Safety and Efficacy of Gene Transfer for Leber's Congenital Amaurosis
Albert M. Maguire, M.D., Francesca Simonelli, M.D., Eric A. Pierce, M.D., Ph.D., Edward N. Pugh, Jr., Ph.D., Federico Mingozzi, Ph.D., Jeannette Bennicelli, Ph.D., Sandro Banfi, M.D., Kathleen A. Marshall, C.O.T., Francesco Testa, M.D., Enrico M. Surace, D.V.M., Settimio Rossi, M.D., Arkady Lyubarsky, Ph.D., Valder R. Arruda, M.D., Barbara Konkle, M.D., Edwin Stone, M.D., Ph.D., Junwei Sun, M.S., Jonathan Jacobs, Ph.D., Lou Dell'Osso, Ph.D., Richard Hertle, M.D., Jian-xing Ma, M.D., Ph.D., T. Michael Redmond, Ph.D., Xiaosong Zhu, M.D., Bernd Hauck, Ph.D., Olga Zelenaia, Ph.D., Kenneth S. Shindler, M.D., Ph.D., Maureen G. Maguire, Ph.D., J. Fraser Wright, Ph.D., Nicholas J. Volpe, M.D., Jennifer Wellman McDonnell, M.S., Alberto Auricchio, M.D., Katherine A. High, M.D., and Jean Bennett, M.D., Ph.D.
Leber's congenital amaurosis (LCA) is a group of inherited blindingdiseases with onset during childhood. One form of the disease,LCA2, is caused by mutations in the retinal pigment epithelium–specific65-kDa protein gene (RPE65). We investigated the safety of subretinaldelivery of a recombinant adeno-associated virus (AAV) carryingRPE65 complementary DNA (cDNA) (ClinicalTrials.gov number, NCT00516477
[ClinicalTrials.gov]
).Three patients with LCA2 had an acceptable local and systemicadverse-event profile after delivery of AAV2.hRPE65v2. Eachpatient had a modest improvement in measures of retinal functionon subjective tests of visual acuity. In one patient, an asymptomaticmacular hole developed, and although the occurrence was consideredto be an adverse event, the patient had some return of retinalfunction. Although the follow-up was very short and normal visionwas not achieved, this study provides the basis for furthergene therapy studies in patients with LCA.
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From the Scheie Eye Institute, University of Pennsylvania (A.M.M., E.A.P., E.N.P., J. Bennicelli, A.L., K.S.S., M.G.M., N.J.V., J. Bennett), Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia (A.M.M., F.M., K.A.M., V.R.A., J.S., X.Z., B.H., O.Z., J.F.W., J.W.M., K.A.H., J. Bennett), and the University of Pennsylvania School of Medicine (A.M.M., E.A.P., J. Bennicelli, A.L., V.R.A., B.K., K.S.S., M.G.M., J.F.W., N.J.V., K.A.H.) — all in Philadelphia; Seconda Universita degli Studi di Napoli (F.S., F.T., S.R.), Telethon Institute of Genetics and Medicine (F.S., S.B., E.M.S., A.A.), and Federico II University (A.A.) — all in Naples; the University of Iowa Carver Center, College of Medicine, Iowa City (E.S.); Veterans Affairs Medical Center, Cleveland (J.J., L.D.); Children's Hospital of Pittsburgh, Pittsburgh (R.H.); the University of Oklahoma, Oklahoma City (J.M.); the National Eye Institute, Bethesda, MD (T.M.R.); and the Howard Hughes Medical Institute (K.A.H., E.S.). Drs. Maguire, Simonelli, Auricchio, High, and Bennett contributed equally to this article. This article (10.1056/NEJMoa0802315) was published at www.nejm.org on April 27, 2008.
Address reprint requests to Dr. Bennett at the F.M. Kirby Center for Molecular Ophthalmology, 309C Stellar-Chance Labs, 422 Curie Blvd., Philadelphia, PA 19104, or at jebennet{at}mail.med.upenn.edu.
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