes significantly drives rapid disease progression6, 8, findings which have lead to the conclusion that ALS pathophysiology is non-cell autonomous3.
Further, astrocytes have been found to be toxic to motor neurons in multiple in vitro models where mutant forms of human SOD1 were overexpressed9-11. A recent study derived astrocytes from post-mortem spinal cords of ALS patients with or without SOD1 mutations. In all cases, astrocytes from sporadic ALS patients were as toxic to motor neurons as astrocytes carrying genetic mutations in SOD12. Even more strikingly, reduction of SOD1 in astrocytes derived from both sporadic and familial ALS patients decreased astrocyte-derived toxicity that is selective for motor, but not GABA, neurons. This remarkable finding, along with reports that misfolded SOD1 inclusions are found in the spinal cords of familial as well as some sporadic ALS patients13,14, 15, has provided strong evidence for a pathogenic role of wild-type SOD1 in sporadic ALS.
Despite the insights that SOD1 mutant-expressing animal models have provided for understanding mechanisms involved in motor neuron degeneration, their utility for the development of therapeutic approaches has been questioned16, as no drug with a reported survival benefit in mutant SOD1G93A mice has been effective in clinical trials with sporadic ALS patients. In all but one case the drugs taken to human trial had been reported only to extend mutant SOD1 mouse survival when applied presymptomatically, and even then to provide a survival benefit solely by delaying disease onset with no benefit in slowing disease progression. The one exception to this was riluzole, which like the human situation, modestly extended survival of mutant SOD1G93A mice and did so by slowing disease progression17. Recognizing that success at human trial will require slowing of disease progression, the SOD1 mutant mice have perfectly predicted the success of riluzole and the failure of efficacy of each other drug attempted in human trial. What has been missing are additional therapies that affect disease progression in these mice.
Thus, riluzole is the only drug currently approved by the FDA as a therapy for ALS, providing a modest survival benefit21. For the 20% of familial cases caused by mutation in SOD1, attempts at improving therapy by reducing synthesis of SOD1 have been the focus of multiple therapeutic development approaches. Antisense oligonucleotides and viral delivered RNA interference (RNAi) were tested in rat22 and mouse models23-25 that develop fatal paralysis from overexpressing human SOD1G93A. Antisense oligonucleotides infused at disease onset produced SOD1 reduction and a modest slowing of disease progression22. Direct CSF infusion of antisense oligonucleotides has been tested clinically26, leading to encouraging results in terms of tolerability and safety, but without significant reduction in SOD1 levels at the low dosages utilized. In each of the prior viral studies23-25, SOD1 knockdown was achieved before disease onset by direct injection into the nervous system or taking advantage of axonal retrograde transport when a virus was injected intramuscularly23, 24. These studies led to varying degrees of success in extending survival or improving motor performance, depending on the time of treatment as well as level of SOD1 knockdown achieved in the spinal cord. Although these studies provided important proof of principle, the approaches were far from being readily translated into clinical strategies. Indeed, there have been controversial reports surrounding these initial viral mediated SOD1 suppression studies23, 24, 27-29.
Adeno-associated virus (AAV) vectors have been used in a number of recent clinical trials for treatment of neurological disorders [Kaplitt et al., Lancet 369: 2097-2105 (2007); Marks et al., Lancet Neurol 7: 400-408 (2008); Worgall et al., Hum Gene Ther (2008)].
AAV is a replication-deficient parvovirus, the single-stranded DNA genome of which is about 4.7 kb in length including 145 nucleotide inverted terminal repeat (ITRs). The nucleotide sequence of the AAV serotype 2 (AAV2) genome is presented in Srivastava et al., J Virol, 45: 555-564 (1983) as corrected by Ruffing et al., J Gen Virol, 75: 3385-3392 (1994). Cis-acting sequences directing viral DNA replication (rep), encapsidation/packaging and host cell chromosome integration are contained within the ITRs. Three AAV promoters (named p5, p19, and p40 for their relative map locations) drive the expression of the two AAV internal open reading frames encoding rep and cap genes. The two rep promoters (p5 and p19), coupled with the differential splicing of the single AAV intron (at nucleotides 2107 and 2227), result in the production of four rep proteins (rep 78, rep 68, rep 52, and rep 40) from the rep gene. Rep proteins possess multiple enzymatic properties that are ultimately responsible for replicating the viral genome. The cap gene is expressed from the p40 promoter and it encodes the three capsid proteins VP1, VP2, and VP3. Alternative splicing and non-consensus translational start sites are responsible for the production of the three related capsid proteins. A single consensus polyadenylation site is located at map position 95 of the AAV genome. The life cycle and genetics of AAV are reviewed in Muzyczka, Current Topics in Microbiology and Immunology, 158: 97-129 (1992).
AAV possesses unique features that make it attractive as a vector for delivering foreign DNA to cells, for example, in gene therapy. AAV infection of cells in culture is noncytopathic, and natural infection of humans and other animals is silent and asymptomatic. Moreover, AAV infects many mammalian cells allowing the possibility of targeting many different tissues in vivo. Moreover, AAV transduces slowly dividing and non-dividing cells, and can persist essentially for the lifetime of those cells as a transcriptionally active nuclear episome (extrachromosomal element). The AAV proviral genome is infectious as cloned DNA in plasmids which makes construction of recombinant genomes feasible. Furthermore, because the signals directing AAV replication, genome encapsidation and integration are contained within the ITRs of the AAV genome, some or all of the internal approximately 4.3 kb of the genome (encoding replication and structural capsid proteins, rep-cap) may be replaced with foreign DNA such as a gene cassette containing a promoter, a DNA of interest and a polyadenylation signal. The rep and cap proteins may be provided in trans. Another significant feature of AAV is that it is an extremely stable and hearty virus. It easily withstands the conditions used to inactivate adenovirus (56 to 65° C. for several hours), making cold preservation of AAV less critical. AAV may even be lyophilized. Finally, AAV-infected cells are not resistant to superinfection.
Multiple serotypes of AAV exist and offer varied tissue tropism. Known serotypes include, for example, AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11 and AAVrh74. Advances in the delivery of AAV6 and AAV8 have made possible the transduction by these serotypes of skeletal and cardiac muscle following simple systemic intravenous or intraperitoneal injections. See Pacak et al., Circ. Res., 99(4): 3-9 (1006) and Wang et al., Nature Biotech., 23(3): 321-8 (2005). The use of AAV to target cell types within the central nervous system has involved surgical intraparenchymal injection. See, Kaplitt et al., supra; Marks et al., supra and Worgall et al., supra. Regarding the use of AAV to target cell types within the nervous system, see International Publication No. WO 2010/071832. International Publication Nos. WO 2009/043936 and WO 2009/013290 state they relate to delivering genes to the central nervous system. International Publication No. WO 2011/133890 states it relates to recombinant adeno-associated viruses useful for targeting transgenes to central nervous system tissue.
There thus remains a need in the art for methods and materials for treatment of ALS.
SUMMARYThe present invention provides products and methods useful for reducing mutant SOD1 protein levels in subjects in need thereof. The invention provides AAV-mediated delivery of RNAs including, but not limited to short hairpin RNAs, to reduce synthesis of ALS-causing human SOD1 mutants in subjects in need thereof. Recombinant AAV (rAAV) contemplated by the invention include, but are not limited to, rAAV9, rAAV2 and rAAVrh74. Delivery routes contemplated by the invention include, but are not limited to, systemic delivery and intrathecal delivery. Use of the methods and products of the invention is indicated, for example, in treating ALS.
