Effective gene therapy of Stargardt disease with PEG-ECO/ pGRK1-ABCA4-S/MAR nanoparticles

Abstract

Stargardt disease (STGD) is the most common form of inherited retinal genetic disorders and is often caused by mutations in ABCA4. Gene therapy has the promise to effectively treat monogenic retinal disorders. However, clinically approved adeno-associated virus (AAV) vectors do not have a loading capacity for large genes, such as ABCA4. Self-assembly nanoparticles composed of (1-aminoethyl)iminobis[N-(oleoylcysteinyl-1-amino-ethyl)propionamide (ECO; a multifunctional pH-sensitive/ionizable amino lipid) and plasmid DNA produce gene transfection comparable with or better than the AAV2 capsid. Stable PEG-ECO /pGRK1-ABCA4-S/MAR nanoparticles produce specific and prolonged expression of ABCA4 in the photoreceptors of Abca4 ^−/− mice and significantly inhibit accumulation of toxic A2E in the eye. Multiple subretinal injections enhance gene expression and therapeutic efficacy with an approximately 69% reduction in A2E accumulation in Abca4 ^−/− mice after 3 doses. Very mild inflammation was observed after multiple injections of the nanoparticles. PEG-ECO/ pGRK1-ABCA4-S/MAR nanoparticles are a promising non-viral mediated gene therapy modality for STGD type 1 (STGD1).

Graphical abstract

Abstract

Sun et al. developed a novel lipid nanoparticle-based gene therapy for Stargardt disease (STGD) that produced specific and prolonged ABCA4 gene expression in the photoreceptors of Abca4 ^−/− mice (STGD model) and significantly inhibited accumulation of toxic A2E through single and repeated treatments with an excellent safety profile.