FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Published at www.nejm.org April 27, 2008 (10.1056/NEJMoa0802315)

	Full Text PDF Supplementary Material Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

SUMMARY

Leber's congenital amaurosis (LCA) is a group of inherited blinding diseases with onset during childhood. One form of the disease, LCA2, is caused by mutations in the retinal pigment epithelium–specific 65-kDa protein gene (RPE65). We investigated the safety of subretinal delivery of a recombinant adeno-associated virus (AAV) carrying RPE65 complementary DNA (cDNA) (ClinicalTrials.gov number, NCT00516477 [ClinicalTrials.gov] ). Three patients with LCA2 had an acceptable local and systemic adverse-event profile after delivery of AAV2.hRPE65v2. Each patient had a modest improvement in measures of retinal function on subjective tests of visual acuity. In one patient, an asymptomatic macular hole developed, and although the occurrence was considered to be an adverse event, the patient had some return of retinal function. Although the follow-up was very short and normal vision was not achieved, this study provides the basis for further gene therapy studies in patients with LCA.

Source Information

From the Scheie Eye Institute, University of Pennsylvania (A.M.M., E.A.P., E.N.P., J. Bennicelli, A.L., K.S.S., M.G.M., N.J.V., J. Bennett), Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia (A.M.M., F.M., K.A.M., V.R.A., J.S., X.Z., B.H., O.Z., J.F.W., J.W.M., K.A.H., J. Bennett), and the University of Pennsylvania School of Medicine (A.M.M., E.A.P., J. Bennicelli, A.L., V.R.A., B.K., K.S.S., M.G.M., J.F.W., N.J.V., K.A.H.) — all in Philadelphia; Seconda Universita degli Studi di Napoli (F.S., F.T., S.R.), Telethon Institute of Genetics and Medicine (F.S., S.B., E.M.S., A.A.), and Federico II University (A.A.) — all in Naples; the University of Iowa Carver Center, College of Medicine, Iowa City (E.S.); Veterans Affairs Medical Center, Cleveland (J.J., L.D.); Children's Hospital of Pittsburgh, Pittsburgh (R.H.); the University of Oklahoma, Oklahoma City (J.M.); the National Eye Institute, Bethesda, MD (T.M.R.); and the Howard Hughes Medical Institute (K.A.H., E.S.).

Drs. Maguire, Simonelli, Auricchio, High, and Bennett contributed equally to this article.

This article (10.1056/NEJMoa0802315) was published at www.nejm.org on April 27, 2008. It will appear in the May 22 issue of the Journal.

Address reprint requests to Dr. Bennett at the F.M. Kirby Center for Molecular Ophthalmology, 309C Stellar-Chance Labs, 422 Curie Blvd., Philadelphia, PA 19104, or at jebennet{at}mail.med.upenn.edu.

Full Text of this Article

This article has been cited by other articles:

• Jacobson, S. G., Cideciyan, A. V., Aleman, T. S., Sumaroka, A., Windsor, E. A. M., Schwartz, S. B., Heon, E., Stone, E. M. (2008). Photoreceptor Layer Topography in Children with Leber Congenital Amaurosis Caused by RPE65 Mutations. IOVS 49: 4573-4577 [Abstract] [Full Text]  
• Cideciyan, A. V., Aleman, T. S., Boye, S. L., Schwartz, S. B., Kaushal, S., Roman, A. J., Pang, J.-j., Sumaroka, A., Windsor, E. A. M., Wilson, J. M., Flotte, T. R., Fishman, G. A., Heon, E., Stone, E. M., Byrne, B. J., Jacobson, S. G., Hauswirth, W. W. (2008). Human gene therapy for RPE65 isomerase deficiency activates the retinoid cycle of vision but with slow rod kinetics. Proc. Natl. Acad. Sci. USA 105: 15112-15117 [Abstract] [Full Text]  
• Rattner, A., Toulabi, L., Williams, J., Yu, H., Nathans, J. (2008). The Genomic Response of the Retinal Pigment Epithelium to Light Damage and Retinal Detachment. J. Neurosci. 28: 9880-9889 [Abstract] [Full Text]  
• (2008). Gene Therapy for Congenital Retinal Degeneration. JWatch Neurology 2008: 1-1 [Full Text]  
• Miller, J. W. (2008). Preliminary Results of Gene Therapy for Retinal Degeneration. NEJM 358: 2282-2284 [Full Text]