AAV serotype 9 (AAV9) was first identified in human isolates in 2004. As a primary receptor, AAV9 uses terminal N-linked galactose, and it is also suggested to bind a putative integrin, along with laminin receptor (LR) as coreceptors. The capsid of rAAV9 has one of the highest total post-translational modifications (PTMs), including multiple ubiquitination, phosphorylation, SUMOylation, and glycosylation modifications, as well as acetylation.
AAV9 appears to be able to achieve cell transduction with superior efficiency to other AAVs in most tissues. For example, in a study designed to investigate the distribution of AAV1–9 after systemic administration in a mouse model, AAV9 demonstrated rapid onset of efficacy, optimal genome distribution, and highest protein levels compared to all other AAVs. Furthermore, in the CNS of mouse, NHP, and feline models, it has unique properties compared to other serotypes in that it can cross the BBB and transduce not only neuronal cells, but also non-neuronal cells, including astrocytes, which are not normally transduced by other AAVs, and also exhibits tropism for photoreceptor cells in the retina. AAV9-based viral vectors have also been shown to be more efficient than AAV1 and AAV8 for myocardial transduction in mice, NHP, and pigs due to another notable feature of AAV9—its ability to traverse the physical barrier of vascular system endothelia. AAV9-based viral vectors also appear to have tropism for mouse photoreceptor cells, renal tubular epithelial cells, Leydig cells in the testicular interstitial tissue, and alveolar and nasal epithelia.
The chemotherapeutic drug doxorubicin is known to induce myofibril damage and cardiac atrophy. Here, researchers tested the potential counteracting effects of the pro-hypertrophic miR-212/132 family on doxorubicin-induced cardiotoxicity. In vitro, overexpression of the pro-hypertrophic miR-212/132 cluster in primary rodent and human iPSC-derived cardiomyocytes suppressed doxorubicin-induced toxicity. Next, a disease model of doxorubicin-induced cardiotoxicity was established in male C57BL/6N mice. Mice were administered adeno-associated virus (AAV)9-control or AAV9-miR-212/132 to achieve myocardial overexpression of the miR-212/132 cluster. AAV9-mediated overexpression limited cardiac atrophy by increasing left ventricular mass and wall thickness, reduced doxorubicin-mediated apoptosis, and prevented myofibril damage. Based on transcriptome analysis, the researchers identified fat storage-induced transmembrane protein 2 (Fitm2) as a novel target and downstream effector molecule, at least in part, responsible for the observed anti-cardiotoxic effects of miR-212/132. Overexpression of Fitm2 partially reversed the effects of miR-212/132. Overexpression of the miR-212/132 family reduced the development of doxorubicin-induced cardiotoxicity and could therefore serve as a therapeutic entry point to limit doxorubicin-mediated adverse cardiac effects.
To assess myofibrillar damage in the study, the researchers analyzed heart sections by transmission electron microscopy. Doxorubicin-induced myofibrillar damage was evident in electron microscopy images of mice that received AAV9 control treatment, manifesting as lower density and damaged myofibrils compared with controls that did not receive doxorubicin (Fig. 1A). Heart sections from animals treated with AAV9-miR-212/132 showed well-preserved myofibrils, indicating that doxorubicin-induced myofibril damage was rescued (Figure 1A). Doxorubicin treatment also induced apoptosis as detected by TUNEL staining (Figures 1B and 1C). The effect of AAV9-miR-212/132 treatment on cardiac cell apoptosis in mice showed only a trend towards reduced apoptosis (Figures 1B and 1C). Doxorubicin treatment also significantly reduced cardiomyocyte size, confirming the atrophy visible on echocardiographic measurements (Figures 1D and 1E). However, treatment with AAV9-miR-212/132 prevented doxorubicin-mediated atrophy and resulted in significant enlargement of cardiomyocytes compared with AAV9 controls that received doxorubicin (Figures 1D and 1E). These results suggest that overexpression of the miR-212/132 cluster abolishes some, but not all, of the cardiotoxic effects of doxorubicin.
Figure 1. AAV9-miR-212/132 Prevents Doxorubicin-Induced Cardiac Apoptosis and Atrophy. (Gupta S K, et al., 2019)
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