Preclinical Potency and Biodistribution Studies of an AAV 5 Vector Expressing Human Interferon-ß (ART-I02) for Local Treatment of Patients with Rheumatoid Arthritis.

INTRODUCTION: Proof of concept for local gene therapy for the treatment of arthritis with immunomodulatory cytokine interferon beta (IFN-ß) has shown promising results in animal models of rheumatoid arthritis (RA). For the treatment of RA patients, we engineered a recombinant adeno-associated serotype 5 vector (rAAV5) encoding human (h)IFN-ß under control of a nuclear factor κB promoter (ART-I02). METHODS: The potency of ART-I02 in vitro as well as biodistribution in vivo in arthritic animals was evaluated to characterize the vector prior to clinical application. ART-I02 expression and bioactivity after transduction was evaluated in fibroblast-like synoviocytes (FLS) from different species. Biodistribution of the vector after local injection was assessed in a rat adjuvant arthritis model through qPCR analysis of vector DNA. In vivo imaging was used to investigate transgene expression and kinetics in a mouse collagen induced arthritis model. RESULTS: Transduction of RA FLS in vitro with ART-I02 resulted in high expression levels of bioactive hIFN-ß. Transduction of FLS from rhesus monkeys, rodents and rabbits with ART-I02 showed high transgene expression, and hIFN-ß proved bioactive in FLS from rhesus monkeys. Transgene expression and bioactivity in RA FLS were unaltered in the presence of methotrexate. In vivo, vector biodistribution analysis in rats after intra-articular injection of ART-I02 demonstrated that the majority of vector DNA remained in the joint (>93%). In vivo imaging in mice confirmed local expression of rAAV5 in the knee joint region and demonstrated rapid detectable and sustained expression up until 7 weeks. CONCLUSIONS: These data show that hIFN-ß produced by RA FLS transduced with ART-I02 is bioactive and that intra-articular delivery of rAAV5 drives expression of a therapeutic transgene in the joint, with only limited biodistribution of vector DNA to other tissues, supporting progress towards a phase 1 clinical trial for the local treatment of arthritis in patients with RA.

Bone marrow-derived macrophages incorporate into the endothelium and influence vascular and renal function after irradiation.

PURPOSE: We recently demonstrated that endoglin, an ancillary transforming growth factor beta (TGF-ß) receptor, modulates vascular damage and fibrosis formation and influences renal function after kidney irradiation. We also suggested that this was partially accomplished by endoglin-mediated regulation of cytokine production in macrophages. Endoglin is expressed on both endothelial cells and on activated macrophages. Therefore, in the current study, we addressed the respective contribution of altered endoglin levels in the different cellular compartments to the development of kidney toxicity after irradiation. MATERIALS AND METHODS: Female endoglin wild-type (Eng(+/+) or WT) or heterozygous (Eng(+/-) or HET) mice were subjected to total body irradiation (2 × 6 Gy with a 6-hour interval) followed by kidney irradiation (1 × 3 Gy). Recipient mice were then transplanted with 4 × 10E(6) green fluorescent protein heterozygous (GFP(+/-)) bone marrow cells from either Eng(+/+) or Eng(+/-) male donor mice. Chimerism was determined 6 weeks thereafter. Blood samples were taken every 10 weeks after irradiation and at sacrifice at 35 weeks. One kidney was used to isolate macrophages; the other kidney was used for histology and to determine cytokine and chemokine concentrations. RESULTS: In all treatment groups, the majority of infiltrating macrophages were bone marrow-derived and this was not altered by endoglin. Bone marrow cells accumulated in damaged tissue areas in the interstitium, but also incorporated into the vasculature. Reducing endoglin levels in macrophages, but not in the endothelium, led to improved renal function (hematocrit, blood urea nitrogen) after irradiation. This was probably promoted by lowered production of pro-inflammatory cytokines and chemokines in macrophages. Other measurements of tissue toxicity (pericyte coverage, fibrosis, damage score) were not altered by differential endoglin expression. CONCLUSIONS: Endoglin regulates pro-inflammatory macrophage properties thereby influencing vascular and renal function after kidney irradiation.