Name: intravitreal injections in the ovine eye
Uploaded: 2022-07-05T14:00:00
Description: Watch this Scientific Journal Video about Intravitreal Injections in the Ovine Eye at JoVE.com

Forfatterne vil gerne anerkende Dr. Steve Heap (BVSc, CertVOphthal) for hans hjælp til at etablere denne protokol og udføre injektionerne beskrevet af Murray et al.15. Forfatterne anerkender også finansiering fra CureKids New Zealand, Canterbury Medical Research Foundation, Neurogene Inc og Batten Disease Support and Research Association.

Alle eksperimentelle protokoller blev godkendt af Lincoln University Animal Ethics Committee og er i overensstemmelse med US National Institutes of Health retningslinjer for pleje og brug af dyr i forskning og New Zealand Animal Welfare Act (1999). Borderdale får blev diagnosticeret ved fødslen14 og vedligeholdt på Lincoln University forskningsbedrifter. Tre 3 måneder gamle homozygote (CLN5-/-) moderfår fik en enkelt IVT-injektion på venstre øje, hvor det ubehandlede højre øje ...

<ol>
	<li>Himawan, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Drug+delivery+to+retinal+photoreceptors.">Drug delivery to retinal photoreceptors.</a> Drug Discovery Today. 24 (8), 1637-1643 (2019).</li><li>Murray, S. J., Mitchell, N. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ocular+therapies+for+neuronal+ceroid+lipofuscinoses:+More+than+meets+the+eye.">Ocular therapies for neuronal ceroid lipofuscinoses: More than meets the eye.</a> Neural Regeneration Research. 17 (8), 1755-1756 (2022).</li><li>Bishop, P. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Structural+macromolecules+and+supramolecular+organisation+of+the+vitreous+gel.">Structural macromolecules and supramolecular organisation of the vitreous gel.</a> Progress in Retinal and Eye Research. 19 (3), 323-344 (2000).</li><li>Grzybowski, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=update+on+intravitreal+injections:+Euretina+expert+consensus+recommendations.">update on intravitreal injections: Euretina expert consensus recommendations.</a> Ophthalmologica. 239 (4), 181-193 (2018).</li><li>Pavlou, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+AAV+capsids+for+intravitreal+gene+therapy+of+photoreceptor+disorders.">Novel AAV capsids for intravitreal gene therapy of photoreceptor disorders.</a> EMBO Molecular Medicine. 13 (4), 13392 (2021).</li><li>Kousi, M., Lehesjoki, A. -. E., Mole, S. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Update+of+the+mutation+spectrum+and+clinical+correlations+of+over+360+mutations+in+eight+genes+that+underlie+the+neuronal+ceroid+lipofuscinoses.">Update of the mutation spectrum and clinical correlations of over 360 mutations in eight genes that underlie the neuronal ceroid lipofuscinoses.</a> Human Mutation. 33 (1), 42-63 (2012).</li><li>Wibbeler, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cerliponase+alfa+for+the+treatment+of+atypical+phenotypes+of+CLN2+disease:+A+retrospective+case+series.">Cerliponase alfa for the treatment of atypical phenotypes of CLN2 disease: A retrospective case series.</a> Journal of Child Neurology. 36 (6), 468-474 (2021).</li><li>Schulz, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Study+of+intraventricular+cerliponase+alfa+for+CLN2+disease.">Study of intraventricular cerliponase alfa for CLN2 disease.</a> The New England Journal of Medicine. 378 (20), 1898-1907 (2018).</li><li>Mitchell, N. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Longitudinal+in+vivo+monitoring+of+the+CNS+demonstrates+the+efficacy+of+gene+therapy+in+a+sheep+model+of+CLN5+Batten+disease.">Longitudinal in vivo monitoring of the CNS demonstrates the efficacy of gene therapy in a sheep model of CLN5 Batten disease.</a> Molecular Therapy. 26 (10), 2366-2378 (2018).</li><li>Murray, S. J., Mitchell, N. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Natural+history+of+retinal+degeneration+in+ovine+models+of+CLN5+and+CLN6+neuronal+ceroid+lipofuscinoses.">Natural history of retinal degeneration in ovine models of CLN5 and CLN6 neuronal ceroid lipofuscinoses.</a> Scientific Reports. 12 (1), 3670 (2022).</li><li>Russell, K. N., Mitchell, N. L., Wellby, M. P., Barrell, G. K., Palmer, D. