Gene therapy in the retina: Exploring neurotrophic treatment and AAV readministration in retinal disease
by Amado, Defne Audrey, Ph.D., UNIVERSITY OF PENNSYLVANIA, 2010, 119 pages; 3414128

Abstract:

Inherited retinal degeneration is a devastating illness comprising nearly 200 disease-causing mutations. The difficulty of developing cures for each disease individually makes clear the need for a widely applicable and nonspecific treatment. My first project involved a recently discovered neurotrophic factor, rod-derived cone viability factor (RdCVF), known to protect degenerating cones. My aim was to determine whether achieving constitutive retinal overexpression of RdCVF in mouse models of retinal degeneration could prevent photoreceptor death. I demonstrated that subretinal delivery of an AAV2 vector delivering RdCVF to retinal RPE cells achieves stable expression for at least 9 months. I then delivered the vector to retinal degeneration (Rd10) mice and demonstrated that treated eyes showed significant improvement over control injected eyes. This was seen histologically, with increased outer nuclear layer thickness and improved cone morphology; physiologically, with improved electroretinograph and pupillometry responses; and in behaving animals, with improved optokinetic responses. Gene therapy-mediated expression of RdCVF may therefore be an effective treatment in delaying retinal degeneration. Meanwhile, recent Phase I clinical trials have demonstrated safety and efficacy in restoring vision in Type 2 Leber's Congenital Amaurosis (LCA2), using AAV2-mediated gene replacement of the RPE65 gene. Current clinical trial guidelines do not allow contralateral readministration of vector or treatment of patients with high pre-existing neutralizing antibody (NAb) titers to AAV2, because safety and efficacy are unknown. My second project assessed the safety and feasibility of readministration of the clinical trial-grade vector AAV2-hRPE65 in the contralateral eye of monkeys previously exposed to AAV2 vectors. Results showed that while serum neutralizing antibodies increased following both the first and second subretinal injections, ocular titer only rose following local injection of that eye. Furthermore, all monkeys showed increased RPE65 expression in both injected retinas. One animal developed a CD4+ T-cell response post-first injection, and histology showed minimal inflammatory changes. These results indicate that even in the context of humoral or CD4+ T-cell responses, administration and contralateral readministration of vector are safe and feasible and have high transduction efficiency. It is my hope that these studies will contribute to making retinal gene therapy treatment a reality for more patients.

 
AdviserJean Bennett
SchoolUNIVERSITY OF PENNSYLVANIA
SourceDAI/B 71-07, p. , Jul 2010
Source TypeDissertation
SubjectsGenetics; Ophthalmology; Neurobiology Biology
Publication Number3414128
Adobe PDF Access the complete dissertation:
 

» Find an electronic copy at your library.
  Use the link below to access a full citation record of this graduate work:
  http://gateway.proquest.com/openurl%3furl_ver=Z39.88-2004%26res_dat=xri:pqdiss%26rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation%26rft_dat=xri:pqdiss:3414128
  If your library subscribes to the ProQuest Dissertations & Theses (PQDT) database, you may be entitled to a free electronic version of this graduate work. If not, you will have the option to purchase one, and access a 24 page preview for free (if available).

About ProQuest Dissertations & Theses
With over 2.3 million records, the ProQuest Dissertations & Theses (PQDT) database is the most comprehensive collection of dissertations and theses in the world. It is the database of record for graduate research.

The database includes citations of graduate works ranging from the first U.S. dissertation, accepted in 1861, to those accepted as recently as last semester. Of the 2.3 million graduate works included in the database, ProQuest offers more than 1.9 million in full text formats. Of those, over 860,000 are available in PDF format. More than 60,000 dissertations and theses are added to the database each year.

If you have questions, please feel free to visit the ProQuest Web site - http://www.proquest.com - or call ProQuest Hotline Customer Support at 1-800-521-3042.