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Peroral gene therapy of lactose intolerance using an adeno-associated virus vector

Abstract

Gene therapy is usually reserved for severe and medically refractory disorders because of the toxicity, potential long-term risks and invasiveness of most gene transfer protocols. Here we show that an orally administered adeno-associated viral vector leads to persistent expression of a ß-galactosidase transgene in both gut epithelial and lamina propria cells, and that this approach results in long-term phenotypic recovery in an animal model of lactose intolerance. A gene 'pill' associated with highly efficient and stable gene expression might be a practical and cost-effective strategy for even relatively mild disorders, such as lactase deficiency.

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Figure 1: RT–PCR analysis of total RNA extracted from the proximal intestine from a rat at 3 days and at 6 months after peroral delivery of AAVlac.
Figure 2: X-gal staining in gut sections of a control rat treated with AAVluc (a) and a rat treated with AAVlac after 3 days (b) and 6 months (c); images at low magnification.
Figure 3: Propidium iodide staining (a and b) combined with ß-galactosidase immunohistochemistry (c and d) showing the lamina propria (lp) and epithelial layers (e) from a control rat (treated with AAVluc) (a) and a rat treated with AAVlac (b) 3 days after vector administration.
Figure 4: a, Propidium iodide staining showing lamina propria (lp) and epithelial (e) cell layers from the proximal jejenum from a rat treated with AAVlac,1 month after vector administration.
Figure 5: Plasma glucose and body weight after an acute lactose challenge and a lactose-only diet.
Figure 6: a, Change in plasma glucose after ingestion of lactose in rats fasted overnight, which were challenged 120 days after a single peroral dose of AAVlac () or PBS (). *, P = 0.03.

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Acknowledgements

This work was supported by grants from the Juvenile Diabetes Foundation International, the New Zealand Health Research Council, New Zealand Marsden Fund and the New Zealand Lotteries Board.

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Correspondence to Matthew J. During.

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During, M., Xu, R., Young, D. et al. Peroral gene therapy of lactose intolerance using an adeno-associated virus vector. Nat Med 4, 1131–1135 (1998). https://doi.org/10.1038/2625

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