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electroretinography+data+from+ovine+models+of+CLN5+and+CLN6+neuronal+ceroid+lipofuscinoses.">Electroretinography data from ovine models of CLN5 and CLN6 neuronal ceroid lipofuscinoses.</a> Data in Brief. 37, 107188 (2021).</li><li>Shafiee, A., McIntire, G. L., Sidebotham, L. C., Ward, K. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+determination+and+allometric+prediction+of+vitreous+volume,+and+retina+and+lens+weights+in+G&#246;ttingen+minipigs.">Experimental determination and allometric prediction of vitreous volume, and retina and lens weights in G&#246;ttingen minipigs.</a> Veterinary Ophthalmology. 11 (3), 193-196 (2008).</li><li>Shinozaki, A., Hosaka, Y., Imagawa, T., Uehara, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Topography+of+ganglion+cells+and+photoreceptors+in+the+sheep+retina.">Topography of ganglion cells and photoreceptors in the sheep retina.</a> The Journal of Comparative Neurology. 518 (12), 2305-2315 (2010).</li><li>Frugier, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+large+animal+model+of+CLN5+neuronal+ceroid+lipofuscinosis+in+Borderdale+sheep+is+caused+by+a+nucleotide+substitution+at+a+consensus+splice+site+(c.571+1G&gt;A)+leading+to+excision+of+exon+3.">A new large animal model of CLN5 neuronal ceroid lipofuscinosis in Borderdale sheep is caused by a nucleotide substitution at a consensus splice site (c.571+1G&gt;A) leading to excision of exon 3.</a> Neurobiology of Disease. 29 (2), 306-315 (2008).</li><li>Murray, S. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intravitreal+gene+therapy+protects+against+retinal+dysfunction+and+degeneration+in+sheep+with+CLN5+Batten+disease.">Intravitreal gene therapy protects against retinal dysfunction and degeneration in sheep with CLN5 Batten disease.</a> Experimental Eye Research. 207, 108600 (2021).</li><li>Ross, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Outer+retinal+transduction+by+AAV2-7m8+following+intravitreal+injection+in+a+sheep+model+of+CNGA3+achromatopsia.">Outer retinal transduction by AAV2-7m8 following intravitreal injection in a sheep model of CNGA3 achromatopsia.</a> Gene Therapy. , (2021).</li><li>Boyd, R. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Photoreceptor-targeted+gene+delivery+using+intravitreally+administered+AAV+vectors+in+dogs.">Photoreceptor-targeted gene delivery using intravitreally administered AAV vectors in dogs.</a> Gene Therapy. 23 (2), 223-230 (2016).</li><li>Dalkara, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo-directed+evolution+of+a+new+adeno-associated+virus+for+therapeutic+outer+retinal+gene+delivery+from+the+vitreous.">In vivo-directed evolution of a new adeno-associated virus for therapeutic outer retinal gene delivery from the vitreous.</a> Science Translational Medicine. 5 (189), (2013).</li><li>Gearhart, P. M., Gearhart, C., Thompson, D. A., Petersen-Jones, S. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improvement+of+visual+performance+with+intravitreal+administration+of+9-cis-retinal+in+Rpe65-mutant+dogs.">Improvement of visual performance with intravitreal administration of 9-cis-retinal in Rpe65-mutant dogs.</a> Archives of Ophthalmology. 128 (11), 1442-1448 (2010).</li><li>Ross, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+photoreceptor+transduction+efficacy+of+capsid-modified+adeno-associated+viral+vectors+following+intravitreal+and+subretinal+delivery+in+sheep.">Evaluation of photoreceptor transduction efficacy of capsid-modified adeno-associated viral vectors following intravitreal and subretinal delivery in sheep.</a> Human Gene Therapy. 31 (13-14), 719-729 (2020).</li><li>Kotterman, M. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antibody+neutralization+poses+a+barrier+to+intravitreal+adeno-associated+viral+vector+gene+delivery+to+non-human+primates.">Antibody neutralization poses a barrier to intravitreal adeno-associated viral vector gene delivery to non-human primates.</a> Gene Therapy. 22 (2), 116-126 (2015).