Cas9-specific immune responses compromise local and systemic AAV CRISPR therapy in multiple dystrophic canine models

Abstract

Adeno-associated virus (AAV)-mediated CRISPR-Cas9 editing holds promise to treat many diseases. The immune response to bacterial-derived Cas9 has been speculated as a hurdle for AAV-CRISPR therapy. However, immunological consequences of AAV-mediated Cas9 expression have thus far not been thoroughly investigated in large mammals. We evaluate Cas9-specific immune responses in canine models of Duchenne muscular dystrophy (DMD) following intramuscular and intravenous AAV-CRISPR therapy. Treatment results initially in robust dystrophin restoration in affected dogs but also induces muscle inflammation, and Cas9-specific humoral and cytotoxic T-lymphocyte (CTL) responses that are not prevented by the muscle-specific promoter and transient prednisolone immune suppression. In normal dogs, AAV-mediated Cas9 expression induces similar, though milder, immune responses. In contrast, other therapeutic (micro-dystrophin and SERCA2a) and reporter (alkaline phosphatase, AP) vectors result in persistent expression without inducing muscle inflammation. Our results suggest Cas9 immunity may represent a critical barrier for AAV-CRISPR therapy in large mammals.

Document Details

Document Type
Pub Defense Publication
Publication Date
Nov 24, 2021
Source ID
10.1038/s41467-021-26830-7

Entities

People

  • Bruce F Smith
  • Chady H. Hakim
  • Charles A. Gersbach
  • Christopher E Nelson
  • Dennis O. Pérez-lópez
  • Dirk Grimm
  • Dong Zhang
  • Dongsheng Duan
  • Emily D. Million
  • Feng Feng
  • Florian Schmidt
  • Gang Yao
  • Jacqueline A. Louderman
  • James Teixeira
  • Jin Han
  • Keqing Zhang
  • N. Nora Yang
  • Nalinda B. Wasala
  • Roland W Herzog
  • Samantha Metzger
  • Sandeep R. P. Kumar
  • Shi-Jie Chen
  • Xiufang Pan
  • Yongping Yue

Organizations

  • National Institute of Arthritis and Musculoskeletal and Skin Diseases
  • National Institute of General Medical Sciences
  • National Institute of Neurological Disorders and Stroke
  • Parent Project Muscular Dystrophy
  • United States Department of Defense
  • University of Missouri

Tags

Fields of Study

  • Biology
  • Medicine

Readers

  • Immunology and Pathology
  • Molecular Genetics

Technology Areas

  • Biotechnology
  • Biotechnology - Cancer Biotech