An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and Patients

Antiangiogenesis gene therapy based on adeno-associated virus (AAV) vectors represents a promising advancement in the treatment of neovascular age-related macular degeneration (nAMD), providing an alternative to antibody-based therapies. However, the development of a safe and effective AAV vector ca...

Full description

Saved in:
Bibliographic Details
Main Authors: Yuan Cai, Yonghao Gu, Jie Zhang, Ying Zhu, Zhen Ma, Qin He, Yongjia Sun, Mengmeng Yuan, Xiaojun Li, Kai Zhu, Bolong Miao, Jin Zhao, Juan Liu, Min Tang, Dali Tong, Lixia Feng, Ming Ma, Guisheng Zhong, Zilong Qiu, Tian Xue
Format: Article
Language:English
Published: American Association for the Advancement of Science (AAAS) 2025-01-01
Series:Research
Online Access:https://spj.science.org/doi/10.34133/research.0717
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849689669146509312
author Yuan Cai
Yonghao Gu
Jie Zhang
Ying Zhu
Zhen Ma
Qin He
Yongjia Sun
Mengmeng Yuan
Xiaojun Li
Kai Zhu
Bolong Miao
Jin Zhao
Juan Liu
Min Tang
Dali Tong
Lixia Feng
Ming Ma
Guisheng Zhong
Zilong Qiu
Tian Xue
author_facet Yuan Cai
Yonghao Gu
Jie Zhang
Ying Zhu
Zhen Ma
Qin He
Yongjia Sun
Mengmeng Yuan
Xiaojun Li
Kai Zhu
Bolong Miao
Jin Zhao
Juan Liu
Min Tang
Dali Tong
Lixia Feng
Ming Ma
Guisheng Zhong
Zilong Qiu
Tian Xue
author_sort Yuan Cai
collection DOAJ
description Antiangiogenesis gene therapy based on adeno-associated virus (AAV) vectors represents a promising advancement in the treatment of neovascular age-related macular degeneration (nAMD), providing an alternative to antibody-based therapies. However, the development of a safe and effective AAV vector capable of precisely targeting neovascularization and choroidal leakage remains a critical unmet need. In the present study, we engineered a novel intravitreally administered AAV vector with retinal-pigment-epithelium (RPE)-specific tropism. This vector demonstrated robust and localized gene expression in RPE cells while maintaining a favorable safety profile. The RPE-tropic AAV vector delivered a dual-acting antibody against vascular endothelial growth factor (VEGF) and angiopoietin-2 (ANG-2), exhibiting strong therapeutic efficacy and tolerability in both rodent and nonhuman primate choroidal neovascularization models. Based on the promising preclinical data, a single-center, single-arm, investigator-initiated trial (ChiCTR2400085329) was conducted to assess its safety and efficacy in patients with nAMD. The RPE-tropic AAV vector expressing anti-VEGF-A and anti-ANG-2 effectively alleviated disease progression and was well tolerated in the clinical setting. These findings highlight the potential of this engineered AAV-RPE capsid as a versatile platform for gene therapy, not only for nAMD but also for other ocular diseases involving RPE cells.
format Article
id doaj-art-5a528aebc28846cc9a0cca352121b264
institution DOAJ
issn 2639-5274
language English
publishDate 2025-01-01
publisher American Association for the Advancement of Science (AAAS)
record_format Article
series Research
spelling doaj-art-5a528aebc28846cc9a0cca352121b2642025-08-20T03:21:32ZengAmerican Association for the Advancement of Science (AAAS)Research2639-52742025-01-01810.34133/research.0717An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and PatientsYuan Cai0Yonghao Gu1Jie Zhang2Ying Zhu3Zhen Ma4Qin He5Yongjia Sun6Mengmeng Yuan7Xiaojun Li8Kai Zhu9Bolong Miao10Jin Zhao11Juan Liu12Min Tang13Dali Tong14Lixia Feng15Ming Ma16Guisheng Zhong17Zilong Qiu18Tian Xue19First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.iHuman Institute, ShanghaiTech University, Shanghai 201210, China.Starrygene Therapeutics Company Limited, Hefei 230031, China.First Affiliated Hospital of USTC, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China.Antiangiogenesis gene therapy based on adeno-associated virus (AAV) vectors represents a promising advancement in the treatment of neovascular age-related macular degeneration (nAMD), providing an alternative to antibody-based therapies. However, the development of a safe and effective AAV vector capable of precisely targeting neovascularization and choroidal leakage remains a critical unmet need. In the present study, we engineered a novel intravitreally administered AAV vector with retinal-pigment-epithelium (RPE)-specific tropism. This vector demonstrated robust and localized gene expression in RPE cells while maintaining a favorable safety profile. The RPE-tropic AAV vector delivered a dual-acting antibody against vascular endothelial growth factor (VEGF) and angiopoietin-2 (ANG-2), exhibiting strong therapeutic efficacy and tolerability in both rodent and nonhuman primate choroidal neovascularization models. Based on the promising preclinical data, a single-center, single-arm, investigator-initiated trial (ChiCTR2400085329) was conducted to assess its safety and efficacy in patients with nAMD. The RPE-tropic AAV vector expressing anti-VEGF-A and anti-ANG-2 effectively alleviated disease progression and was well tolerated in the clinical setting. These findings highlight the potential of this engineered AAV-RPE capsid as a versatile platform for gene therapy, not only for nAMD but also for other ocular diseases involving RPE cells.https://spj.science.org/doi/10.34133/research.0717
spellingShingle Yuan Cai
Yonghao Gu
Jie Zhang
Ying Zhu
Zhen Ma
Qin He
Yongjia Sun
Mengmeng Yuan
Xiaojun Li
Kai Zhu
Bolong Miao
Jin Zhao
Juan Liu
Min Tang
Dali Tong
Lixia Feng
Ming Ma
Guisheng Zhong
Zilong Qiu
Tian Xue
An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and Patients
Research
title An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and Patients
title_full An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and Patients
title_fullStr An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and Patients
title_full_unstemmed An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and Patients
title_short An Engineered Intravitreal Injection Retinal-Pigment-Epithelium-Tropic Adeno-Associated Virus Vector Expressing a Bispecific Antibody Binding VEGF-A and ANG-2 Rescues Neovascular Age-Related Macular Degeneration in Animal Models and Patients
title_sort engineered intravitreal injection retinal pigment epithelium tropic adeno associated virus vector expressing a bispecific antibody binding vegf a and ang 2 rescues neovascular age related macular degeneration in animal models and patients
url https://spj.science.org/doi/10.34133/research.0717
work_keys_str_mv AT yuancai anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT yonghaogu anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT jiezhang anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT yingzhu anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT zhenma anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT qinhe anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT yongjiasun anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT mengmengyuan anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT xiaojunli anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT kaizhu anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT bolongmiao anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT jinzhao anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT juanliu anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT mintang anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT dalitong anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT lixiafeng anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT mingma anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT guishengzhong anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT zilongqiu anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT tianxue anengineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT yuancai engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT yonghaogu engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT jiezhang engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT yingzhu engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT zhenma engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT qinhe engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT yongjiasun engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT mengmengyuan engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT xiaojunli engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT kaizhu engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT bolongmiao engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT jinzhao engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT juanliu engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT mintang engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT dalitong engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT lixiafeng engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT mingma engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT guishengzhong engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT zilongqiu engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients
AT tianxue engineeredintravitrealinjectionretinalpigmentepitheliumtropicadenoassociatedvirusvectorexpressingabispecificantibodybindingvegfaandang2rescuesneovascularagerelatedmaculardegenerationinanimalmodelsandpatients