</li><li>Whitehead, M., Osborne, A., Yu-Wai-Man, P., Martin, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Humoral+immune+responses+to+AAV+gene+therapy+in+the+ocular+compartment.">Humoral immune responses to AAV gene therapy in the ocular compartment.</a> Biological Reviews. 96 (4), 1616-1644 (2021).</li><li>Yun, C., Oh, J., Hwang, S. -. Y., Kim, S. -. W., Huh, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Subconjunctival+hemorrhage+after+intravitreal+injection+of+anti-vascular+endothelial+growth+factor.">Subconjunctival hemorrhage after intravitreal injection of anti-vascular endothelial growth factor.</a> Graefe's Archive for Clinical and Experimental Ophthalmology. 253 (9), 1465-1470 (2015).</li><li>Christensen, L., Cerda, A., Olson, J. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Real-time+measurement+of+needle+forces+and+acute+pressure+changes+during+intravitreal+injections.">Real-time measurement of needle forces and acute pressure changes during intravitreal injections.</a> Clinical &amp; Experimental Ophthalmology. 45 (8), 820-827 (2017).</li><li>Allmendinger, A., Butt, Y. L., Mueller, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraocular+pressure+and+injection+forces+during+intravitreal+injection+into+enucleated+porcine+eyes.">Intraocular pressure and injection forces during intravitreal injection into enucleated porcine eyes.</a> European Journal of Pharmaceutics and Biopharmaceutics. 166, 87-93 (2021).</li><li>Ross, M., Ofri, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+future+of+retinal+gene+therapy:+Evolving+from+subretinal+to+intravitreal+vector+delivery.">The future of retinal gene therapy: Evolving from subretinal to intravitreal vector delivery.</a> Neural Regeneration Research. 16 (9), 1751-1759 (2021).</li><li>Henein, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hydrodynamics+of+intravitreal+injections+into+liquid+vitreous+substitutes.">Hydrodynamics of intravitreal injections into liquid vitreous substitutes.</a> Pharmaceutics. 11 (8), 371 (2019).</li><li>Park, I., Park, H. S., Kim, H. K., Chung, W. K., Kim, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Real-time+measurement+of+intraocular+pressure+variation+during+automatic+intravitreal+injections:+An+ex-vivo+experimental+study+using+porcine+eyes.">Real-time measurement of intraocular pressure variation during automatic intravitreal injections: An ex-vivo experimental study using porcine eyes.</a> PloS One. 16 (8), 0256344 (2021).</li><li>Willekens, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intravitreally+injected+fluid+dispersion:+Importance+of+injection+technique.">Intravitreally injected fluid dispersion: Importance of injection technique.</a> Investigative Ophthalmology &amp; Visual Science. 58 (3), 1434-1441 (2017).</li><li>Peynshaert, K., Devoldere, J., De Smedt, S. C., Remaut, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vitro+and+ex+vivo+models+to+study+drug+delivery+barriers+in+the+posterior+segment+of+the+eye.">In vitro and ex vivo models to study drug delivery barriers in the posterior segment of the eye.</a> Advanced Drug Delivery Reviews. 126, 44-57 (2018).</li><li>Kiss, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Vector+Considerations+for+Ocular+Gene+Therapy.+Adeno-associated+virus+vectors+offer+a+safe+and+effective+tool+for+gene+delivery.">Vector Considerations for Ocular Gene Therapy. Adeno-associated virus vectors offer a safe and effective tool for gene delivery.</a> Retinal Physician. 17, 40-45 (2020).</li><li>Kleine Holthaus, S. -. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gene+therapy+targeting+the+inner+retina+rescues+the+retinal+phenotype+in+a+mouse+model+of+CLN3+Batten+disease.">Gene therapy targeting the inner retina rescues the retinal phenotype in a mouse model of CLN3 Batten disease.</a> Human Gene Therapy. 31 (13-14), 709-718 (2020).</li><li>Kleine Holthaus, S. -. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neonatal+brain-directed+gene+therapy+rescues+a+mouse+model+of+neurodegenerative+CLN6+Batten+disease.">Neonatal brain-directed gene therapy rescues a mouse model of neurodegenerative CLN6 Batten disease.</a> Human Molecular Genetics. 28 (23), 3867-3879 (2019).</li></ol>

