Name: limbal approach-subretinal injection of viral vectors for gene therapy in mice retinal pigment epithelium
Uploaded: 2015-08-07T14:00:00.000+00:00
Duration: 6 min 48 s
Description: Watch this Scientific Journal Video about Limbal Approach-Subretinal Injection of Viral Vectors for Gene Therapy in Mice Retinal Pigment Epithelium at JoVE.com

この研究は、ソウル大学研究助成（800から20140542）によってサポートされていました、NRF / MESTのパイオニア研究プログラム（2012から0009544）、およびNRF / MESTの生体信号解析技術イノベーションプログラム（2009から0090895）、とNRF / MESTのグラント（2015M3A9E6028949）。

動物の全ての実験は、眼科と視覚研究における動物の使用のためのビジョンと眼科文の研究のための協会に従って実行、およびガイドラインや規制は、ソウル国立大学施設内動物管理使用委員会とソウルで定められました大学病院バイオセーフティ委員会。 1.インジェクションキットおよびウイルスベクターを準備<ol><li>酸化エチレンガスを使用して滅菌33 G鈍針を備えたマイクロシリンジを準備します。マイクロチューブ（ すなわち、1×10 6 TU /μL）で十分な力価のために、PBS中のウイルスベクターを希釈します。シリンジ内の任意のデッドスペースを除去するために、ウイルスベクターを用いて、シリンジを数回フラッシュします。 </li></ol>ウイルスベクターの2網膜下注射<ol><li> tiletamiの混合物の腹腔内注射で-成体マウス（8週齢、すなわち、6）麻酔NE及びゾラゼパム（1：1、2.25 mg / kg体重）及びキシラジン塩酸塩（0.7 mg / kg体重）、または代替の適切な麻酔レジーム。 </li><li>フェニレフリン0.5％の点眼で瞳孔を拡張し、0.5％のトロピカミド。 </li><li>ウイルスベクター2μlの - 1.5でロードすることにより、マイクロシリンジを準備します。 </li><li>まぶたを開いて、便利な注射のための赤道を露出させ、手術用顕微鏡下に集中するために目を突出しています。注入を終えまで突出目の位置を維持する、または針の変位が注入中に発生する可能性があります。しっかりと眼球を保持するために、眼窩縁の外側に指を置きます。 </li><li>角膜表面への眼科用粘弾性溶液の液滴を適用します。 </li><li>網膜を視覚化するために、角膜の上に小さな丸いカバースライドを置きます。 </li><li>さらに網膜下注射のための無菌の30 G 1/2針を使用して角膜縁にわずかに後方に小さな穴を穿刺。劣っFO穴を作りますR右目、利便性のために、左眼のための優れました。 注：穴が時間的または経鼻で行われる場合、それは注射後まぶたによって覆われるのは難しいです。初期パンクはわずか輪部に沿って実行して、容易に認識することができ輪部血管を回避するために、角膜輪部に後方なされるべきです。最初の穿刺をしながら針でレンズを打つないように注意してください。レンズ穿刺を回避するために、針の全体の傘を挿入しないでください。 </li><li>プレパンクチャーホールを介してマイクロリットルの注射器の33 G鈍針を置き、穏やかな抵抗が感じられる点まで、網膜下腔に針を近づけます。 注：網膜下注射のために、針の最良のアプローチ角は、虹彩面に対して約45度であり、鈍い針は乳頭周囲の領域に向かって後方に押されるべきです。点線の四角は網膜下の充血のために硝子体腔を横切る示唆針経路を示しました図1中のn。 注：彼らは非常に柔らかいようピアス（または通過）網膜層ときに抵抗が感じないがあるでしょう。