DETAILED DESCRPTIONIn one aspect, the invention provides rAAV genomes comprising one or more AAV ITRs flanking a polynucleotide encoding one or more RNAs (including, but not limited to, small hairpin RNAs, antisense RNAs and/or microRNAs) that target mutant SOD1 polynucleotides. The examples describe the use of exemplary rAAV encoding small hairpin RNAs (shRNAs). In the rAAV genomes, the shRNA-encoding polynucleotide is operatively linked to transcriptional control DNA, specifically promoter DNA that is functional in target cells. Commercial providers such as Ambion Inc. (Austin, Tex.), Darmacon Inc. (Lafayette, Colo.), InvivoGen (San Diego, Calif.), and Molecular Research Laboratories, LLC (Herndon, Va.) generate custom inhibitory RNA molecules. In addition, commercially kits are available to produce custom siRNA molecules, such as SILENCER™ siRNA Construction Kit (Ambion Inc., Austin, Tex.) or psiRNA System (InvivoGen, San Diego, Calif.). In some embodiments, the rAAV genome comprises a DNA encoding a SOD1 shRNA such as:
The rAAV genomes of the invention lack AAV rep and cap DNA. AAV DNA in the rAAV genomes (e.g., ITRs) may be from any AAV serotype for which a recombinant virus can be derived including, but not limited to, AAV serotypes AAV-1, AAV-2, AAV-3, AAV-4, AAV-5, AAV-6, AAV-7, AAV-8, AAV-9, AAV-10 and AAV-11. The nucleotide sequences of the genomes of the AAV serotypes are known in the art. For example, the complete genome of AAV-1 is provided in GenBank Accession No. NC_002077; the complete genome of AAV-2 is provided in GenBank Accession No. NC_001401 and Srivastava et al., J. Virol., 45: 555-564 {1983); the complete genome of AAV-3 is provided in GenBank Accession No. NC_1829; the complete genome of AAV-4 is provided in GenBank Accession No. NC_001829; the AAV-5 genome is provided in GenBank Accession No. AF085716; the complete genome of AAV-6 is provided in GenBank Accession No. NC_00 1862; at least portions of AAV-7 and AAV-8 genomes are provided in GenBank Accession Nos. AX753246 and AX753249, respectively; the AAV-9 genome is provided in Gao et al., J. Virol., 78: 6381-6388 (2004); the AAV-10 genome is provided in Mol. Ther., 13(1): 67-76 (2006); and the AAV-11 genome is provided in Virology, 330(2): 375-383 (2004). The AAVrh74 genome is provided in International Publication No. WO 2013/078316.
In another aspect, the invention provides DNA plasmids comprising rAAV genomes of the invention. The DNA plasmids are transferred to cells permissible for infection with a helper virus of AAV (e.g., adenovirus, E1-deleted adenovirus or herpesvirus) for assembly of the rAAV genome into infectious viral particles. Techniques to produce rAAV particles, in which an AAV genome to be packaged, rep and cap genes, and helper virus functions are provided to a cell are standard in the art. Production of rAAV requires that the following components are present within a single cell (denoted herein as a packaging cell): a rAAV genome, AAV rep and cap genes separate from (i.e., not in) the rAAV genome, and helper virus functions. The AAV rep and cap genes may be from any AAV serotype for which recombinant virus can be derived and may be from a different AAV serotype than the rAAV genome ITRs, including, but not limited to, AAV serotypes AAV-1, AAV-2, AAV-3, AAV-4, AAV-5, AAV-6, AAV-7, AAV-8, AAV-9, AAV-10 and AAV-11. Production of pseudotyped rAAV is disclosed in, for example, WO 01/83692 which is incorporated by reference herein in its entirety. In various embodiments, AAV capsid proteins may be modified to enhance delivery of the recombinant vector. Modifications to capsid proteins are generally known in the art. See, for example, US 20050053922 and US 20090202490, the disclosures of which are incorporated by reference herein in their entirety.
A method of generating a packaging cell is to create a cell line that stably expresses all the necessary components for AAV particle production. For example, a plasmid (or multiple plasmids) comprising a rAAV genome lacking AAV rep and cap genes, AAV rep and cap genes separate from the rAAV genome, and a selectable marker, such as a neomycin resistance gene, are integrated into the genome of a cell. AAV genomes have been introduced into bacterial plasmids by procedures such as GC tailing (Samulski et al., 1982, Proc. Natl. Acad. S6. USA, 79:2077-2081), addition of synthetic linkers containing restriction endonuclease cleavage sites (Laughlin et al., 1983, Gene, 23:65-73) or by direct, blunt-end ligation (Senapathy & Carter, 1984, J. Biol. Chem., 259:4661-4666). The packaging cell line is then infected with a helper virus such as adenovirus. The advantages of this method are that the cells are selectable and are suitable for large-scale production of rAAV. Other examples of suitable methods employ adenovirus or baculovirus rather than plasmids to introduce rAAV genomes and/or rep and cap genes into packaging cells.
General principles of rAAV production are reviewed in, for example, Carter, 1992, Current Opinions in Biotechnology, 1533-539; and Muzyczka, 1992, Curr. Topics in Microbial. and Immunol., 158:97-129). Various approaches are described in Ratschin et al., Mol. Cell. Biol. 4:2072 (1984); Hermonat et al., Proc. Natl. Acad. Sci. USA, 81:6466 (1984); Tratschin et al., Mol. Cell. Biol. 5:3251 (1985); McLaughlin et al., J. Virol., 62:1963 (1988); and Lebkowski et al., 1988 Mol. Cell. Biol., 7:349 (1988). Samulski et al. (1989, J. Virol., 63:3822-3828); U.S. Pat. No. 5,173,414; WO 95/13365 and corresponding U.S. Pat. No. 5,658,776; WO 95/13392; WO 96/17947; PCT/US98/18600; WO 97/09441 (PCT/US96/14423); WO 97/08298 (PCT/US96/13872); WO 97/21825 (PCT/US96/20777); WO 97/06243 (PCT/FR96/01064); WO 99/11764; Perrin et al. (1995) Vaccine 13:1244-1250; Paul et al. (1993) Human Gene Therapy 4:609-615; Clark et al. (1996) Gene Therapy 3:1124-1132; U.S. Pat. Nos. 5,786,211; 5,871,982; and 6,258,595. Single-stranded rAAV are specifically contemplated. The foregoing documents are hereby incorporated by reference in their entirety herein, with particular emphasis on those sections of the documents relating to rAAV production.
The invention thus provides packaging cells that produce infectious rAAV. In one embodiment packaging cells may be stably transformed cancer cells such as HeLa cells, 293 cells and PerC.6 cells (a cognate 293 line). In another embodiment, packaging cells are cells that are not transformed cancer cells such as low passage 293 cells (human fetal kidney cells transformed with E1 of adenovirus), MRC-5 cells (human fetal fibroblasts), WI-38 cells (human fetal fibroblasts), Vero cells (monkey kidney cells) and FRhL-2 cells (rhesus fetal lung cells).
