Article
作者: Whitton, Jonathon P ; Economides, Aris N ; Gibson, Tyler M ; Valayannopoulos, Vassili ; Quigley, Tera M ; Drummond, Meghan C ; Artinian, Quynh-Anh ; Palermo, Adam T ; So, Kathy S ; Weber, Peter ; Zambrowicz, Brian ; Koehler, Seth D ; Burns, Joseph C ; Pan, Ning ; Smith, Lillian M ; Pregernig, Gabriela ; Lee, John ; Corrales, C Eduardo ; Senapati, Arun ; Sabin, Leah R ; Goodliffe, Joseph W ; Becker, Lars ; Kyratsous, Christos A ; Macdonald, Lynn E ; Chung, Yoojin ; Cancelarich, Sarah ; Zhang, Xichun ; Slade, Peter G
Biallelic loss-of-function variants in the Otoferlin gene (OTOF) lead to congenital hearing loss in both humans and mice. We developed DB-OTO, a hair-cell-specific adeno-associated virus (AAV)-based dual-vector gene therapy designed to restore hearing in individuals with OTOF-related hearing loss. DB-OTO is composed of two AAV1 vectors that reconstitute a functional OTOF gene expression cassette to form the full-length human OTOF variant 5 (h OTOFv5). A synthetic promoter (mMyo15) based on the murine Myosin 15 a gene was engineered to restrict the transgene expression to hair cells. The promoter construct was chosen after comparison of multiple variants using a GFP reporter in ex vivo murine explant models, followed by in vivo studies in wild-type mice and cynomolgus macaques. Comparison between the 1.0 kb mMyo15 and a ubiquitous promoter driving expression of h OTOFv5 transgene in mice showed that hair-cell-specific expression is critical for safe expression of otoferlin. DB-OTO induced dose-dependent establishment of auditory brainstem response, and OTOF expression in inner hair cells over a 10-fold dose range sustained for at least 3 months in a mouse model of OTOF deficiency. These data supported the initiation of an ongoing phase I/II clinical trial of DB-OTO in pediatric patients with OTOF-related hearing loss.