Intravitreale injektioner er en af de mest almindelige kirurgiske procedurer inden for human oftalmologi og har vist sig effektiv til at levere AAV-medierede genterapier til nethinden hos får. Vi havde tidligere demonstreret effekten af AAV9. CLN5 genterapi leveret intravitrealt i dæmpning af retinal dysfunktion og degeneration hos får med CLN5 NCL15. Det er håbet, at oversættelsen af denne administrationsvej til humane NCL-patienter også vil vise sig gavnlig.
Pro...

Flere metoder kan bruges til at levere terapeutiske midler til nethinden, herunder intravitreal (IVT), subretinal, suprachoroidal, periokulær eller topisk administration. Hver administrationsvej involverer overvindelse af barrierer såsom blod-nethindebarrieren eller de indre og ydre begrænsende membraner og har varierende effektivitetshastigheder afhængigt af det lægemiddel, der leveres, og det specifikke retinale mål 1,2.
IVT-lægemiddelafgivelse involverer en injektion i øjets glasagtige humor, et gelatinøst stof, der optager øjets bageste kammer. Den primære funktion af glasagtig humor er at opretholde formen på øjenkloden og holde okulært væv, såsom linsen og nethinden, på plads. Den glasagtige humor består stort set af vand med små mængder kollagen, hyaluronsyre og andre ikke-kollagenøse proteiner3. IVT-injektion er en enkel og almindelig procedure, der rutinemæssigt anvendes til behandling af en lang række okulære tilstande, herunder aldersrelateret makuladegeneration, diabetisk makulært ødem, diabetisk retinopati, retinal veneokklusion og flere arvelige retinale dystrofier 4,5.
Neuronale ceroid lipofuscinoser (NCL; Batten sygdom) er en gruppe af dødelige lysosomale opbevaringssygdomme, der forårsager alvorlig degeneration af hjernen og nethinden. Der er i øjeblikket 13 kendte varianter af NCL som følge af mutationer i forskellige gener (CLN1-8, CLN10-14), der overvejende påvirker børn, men har varierende debutalder og sygdommens sværhedsgrad6. NCL'erne deler almindelige progressive symptomer, herunder kognitiv og motorisk tilbagegang, anfald og tab af syn. Der er ingen kur mod NCL; imidlertid er hjernestyret enzymerstatningsterapi i øjeblikket i kliniske forsøg med CLN2-sygdom 7,8, og AAV-medieret genterapi har vist stort løfte i prækliniske undersøgelser, med et klinisk forsøg med CLN5-genterapi, der forventes at begynde i 2022 9,10.
Mange andre arter udvikler naturligt forekommende former for NCL, herunder katte, hunde, får og køer. To fåremodeller af NCL er i øjeblikket under aktiv undersøgelse i New Zealand: en CLN5-sygdomsmodel hos Borderdale-får og en CLN6-sygdomsmodel hos får i South Hampshire. Berørte får udviser mange af de kliniske og patologiske træk ved den menneskelige sygdom, herunder retinal atrofi og tab af syn10,11. Selvom hjernestyret CLN5-genterapi hos får med CLN5-sygdom kan forhindre eller standse hjerneatrofi og klinisk tilbagegang, mister de behandlede får stadig deres syn9. Dette fremhævede behovet for at behandle nethinden for at bevare synet og opretholde en bedre livskvalitet, hvilket førte til etablering af en protokol for okulær genterapi hos får.
