First-in-human case report: AAV9-hGAA gene therapy for a patient with infantile-onset Pompe disease.

Abstract

BackgroundThe classic infantile-onset Pompe disease (IOPD) is characterized by cardiac hypertrophy, respiratory insufficiency, and rapidly progressive muscle weakness due to the acid alpha-glucosidase (GAA) deficiency. Enzyme replacement therapy (ERT) is the current approach for IOPD, but it entails several limitations. Aiming to overcome the limited efficiency of ERT, we developed adeno-associated virus (AAV) gene therapy for IOPD patients. MethodOne IOPD patient received a single intravenous dose of GC301, a recombinant adeno-associated virus 9 (rAAV9) expressing the human GAA (rAAV-hGAA). During the follow-up, safety was accessed by the physical examinations, cardiac and laboratory evaluations. GAA activity, the titers of serum antibodies to AAV9 and GAA, and motor development were monitored regularly. ResultThe infant showed significant improvements in motor milestones. The GAA enzyme activity increased to the normal range. The cardiac function improved notably. ConclusionIn patient with IOPD, a single intravenous AAV9-hGAA gene therapy improved the clinical outcomes remarkably. The trial is still ongoing, the safety of this gene therapy and the long-term clinical benefit remain to be monitored for months and years to come.