PROJECT 2 ABSTRACT PI: Daniel J. Rader, M.D. Recent evidence supports the potential of adeno-associated virus (AAV)-mediated liver-directed gene therapy as an effective therapeutic intervention for a variety of metabolic disorders. Monogenic lipid disorders are excellent models for the development of liver-directed gene therapy. Based on previous work funded by this P01 we are now poised to use a first-generation AAV8 clinical candidate to launch a clinical trial (Project 1) for one such disorder, Homozygous Familial Hypercholesterolemia (hoFH). This lipid disorder is caused by loss- of-function mutations in the LDL receptor (LDLR) and is associated with severe hypercholesterolemia and markedly premature atherosclerotic cardiovascular disease (ASCVD). In this Project 2, we propose to expand on our preclinical proof-of-concept studies for the treatment of hoFH by developing a second-generation AAV clinical candidate vector expressing an engineered LDLR transgene of superior efficacy for the correction of hoFH. Another serious lipid disorder is Familial LCAT Deficiency (FLD), which results in accumulation of unesterified cholesterol and chronic kidney disease progressing to end-stage renal failure. In contrast to the LDL receptor, LCAT is a secreted protein and restoration of a small fraction of the normal levels in blood would be expected to ameliorate the disease and prevent progressive renal disease. In this Project 2, we will develop an optimized clinical candidate vector for the treatment of FLD. Our goal is to optimize the hLDLR and hLCAT transgenes and work closely with Project 3 to optimize AAV-based vectors for correction of hoFH and FLD, such that the minimum efficacious dose of the clinical candidate vector is as low as possible. The overall intent of Project 2 is to lay the preclinical groundwork for conducting Phase 1 clinical trials using a second generation AAV-hLDLR for treatment of hoFH and the first AAV8-hLCAT for the treatment of FLD.

Public Health Relevance

PROJECT 2 NARRATIVE The studies proposed in this project will expand on our earlier preclinical proof of concept studies for the treatment of two life-threatening lipid disorders, Homozygous Familial Hypercholesterolemia (hoFH) and Familial LCAT Deficiency (FLD), using adeno-associated viral (AAV) vectors. The present goals are: 1) to develop a second-generation clinical candidate AAV vector of superior efficacy than that which currently exists for the correction of hoFH; and 2) to develop and optimize the first clinical candidate vector for the treatment of FLD. The objective is to optimize the transgene such that the minimum efficacious dose of both clinical candidate vectors is as low as possible. The overall intent of Project 2 is to lay the preclinical groundwork for conducting Phase I clinical trials using a second generation AAV-hLDLR for treatment of hoFH and the first AAV8-hLCAT for the treatment of FLD.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Program Projects (P01)
Project #
5P01HL059407-19
Application #
9504518
Study Section
Heart, Lung, and Blood Initial Review Group (HLBP)
Program Officer
Mcdonald, Cheryl
Project Start
Project End
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
19
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Type
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Giles, April R; Govindasamy, Lakshmanan; Somanathan, Suryanarayan et al. (2018) Mapping an Adeno-associated Virus 9-Specific Neutralizing Epitope To Develop Next-Generation Gene Delivery Vectors. J Virol 92:
Amengual, Jaume; Guo, Liang; Strong, Alanna et al. (2018) Autophagy Is Required for Sortilin-Mediated Degradation of Apolipoprotein B100. Circ Res 122:568-582
Giles, April R; Sims, Joshua J; Turner, Kevin B et al. (2018) Deamidation of Amino Acids on the Surface of Adeno-Associated Virus Capsids Leads to Charge Heterogeneity and Altered Vector Function. Mol Ther 26:2848-2862
Calcedo, Roberto; Somanathan, Suryanarayan; Qin, Qiuyue et al. (2017) Class I-restricted T-cell responses to a polymorphic peptide in a gene therapy clinical trial for ?-1-antitrypsin deficiency. Proc Natl Acad Sci U S A 114:1655-1659
Ai, Jianzhong; Li, Jia; Gessler, Dominic J et al. (2017) Adeno-associated virus serotype rh.10 displays strong muscle tropism following intraperitoneal delivery. Sci Rep 7:40336
Ai, Jianzhong; Tai, Phillip W L; Lu, Yi et al. (2017) Characterization of adenoviral transduction profile in prostate cancer cells and normal prostate tissue. Prostate 77:1265-1270
Greig, Jenny A; Limberis, Maria P; Bell, Peter et al. (2017) Non-Clinical Study Examining AAV8.TBG.hLDLR Vector-Associated Toxicity in Chow-Fed Wild-Type and LDLR+/- Rhesus Macaques. Hum Gene Ther Clin Dev 28:39-50
Greig, Jenny A; Limberis, Maria P; Bell, Peter et al. (2017) Nonclinical Pharmacology/Toxicology Study of AAV8.TBG.mLDLR and AAV8.TBG.hLDLR in a Mouse Model of Homozygous Familial Hypercholesterolemia. Hum Gene Ther Clin Dev 28:28-38
Ibrahim, Salam; Somanathan, Suryanarayan; Billheimer, Jeffrey et al. (2016) Stable liver-specific expression of human IDOL in humanized mice raises plasma cholesterol. Cardiovasc Res 110:23-9
Calcedo, Roberto; Wilson, James M (2016) AAV Natural Infection Induces Broad Cross-Neutralizing Antibody Responses to Multiple AAV Serotypes in Chimpanzees. Hum Gene Ther Clin Dev 27:79-82

Showing the most recent 10 out of 149 publications