Fåreøjet repræsenterer en god model af det menneskelige øje på grund af dets lighed i øjenglobens dimensioner, glaslegemevolumen og retinal struktur10,12,13. Dette papir beskriver den kirurgiske protokol for IVT-levering af et lille volumen (≤100 μL) terapeutisk viral vektor til fåreøjet.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>1 mL low dead-space safety syringe with permanently attached 0.5 inch needle</td>
			<td>Fisher Scientific, Auckland, New Zealand</td>
			<td>05-561-28</td>
			<td>Covidien Monoject Tuberculin Safety syringe or similar</td>
		</tr>
		<tr>
			<td>1.5 mL microcentrifuge tube</td>
			<td>Sigma Aldrich</td>
			<td>HS4323</td>
			<td>Autoclave tubes to sterilise prior to use</td>
		</tr>
		<tr>
			<td>Anesthesia machine with gas bench and monitor&#160;</td>
			<td>Hyvet Anesthesia, Christchurch, New Zealand</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Antibiotic eye drops&#160;</td>
			<td>Teva Pharma Ltd, Auckland, New Zealand</td>
			<td></td>
			<td>Commercial name: Chlorafast (0.5% chloramphenicol)</td>
		</tr>
		<tr>
			<td>BrightMount plus anti-fade mounting medium</td>
			<td>Abcam, Cambridge, United Kingdom</td>
			<td>ab103748</td>
			<td></td>
		</tr>
		<tr>
			<td>DAPI (4&#8242; ,6-diamidino-2-phenylindole dihydrochloride)</td>
			<td>Sigma Aldrich, St. Louis, Missouri, United States</td>
			<td>10236276001</td>
			<td></td>
		</tr>
		<tr>
			<td>Diazepam sedative</td>
			<td>Ilium, Troy Laboratories Pty Ltd, Tauranga, New Zealand</td>
			<td></td>
			<td>5 mg/mL</td>
		</tr>
		<tr>
			<td>Endotracheal tubes</td>
			<td>Flexicare Medical Ltd, Mountain Ash, United Kingdom</td>
			<td></td>
			<td>Standard, cuffed. Sizes 7, 7.5, or 8 depending on sheep size</td>
		</tr>
		<tr>
			<td>Eye speculum</td>
			<td>Capes Medical Ltd, Tauranga, New Zealand</td>
			<td>KP151/14</td>
			<td>Nopa Barraquer-Colibri (10 mm)</td>
		</tr>
		<tr>
			<td>Fenestrated surgical drape</td>
			<td>Amtech Medical Ltd, Whanganui, New Zealand</td>
			<td>DI583</td>
			<td>Or similar&#160;</td>
		</tr>
		<tr>
			<td>Filter Tips</td>
			<td>Interlab, Auckland, New Zealand</td>
			<td></td>
			<td>10, 200, and 1,000 &#181;L&#160;</td>
		</tr>
		<tr>
			<td>Formaldehyde solution (37%)</td>
			<td>Fisher Scientific, Auckland, New Zealand</td>
			<td>AJA809-2.5PL</td>
			<td>Make up to 10% in distilled water with 0.9% NaCl</td>
		</tr>
		<tr>
			<td>Goat anti-rabbit Alexa Fluor 594</td>
			<td>Invitrogen Carlsbad, CA, USA</td>
			<td>&#160;A-11012</td>
			<td>Use at a dilution of 1:500</td>
		</tr>
		<tr>
			<td>Isoflurane anesthetic</td>
			<td>Attane, Bayer Animal Health, Auckland, New Zealand</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Ketamine HCl anesthetic/analgesic</td>
			<td>PhoenixPharm Distributors Ltd, Auckland, New Zealand</td>