このように、軽度の抵抗の最初の気持ちは、針が既にRPE層に触れた、針の挿入が停止されるべきであることを示しています。針は、潜在的な網膜下腔に配置する必要がありますので、過度の圧力と強膜組織を貫通しないように注意してください。針が過大な力で強膜組織を穿刺した場合、それは抵抗なく外眼軌道の空間に入ります。 （このステップは非常に重要です） </li></ol><img alt="図1" src="/files/ftp_upload/53030/53030fig1.jpg" /> 網膜下注射の図1の模式図で。H＆Eは、マークされた網膜下注射用の針経路（点線の四角）との構造を描いたマウスの眼の断面を染色しました。倍率：40X、スケールバー：<html> 500ミクロン。 <a href="https://www.jove.com/files/ftp_upload/53030/53030fig1large.jpg" target="_blank">この図の拡大版を表示するには、こちらをクリックしてください。</a> <ol start="9"><li>不要な組織の損傷を避けるため、ゆっくりと針を撤回する震えずに網膜下の空間に静かにウイルスベクター（ すなわち、1×10 6 TU /μl）を注入します。 2.4で説明したように、注射の際にしっかりと眼球を保持します。 </li><li>何の網膜出血がないことを確認する手術用顕微鏡下で注入後の網膜下ブレブの形成を観察します。 </li></ol><img alt="図2" src="/files/ftp_upload/53030/53030fig2.jpg" /> 図2.網膜出血せずに網膜下Belb形成。手術用顕微鏡下での網膜下注射後の網膜下belbの顕微鏡図は、網膜出血のない成功ブレブ形成を示します。M /ファイル/ ftp_upload / 53030 / 53030fig2large.jpg「ターゲット= &quot;_空白&quot;&gt;この図の拡大版を表示するには、こちらをクリックしてください。 <ol start="11"><li>静かに自己封止用注射部位をカバーするために瞼を閉じます。ホームケージにマウスを返し、評価まで生き続けます。 注：研究者は手順に慣れた後、彼らはこれらのステップをスキップすることにより、迅速な手順で再現性のある結果を得ることができます（2.5、6、および10） </li></ol>網膜色素上皮における遺伝子送達の有効性の評価3。 <ol start="1"><li> CO 2チャンバー内でマウスを生け贄に捧げます。はさみを使用して、目を摘出。 </li><li>数日に最低1時間、4℃で4％パラホルムアルデヒド溶液中で目を修正しました。 </li><li>細かい鉗子で角膜をつかみ、マイクロはさみで角膜を穿刺。角膜輪部に沿ってシザリング後の角膜を削除します。ピンセットでレンズを取り外してください。 </li><li> mの毛様体トリムicro-はさみ網膜剥離を可能にします。静かRPE /脈絡膜/強膜複合体からの全網膜を引っ張ります。フラットマウント用4〜8葉を作るために視神経に近い中心に周囲から放射状に数回RPE /脈絡膜/強膜複合体をカットします。 </li><li>ダウンRPE側を行い、筋肉、結膜および視神経を含む強膜側の残りのすべての組織をトリミングするRPE /脈絡膜/強膜複合体を反転します。残りの組織は複雑な凹凸を作るため、この手順は、フラットRPE /脈絡膜/強膜複合体を作ることが重要です。 </li><li> （詳細な方法のための参考文献を参照して、オプション）特定の研究目的のために一次および二次抗体との複合体をインキュベートします。スライドガラス上のRPE /脈絡膜/強膜複合体をフラットマウントし、吸収性スポンジを含むPBSを吸収します。 </li><li>取付溶液30μlを添加して、カバースライドを配置します。フルオレセイン顕微鏡下でベクター送達の有効性のためのサンプルを観察します。でサンプルを保ちますさらに観察用冷蔵庫。 </li></ol>

