Evidence map›Paper›PMID 34197834›Full record

ArticleGastrointestinal endoscopy2021

Endoscopic-mediated, biliary hydrodynamic injection mediating clinically relevant levels of gene delivery in pig liver.

Robert L Kruse, Yuting Huang, Thomas Shum, Lu Bai, Hui Ding, Zack Z Wang, Florin M Selaru, Vivek Kumbhari

Open access · greenAbstract read
In one paragraph

Article in Gastrointestinal endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Robert L KruseDepartment of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Yuting HuangDivision of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, Maryland, USA.
Thomas ShumDepartment of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Lu BaiDepartment of Biology, Johns Hopkins University, Baltimore, Maryland, USA.
Hui DingDivision of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China.
Zack Z WangDivision of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Florin M SelaruDivision of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Vivek KumbhariDivision of Gastroenterology & Hepatology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Division of Gastroenterology & Hepatology, Department of Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA.
Johns Hopkins University · USJohns Hopkins Medicine · USBrigham and Women's Hospital · USJacksonville College · USUniversity of Maryland Medical Center Midtown Campus · US

Funding

Translational Research Enhancement CoreP30DK089502 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI ZACHOS, NICHOLAS CONSTANTINE · 2011 to 2020
$12.0M
Endoscopic-mediated hydrodynamic gene therapy for hemophilia B through the biliary systemR21HL159561 · NHLBI · MAYO CLINIC JACKSONVILLE · PI KUMBHARI, VIVEK · 2021 to 2022
$378k
NHLBI NIH HHS R21 HL159561NIDDK NIH HHS P30 DK089502
6 · The paper itself

Abstract

BACKGROUND AND

aimsGene therapy could provide curative therapies to many inherited monogenic liver diseases. Clinical trials have largely focused on adeno-associated viruses (AAVs) for liver gene delivery. These vectors, however, are limited by small packaging size, capsid immune responses, and inability to redose. As an alternative, nonviral, hydrodynamic injection through vascular routes can successfully deliver plasmid DNA (pDNA) into mouse liver but has achieved limited success in large animal models.

methodsWe explored hydrodynamic delivery of pDNA through the biliary system into the liver of pigs using ERCP and a power injector to supply hydrodynamic force. Human factor IX (hFIX), deficient in hemophilia B, was used as a model gene therapy.

resultsBiliary hydrodynamic injection was well tolerated without significant changes in vital signs, liver enzymes, hematology, or histology. No off-target pDNA delivery to other organs was detected by polymerase chain reaction. Immunohistochemistry revealed that 50.19% of the liver stained positive for hFIX after hydrodynamic injection at 5.5 mg pDNA, with every hepatic lobule in all liver lobes demonstrating hFIX expression. hFIX-positive hepatocytes were concentrated around the central vein, radiating outward across all 3 metabolic zones. Biliary hydrodynamic injection in pigs resulted in significantly higher transfection efficiency than mouse vascular hydrodynamic injection at matched pDNA per liver weight dose (32.7%-51.9% vs 18.9%, P < .0001).

conclusionsBiliary hydrodynamic injection using ERCP can achieve higher transfection efficiency into hepatocytes compared with AAVs at magnitudes of less cost in a clinically relevant human-sized large animal. This technology may serve as a platform for gene therapy of human liver diseases.

Indexed as

Biliary TractHydrodynamicsAnimalsGenetic TherapyGene Transfer TechniquesLiverMiceSwine

Identifiers

PMID34197834
PMCPMC8605992
OpenAlexW3177203904

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.