			<td></td>
			<td>100 mg/mL</td>
		</tr>
		<tr>
			<td>Laryngoscope (veterinary)</td>
			<td>KaWe Medical, Denmark</td>
			<td></td>
			<td>Miller C blade, size 2</td>
		</tr>
		<tr>
			<td>Needles&#160;</td>
			<td>Capes Medical Ltd, Tauranga, New Zealand</td>
			<td>302025</td>
			<td>BD Hypodermic Needles, or similar</td>
		</tr>
		<tr>
			<td>Non-steroidal anti-inflammatory</td>
			<td>Boehringer Ingelheim (NZ) Ltd, Auckland, New Zealand</td>
			<td>49402/008</td>
			<td>Commercial name: Metacam 20 (20 mg/mL meloxicam)</td>
		</tr>
		<tr>
			<td>Non-toothed forceps</td>
			<td>Capes Medical Ltd, Tauranga, New Zealand</td>
			<td>AB864/16</td>
			<td>Or similar&#160;</td>
		</tr>
		<tr>
			<td>Non-toothed hemostat</td>
			<td>Capes Medical Ltd, Tauranga, New Zealand</td>
			<td>AA150/12</td>
			<td>Or similar&#160;</td>
		</tr>
		<tr>
			<td>Normal goat serum</td>
			<td>Thermo Fisher Scientific, Christchurch, New Zealand</td>
			<td>16210072</td>
			<td></td>
		</tr>
		<tr>
			<td>Oxygen (medical)</td>
			<td>BOC Gas, Christchurch, New Zealand</td>
			<td></td>
			<td>D2 cylinder, gas code 180</td>
		</tr>
		<tr>
			<td>Phosphate buffered saline&#160;</td>
			<td>Thermo Fisher Scientific, Christchurch, New Zealand</td>
			<td>10010023</td>
			<td>Sterile, filtered</td>
		</tr>
		<tr>
			<td>Povidone-Iodine solution</td>
			<td>Capes Medical Ltd, Tauranga, New Zealand</td>
			<td>005835</td>
			<td>Commercial name: Betadine (10% povidone-iodine)</td>
		</tr>
		<tr>
			<td>Rabbit anti-cow glial fibrillary acidic protein (GFAP)</td>
			<td>Dako, Glostrup, Denmark</td>
			<td>Z0334</td>
			<td>Use at a dilution of 1:2,500</td>
		</tr>
		<tr>
			<td>Self-complementary adeno-associated virus serotype 9, containing the chicken beta action (CBh) promoter and codon-optimized ovine CLN5</td>
			<td>University of North Carolina Vector Core, NC, USA.</td>
			<td>scAAV9/CBh-oCLN5opt</td>
			<td></td>
		</tr>
		<tr>
			<td>Sodium Chloride 0.9% IV Solution</td>
			<td>Capes Medical Ltd, Tauranga, New Zealand</td>
			<td>AHB1322</td>
			<td>Commercial name: Saline solution&#160;</td>
		</tr>
		<tr>
			<td>Subcutaneous antibiotics</td>
			<td>Intervet Schering Plough Animal Health Ltd, Wellington, New Zealand</td>
			<td></td>
			<td>Commercial name: Duplocillin LA (150,000 IU/mL procaine penicillin and 115,000 IU/mL benzathine penicillin)</td>
		</tr>
		<tr>
			<td>Surgical sharp blunt curved scissors&#160;</td>
			<td>Capes Medical Ltd, Tauranga, New Zealand</td>
			<td>SSSHBLC130</td>
			<td></td>
		</tr>
		<tr>
			<td>Terumo Syringe Luer Lock</td>
			<td>Amtech Medical Ltd, Whanganui, New Zealand</td>
			<td>SH159/SH160</td>
			<td>Sterile syringes; 10 mL for drawing up induction drugs, 20 mL for drawing up saline</td>
		</tr>
		<tr>
			<td>Virkon Disinfectant Powder</td>
			<td>EBOS Group Ltd, Christchurch, NZ</td>
			<td>28461115</td>
			<td></td>
		</tr>
	</tbody>
</table>