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The authors have nothing to disclose.

このビデオの記事では、RPE /脈絡膜/強膜フラットマウントの代表的な結果で詳細に輪部-アプローチ網膜下注入技術を説明しました。これは、RPEへのウイルスベクターの網膜下注射のための簡単​​で便利な技術です。注入時のブレブ形成の直接可視化は初心者のための正確な配達のための重要なステップです。可視化実験8-10誌で紹介し、いくつかの網膜下注入技術があります。網膜...

眼科では、遺伝子治療は、単一遺伝子継承網膜症における治療法として浮上しています。レーバー先天性amurosis 1,2、網膜色素変性症3、および先天性脈絡膜欠如4を含む網膜色素上皮（RPE）における遺伝子に関連した継承された網膜症があります。遺伝子治療の研究分野は、前臨床研究や、 アデノ -関連ウイルス（AAV）、 レンチウイルス （LV）およびアデノウイルス （AD）などのウイルスベクターを用いた臨床試験の両方に拡大している5。別のウイルスベクターは、網膜内の異なる親和性を有しています。安全かつ効果的な遺伝子治療のために、ウイルスベクターは、注意深く標的細胞および標的遺伝子に応じて選択されるべきです。 遺伝子送達の経路は、従って、それは慎重に同様に選択されるべきで、また、細胞を標的とする効果的な遺伝子送達のために重要です。ウイルスベクターの眼内送達のための2つの最も一般的な方法は、subretされていますinal注射や硝子体内注射6。後者は、硝子体内注射は、広く滲出型加齢黄斑変性症（AMD）および糖尿病性網膜症7の黄斑浮腫で脈絡膜血管新生を治療するための薬物送達のために使用されています。硝子体内経路は、硝子体と内側の網膜へのウイルスベクターの露出を提供していますが、外側の網膜へのベクターの拡散が制限されています。一方、網膜下の経路は、ローカライズ胞を誘導する、網膜とRPEの間の潜在的な空間へのウイルスベクターの直接送達を提供します。したがって、網膜下注射は、現在、光受容体細胞およびRPEを標的とする、より効率的なルートであると考えられます。外科的アプローチの面では、プラナは、ヒト患者における網膜の損傷を避けるために硝子体内注射のための安全なエリアとして選択されているPARS。単にマウスにこの方法を変更することによって、私たちは輪部アプローチを介して、網膜下またはintravireallyウイルスベクターを注入することができます。 このビデオで記事は、我々は、マウスのRPEへのウイルスベクターの網膜下注射の簡単で便利な方法を示しています。 30 G 1/2針で角膜輪​​部の後方に単一の穿刺後、33 G鈍針搭載マイクロリットルのシリンジは輪部穿刺部位を介して網膜下腔に挿入されます。 1.5のウイルスベクター - 2μlのボリュームが網膜下ブレブを誘発網膜とRPEとの間の潜在的な空間に注入されます。この手順では、手術用顕微鏡を用いて直接可視化の下で行うことができます。反復練習も、ブレブ形成の直接可視化することなく、複製の結果を保証します。これは、研究者がマウスのRPEにおける網膜下の遺伝子送達のために、正確かつ時間節約実験を行うのに役立ちます。

<table><tbody><tr><td>TWEEZERS DUMONT #5 11cm DUMOSTAR 0.1 x 0.06 mm TIPS</td><td>WPI</td><td>500233</td><td></td></tr><tr><td>VANNAS Scissors S/S, 105 mm</td><td>WPI</td><td>555583S</td><td></td></tr><tr><td>33 G Blunt needle</td><td>WPI</td><td>NF33BL-2</td><td></td></tr><tr><td>NanoFil Syringe, 10 microliter&amp;nbsp;</td><td>WPI</td><td>NANOFIL</td><td></td></tr><tr><td>RPE-KIT</td><td>WPI</td><td>RPE-KIT</td><td>For easy one hand injection</td></tr><tr><td>30 G x 1/2 (0.3 mm x 13 mm) BD PrecisionGlide&lt;sup&gt;TM&lt;/sup&gt; Needle</td><td>BD</td><td>305107</td><td>Initial puncture for subretinal injection</td></tr><tr><td>Microscope Cover Glasses (No. 1 3 mm diameter)</td><td>Warner Instruments</td><td>64-0720&amp;nbsp; (CS-3R)</td><td></td></tr><tr><td>Leica operating microscope</td><td>Leica</td><td>LM M80</td><td></td></tr><tr><td>Fluoresecein microscope</td><td>Nikon</td><td>Eclipse 80i</td><td></td></tr><tr><td>Lentivirus</td><td>Thermo scientific</td><td>TMO.LV-Ctr</td><td>Used to dilute vectors</td></tr><tr><td>PBS</td><td>Gibco</td><td>10010-015</td><td>Used to dilute vectors</td></tr><tr><td>Troperin (Phenylephrin 0.5% - Tropicamide 0.5%)</td><td>Hanmi</td><td></td><td>For dilation</td></tr><tr><td>Proparacaine Hydrochloride Ophthalmic Solution USP, 0.5% (Sterile)</td><td>Bausch&amp;amp;Lomb</td><td></td><td>For topical anesthesia</td></tr><tr><td>Healon GV OVD</td><td>Abbott Medical Optics Inc.</td><td></td><td></td></tr><tr><td>Zoletil 50 (tiletamine hypochloride and zolazepam hypochloride)</td><td>Virbac</td><td></td><td>For general anesthesia</td></tr><tr><td>Rompun injection (Xylazine HCl)</td><td>Bayer</td><td></td><td>For general anesthesia</td></tr></tbody></table>

limbal approach-subretinal injection of viral vectors for gene therapy in mice retinal pigment epithelium

