Ocular toxicity, distribution, and shedding of intravitreal AAV-eqIL-10 in horses.
Abstract: Non-infectious uveitis (NIU) is a painful recurrent disease affecting 2%-5% of horses. Current treatments require frequent administration with associated adverse events. In a previous study, intravitreal (IVT) adeno-associated virus (AAV) harboring equine interleukin-10 (eqIL-10) cDNA inhibited experimental uveitis in rats. The goal of this study was to evaluate the ocular tolerability, vector genome (vg) distribution, and vector shedding following an IVT injection of AAV8-eqIL-10 in normal horses with the hypothesis that it would be well tolerated in a dose-dependent manner in horses. Injections were well tolerated with mild transient signs of ocular inflammation; however, horses receiving the highest dose developed keratic precipitates. The vgs were not detected in the tears 3 days after injection, or in urine or feces at any time. Aqueous and vitreous humor eqIL-10 levels increased to higher than 1.5 ng/mL, more than 20 times higher than reported effective endogenous and induced levels. The vgs were detected in ocular tissues, and systemic distribution was identified only in the liver and kidney. No systemic effects were identified 86 days after dosing with IVT AAV-eqIL-10. Further investigation of lower doses of IVT AAV8-eqIL-10 therapy is an important next step toward a safe and effective single-dose treatment of equine uveitis with broader implications for treating NIU in humans.
© 2024 The Author(s).
Publication Date: 2024-10-28 PubMed ID: 39703903PubMed Central: PMC11656199DOI: 10.1016/j.omtm.2024.101360Google Scholar: Lookup
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Summary
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Overview
- This study investigates the safety, distribution, and shedding of an experimental gene therapy using AAV-eqIL-10 injected directly into the eyes of healthy horses to treat non-infectious uveitis (NIU), a recurrent eye disease.
- The research aims to determine if this treatment is well tolerated and how the viral vector spreads and persists in the body after administration.
Background
- Non-infectious uveitis (NIU) is a painful and recurrent inflammatory eye condition affecting 2%-5% of horses, which causes discomfort and vision issues.
- Existing treatments need frequent administration and are associated with potential adverse effects.
- Prior research showed that delivering the gene for equine interleukin-10 (eqIL-10), an anti-inflammatory cytokine, via adeno-associated virus (AAV) vectors into the eye suppressed experimental uveitis in rats.
- This suggested potential for gene therapy as a single-dose treatment that could provide sustained anti-inflammatory effects.
Study Objective
- The primary goal was to evaluate ocular safety (toxicity), the biodistribution of the viral vector genomes (vgs), and shedding of the vector following a single intravitreal (IVT) injection of AAV8-eqIL-10 into the eyes of normal horses.
- The hypothesis was that the treatment would be tolerated in a dose-dependent manner—that is, higher doses could cause more side effects but still be safe.
Methods
- Healthy horses were administered varying doses of AAV8-eqIL-10 directly into the eye’s vitreous humor via intravitreal injection.
- Ocular inflammation and other signs of toxicity were monitored to assess tolerability.
- Tears, urine, feces, and ocular tissues were sampled to detect presence and shedding of viral vector genomes over time.
- Levels of eqIL-10 protein were measured in ocular fluids (aqueous and vitreous humor) to evaluate the biological activity of the gene therapy.
- Systemic organs such as liver and kidney were analyzed to assess distribution beyond the eye.
- Long-term effects were monitored up to 86 days post-injection.
Key Findings
- Tolerability: The injections were generally well tolerated. Mild and transient ocular inflammation was observed, indicating some eye irritation but no severe adverse effects.
- High Dose Effects: Horses receiving the highest dose developed keratic precipitates—accumulations of inflammatory cells on the corneal endothelium, suggesting a localized immune response at high dosage levels.
- Vector Shedding: Vector genomes were undetectable in tears after 3 days and were not found in urine or feces at any time point, suggesting minimal risk of environmental shedding or spread via bodily excretions.
- Protein Expression: Levels of eqIL-10 in eye fluids rose to over 1.5 ng/mL, which is more than 20 times greater than levels previously known to be effective, indicating successful gene delivery and protein expression.
- Biodistribution: Viral genomes were detected in ocular tissues, confirming localized vector presence.
- Systemic Distribution: Aside from the eye, vector genomes were found only in the liver and kidney, likely due to natural systemic circulation and clearance processes.
- Safety: No systemic adverse effects were observed 86 days post-treatment, supporting the overall safety of the approach in this timeframe.
Implications and Future Directions
- The study supports that single-dose intravitreal injection of AAV8-eqIL-10 is a promising therapeutic strategy to deliver anti-inflammatory treatment for equine uveitis.
- Since the therapy achieved high intraocular levels of eqIL-10 with minimal systemic distribution and manageable side effects, it could reduce or replace the need for frequent conventional treatments.
- Finding the optimal lower dose that balances efficacy and safety is important for future research.
- The successful demonstration in horses could have broader implications for treating non-infectious uveitis in humans, as horses are often good models for human ocular diseases.
- Further studies would be needed to evaluate long-term safety, efficacy in diseased eyes, and possible immune responses over extended periods.
Cite This Article
APA
Young K, Hasegawa T, Vridhachalam N, Henderson N, Salmon JH, McCall TF, Hirsch ML, Gilger BC.
(2024).
Ocular toxicity, distribution, and shedding of intravitreal AAV-eqIL-10 in horses.
Mol Ther Methods Clin Dev, 32(4), 101360.
https://doi.org/10.1016/j.omtm.2024.101360 Publication
Researcher Affiliations
- Clinical Sciences, North Carolina State University, Raleigh, NC 27607, USA.
- Ophthalmology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
- Gene Therapy Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Ophthalmology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
- Gene Therapy Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Clinical Sciences, North Carolina State University, Raleigh, NC 27607, USA.
- Clinical Sciences, North Carolina State University, Raleigh, NC 27607, USA.
- Ophthalmology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
- Ophthalmology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
- Gene Therapy Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Clinical Sciences, North Carolina State University, Raleigh, NC 27607, USA.
Conflict of Interest Statement
B.C.G. and M.L.H. hold a provisional patent for the clinical therapeutic investigated.
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Citations
This article has been cited 1 times.- Young KAS, Schnabel LV, Gilger BC. Cell and Gene Therapy in Equine Ocular Disease.. Vet Ophthalmol 2026 Mar;29(2):e70151.
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