In still another aspect, the invention provides rAAV (i.e., infectious encapsidated rAAV particles) comprising a rAAV genome of the invention. In some embodiments, the rAAV genome is a self-complementary genome. The genomes of the rAAV lack AAV rep and cap DNA, that is, there is no AAV rep or cap DNA between the ITRs of the genomes. Embodiments include, but are not limited to, the exemplary rAAV including a genome encoding the SOD1 shRNA named “AAV-SOD1-shRNA.” A sequence including the AAV-SOD1-shRNA genome is set out below as an inverted sequence from a plasmid used in production.
The SOD shRNA nucleotides 901-965 comprise the entire hairpin sequence including the sense and antisense arms, stem loop and termination sequence. The sequence in a forward orientation (with target sequences against SOD1 underlined) is:
The rAAV of the invention may be purified by methods standard in the art such as by column chromatography or cesium chloride gradients. Methods for purifying rAAV vectors from helper virus are known in the art and include methods disclosed in, for example, Clark et al., Hum. Gene Ther., 10(6): 1031-1039 (1999); Schenpp and Clark, Methods Mol. Med., 69: 427-443 (2002); U.S. Pat. No. 6,566,118 and WO 98/09657.
In another aspect, the invention contemplates compositions comprising rAAV of the present invention. Compositions of the invention comprise rAAV in a pharmaceutically acceptable carrier. The compositions may also comprise other ingredients such as diluents and adjuvants. Acceptable carriers, diluents and adjuvants are nontoxic to recipients and are preferably inert at the dosages and concentrations employed, and include buffers such as phosphate, citrate, or other organic acids; antioxidants such as ascorbic acid; low molecular weight polypeptides; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, arginine or lysine; monosaccharides, disaccharides, and other carbohydrates including glucose, mannose, or dextrins; chelating agents such as EDTA; sugar alcohols such as mannitol or sorbitol; salt-forming counterions such as sodium; and/or nonionic surfactants such as Tween, pluronics or polyethylene glycol (PEG).
Titers of rAAV to be administered in methods of the invention will vary depending, for example, on the particular rAAV, the mode of administration, the treatment goal, the individual, and the cell type(s) being targeted, and may be determined by methods standard in the art. Titers of rAAV may range from about 1×102, about 1×103, about 1×104, about 1×105, about 1×106, about 1×107, about 1×108, about 1×109, about 1×1010, about 1×1011, about 1×1012, about 1×1013 to about 1×1014 or more DNase resistant particles (DRP) per ml. Dosages may also be expressed in units of viral genomes (vg). Dosages may also vary based on the timing of the administration to a human. These dosages of rAAV may range from about 1×104, about 1×105, about 1×106, about 1×107, about 1×108, about 1×109, about 1×1010, about 1×1011, about 1×1012, about 1×1013, about 1×1014, about 1×1015, about 1×1016 or more viral genomes per kilogram body weight in an adult. For a neonate, the dosages of rAAV may range from about 1×104, about 3×104, about 1×105, about 3×105, about 1×106, about 3×106, about 1×107, about 3×107, about 1×108, about 3×108, about 1×109, about 3×109, about 1×1010, about 3×1010, about 1×1011, about 3×1011, about 1×1012, about 3×1012, about 1×1013, about 3×1013, about 1×1014, about 3×1014, about 1×1015, about 3×1015, about 1×1016, about 3×1016 or more viral genomes per kilogram body weight.
In another aspect, the invention contemplates compositions comprising rAAV of the present invention. Compositions of the invention comprise rAAV in a pharmaceutically acceptable carrier. The compositions may also comprise other ingredients such as diluents and adjuvants. Acceptable carriers, diluents and adjuvants are nontoxic to recipients and are preferably inert at the dosages and concentrations employed, and include buffers such as phosphate, citrate, or other organic acids; antioxidants such as ascorbic acid; low molecular weight polypeptides; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, arginine or lysine; monosaccharides, disaccharides, and other carbohydrates including glucose, mannose, or dextrins; chelating agents such as EDTA; sugar alcohols such as mannitol or sorbitol; salt-forming counterions such as sodium; and/or nonionic surfactants such as Tween, pluronics or polyethylene glycol (PEG).
In still another aspect, the invention provides methods of transducing a target cell with a rAAV of the invention, in vivo or in vitro. The in vivo methods comprise the step of administering an effective dose, or effective multiple doses, of a composition comprising a rAAV of the invention to a subject, a subject (including a human being), in need thereof. If the dose is administered prior to onset/development of a disorder/disease, the administration is prophylactic. If the dose is administered after the onset/development of a disorder/disease, the administration is therapeutic. In embodiments of the invention, an effective dose is a dose that alleviates (eliminates or reduces) at least one symptom associated with the disorder/disease state being treated, that slows or prevents progression to a disorder/disease state, that slows or prevents progression of a disorder/disease state, that diminishes the extent of disease, that results in remission (partial or total) of disease, and/or that prolongs survival. An example of a disease contemplated for treatment with methods of the invention is ALS. “Treatment” according to the invention thus alleviates (eliminates or reduces) at least one symptom associated with the disorder/disease state being treated (for example, weight loss is eliminated or reduced by at least 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 100% or greater), that slows or prevents progression to (onset/development) of a disorder/disease state, that slows or prevents progression of a disorder/disease state, that diminishes the extent of disease, that results in remission (partial or total) of disease, and/or that prolongs survival. In some embodiments, survival is prolonged by at least 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 100% or greater.
Combination therapies are also contemplated by the invention. Combination as used herein includes both simultaneous treatment or sequential treatments. Combinations of methods of the invention with standard medical treatments (e.g., riluzole) are specifically contemplated, as are combinations with novel therapies.
Administration of an effective dose of the compositions may be by routes standard in the art including, but not limited to, systemic intramuscular, parenteral, intravenous, oral, buccal, nasal, pulmonary, intracranial, intrathecal, intraosseous, intraocular, rectal, or vaginal. Route(s) of administration and serotype(s) of AAV components of the rAAV (in particular, the AAV ITRs and capsid protein) of the invention may be chosen and/or matched by those skilled in the art taking into account the infection and/or disease state being treated and the target cells/tissue(s) that are to express the SOD1 shRNAs. In some embodiments, the route of administration is systemic. In some, embodiments the route of administration is intrathecal. In some, embodiments the route of administration is introcerebroventricular. In some, embodiments the route of administration is cisterna magna. In some, embodiments the route of administration is by lumbar puncture.
Transduction of cells with rAAV of the invention results in sustained expression of SOD1 shRNAs. In another aspect, the present invention thus provides methods of administering/delivering rAAV which express SOD1 shRNA to a subject, preferably a human being. The term “transduction” is used to refer to the administration/delivery of SOD1 shRNAs to a recipient cell either in vivo or in vitro, via a replication-deficient rAAV of the invention resulting in expression of a SOD1 shRNA by the recipient cell.
Thus, the invention provides methods of administering an effective dose (or doses, administered essentially simultaneously or doses given at intervals) of rAAV that encode SOD1 shRNAs to a subject in need thereof.
In one aspect, the invention provides methods of delivering a polynucleotide encoding an shRNA of the invention across the BBB comprising systemically administering a rAAV with a genome including the polynucleotide to a subject. In some embodiments, the rAAV genome is a self complementary genome. In other embodiments, the rAAV genome is a single-stranded genome. In some embodiments, the rAAV is a rAAV9. In some embodiments, the rAAV is a rAAV2. In some embodiments, the rAAV is a rAAVrh74.