The eye is a small and enclosed organ which makes it an ideal target for gene therapy. Recently various strategies have been applied to gene therapy in retinopathies using non-viral and viral gene delivery to the retina and retinal pigment epithelium (RPE). Subretinal injection is the best approach to deliver viral vectors directly to RPE cells. Before the clinical trial of a gene therapy, it is inevitable to validate the efficacy of the therapy in animal models of various retinopathies. Thus, subretinal injection in mice becomes a fundamental technique for an ocular gene therapy. In this protocol, we provide the easy and replicable technique for subretinal injection of viral vectors to experimental mice. This technique is modified from the intravitreal injection, which is widely used technique in ophthalmology clinics. The representative results of RPE/choroid/scleral complex flat-mount will help to understand the efficacy of this technique and adjust the volume and titer of viral vectors for the extent of gene transduction.

このプロトコルにより、ウイルスの遺伝子導入の網膜下注射の有効性を評価するために、我々は、インジケータ用GFPおよびRFPの両方を発現するCMVプロモーターを有する市販のLVベクターを使用していました。目は研究目的に応じて適切な期間の後に摘出しました。代表的な結果を得るためには、目が網膜下注射後10週および20週に摘出しました。上述の方法を用いて網膜を完全に除去した後、R...

Watch this Scientific Journal Video about Limbal Approach-Subretinal Injection of Viral Vectors for Gene Therapy in Mice Retinal Pigment Epithelium at JoVE.com

Limbal Approach-Subretinal Injection of Viral Vectors for Gene Therapy in Mice Retinal Pigment Epithelium

Subretinal injection is a surgical technique for effective gene delivery to retinal pigment epithelium in the mouse eye. Here we describe an easy and replicable method for subretinal injection of viral vectors to retinal pigment epithelium in experimental mice.

マウス網膜色素上皮における遺伝子治療用ウイルスベクターの縁アプローチ、網膜下注射

The eye is a small and enclosed organ which makes it an ideal target for gene therapy. Recently various strategies have been applied to gene therapy in ...

limbal-approach-subretinal-injection-viral-vectors-for-gene-therapy

Research

JoVE Journal

Neuroscience

21.0K ビュー.  Seoul National University College of Medicine. Subretinal injection is a surgical technique for effective gene delivery to retinal pigment epithelium in the mouse eye. Here we describe an easy and replicable method for subretinal injection of viral vectors to retinal pigment epithelium in experimental mice.

ビデオ: Limbal Approach-Subretinal Injection of Viral Vectors for Gene Therapy in Mice Retinal Pigment Epithelium

Subretinal Injection of Gene Therapy Vectors and Stem Cells in the Perinatal Mouse Eye

The loss of sight affects approximately 3.4 million people in the United States and is expected to increase in the upcoming years.1 Recently, gene therapy and stem cell transplantations have become key therapeutic tools for treating blindness resulting from retinal degenerative diseases. Several forms of autologous transplantation for age-related macular degeneration (AMD), such as iris pigment epithelial cell transplantation, have generated encouraging results, and human clinical trials have begun for other forms of gene and stem cell therapies.2 These include RPE65 gene replacement therapy in patients with Leber's congenital amaurosis and an RPE cell transplantation using human embryonic stem (ES) cells in Stargardt's disease.3-4 Now that there are gene therapy vectors and stem cells available for treating patients with retinal diseases, it is important to verify these potential therapies in animal models before applying them in human studies. The mouse has become an important scientific model for testing the therapeutic efficacy of gene therapy vectors and stem cell transplantation in the eye.5-8 In this video article, we present a technique to inject gene therapy vectors or stem cells into the subretinal space of the mouse eye while minimizing damage to the surrounding tissue.

This surgical technique illustrates the injection of gene therapy vectors and stem cells into the subretinal space of the mouse eye.

マウスの眼の中に遺伝子治療ベクターと幹細胞の網膜下注入

The loss of sight affects approximately 3.4 million people in the United States and is expected to increase in the upcoming years.1 Recently, gene therapy ...

