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Published on: April 14, 2016
AAV for pain: steps towards clinical translation
1Department of Medicine (Hematology/Oncology), Mount Sinai School of Medicine, New York, NY, USA. beutler.andreas@mayo.edu
Abstract:
Recombinant adeno-associated virus (rAAV) vectors consisting of self-complementary genomes and packaged in certain capsids can target primary sensory neurons efficiently and can control neuropathic pain long term by expressing opioid or non-opioid analgesic genes. This review examines the therapeutic potential of the approach in five sections: Pain control in oncology (including a discussion of cancer centers as translational pain research environment); vector biology; safety considerations and immunological lessons learned from rAAV clinical trials of other disorders; development of intrathecal rAAV therapy in rodent models of pain; and preclinical steps towards clinical translation of rAAV for pain. In the field of analgesic drug development, clinical validation of new approaches identified in rodents is currently a critical limiting step. Small-molecule therapeutics suitable as conventional drugs to probe novel targets in clinical trials are often unavailable. In this context, gene therapy could fill an important gap in the drug development process facilitating first-into-human trials of untested targeted treatments, each instantiated as a therapeutic gene.
Insights
Recombinant adeno-associated virus (rAAV) gene therapy shows promise for long-term neuropathic pain control by targeting sensory neurons. This approach could accelerate clinical translation of novel pain treatments.
Area of Science:
- Neuroscience
- Gene Therapy
- Pain Management
Background:
- Neuropathic pain presents a significant challenge in clinical practice, with limited effective long-term therapeutic options.
- Current analgesic drug development faces hurdles in clinical validation and the availability of suitable small-molecule therapeutics for novel targets.
- Recombinant adeno-associated virus (rAAV) vectors offer a potential gene therapy strategy for sustained pain relief.
Purpose of the Study:
- To review the therapeutic potential of rAAV vectors for targeting primary sensory neurons to control neuropathic pain.
- To examine the preclinical development and clinical translation of rAAV-based gene therapy for pain management.
- To discuss the role of gene therapy in addressing limitations in analgesic drug development.
Main Methods:
- Review of existing literature on rAAV vector biology, including self-complementary genomes and capsid selection.
- Analysis of safety considerations and immunological data from rAAV clinical trials in other disease areas.
- Examination of preclinical studies involving intrathecal rAAV delivery in rodent pain models.
Main Results:
- rAAV vectors can efficiently target primary sensory neurons for long-term pain control via analgesic gene expression.
- Intrathecal rAAV delivery in rodent models demonstrates potential for neuropathic pain management.
- Gene therapy using rAAV can facilitate first-into-human trials for novel pain targets.
Conclusions:
- rAAV gene therapy represents a promising avenue for developing novel, long-term treatments for neuropathic pain.
- This approach can overcome limitations in traditional analgesic drug development by enabling testing of previously inaccessible targets.
- Further preclinical development is crucial for the clinical translation of rAAV-based pain therapies.
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