In some embodiments, the methods systemically deliver polynucleotides across the BBB to the central and/or peripheral nervous system. Accordingly, a method is provided of delivering a polynucleotide to the central nervous system comprising systemically administering a rAAV with a self-complementary genome including the genome to a subject. In some embodiments, the polynucleotide is delivered to brain. In some embodiments, the polynucleotide is delivered to the spinal cord. Also provided is a method of delivering a polynucleotide to the peripheral nervous system comprising systemically administering a rAAV with a self-complementary genome including the polynucleotide to a subject is provided. In some embodiments, the polynucleotide is delivered to a lower motor neuron. In some embodiments, the rAAV genome is a self complementary genome. In other embodiments, the rAAV genome is a single-stranded genome. In some embodiments, the rAAV is a rAAV9. In some embodiments, the rAAV is a rAAV2. In some embodiments, the rAAV is a rAAVrh74.
In another aspect, the invention provides methods of delivering a polynucleotide to the central nervous system of a subject in need thereof comprising intrathecal delivery of rAAV with a genome including the polynucleotide. In some embodiments, the rAAV genome is a self complementary genome. In other embodiments, the rAAV genome is a single-stranded genome. In some embodiments, the rAAV is a rAAV9. In some embodiments, the rAAV is a rAAV2. In some embodiments, the rAAV is a rAAVrh74. In some embodiments, a non-ionic, low-osmolar contrast agent is also delivered to the subject, for example, iobitridol, iohexol, iomeprol, iopamidol, iopentol, iopromide, ioversol or ioxilan.
Embodiments of the invention employ rAAV to deliver polynucleotides to nerve, glial cells and endothelial cells. In some embodiments, the nerve cell is a lower motor neuron and/or an upper motor neuron. In some embodiments, the glial cell is a microglial cell, an oligodendrocyte and/or an astrocyte. In other aspects the rAAV is used to deliver a polynucleotide to a Schwann cell.
Figures S1A-SF. AAV9-shRNA-SOD1 administration is well tolerated in WT mice. Female and male WT animals were injected with AAV9-SOD1-shRNA at P1 or P21 and monitored up to 6 months of age. (Figure S1A, Figure SB) Both male and female treated mice showed steady increase in body mass as compared to control animals. (Figure S1C, Figure S1D) Rotarod performance and (Figure S1E, Figure S1F) hind limb grip strength were not affected by P1 or P21 treatment in both groups as compared to respective controls. n=5 per group. WT, wild type; P1, postnatal day 1; P21, postnatal day 21.
Figures S2A-S2W. Hematology and Serum Chemistry of AAV9-SOD1-shRNA treated WT animals. (Figure S2A, Figure S2B, Figure S2C, Figure S2D, Figure S2E, Figure S2 F, Figure S2G, Figure S2H, Figure S2I, Figure S2J, Figure S2K, Figure S2L, Figure S2M) Blood was collected from P1 (green) or P21 (red) treated and control (gray) WT animals at 150 days of age for hematology studies. No significant differences were observed between treated and control animals. (Figure S2N, Figure S2O, Figure S2P, Figure S2Q, Figure S2R, Figure S2S, Figure S2T, Figure S2U, Figure S2V, Figure S2W) Serum samples collected at 180 days of age from the same mice showed no significant differences in serum chemistry profile. Mean±SEM. n=5 per group. P1, postnatal day 1; P21, postnatal day 21.
Figures S4A-S4B. Intravenous injection of AAV9-SOD1-shRNA efficiently reduces levels of mutant SOD1 protein in spinal cords of SOD1G37R mice. (Figure S4A) Following disease onset, AAV9-CB-GFP or AAV9-SOD1-shRNA was injected in SOD1G37R mice and spinal cords were harvested at end stage and analyzed by western blot for human SOD1 protein levels. (Figure S4B) Quantification of a) shows suppression of human SOD1 within the spinal cord of SOD1G37R mice (n=4 per group). hSOD1, human superoxide dismutase 1; GAPDH, glyceraldehyde 3 phosphate dehydrogenase.
Figures S5A-S5B shRNA 130 efficiently reduces the levels of monkey SOD1 in vitro. (Figure S5A) Sequence alignment of the region targeted by SOD1 shRNA 130 and a single mismatch with the monkey sequence. Monkey sequence corresponds to SOD1 sequence from Rhesus monkey (NM 001032804.1), Cynomolgus monkey (sequenced in-house) and African green monkey. (Figure S5B) The shRNA 130 expression cassette was cloned into lentiviral vector and used to infect Cos-7 cells. Lysates were analyzed 72 hours post infection by qRT PCR for SOD1. shRNA 130 reduced SOD1 transcript levels by 75% in Cos-7 cells.
EXAMPLESThe present invention is illustrated by the following examples. While the present invention has been described in terms of various embodiments and examples, it is understood that variations and improvements will occur to those skilled in the art. Therefore, only such limitations as appear in the claims should be placed on the invention.
Example 1 AAV9 Transduction Pattern and Persistence in SOD1G93A MiceWe first evaluated the efficiency of AAV9 transduction in the SOD1G93A mouse model that develops fatal paralytic disease. High copy SOD1G93A mice were obtained from Jackson Laboratories (Bar Harbor, Me.) and bred within the Kaspar lab. Animals were genotyped before the treatment to obtain SOD1G93A expressing mice and their wild type littermates. Only female mice were included in the SOD1G93A experiments. Animals were injected intravenously at postnatal day 1 or day 21 (to be referred to as P1 and P21, respectively) with self-complementary AAV9 expressing GFP from the CMV enhancer/beta-actin (CB) promoter (AAV9-CB-GFP) (n=3 per group). Three weeks post-injection, animals were sacrificed, and spinal cords examined for GFP expression (
All procedures with animals described herein were performed in accordance with the NIH Guidelines and approved by the Research Institute at Nationwide Children's Hospital (Columbus, Ohio), University of California (San Diego, Calif.) or Mannheimer Foundation (Homestead, Fla.) Institutional Animal Care and Use Committees.
Transduction efficiency was high in SOD1G93A astrocytes with GFP expressed in 34±2% and 54±3%, respectively, of P1 and P21 injected spinal grey matter astrocytes (defined by immunoreactivity for GFAP). This efficiency was similar to our previous report of 64±1% in P21 injected wild type animals18. Motor neurons were a prominent cell type transduced at all levels of the spinal cords of P1 injected SOD1G93A animals (62±1%), compared with significantly lower targeting to motor neurons in P21 injected animals (8±1%).