医学

Retinal Detachment Model in Rodents by Subretinal Injection of Sodium Hyaluronate

Subretinal injection of sodium hyaluronate is a widely accepted method of inducing retinal detachment (RD). However, the height and duration of RD or the occurrence of subretinal hemorrhage can affect photoreceptor cell death in the detached retina. Hence, it is advantageous to create reproducible RDs without subretinal hemorrhage for evaluating photoreceptor cell death. We modified a previously reported method to create bullous and persistent RDs in a reproducible location with rare occurrence of subretinal hemorrhage. The critical step of this modified method is the creation of a self-sealing scleral incision, which can prevent leakage of sodium hyaluronate after injection into the subretinal space. To make the self-sealing scleral incision, a scleral tunnel is created, followed by scleral penetration into the choroid with a 30 G needle. Although choroidal hemorrhage may occur during this step, astriction with a surgical spear reduces the rate of choroidal hemorrhage. This method allows a more reproducible and reliable model of photoreceptor death in diseases that involve RD such as rhegmatogenous RD, retinopathy of prematurity, diabetic retinopathy, central serous chorioretinopathy, and age-related macular degeneration (AMD).

Creating experimental retinal detachments with a reproducible and sustained height of detachment, and without subretinal hemorrhage, is important for studying the pathophysiology of photoreceptor cell loss in retinal disease and evaluating potential therapeutic interventions. Here, we report such a method in detail.

ヒアルロン酸ナトリウムの網膜下注入によるげっ歯類における網膜剥離モデル

Subretinal injection of sodium hyaluronate is a widely accepted method of inducing retinal detachment (RD). However, the height and duration of RD or the ...

Performing Subretinal Injections in Rodents to Deliver Retinal Pigment Epithelium Cells in Suspension

The conversion of light into electrical impulses occurs in the outer retina and is accomplished largely by rod and cone photoreceptors and retinal pigment epithelium (RPE) cells. RPE provide critical support for photoreceptors and death or dysfunction of RPE cells is characteristic of age-related macular degeneration (AMD), the leading cause of permanent vision loss in people age 55 and older. While no cure for AMD has been identified, implantation of healthy RPE in diseased eyes may prove to be an effective treatment, and large numbers of RPE cells can be readily generated from pluripotent stem cells. Several interesting questions regarding the safety and efficacy of RPE cell delivery can still be examined in animal models, and well-accepted protocols used to inject RPE have been developed. The technique described here has been used by multiple groups in various studies and involves first creating a hole in the eye with a sharp needle. Then a syringe with a blunt needle loaded with cells is inserted through the hole and passed through the vitreous until it gently touches the RPE. Using this injection method, which is relatively simple and requires minimal equipment, we achieve consistent and efficient integration of stem cell-derived RPE cells in between the host RPE that prevents significant amount of photoreceptor degeneration in animal models. While not part of the actual protocol, we also describe how to determine the extent of the trauma induced by the injection, and how to verify that the cells were injected into the subretinal space using in vivo imaging modalities. Finally, the use of this protocol is not limited to RPE cells; it may be used to inject any compound or cell into the subretinal space.

Here we present a community accepted protocol in multimedia format for subretinally injecting a bolus of RPE cells in rats and mice. This approach can be used for determining rescue potentials, safety profiles, and survival capacities of grafted RPE cells upon implantation in animal models of retinal degeneration.

懸濁液中の網膜色素上皮細胞を送達するげっ歯類における網膜下注射の実行

The conversion of light into electrical impulses occurs in the outer retina and is accomplished largely by rod and cone photoreceptors and retinal pigment ...

An Alternative and Validated Injection Method for Accessing the Subretinal Space via a Transcleral Posterior Approach

Subretinal injections have been successfully used in both humans and rodents to deliver therapeutic interventions of proteins, viral agents, and cells to the interphotoreceptor/subretinal compartment that has direct exposure to photoreceptors and the retinal pigment epithelium (RPE). Subretinal injections of plasminogen as well as recent preclinical and clinical trials have demonstrated safety and/or efficacy of delivering viral vectors and stem cells to individuals with advanced retinal disease. Mouse models of retinal disease, particularly hereditary retinal dystrophies, are essential for testing these therapies. The most common injection procedure in rodents is to use small transcorneal or transcleral incisions with an anterior approach to the retina. With this approach, the injection needle penetrates the neurosensory retina disrupting the underlying RPE and on insertion can easily nick the lens, causing lens opacification and impairment of noninvasive imaging. Accessing the subretinal space via a transcleral, posterior approach avoids these problems: the needle crosses the sclera approximately 0.5 mm from the optic nerve, without retinal penetration and avoids disrupting the vitreous. Collateral damage is limited to that associated with the focal sclerotomy and the effects of a transient, serous retinal detachment. The simplicity of the method minimizes ocular injury, ensures rapid retinal reattachment and recovery, and has a low failure rate. The minimal damage to the retina and RPE allows for clear assessment of the efficacy and direct effects of the therapeutic agents themselves. This manuscript describes a novel subretinal injection technique that can be used to target viral vectors, pharmacological agents, stem cells or induced pluripotent stem (iPS) cells to the subretinal space in mice with high efficacy, minimal damage, and fast recovery.