intravitreal injections in the ovine eye

Der er flere metoder til levering af terapeutiske midler til nethinden, herunder intravitreal (IVT), subretinal, suprachoroidal, periokulær eller topisk administration. IVT-lægemiddellevering involverer en injektion i øjets glasagtige humor, et gelatinøst stof, der fylder øjets bageste kammer og opretholder formen på øjenkloden. Selvom IVT-ruten er mindre specifikt målrettet end subretinal levering, er den meget mindre invasiv og bruges i vid udstrækning i kliniske omgivelser til en række okulære sygdomme. 
Vi har tidligere demonstreret effekten af intravitreal levering af et adeno-associeret virus (AAV)-medieret genterapiprodukt (AAV9). CLN5) hos får med en naturligt forekommende CLN5-form for neuronal ceroid lipofuscinose (NCL). Berørte får modtog IVT-genterapi på det ene øje, mens det andet ubehandlede øje fungerede som en intern kontrol. Retinal struktur og funktion blev opretholdt i det behandlede øje op til 15 måneder efter behandlingen, mens det ubehandlede øje viste gradvist faldende funktion og svær atrofi under postmortem undersøgelse. Baseret på fåreundersøgelserne blev CLN5-genterapiproduktet godkendt som et kandidatforsøgsnyt lægemiddel (IND) af United States Food and Drug Administration i september 2021. Dette papir beskriver den kirurgiske protokol for IVT-levering af en terapeutisk viral vektor til fåreøjet.

Effekten af IVT-levering af en CLN5-genterapivektor til dæmpning af retinal dysfunktion og degeneration hos får med CLN5 NCL er tidligere blevet demonstreret af denne forskningsgruppe15. Berørte får fik en enkelt 100 μL IVT-injektion af CLN5 pakket i en AAV-serotype 9 (AAV9) vektor (AAV9). CLN5) ind i det ene øje, hvor det kontralaterale øje tjener som en ubehandlet intern kontrol. Synet blev vurderet månedligt fra injektionsalderen (3 måneder) til sygdommen i slutstadiet (18 måneder). P...

Watch this Scientific Journal Video about Intravitreal Injections in the Ovine Eye at JoVE.com

Intravitreal Injections in the Ovine Eye

Intravitreale injektioner blev udført i fåreøjet med det formål at levere viral-medieret genterapi til nethinden.