Although we have previously reported that transduced astrocytes in wild type spinal cords persist with continued GFP accumulation for at least 7 weeks post injection18, longevity of mutant SOD1 astrocytes (and their continued synthesis of genes encoded by the AAV9 episome) during active ALS-like disease was untested. Therefore, SOD1G93A mice were injected at P1 and P21 with AAV9-CB-GFP and followed to end-stage (˜P130, n=3 per group) (
Further, recognizing that SOD1 mutant mediated damage, including astrocytic and microglial activation and early changes in the blood brain barrier develop during disease in mice in SOD1 mutant mice20, we tested if this damage affected AAV9 transduction. SOD1G93A mice were injected at P85 with AAV9-CB-GFP and sacrificed at endstage (n=3) (
Development of an shRNA Sequence Specific for Human SOD1
To specifically target the human SOD1 mRNA, four shRNA constructs targeting human SOD1 were generated and obtained from the Life Technologies design tool. The constructs that had a minimum of four base mismatches compared to the mouse mRNA sequence (
shRNA130 was selected for further experiments because it produced the most consistent knockdown across three separate transfection experiments. It was cloned into a self-complementary AAV9 vector that also contained a GFP gene whose expression would identify transduced cells (referred to as AAV9-SOD1-shRNA). Self-complementary AAV9-SOD1-shRNA was produced by transient transfection procedures using a double-stranded AAV2-ITR-based CB-GFP vector, with a plasmid encoding Rep2Cap9 sequence as previously described along with an adenoviral helper plasmid pHelper (Stratagene, Santa Clara, Calif.) in 293 cells18.
To confirm that the shRNA could suppress accumulation of human SOD1, SOD1G93A mice (n=3) were injected intravenously with AAV9-SOD1-shRNA at either P1 or P21. For neonatal mouse injections, postnatal day 1-2 SOD1G3A pups were utilized. Total volume of 50 μl containing 5×1011 DNAse resistant viral particles of AAV9-SOD1-shRNA (Virapur LLC, San Diego, Calif.) was injected via temporal vein as previously described18. A correct injection was verified by noting blanching of the vein. After the injection, pups were returned to their cage. Animals were euthanized three weeks post injection and the spinal cords were harvested and analyzed by immunoblotting for both human (mutant) and murine (wild-type) SOD1 protein. P1 and P21 injected spinal cords showed 60% and 45% reductions in mutant SOD1 protein, respectively (
To determine whether high dose AAV9-SOD1-shRNA would be safe, normal mice of both sexes were intravenously injected at P1 or P21 (P1=5 males, 5 females at 5×1011 vg; P21=5 males, 5 females at 2×1012 vector genomes (vg)) and then monitored up to 6 months of age. Both P1 and P21 injected mice showed a steady increase in body mass similar to untreated mice (Figure S1A-S1F). Weekly behavioral tests observed no significant differences between injected and control groups in motor skills (measured by rotarod) as well as in hind limb grip strength. At 150 and 180 days of age, blood samples were collected. Complete and differential blood counts of both treated and untreated groups showed similar blood chemistry parameters (Figure S2). Serum samples from both groups showed no significant differences in the levels of alkaline phosphatase, creatinine, blood urea nitrogen, potassium, sodium and chloride. Finally, all the animals were sacrificed at the age of 180 days. Histopathological analyses by a pathologist blinded to treatment group revealed no significant alterations in the AAV9-SOD1-shRNA treated animals compared to uninjected controls (data not shown). We conclude that both administration of AAV9 and sustained shRNA expression were apparently safe and well tolerated.
Example 4 Extended Survival of SOD1G93A Mice from AAV9 Mediated Reduction in Mutant SOD1 Even when Initiated Mid-DiseaseTo test the efficacy of AAV9-mediated SOD1 reduction, we treated cohorts of SOD1G93A mice with a single intravenous injection of AAV9-SOD1-shRNA before (P1, 5×1011 vg, n=6 and P21, 2×1012 vg, n=9) or after (P85, 3×102 vg, n=5) onset, recognizing that many astrocytes, but few motor neurons, would be transduced at the two later time points. For adult tail vein injections, animals were placed in a restraint that positioned the mouse tail in a lighted, heated groove. The tail was swabbed with alcohol then injected intravenously with AAV9-SOD1-shRNA.
Onset of disease (measured by weight loss from denervation-induced muscle atrophy) was significantly delayed by a median of 39.5 days (
Indirect immunofluorescence with an antibody that recognizes human, but not mouse SOD1, was used to determine accumulated mutant SOD1 levels in end-stage spinal cords of treated and control mice. Human SOD1 levels in end-stage spinal cord sections inversely correlated with increased survival (
To determine if AAV9-mediated mutant SOD1 reduction would slow disease progression, a cohort of SOD1G37R mice6 were injected intravenously with AAV9-SOD1-shRNA after disease onset (average age at treatment=215 d versus median onset of 197 d in treated animals; Log Rank Test p=0.46;
Post hoc analysis showed no differences between GFP and uninjected animals, therefore the groups were compiled as “control” in
Histological examination of end-stage SOD1G37R treated animals revealed similar levels of intraspinal cell transduction in animals treated with AAV9-SOD1-shRNA or AAV9-GFP (
To test whether SOD1 levels could be efficiently lowered using AAV9 in the non-human primate spinal cord, AAV9 was injected intrathecally via lumbar puncture. This method was chosen over systemic delivery to decrease the amount of virus required and to minimize any effects from reduction of SOD1 in peripheral tissues. One year old cynomolgus macaques (Macaca fascicularis) with average body weight of 2 kg were used for this study at the Mannheimer Foundation. Regular monitoring of overall health and body weight was performed prior and after the injections to assess the welfare of the animals.
Sequencing of cDNA copied from mRNA isolated from African Green Monkey (COS cells) and the Cynomolgus macaque verified that the 130 shRNA had a single base mismatch to either sequence (Figure S5A-S5B). The 130 shRNA expression cassette was inserted into a lentiviral vector which was then used to transduce COS cells. Cos-7 cells were maintained in DMEM with 10% FBS and 1% penicillin/streptomycin. Cells were infected with a lentiviral vector expressing SOD1 shRNA 130 under the H1 promoter and RFP under CMV promoter. RNA was extracted from infected and non-infected cells 72 hours post infection using an RNAeasy Kit (Qiagen). cDNA was prepared using RT2 First strand synthesis kit (SABiosciences). SOD1 transcript levels were analyzed by qRT-PCR which revealed that the monkey SOD1 mRNA was reduced by ˜75% in 130 shRNA transduced cells compared to mock transduced control cells (Figure S5A-S5B).
The AAV9-SOD1-shRNA virus (1×1013 vg/kg) was infused along with contrast agent via lumbar puncture into the subarachnoid space of three male cynomolgus macaques and one control subject was injected with AAV9-CB-GFP (1×1013 vg/kg) (
No side effects from the treatments were identified. Two weeks post injection, the spinal cords were harvested for analysis of GFP expression and SOD1 RNA levels. GFP expression was seen broadly in neuronal and astrocytic cells throughout the grey and white matter of the lumbar spinal cord, the area closest to the site of injection (
Next we examined the level of cell transduction throughout the spinal cord including cervical, thoracic and lumbar segments. GFP was found to be expressed broadly within all sections analyzed (
The examples above show that intravenous administration of AAV9-SOD1-shRNA is safe and well tolerated in wild type mice, with the absence of adverse effects after long-term assessment. This approach have achieved one of the longest extensions in survival ever reported in the rapidly progressive SOD1G93A mouse model of ALS (increasing survival by 39% when treatment is initiated at birth). Even more encouraging, markedly slowed disease progression is seen even when AAV9 therapy to reduce mutant SOD1 synthesis is applied after disease onset in SOD1G37R mice, thereby significantly extending survival. Thus, the vascular delivery paradigm in mice represents a proof of concept that mutant SOD1 knockdown after disease onset can be beneficial in both rapid and more slowly progressive models of ALS at clinically relevant points in disease. Together, these data show that robust targeting and suppression of SOD1 levels via AAV9-mediated delivery of shRNA is effective in slowing disease progression in mouse models of ALS, critically even when treatment is initiated after onset.