An Alternative and Validated Injection Method for Accessing the Subretinal Space via a Transcleral Posterior Approach

Subretinal injections are the most common technique for delivering large therapeutic agents such as proteins and viral vectors to photoreceptors and the retinal pigment epithelium. An alternative method in mice that successfully targets the subretinal space with minimal collateral damage and fast recovery times is described here.

網膜下腔にアクセスするための代替と検証済みの注入方法<i&gt;経由で</i&gt;経強後方アプローチ

Subretinal injections have been successfully used in both humans and rodents to deliver therapeutic interventions of proteins, viral agents, and cells to ...

神経科学

Development of a Refined Protocol for Trans-scleral Subretinal Transplantation of Human Retinal Pigment Epithelial Cells into Rat Eyes

Degenerative retinal diseases such as age-related macular degeneration (AMD) are the leading cause of irreversible vision loss worldwide. AMD is characterized by the degeneration of retinal pigment epithelial (RPE) cells, which are a monolayer of cells functionally supporting and anatomically wrapping around the neural retina. Current pharmacological treatments for the non-neovascular AMD (dry AMD) only slow down the disease progression but cannot restore vision, necessitating studies aimed at identifying novel therapeutic strategies. Replacing the degenerative RPE cells with healthy cells holds promise to treat dry AMD in the future. Extensive preclinical studies of stem cell replacement therapies for AMD involve the transplantation of stem cell-derived RPE cells into the subretinal space of animal models, in which the subretinal injection technique is applied. The approach most frequently used in these preclinical animal studies is through the trans-scleral route, which is made difficult by the lack of direct visualization of the needle end and can often result in retinal damage. An alternative approach through the vitreous allows for direct observation of the needle end position, but it carries a high risk of surgical traumas as more eye tissues are disturbed. We have developed a less risky and reproducible modified trans-scleral injection method that uses defined needle angles and depths to successfully and consistently deliver RPE cells into the rat subretinal space and avoid excessive retinal damage. Cells delivered in this manner have been previously demonstrated to be efficacious in the Royal College of Surgeons (RCS) rat for at least 2 months. This technique can be used not only for cell transplantation but also for delivery of small molecules or gene therapies.

Subretinal injection has been widely applied in preclinical studies of stem cell replacement therapy for age-related macular degeneration. In this visualized article, we describe a less risky, reproducible and precisely modified subretinal injection technique via the trans-scleral approach to deliver cells into rat eyes.

強膜網膜移植ひと網膜色素上皮細胞のラットの目の洗練されたプロトコルの開発

Degenerative retinal diseases such as age-related macular degeneration (AMD) are the leading cause of irreversible vision loss worldwide. AMD is ...

Ultrahigh Resolution Mouse Optical Coherence Tomography to Aid Intraocular Injection in Retinal Gene Therapy Research