Intravitreal injektioner i Ovine Eye

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

Intravitreale injektioner kan bruges til at levere terapeutiske midler til nethinden. En protokol for intravitreale injektioner i fåreøjet, som en model af det menneskelige øje, præsenteres her. Intravitreale injektioner er meget mindre invasive end andre okulære injektioner.Intravitreale injektioner kan med succes anvendes til at levere et genterapiprodukt og behandle retinal degeneration hos får med naturligt forekommende neuronale ceroid lipofuscinoser. Når fårene er bedøvet, skal du begynde aseptisk at desinficere øjet, der skal injiceres, ved at skylle det med 1 til 5% povidoniodopløsning ved hjælp af en 20 milliliter sprøjte. Placer derefter en steril, fenestreret kirurgisk drapering over øjet.Tilpas et øjenspekulum til øjenlågene for at holde øjet åbent. Tag fat i bulbar conjunctiva på det dorsale laterale aspekt af øjet med tang og drej øjenglobussen ventromedialt. Indsæt nålen cirka syv millimeter bagud til sclera på øjets laterale aspekt og vinklet bagud for at undgå linsen.Administrer den enkelte injektion på 100 mikroliter som en bolus, så tæt på nethinden som muligt, uden at forstyrre nethinden. Skyl øjet med ca. 10 til 15 ml 1 til 5% povidonjodopløsning efterfulgt af 10 ml saltvand, før du fjerner spekulum og drapering. Elektroretinografianalyse viste bevaret retinal funktion i det behandlede øje, mens det ubehandlede øje faldt på samme måde som CLN5-ramte dyr.Retinal histologi blev næsten normaliseret i det behandlede øje med en total retinal tykkelse, der kan sammenlignes med sunde kontroldyr i den centrale nethinde. I modsætning hertil var tykkelsen af den ubehandlede nethinde sammenlignelig med CLN5-berørte dyr. Ekspressionen af glialfibrillærsyreproteinet eller GFAP, en markør for retinal stress og astroglia, var lavere i behandlede øjne end de ubehandlede øjne, hvilket indikerer, at sygdomsrelateret inflammation blev svækket efter behandling.Med etableringen af en protokol for intravitreale injektioner i fåreøjet kunne får nu bruges til at teste sikkerheden og effekten af mange intravitreally-leverede terapeutiske midler.

Research

JoVE Journal

Medicine

A Mouse Model of the Cornea Pocket Assay for Angiogenesis Study

A normal cornea is clear of vascular tissues. However, blood vessels can be induced to grow and survive in the cornea when potent angiogenic factors are ...

Development of an Audio-based Virtual Gaming Environment to Assist with Navigation Skills in the Blind

Udvikling af en Audio-based Virtual Gaming Miljø til at hjælpe med Navigation Skills i Blind

Audio-based Environment Simulator (AbES) is virtual environment software designed to improve real world navigation skills in the blind. Using only audio ...

Heterotopic Mucosal Engrafting Procedure for Direct Drug Delivery to the Brain in Mice

Heterotop Mucosal transplantere Procedure for direkte Drug Delivery til Brain i mus

Delivery of therapeutics into the brain is impeded by the presence of the blood-brain barrier (BBB) which restricts the passage of polar and high ...

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

Udførelse subretinale Injektioner i Gnavere at levere retinale pigmentepitel celler i 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 ...

Trabecular Meshwork Response to Pressure Elevation in the Living Human Eye

Trabekelværket Reaktion på tryk Elevation i Living menneskelige øje

The mechanical characteristics of the trabecular meshwork (TM) are linked to outflow resistance and intraocular pressure (IOP) regulation. The rationale ...

Fluorescent Dye Labeling of Erythrocytes and Leukocytes for Studying the Flow Dynamics in Mouse Retinal Circulation

Fluorescerende farvestofmærkning af erytrocytter og leukocytter til at studere strømdynamikken i muskelspiralcirkulation

The retinal and choroidal blood flow dynamics may provide insight into the pathophysiology and sequelae of various ocular diseases, such as glaucoma, ...

Transvaginal Mesh Insertion in the Ovine Model

Transvaginal Mesh Insertion i Ovine Model

This protocol describes mesh insertion into the rectovaginal septum in sheep using a single vaginal incision technique, with and without the trocar-guided ...

Ovine Lumbar Intervertebral Disc Degeneration Model Utilizing a Lateral Retroperitoneal Drill Bit Injury

Ovine Lumbar Intervertebral Disc Degeneration Model Brug en lateral retroperitoneal Drill Bit Skade

Intervertebral disc degeneration is a significant contributor to the development of back pain and the leading cause of disability worldwide. Numerous ...

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

Ultrahigh opløsning musen optisk kohærens tomografi til støtte intraokulært injektion i Retinal genterapi forskning

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