Multiple recent studies have brought forward the hypothesis that wild-type SOD1 may contribute through misfolding to the pathogenic mechanism(s) that underlie sporadic ALS through a pathway similar to that triggered by mutant SOD114, 30-32 Included in this body of evidence is our own demonstration that astrocytes produced from sporadic ALS patients are toxic to co-cultured motor neurons and that toxicity is alleviated by siRNA-mediated reduction in wild type SOD130. This evidence creates the potential that a proportion of sporadic ALS patients could also benefit from an AAV9-mediated SOD1 reduction approach that we have demonstrated to be effective in slowing disease progression in mice that develop fatal, ALS-like disease from expressing ALS-causing mutations in SOD1.
Finally, for translation of an AAV9-mediated suppression of SOD1 synthesis to the human setting, we have determined that infusion directly into the CSF at the lumbar level in a non-human primate produce substantial SOD1 reduction by targeting both motor neurons and non-neuronal cells. This outcome provides strong support for extending these efforts to an adult human by direct injection into CSF, as previously proposed33, 34, so as to 1) limit the cost of viral production, 2) reduce the possibility that chronic suppression of SOD1 in the periphery may have deleterious consequences, and 3) reduce viral exposure to the peripheral immune system33. These data strongly indicate AAV9-SOD1-shRNA as a treatment for ALS.
Techniques/Methods Used in Examples 1-7Perfusion and Tissue Processing. Control and treated SOD1G93A mice were sacrificed at either 21 days post injection or at endstage for immunohistochemical analysis. Animals were anesthetized with xylazene/ketamine cocktail, transcardially perfused with 0.9% saline, followed by 4% paraformaldehyde. Spinal cords were harvested, cut into blocks of tissue 5-6 mm in length, and then cut into 40 μm thick transverse sections on a vibratome (Leica, Bannockburn, Ill.). Serial sections were kept in a 96-well plate that contained 4% paraformaldehyde and were stored at 4° C. End stage loxSOD1G37R mice were anesthetized using isoflurane and perfused with 4% paraformaldehyde. Spinal cord segments, including cervical, thoracic and lumbar segments were dissected. Following cryoprotection with 20% sucrose/4% paraformaldehyde overnight, spinal cords were frozen in isopentane at −65° C., and serial 30 μm coronal sections were collected free floating using sliding microtome.
For safety studies, P1, P21 treated and control wild type mice were sacrificed at 180 days of age. Animals were anesthetized using xylazene/ketamine cocktail and perfused with 0.9% saline. Different tissues were removed and stored in 10% buffered formalin. These tissues were further processed, blocked and mounted for hematoxilin & eosin staining by the Nationwide Children's Hospital Morphology Core.
Cynomolgus monkeys injected with virus were euthanized 2 weeks post injection. Animals were anesthetized with sodium pentobarbital at the dose of 80-100 mg/kg intravenously and perfused with saline solution. Brain and spinal cord dissection were performed immediately and tissues were processed either for nucleic acid isolation (snap frozen) or post-fixed in 4% paraformaldehyde and subsequently cryoprotected with 30% sucrose and frozen in isopentane at −65° C. 12 μm coronal sections were collected from lumbar cord using a cryostat for free floating immunostaining.
Immunohistochemistry. Mouse spinal cords were stained as floating sections. Tissues were washed three-times for 10 minutes each in TBS, then blocked in a solution containing 10% donkey serum, 1% Triton X-100 and 1% penicillin/streptomycin for two hours at room temperature. All the antibodies were diluted with the blocking solution. Primary antibodies used were as follows: rabbit anti-GFP (1:400, Invitrogen, Carlsbad, Calif.), rabbit anti-SOD1 (1:200, Cell signaling, Danvers, Mass.), goat anti-ChAT (1:50 Millipore, Billerica, Mass.), mouse anti-GFAP (1:200, Millipore, Billerica, Mass.), chicken anti GFAP (1:400, Abcam, Cambridge, Mass.), and rabbit anti-Iba1 (1:400, Wako, Richmond Va.). Tissues were incubated in primary antibody at 4° C. for 48-72 hours then washed three times with TBS. After washing, tissues were incubated for 2 hours at room temperature in the appropriate FITC-, Cy3-, or Cy5-conjugated secondary antibodies (1:200 Jackson Immunoresearch, Westgrove, Pa.) and DAPI (1:1000, Invitrogen, Carlsbad, Calif.). Tissues were then washed three times with TBS, mounted onto slides then coverslipped with PVA-DABCO. All images were captured on a Zeiss-laser-scanning confocal microscope.
For DAB staining, monkey spinal cord sections were washed three times in TBS, blocked for 2 h at RT in 10% donkey serum and 1% Triton X-100. Sections were then incubated overnight at 4° C. with rabbit anti-GFP primary antibody (1:1000 Invitrogen, Carlsbad, Calif.) diluted in blocking buffer. The following day, tissues were washed with TBS 3 times, incubated with biotinylated secondary antibody anti-rabbit (1:200 Jackson Immunoresearch, Westgrove, Pa.) in blocking buffer for 30 min at RT, washed 3 times in TBS and incubated for 30 min at RT with ABC (Vector, Burlingame, Calif.). Sections were then washed for 3 times in TBS and incubated for 2 min with DAB solution at RT and washed with distilled water. These were then mounted onto slides and covered with coverslips in mounting medium. All images were captured with the Zeiss Axioscope.
Motor neuron and astrocyte quantification. For MN quantification, serial 40 μm thick lumbar spinal cord sections, each separated by 480 μm, were labeled as described for GFP and ChAT expression. Stained sections were serially mounted on slides from rostral to caudal, then coverslipped. Sections were evaluated using confocal microscopy (Zeiss) with a 40× objective and simultaneous FITC and Cy3 filters. The total number of ChAT positive cells found in the ventral horns with defined soma was tallied by careful examination through the entire z-extent of the section. GFP labeled cells were quantified in the same manner, while checking for co-localization with ChAT. For astrocyte quantification, as with MNs, serial sections were stained for GFP, GFAP and then mounted. Using confocal microscopy with a 63× objective and simultaneous FITC and Cy5 filters, random fields in the ventral horns of lumbar spinal cord sections from tail vein injected animals were selected. The total numbers of GFP and GFAP positive cells were counted from a minimum of at least 24-fields per animal while focusing through the entire z extent of the section. Spinal cord sections of 3 animals per group were examined for MN and astrocyte quantification.
Immunoblot analysis. Spinal cords were harvested from P1, P21 injected and control SOD1G93A mice 21 days post injection and from treated and control monkeys 2 weeks post injection of AAV9-SOD1-shRNA. Spinal cords were homogenized and protein lysates were prepared using T-Per (Pierce) with protease inhibitor cocktail. Samples were resolved on SDS-PAGE according to manufacturer's instructions. Primary antibodies used were rabbit anti-SOD1 (1:750, Cell signaling, Danvers, Mass.) mouse anti-SOD1 (1:750, Millipore, Billerica, Mass.), rabbit anti-SOD1 (1:1000, Abcam, Cambridge, Mass.), rabbit anti-Actin (1:1000, Abcam, Cambridge, Mass.) and mouse anti-GAPDH (1:1000, Millipore, Billerica, Mass.). Secondary antibodies used were anti-rabbit HRP (1:10000-1:50000) and anti-mouse HRP (1:10000). Densitometric analysis was performed using Image J software.
