Homologous Recombination Mediates Functional Recovery of Dysferlin Deficiency following AAV5 Gene Transfer

Department of Pediatrics, The Ohio State University, Columbus, Ohio, United States of America.
PLoS ONE (Impact Factor: 3.23). 06/2012; 7(6):e39233. DOI: 10.1371/journal.pone.0039233
Source: PubMed


The dysferlinopathies comprise a group of untreatable muscle disorders including limb girdle muscular dystrophy type 2B, Miyoshi myopathy, distal anterior compartment syndrome, and rigid spine syndrome. As with other forms of muscular dystrophy, adeno-associated virus (AAV) gene transfer is a particularly auspicious treatment strategy, however the size of the DYSF cDNA (6.5 kb) negates packaging into traditional AAV serotypes known to express well in muscle (i.e. rAAV1, 2, 6, 8, 9). Potential advantages of a full cDNA versus a mini-gene include: maintaining structural-functional protein domains, evading protein misfolding, and avoiding novel epitopes that could be immunogenic. AAV5 has demonstrated unique plasticity with regards to packaging capacity and recombination of virions containing homologous regions of cDNA inserts has been implicated in the generation of full-length transcripts. Herein we show for the first time in vivo that homologous recombination following AAV5.DYSF gene transfer leads to the production of full length transcript and protein. Moreover, gene transfer of full-length dysferlin protein in dysferlin deficient mice resulted in expression levels sufficient to correct functional deficits in the diaphragm and importantly in skeletal muscle membrane repair. Intravascular regional gene transfer through the femoral artery produced high levels of transduction and enabled targeting of specific muscle groups affected by the dysferlinopathies setting the stage for potential translation to clinical trials. We provide proof of principle that AAV5 mediated delivery of dysferlin is a highly promising strategy for treatment of dysferlinopathies and has far-reaching implications for the therapeutic delivery of other large genes.

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Available from: Paulus ML Janssen,
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    • "This dual vector approach was later expanded to include other strategies for gene reconstitution like sequence overlap (Duan, Yue, & Engelhardt, 2001), a triple Trans-splicing (Koo et al., 2014) and a hybrid of Trans-splicing and sequence overlap with the hybrid strategy showing the highest efficiency (Ghosh et al., 2008). Also subsequent studies have shown protein expression and functional in vivo rescue after reconstitution of other large genes like dystrophin (Zhang & Duan, 2012; Zhang et al., 2013) and dysferlin (Grose et al., 2012; Lostal et al., 2010). "
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