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Treatment of phenylketonuria using minicircle-based naked-DNA gene transfer to murine liver.
[phenylketonuria]
Host
immune
response
to
viral
vectors
,
persistence
of
nonintegrating
vectors
,
and
sustained
transgene
expression
are
among
the
major
challenges
in
gene
therapy
.
To
overcome
these
hurdles
,
we
successfully
used
minicircle
(
MC
)
naked-
DNA
vectors
devoid
of
any
viral
or
bacterial
sequences
for
the
long
-term
treatment
of
murine
phenylketonuria
,
a
model
for
a
genetic
liver
defect
.
MC
-DNA
vectors
expressed
the
murine
phenylalanine
hydroxylase
(
Pah
)
complementary
DNA
(
cDNA
)
from
a
liver
-
specific
promoter
coupled
to
a
de
novo
designed
hepatocyte-
specific
regulatory
element
,
designated
P
3
,
which
is
a
cluster
of
evolutionary
conserved
transcription
factor
binding
sites
.
MC
-DNA
vectors
were
subsequently
delivered
to
the
liver
by
a
single
hydrodynamic
tail
vein
(
HTV
)
injection
.
The
MC
-DNA
vector
normalized
blood
phenylalanine
concomitant
with
reversion
of
hypopigmentation
in
a
dose-dependent
manner
for
more
than
1
year
,
whereas
the
corresponding
parental
plasmid
did
not
result
in
any
phenylalanine
clearance
.
MC
vectors
persisted
in
an
episomal
state
in
the
liver
consistent
with
sustained
transgene
expression
and
hepatic
PAH
enzyme
activity
without
any
apparent
adverse
effects
.
Moreover
,
14
-
20
%
of
all
hepatocytes
expressed
transgenic
PAH
,
and
the
expression
was
observed
exclusively
in
the
liver
and
predominately
around
pericentral
areas
of
the
hepatic
lobule
,
while
there
was
no
transgene
expression
in
periportal
areas
.
This
study
demonstrates
that
MC
technology
offers
an
improved
safety
profile
and
has
the
potential
for
the
genetic
treatment
of
liver
diseases
.
Diseases
Validation
Diseases presenting
"long-term treatment"
symptom
classical phenylketonuria
congenital adrenal hyperplasia
dystrophic epidermolysis bullosa
fabry disease
homocystinuria without methylmalonic aciduria
phenylketonuria
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