Laser Capture Microdissection. 12 □m lumbar spinal cord frozen sections were collected onto PEN membrane slides (Zeiss, Munich, Germany) and stained with 1% Cresyl violet (Sigma, St. Louis, Mo.) in methanol. Sections were air dried and stored at −80° C. After thawing, motor neurons were collected within 30 min from staining using the laser capture microdissector PALM Robo3 Zeiss) using the following settings: Cut energy: 48, LPC energy: 20, Cut focus: 80/81, LPC focus: 1, Position speed: 100, Cut speed: 50. About 500 MNs were collected per animal. Non-neuronal cells from the ventral horn were collected from the same sections after collecting the motor neurons.
qRT-PCR. RNA from laser captured cells or whole spinal cord sections from the cervical, thoracic and lumbar segments was isolated using the RNaqueous Micro Kit (Ambion, Grand Island, N.Y.) according to manufacturer's instructions. RNA was then reverse-transcribed into cDNA using the RT2 HT First Strand Kit (SABiosciences, Valencia, Calif.). 12.5 ng RNA were used in each Q-PCR reaction using SyBR Green (Invitrogen, Carlsbad, Calif.) to establish the relative quantity of endogenous monkey SOD1 transcript in animals who had received the AAV9-SOD1-shRNA compared to animals who had received only AAV9-GFP. Each sample was run in triplicate and relative concentration calculated using the ddCt values normalized to endogenous actin transcript.
Behavior and Survival Analysis. Treated and control SOD1G93A mice were monitored for changes in body mass twice a week. loxSOD1G37R mice were weighed on a weekly basis. Motor coordination was recorded using a rotarod instrument (Columbus Instruments, Columbus, Ohio). Each weekly session consisted of three trials on the accelerating rotarod beginning at 5 rpm/min. The time each mouse remained on the rod was registered. Both SOD1G93A and loxSOD1G37R mice were subjected to weekly assessment of hindlimb grip strength using a grip strength meter (Columbus Instruments, Columbus, Ohio). Each weekly session consisted of 3 (SOD1G93A mice) or 5 (loxSOD1G37R mice) tests per animal. Survival analysis was performed using Kaplan-Meier survival analysis. End stage was defined as an artificial death point when animals could no longer “right” themselves within 30 sec after being placed on its back. Onset and disease progression were determined from retrospective analysis of the data. Disease onset is defined as the age at which the animal reached its peak weight. Disease duration is defined as the time period between disease onset and end stage. Early disease duration is the period between peak weight and loss of 10% of body weight while late disease duration is defined as the period between 10% loss of body weight until disease end stage. Due to shorter life span of SOD1G93A animals, we did not assess the distinction between the early and late progression.
For toxicity analysis following injection at P1 or P21, treated and control WT mice were subjected to behavioral analysis starting at ˜30 days of age and monitored up to 6 months. Body mass was recorded weekly while rotarod performance and hindlimb grip strength were recorded biweekly.
Hematology and Serum Studies. Blood samples were collected in (K2) EDTA microtainer tubes (BD) from treated and control WT mice at 150 days of age by mandibular vein puncture. The same animals were bled at 180 days of age and blood was collected in serum separator microtainer tubes. The blood was allowed to clot for an hour and was then centrifuged at 10,000 rpm for 5 minutes. The clear upper phase (serum) was collected and frozen at −80° C. Hematological and serum analysis were conducted by Ani Lytics Inc, Gaithersburg, Md.
Statistical analysis. All statistical tests were performed using the GraphPad Prism (San Diego, Calif.) software package. Kaplan Meier survival analyses were analyzed by the Log Rank Test. Comparisons of median disease durations and survival times were analyzed by the Wilcoxon Signed Rank Test.
Example 8 Development of a Clinical SOD1 shRNA ConstructThe AAV SOD1 shRNA vector described in Example 2 carries shRNA against human SOD1 sequence under the H1 promoter (
To date, none of the FDA approved stuffer sequences are readily available. There are, however, several plasmid backbones that are approved by FDA for the human administration. Small DNA fragments were picked from these plasmids which do not correspond to any essential DNA sequences necessary for selection and replication of the plasmid or the elements of the transcriptional units. The plasmid backbones are listed in Table 1. The DNA elements from different plasmids were arranged in tandem to generate a complete, 1607 bp stuffer sequence (SEQ ID NO: 22). Finally, a DNA construct containing the SOD1 shRNA expression cassette, followed by the stuffer sequence was synthesized from Genscript.
Clinical SOD1 shRNA construct has shRNA against human SOD1 under H1 promoter which is followed by the non-coding stuffer sequence. This construct is designed in such a way that multiple shRNA expression cassettes can be added to the final vector by simultaneous removal of the stuffer sequence. Restriction endonuclease sites have been added to the stuffer sequence so that a part of the stuffer can be removed when another shRNA expression cassette is added (
Clinical SOD1 shRNA construct from Genscript was cloned into pJet1.2 shuttle vector via EcoRV. This parental clone was screened using various restriction endonucleases designed within the construct to confirm the correct clone. Kpn1/Sph1 double digestion of pJet SOD1 shRNA confirmed the presence of the complete construct (2023 bp) while Xba1 digestion confirmed the presence of SOD1 shRNA expression cassette (414 bp) and the stuffer element, along with pJet backbone (˜3000 bp). EcoRV/Pme1 double digestion also revealed the presence of stuffer element.
Example 9 Clinical SOD1 shRNA Efficiently Reduces Human SOD1 Protein Levels In VitroTo determine the efficacy of the de novo synthesized SOD1 shRNA construct to downregulate SOD1 levels, HEK293 cells were transfected with pJet SOD1 shRNA plasmid using Calcium Phosphate method. AAV SOD1 shRNA plasmid was used as a positive control. Immunofluorescence analysis of HEK293 cells, 72 hrs post transfection revealed the lack of native GFP fluorescence from pJet SOD1 shRNA transfected cells as compared to AAV9 SOD1 shRNA transfected cells. Immunoblot analysis of cell lysates from these cells further confirmed the successful replacement of GFP from pJet SOD1 shRNA plasmid. Importantly, pJet SOD1 shRNA resulted in efficient downregulation of SOD1 protein levels (>50%), similar to AAV SOD1 shRNA plasmid. See
Clinical SOD1 shRNA construct was further cloned into an AAV.CB.MCS vector using Kpn1/Sph1 sites to generate clinical AAV SOD1 shRNA plasmid (
Clinical AAV SOD1 shRNA plasmid was screened with restriction endonucleases to confirm the presence of SOD1 shRNA expression cassette (Xba1 digest), stuffer sequence (EcoRV/Pme1 double digest) and also intact ITR sequences (Sma1 digest).
Example 11 Clinical AAV SOD1 shRNA Efficiently Reduces Human SOD1 Protein Levels In VitroClinical AAV SOD1 shRNA plasmid was transfected in HEK293 cells to determine its knockdown efficiency. Similar to the pJet SOD1 shRNA plasmid, clinical AAV SOD1 shRNA transfected cells were devoid of any GFP expression as evident by immunofluorescence (
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All documents referred to in this application, including priority documents, are hereby incorporated by reference in their entirety with particular attention to the content for which they are referred.