HR-SD-OCT is utilized to monitor the progression of photoreceptor degeneration in live mouse models, assess the delivery of therapeutic agents into the subretinal space, and to evaluate toxicity and efficacy in vivo. HR-SD-OCT uses near infrared light (800-880 nm) and has optics specifically designed for the unique optics of the mouse eye with sub-2-micron axial resolution. Transgenic mouse models of outer retinal (photoreceptor) degeneration and controls were imaged to assess the disease progression. Pulled glass microneedles were used to deliver sub retinal injections of adeno-associated virus (AAV) or nanoparticles (NP) via a trans-scleral and trans-choroidal approach. Careful positioning of the needle into the subretinal space was required prior to a calibrated pressure injection, which delivers fluid into the sub retinal space. Real time subretinal surgery was conducted on our retinal imaging system (RIS). HR-SD-OCT demonstrated progressive uniform retinal degeneration due to expression of a toxic mutant human mutant rhodopsin (P347S) (RHOP347S) transgene in mice. HR-SD-OCT allows rigorous quantification of all the retinal layers. Outer nuclear layer (ONL) thickness and photoreceptor outer segment length (OSL) measurements correlate with photoreceptor vitality, degeneration, or rescue. The RIS delivery system allows real-time visualization of subretinal injections in neonatal (~P10-14) or adult mice, and HR-SD-OCT immediately determines success of delivery and maps areal extent. HR-SD-OCT is a powerful tool that can evaluate the success of subretinal surgery in mice, in addition to measuring vitality of photoreceptors in vivo. HR-SD-OCT can also be used to identify uniform animal cohorts to evaluate the extent of retinal degeneration, toxicity, and therapeutic rescue in preclinical gene therapy research studies.

Here we demonstrate a novel approach to using high resolution spectral-domain optical coherence tomography (HR-SD-OCT) to assist delivery of gene therapy agents into the subretinal space, assess its areal coverage, and characterize photoreceptor vitality.

超高解像度マウス光コヒーレンストモグラフィー網膜遺伝子治療研究における眼内注入を支援するために

HR-SD-OCT is utilized to monitor the progression of photoreceptor degeneration in live mouse models, assess the delivery of therapeutic agents into the ...

Subretinal Transplantation of Human Embryonic Stem Cell-Derived Retinal Tissue in a Feline Large Animal Model

Retinal degenerative (RD) conditions associated with photoreceptor loss such as age-related macular degeneration (AMD), retinitis pigmentosa (RP) and Leber Congenital Amaurosis (LCA) cause progressive and debilitating vision loss. There is an unmet need for therapies that can restore vision once photoreceptors have been lost. Transplantation of human pluripotent stem cell (hPSC)-derived retinal tissue (organoids) into the subretinal space of an eye with advanced RD brings retinal tissue sheets with thousands of healthy mutation-free photoreceptors and has a potential to treat most/all blinding diseases associated with photoreceptor degeneration with one approved protocol. Transplantation of fetal retinal tissue into the subretinal space of animal models and people with advanced RD has been developed successfully but cannot be used as a routine therapy due to ethical concerns and limited tissue supply. Large eye inherited retinal degeneration (IRD) animal models are valuable for developing vision restoration therapies utilizing advanced surgical approaches to transplant retinal cells/tissue into the subretinal space. The similarities in globe size, and photoreceptor distribution (e.g., presence of macula-like region area centralis) and availability of IRD models closely recapitulating human IRD would facilitate rapid translation of a promising therapy to the clinic. Presented here is a surgical technique of transplanting hPSC-derived retinal tissue into the subretinal space of a large animal model allowing assessment of this promising approach in animal models.

Presented here is a surgical technique for transplanting human pluripotent stem cell (hPSC)-derived retinal tissue into the subretinal space of a large animal model.

ネコ大型動物モデルにおけるヒト胚性幹細胞由来網膜組織の網膜下移植

Retinal degenerative (RD) conditions associated with photoreceptor loss such as age-related macular degeneration (AMD), retinitis pigmentosa (RP) and ...

Subconjunctival Administration of Adeno-associated Virus Vectors in Small Animal Models

Ocular diseases include a wide range of inherited genetic and acquired disorders that are appealing targets for local drug delivery due to their relative ease of accessibility via multiple administration routes. Subconjunctival (SCJ) injections offer advantages over other intraocular administration routes as they are simple, safe, and usually performed in an outpatient setting. SCJ injections in small animals usually require the assistance of an operating microscope due to the size of the eye. Previous work has demonstrated that SCJ injection of specific adeno-associated virus (AAV) serotypes is a valid gene delivery strategy for targeted transduction of the ocular surface, eye muscle, cornea, and optic nerve, providing a potential approach for the treatment of many ocular diseases.
Herein, a detailed protocol is presented for SCJ injections in a mouse model using an injection system consisting of a programmable infusion/withdrawal syringe pump (which allows for consistent and precise injection speed and pressure) and a gastight removable syringe coupled with microinjection needles. The injection system is also adaptable for other intraocular administration routes such as intrastromal, intracameral, intravitreal, and subretinal injections in small animals. Although the delivery of adeno-associated viral vectors for ocular gene therapy studies is described, the protocol herein can also be adapted for a variety of ophthalmic solutions in small animal models. The key practical steps in the administration route, setup for the injection platform, preparation of the injection, and tips from direct experience will be discussed in detail. In addition, common validation techniques for AAV delivery confirmation to the desired tissues will also be briefly discussed.

