Bilateral visual improvement with unilateral gene therapy injection for Leber hereditary optic neuropathy

Autor: Günther Rudolph, Magali Taiel, Laure Blouin, Nancy J. Newman, Rustum Karanjia, Catherine Vignal-Clermont, Thomas Klopstock, Serge Picaud, Robert C. Sergott, Valérie Biousse, Gerard Smits, Caroline Chevalier, Mark L. Moster, Valerio Carelli, Chiara La Morgia, Alfredo A. Sadun, Harvey Masonson, Patrick Yu-Wai-Man, Barrett Katz, David J. Calkins, Yordak Salermo, Pierre Burguière, José-Alain Sahel
Přispěvatelé: University of Cambridge [UK] (CAM), Emory University School of Medicine, Emory University [Atlanta, GA], University of Bologna, Jefferson (Philadelphia University + Thomas Jefferson University), University of California [Los Angeles] (UCLA), University of California, Munich Cluster for systems neurology [Munich] (SyNergy), Technische Universität München [München] (TUM)-Ludwig-Maximilians-Universität München (LMU), Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO), Fondation Ophtalmologique Adolphe de Rothschild [Paris], Ludwig Maximilian University [Munich] (LMU), University of Ottawa [Ottawa], GenSight Biologics, Institut de la Vision, Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Institut Hospitalo-Universitaire FOReSIGHT, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO)-Sorbonne Université (SU), University of Pittsburgh School of Medicine, Pennsylvania Commonwealth System of Higher Education (PCSHE), HAL-SU, Gestionnaire, University of Bologna/Università di Bologna, University of California (UC), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM)-Ludwig-Maximilians-Universität München (LMU), Centre d'investigation clinique Quinze-Vingts [CHNO] (CIC1423 - CIC QUINZE-VINGTS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Yu-Wai-Man P., Newman N.J., Carelli V., Moster M.L., Biousse V., Sadun A.A., Klopstock T., Vignal-Clermont C., Sergott R.C., Rudolph G., la Morgia C., Karanjia R., Taiel M., Blouin L., Burguiere P., Smits G., Chevalier C., Masonson H., Salermo Y., Katz B., Picaud S., Calkins D.J., Sahel J.-A., Yu Wai Man, Patrick [0000-0001-7847-9320], Apollo - University of Cambridge Repository
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
medicine.medical_specialty
Visual acuity
genetic structures
Genetic enhancement
Visual Acuity
Phases of clinical research
Optic Atrophy
Hereditary
Leber

therapy [Optic Atrophy
Hereditary
Leber]

visual improvement
law.invention
genetics [Dependovirus]
03 medical and health sciences
LHON
0302 clinical medicine
Randomized controlled trial
Leber's hereditary optic neuropathy
law
Ophthalmology
medicine
Clinical endpoint
Animals
Retina
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology
business.industry
NADH Dehydrogenase
General Medicine
Genetic Therapy
Dependovirus
medicine.disease
gene therapy
eye diseases
3. Good health
030104 developmental biology
medicine.anatomical_structure
genetics [Optic Atrophy
Hereditary
Leber]

Optic nerve
ddc:500
sense organs
medicine.symptom
Visual Fields
business
genetics [NADH Dehydrogenase]
030217 neurology & neurosurgery
Tomography
Optical Coherence

[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: Science Translational Medicine
Science Translational Medicine, American Association for the Advancement of Science, 2020, 12 (573), ⟨10.1126/scitranslmed.aaz7423⟩
Science Translational Medicine, 2020, 12 (573), ⟨10.1126/scitranslmed.aaz7423⟩
Science translational medicine 12(573), eaaz7423 (2020). doi:10.1126/scitranslmed.aaz7423
ISSN: 1946-6234
1946-6242
DOI: 10.1126/scitranslmed.aaz7423⟩
Popis: International audience; REVERSE is a randomized, double-masked, sham-controlled, multicenter, phase 3 clinical trial that evaluated the efficacy of a single intravitreal injection of rAAV2/2-ND4 in subjects with visual loss from Leber hereditary optic neuropathy (LHON). A total of 37 subjects carrying the m.11778G>A (MT-ND4) mutation and with duration of vision loss between 6 to 12 months were treated. Each subject's right eye was randomly assigned in a 1:1 ratio to treatment with rAAV2/2-ND4 (GS010) or sham injection. The left eye received the treatment not allocated to the right eye. Unexpectedly, sustained visual improvement was observed in both eyes over the 96-week follow-up period. At week 96, rAAV2/2-ND4-treated eyes showed a mean improvement in best-corrected visual acuity (BCVA) of -0.308 LogMAR (+15 ETDRS letters). A mean improvement of -0.259 LogMAR (+13 ETDRS letters) was observed in the sham-treated eyes. Consequently, the primary end point, defined as the difference in the change in BCVA from baseline to week 48 between the two treatment groups, was not met (P = 0.894). At week 96, 25 subjects (68%) had a clinically relevant recovery in BCVA from baseline in at least one eye, and 29 subjects (78%) had an improvement in vision in both eyes. A nonhuman primate study was conducted to investigate this bilateral improvement. Evidence of transfer of viral vector DNA from the injected eye to the anterior segment, retina, and optic nerve of the contralateral noninjected eye supports a plausible mechanistic explanation for the unexpected bilateral improvement in visual function after unilateral injection.
Databáze: OpenAIRE