Claims
1-3. (canceled)
4. A method of delivering a SOD1 shRNA-encoding DNA, to a subject in need thereof, comprising administering to the subject a recombinant adeno-associated virus comprising the SOD1 shRNA-encoding DNA, a sequence selected from the group consisting of: (SEQ ID NO: 1) GCATCATCAATTTCGAGCAGAAGGAA, (SEQ ID NO: 2) GAAGCATTAAAGGACTGACTGAA, (SEQ ID NO: 3) CTGACTGAAGGCCTGCATGGATT, (SEQ ID NO: 4) CATGGATTCCATGTTCATGA, (SEQ ID NO: 5) GCATGGATTCCATGTTCATGA, (SEQ ID NO: 6) GGTCTGGCCTATAAAGTAGTC, (SEQ ID NO: 7) GGGCATCATCAATTTCGAGCA, (SEQ ID NO: 8) GCATCATCAATTTCGAGCAGA, (SEQ ID NO: 9) GCCTGCATGGATTCCATGTTC, (SEQ ID NO: 10) GGAGGTCTGGCCTATAAAGTA, (SEQ ID NO: 11) GATTCCATGTTCATGAGTTTG, (SEQ ID NO: 12) GGAGATAATACAGCAGGCTGT, (SEQ ID NO: 13) GCTTTAAAGTACCTGTAGTGA, (SEQ ID NO: 14) GCATTAAAGGACTGACTGAAG, (SEQ ID NO: 16) TCGAGCAGAAGGAAAGTAA, (SEQ ID NO: 17) GCCTGCATGGATTCCATGT, (SEQ ID NO: 18) TCACTCTCAGGAGACCATT, and (SEQ ID NO: 19) GCTTTAAAGTACCTGTAGT;
- wherein the recombinant adeno-associated virus genome lacks rep and cap genes.
5-11. (canceled)
12. The method of claim 4, wherein the subject has amyotrophic lateral sclerosis (ALS).
13. The method of claim 12, wherein the ALS is associated with one or more SOD1 mutations.
14. The method of claim 4, wherein the adeno-associated virus further comprises an H1 promoter operably linked to the SOD1 shRNA-encoding DNA.
15. The method of claim 14, wherein the H1 promoter comprises nucleotides 966 to 1064 of SEQ ID NO:20.
16. The method of claim 4, wherein the virus genome is a self-complementary genome.
17. The method of claim 4, wherein the recombinant adeno-associated virus is an rAAV2, rAAV9 or rAAVrh74 virus.
18. The method of claim 17, wherein the recombinant adeno-associated virus is rAAV9.
19. The method of claim 4, wherein the adeno-associated virus further comprises a stuffer sequence.
20. The method of claim 19, wherein the stuffer sequence comprises SEQ ID NO: 22.
21. The method of claim 4, wherein the SOD1 shRNA-encoding DNA comprises SEQ ID NO: 4.
22. The method of claim 4, wherein the SOD1 shRNA-encoding DNA comprises, from 5′ to 3′: a) nucleotides 104-123 of SEQ ID NO: 21; b) a stem loop; and c) nucleotides 133-152 of SEQ ID NO: 21.
23. The method of claim 4, wherein recombinant adeno-associated virus is administered by parenteral, intravenous, intrathecal introcerebroventricular, or cisterna magna administration.
24. The method of claim 23, wherein the recombinant adeno-associated virus is administered by intrathecal administration.
25. The method of claim 24, wherein the intrathecal administration is by lumbar puncture.
26. A superoxide dismutase 1 (SOD1) shRNA-encoding DNA comprising: (SEQ ID NO: 1) GCATCATCAATTTCGAGCAGAAGGAA, (SEQ ID NO: 2) GAAGCATTAAAGGACTGACTGAA, (SEQ ID NO: 3) CTGACTGAAGGCCTGCATGGATT, (SEQ ID NO: 4) CATGGATTCCATGTTCATGA, (SEQ ID NO: 5) GCATGGATTCCATGTTCATGA, (SEQ ID NO: 6) GGTCTGGCCTATAAAGTAGTC, (SEQ ID NO: 7) GGGCATCATCAATTTCGAGCA, (SEQ ID NO: 8) GCATCATCAATTTCGAGCAGA, (SEQ ID NO: 9) GCCTGCATGGATTCCATGTTC, (SEQ ID NO: 10) GGAGGTCTGGCCTATAAAGTA, (SEQ ID NO: 11) GATTCCATGTTCATGAGTTTG, (SEQ ID NO: 12) GGAGATAATACAGCAGGCTGT, (SEQ ID NO: 13) GCTTTAAAGTACCTGTAGTGA, (SEQ ID NO: 14) GCATTAAAGGACTGACTGAAG, (SEQ ID NO: 16) TCGAGCAGAAGGAAAGTAA, (SEQ ID NO: 17) GCCTGCATGGATTCCATGT, (SEQ ID NO: 18) TCACTCTCAGGAGACCATT, or (SEQ ID NO: 19) GCTTTAAAGTACCTGTAGT.
27. A DNA plasmid comprising a recombinant adeno-associated virus genome comprising a superoxide dismutase 1 (SOD1) shRNA-encoding DNA comprising a sequence selected from the group consisting of: (SEQ ID NO: 1) GCATCATCAATTTCGAGCAGAAGGAA, (SEQ ID NO: 2) GAAGCATTAAAGGACTGACTGAA, (SEQ ID NO: 3) CTGACTGAAGGCCTGCATGGATT, (SEQ ID NO: 4) CATGGATTCCATGTTCATGA, (SEQ ID NO: 5) GCATGGATTCCATGTTCATGA, (SEQ ID NO: 6) GGTCTGGCCTATAAAGTAGTC, (SEQ ID NO: 7) GGGCATCATCAATTTCGAGCA, (SEQ ID NO: 8) GCATCATCAATTTCGAGCAGA, (SEQ ID NO: 9) GCCTGCATGGATTCCATGTTC, (SEQ ID NO: 10) GGAGGTCTGGCCTATAAAGTA, (SEQ ID NO: 11) GATTCCATGTTCATGAGTTTG, (SEQ ID NO: 12) GGAGATAATACAGCAGGCTGT, (SEQ ID NO: 13) GCTTTAAAGTACCTGTAGTGA, (SEQ ID NO: 14) GCATTAAAGGACTGACTGAAG, (SEQ ID NO: 16) TCGAGCAGAAGGAAAGTAA, (SEQ ID NO: 17) GCCTGCATGGATTCCATGT, (SEQ ID NO: 18) TCACTCTCAGGAGACCATT, and (SEQ ID NO: 19) GCTTTAAAGTACCTGTAGT,
- wherein the recombinant adeno-associated virus genome lacks rep and cap genes.
28. A packaging cell comprising the DNA plasmid of claim 27.
Type: Application
Filed: Aug 19, 2020
Publication Date: Apr 15, 2021
Inventors: Brian K. Kaspar (Westerville, OH), Kevin Foust (Columbus, OH), Don W. Cleveland (La Jolla, CA)
Application Number: 16/997,304