In this manuscript, subconjunctival injection is demonstrated as a valid vector delivery method for ocular tissues in mice using an injection system consisting of an infusion/withdrawal syringe pump and a gastight removable syringe coupled with microinjection needles. This injection system is also adaptable for other intraocular administration routes.

小動物モデルにおけるアデノ随伴ウイルスベクターの結膜下投与

Ocular diseases include a wide range of inherited genetic and acquired disorders that are appealing targets for local drug delivery due to their relative ...

Intravitreal Injections in the Ovine Eye

There are several methods for the delivery of therapeutic agents to the retina, including intravitreal (IVT), subretinal, suprachoroidal, periocular, or topical administration. IVT drug delivery involves an injection into the vitreous humor of the eye, a gelatinous substance that fills the posterior chamber of the eye and maintains the shape of the eye globe. Although the IVT route is less specifically targeted than subretinal delivery, it is much less invasive and is widely used in clinical settings for a range of ocular diseases. 
We previously demonstrated the efficacy of intravitreal delivery of an adeno-associated virus (AAV)-mediated gene therapy product (AAV9.CLN5) in sheep with a naturally occurring CLN5 form of neuronal ceroid lipofuscinosis (NCL). Affected sheep received IVT gene therapy in one eye, with the other untreated eye serving as an internal control. Retinal structure and function were maintained in the treated eye up to 15 months after treatment, while the untreated eye displayed progressively declining function and severe atrophy during postmortem examination. Based on the sheep studies, the CLN5 gene therapy product was cleared as a candidate investigational new drug (IND) by the United States Food and Drug Administration in September 2021. This paper details the surgical protocol for IVT delivery of a therapeutic viral vector to the ovine eye.

Intravitreal injections were performed in the sheep eye with the aim of delivering viral-mediated gene therapy to the retina.

ヒツジの目の硝子体内注射

There are several methods for the delivery of therapeutic agents to the retina, including intravitreal (IVT), subretinal, suprachoroidal, periocular, or ...

Transpupillary-Guided Trans-Scleral Transplantation of Subretinal Grafts in a Retinal Degeneration Mouse Model

Transplantation of photoreceptor cells and retinal pigment&#160;epithelial (RPE) cells provide a potential therapy for retinal degeneration diseases. Subretinal transplantation of therapeutic donor cells into mouse recipients is challenging due to the limited surgical space allowed by the small volume of the mouse eye. We developed a trans-scleral surgical transplantation platform with direct transpupillary vision guidance to facilitate the subretinal delivery of exogenous cells in mouse recipients. The platform was tested using retinal cell suspensions and three-dimensional retinal sheets collected from rod-rich Rho::EGFP mice and cone-rich OPN1LW-EGFP;NRL-/- mice, respectively. Live/dead assay showed low cell mortality for both forms of donor cells. Retinal grafts were successfully delivered into the subretinal space of a mouse model of retinal degeneration, Rd1/NS, with minimum surgical complications as detected by multimodal confocal scanning laser ophthalmoscope (cSLO) imaging. Two months post-transplantation, histological staining demonstrated evidence of advanced maturation of the retinal grafts into &#39;adult&#39; rods and cones (by robust Rho::EGFP, S-opsin, and OPN1LW:EGFP expression, respectively) in the subretinal space. Here, we provide a surgical platform that can enable highly accurate subretinal delivery with a low rate of complications in mouse recipients. This technique offers precision and relative ease of skill acquisition. Furthermore, the technique could be used not only for studies of subretinal cell transplantation but also for other intraocular therapeutic studies including gene therapies.

This protocol presents a transpupillary vision-guided trans-scleral approach to safely and precisely deliver subretinal cellular grafts, with a low rate of surgical complications, in mouse recipients with or without retinal degeneration.

網膜変性マウスモデルにおける網膜下移植片の経瞳孔ガイド下経強膜移植

Transplantation of photoreceptor cells and retinal pigment&#160;epithelial (RPE) cells provide a potential therapy for retinal degeneration diseases. ...