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John Guy, MD; Xiaoping Qi, MD; Nicholas Muzyczka, PhD; William W. Hauswirth, PhD

Arch Ophthalmol. 1999;117:929-937.

Objective  To determine the foci and duration of protein expression following virus-mediated gene transfer to the optic nerve.

Methods  A cytomegalovirus (CMV) promoter was linked to a lacZ-SV40 polyA reporter gene or a humanized green fluorescent protein (hgfp) reporter gene, then inserted into a bacterial plasmid containing adeno-associated virus (AAV) terminal repeat sequences. The CMV-lacZ or the CMV-hgfp construct were injected into the vitreous cavity of strain-13 guinea pigs. Controls consisted of eyes injected with AAV without the promoter and reporter elements or eyes that received no injections. The eyes and optic nerves were processed for -galactosidase immunohistochemistry and hgfp fluorescence analyses. Cellular transduction at the messenger RNA (mRNA) level was evaluated by in situ reverse transcription–polymerase chain reaction.

Results  Weekly fundus photography, done for 1 month, documented the absence of any ocular abnormality due to the viral injections. No in vivo hgfp fluorescence of the retina was visualized. -Galactosidase histochemical analysis of eye cups that received the lacZ gene construct showed blue lacZ staining of the optic nerve head at 2 weeks. Light microscopy revealed the blue -galactosidase reaction product in fibers, glial cells, and blood vessels of the optic nerve head and retrobulbar nerve. Histochemistry showed absence of -galactosidase in the optic nerve at 3 to 12 months, but immunochemistry showed the persistence of -galactosidase in fibers, glial cells, and blood vessels as late as 1 year after a single ocular injection. In the retina, histochemical staining showed evidence of lacZ at 3 months, but not later. In situ reverse transcription–polymerase chain reaction revealed brown lacZ mRNA reaction product in ganglion cells of the retina. Control eyes that received AAV without the promoter and reporter elements and the eyes that received no viral injections and were processed for -galactosidase showed no reporter gene expression in any ocular tissue or cell type.

Conclusions  Viral-mediated gene transfer can be successfully accomplished in the optic nerve. Further evaluation is needed to determine whether the level of protein expression at 1 year after injection, which is clearly reduced relative to shorter postinjection time, is sufficient for therapeutic purposes.

Clinical Relevance  We have previously shown that gene therapy with catalase suppressed experimental optic neuritis at 1 month after injection. Viral-mediated gene transfer may be a powerful technique for the treatment of optic neuropathies, particularly for recurrences of optic neuritis, if long-term expression of transduced protein can be demonstrated in the optic nerve.

From the Departments of Ophthalmology (Drs Guy, Qi, and Hauswirth), Neurology (Dr Guy), and Molecular Genetics and Microbiology (Drs Muzyczka and Hauswirth), and Gene Therapy Center (Drs Muzyczka and Hauswirth), University of Florida, College of Medicine, Gainesville.

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