Insertional mutagenesis is a potential risk associated with gene therapy, particularly in the context of some viral vector-based therapies. Insertional mutagenesis occurs when the therapeutic gene or vector integrates into the host genome, potentially disrupting or activating nearby genes. This can lead to unintended consequences, including the development of tumors or other adverse effects.
(Figure from https://www.hindawi.com/journals/isrn/2012/616310/)Vector design is a critical aspect of gene therapy development aimed at reducing the risk of insertional mutagenesis, which can lead to unintended genetic changes and adverse events. Here are some strategies and considerations in vector design to mitigate this risk:
1. Self-Inactivating (SIN) Vectors:
Description: Self-inactivating vectors are engineered to reduce the risk of insertional mutagenesis. They typically include deletions or modifications in the long terminal repeats (LTRs) of retroviral or lentiviral vectors.
Mechanism: SIN vectors are designed to self-inactivate upon integration into the host genome, reducing the chances of activating nearby genes.
Benefits: They offer enhanced safety by preventing vector-related enhancer/promoter activity near host genes.
2. Promoter Choice:
Description: The choice of promoter in the vector is crucial. Weak or tissue-specific promoters can minimize the risk of aberrant gene expression.
Mechanism: Using promoters that are less likely to activate nearby genes reduces the chances of insertional mutagenesis.
Benefits: It allows for controlled and targeted gene expression.
3. Insulators and Boundary Elements:
Description: Incorporating insulators or boundary elements into the vector can help shield the integrated transgene from regulatory elements of nearby host genes.
Mechanism: These elements create a barrier that prevents the vector's enhancer/promoter from affecting neighboring genes.
Benefits: They enhance the vector's safety profile by reducing the potential for nearby gene activation.
4. Targeted Integration:
Description: Develop vectors and methodologies that allow for targeted integration of the transgene into specific genomic sites, such as safe harbor loci.
Mechanism: Targeted integration reduces the chances of disrupting essential host genes.
Benefits: It minimizes the risk of insertional mutagenesis and provides more predictable transgene expression.
5. Codon Optimization:
Description: Codon optimization involves adapting the transgene's DNA sequence to the host species' codon usage patterns.
Mechanism: Optimized codon usage can enhance transgene expression while minimizing unwanted effects on host genes.
Benefits: It improves vector safety by reducing the potential for insertional mutagenesis.
6. Non-Integrating Vectors:
Description: Consider using non-integrating vectors like adenoviruses or adeno-associated viruses (AAVs) that do not integrate into the host genome.
Mechanism: Non-integrating vectors remain episomal in the host cell and do not pose a risk of insertional mutagenesis.
Benefits: They offer a safer option for gene therapy but may have limitations in terms of long-term transgene expression.
These vector design strategies, when combined with thorough preclinical testing and regulatory oversight, aim to reduce the risk of insertional mutagenesis in gene therapy. However, it's essential to customize vector design based on the specific therapeutic goals and the underlying genetic condition to ensure both safety and efficacy.
Reference:
Zufferey R, Dull T, Mandel RJ, et al. Self-inactivating lentivirus vector for safe and efficient in vivo gene delivery. J Virol. 1998;72(12):9873-9880.
Thomas CE, Ehrhardt A, Kay MA. Progress and problems with the use of viral vectors for gene therapy. Nat Rev Genet. 2003;4(5):346-358. doi:10.1038/nrg1066
Emery DW, Yannaki E, Tubb J, Nishino T, Li Q, Stamatoyannopoulos G. Development of virus vectors for gene therapy of beta chain hemoglobinopathies: flanking with a chromatin insulator reduces gamma-globin gene silencing in vivo. Blood. 2002;100(6):2012-2019. doi:10.1182/blood-2002-02-0433
Hockemeyer D, Wang H, Kiani S, et al. Genetic engineering of human pluripotent cells using TALE nucleases. Nat Biotechnol. 2011;29(8):731-734. doi:10.1038/nbt.1927
Buchholz CJ, Friedel T, Buning H. Surface-Engineered Viral Vectors for Selective and Cell Type-Specific Gene Delivery. Trends Biotechnol. 2015;33(12):777-790. doi:10.1016/j.tibtech.2015.09.012
Ghosh A, Yue Y, Duan D. Viral serotype- and tissue-specific expression of the endogenous utrophin promoter in muscle cells. J Biol Chem. 2004;279(5):19587-19592. doi:10.1074/jbc.M309734200