Gene therapy aims to transfer therapeutic genes into the patient's cells to treat the disease at the genetic level. In most cases, the natural ability of viruses to enter cells and deliver genetic material is used to transfer therapeutic genes to target cells. Depending on the target cell, two different approaches are mainly used: Stem cells or dividing precursor cells are treated in vitro with viral vectors (such as retroviral or lentiviral vectors) that are able to stably insert the therapeutic gene into the target cell genome. The therapeutic gene is thus preserved in the progenitor cells. A major issue associated with integrating vectors is the potential for insertional mutagenesis. Therefore, post-mitotic, non-dividing cells are often targeted in vivo with non-integrating vectors derived from, for example, adeno-associated viruses (AAV), adenoviruses, or herpes simplex viruses. The genetic information encoded in these vectors is preserved for a long time in the form of free DNA.
With three approvals and more than 200 ongoing clinical trials, AAV vectors have become one of the main gene delivery vectors for gene therapy. The main factors behind the success of AAV as a therapeutic gene delivery vector are its low immunogenicity and lack of pathogenicity. Current clinical research focuses on the treatment of monogenic diseases by gene replacement, gene silencing, or gene editing, as well as gene addition using AAV-based vectors. AAV also holds promise for cancer therapy, development of novel vaccines, and vector-based immunoprophylaxis.
Motor recovery after severe spinal cord injury (SCI) is limited due to the disruption of direct descending commands. Despite the absence of descending input from the brain, sensory afferents below the injury site remain intact. Among them, proprioception is an important sensory source that regulates local spinal circuits and determines motor output. Here, researchers established a viral system to selectively target lumbar proprioceptive neurons, and then introduced excitatory Gq-coupled designer drug-exclusively activated receptors (DREADD) viruses into proprioceptors to achieve specific activation of lumbar proprioceptive neurons after CNO administration. The study showed that chronic activation of lumbar proprioceptive neurons promoted the recovery of hindlimb stepping ability in a bilateral hemisection SCI mouse model. Further studies found that chemical genetic proprioceptive stimulation can coordinately activate proprioceptive spinal interneurons and promote the transmission of supraspinal commands to lumbar motor neurons without affecting the regeneration of proprioceptive afferents or brain-derived descending axons. These findings suggest that proprioception-based combinatorial modalities may be a promising strategy to restore motor function after severe spinal cord injury.
Here, researchers injected AAV/PHP.S-Syn-GFP (AAV/PHP.S-GFP) intrathecally into PV-Cre::Rosa26-tdTomato (RTM) reporter mice (PV-RTM) (Figure 1A). Two weeks later, approximately 80.95% of PV+ proprioceptors in lumbar DRGs were found to be labeled by AAV/PHP.S-GFP virus, while only 22.30% were labeled in cervical DRGs (Figures 1B and 1C). In contrast, despite the high density of PV+ interneurons in the brain, almost no neurons were labeled in the cerebral cortex and cerebellum (Figure 1E). In the superficial dorsal horn of the spinal cord, some neurons that did not overlap with PV+ interneurons were labeled by GFP (Figure 1D). Together, these data indicate that intrathecal injection of PHP.S virus can effectively and preferentially label lumbar DRGs.
Figure 1. Intrathecal injection of AAV/PHP.S preferentially and efficiently targets lumbar DRGs. (Gao Z, et al., 2021)
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