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Development of a liver-specific Tet-off AAV8 vector for improved safety of insulin gene therapy for diabetes

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Abstract
Background: Diabetes mellitus is caused by a partial or complete lack of insulin production in the body. We have previously shown that a single injection of an adeno-associated virus serotype 8 (AAV8) vector carrying a modified and codon optimized human insulin gene induced hepatic production of insulin and corrected streptozotocin (STZ)-induced diabetes in mice for more than 1 year. Insulin production was constitutive, analogous to long-acting insulin therapy. Methods: We have developed a single AAV8 vector with a Tet-Off regulatable system as a safety mechanism to turn off insulin secretion should hypoglycaemia develop in vector-treated diabetic mice. We first transfected HepG2 cells or freshly isolated rat hepatocytes in vitro with the Tet-Off system (pAAV-Tetoffbidir-Alb-luc) regulating a luciferase reporter gene. We subsequently incorporated a furin-cleavable codon-optimised human proinsulin cDNA into pAAV-Tetoffbidir backbone to form the doxycycline inducible pAAV-Tetoffbidir-Alb-hINSco. Results: Using STZ-induced diabetic mice, we were able to switch off insulin secretion repeatedly with doxycycline administration, and showed full restoration of insulin secretion on withdrawing doxycycline. Conclusions: The present study provides proof of concept that, under circumstances when inappropriate basal insulin secretion is a safety concern, insulin secretion from AAV8 gene therapy can be turned off reversibly with doxycycline.
Keywords
Science & Technology, Life Sciences & Biomedicine, Biotechnology & Applied Microbiology, Genetics & Heredity, Medicine, Research & Experimental, Research & Experimental Medicine, adeno-associated virus, diabetes, insulin, inducible, Tet-off, safety, SUBANTIMICROBIAL-DOSE DOXYCYCLINE, LONG-TERM SAFETY, INTRAMUSCULAR INJECTION, TETRACYCLINE, EXPRESSION, MICE, PROLIFERATION, TRANSGENE, EFFICACY, DELIVERY
Source Title
JOURNAL OF GENE MEDICINE
Publisher
WILEY
Series/Report No.
Organizational Units
Organizational Unit
MEDICINE
dept
Organizational Unit
SURGERY
dept
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Date
2019-01-01
DOI
10.1002/jgm.3067
Type
Article
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