One SQ HEDGES DNA vector only dose produces durable hGLA or anti-SARS-CoV-2 mAb therapeutic serum protein levels

Abstract

It is estimated that ~2 billion people worldwide cannot afford even basic medicines. B ioreactor-produced r ecombinant p rotein t herapies (BRPTs), among the world’s most-expensive medicines, have revolutionized treatment of a wide-spectrum of human-diseases, particularly the ~ 7,000 incurable, rare human single-protein, monogenic-deficiency diseases. Currently, BRPT are limited by toxicity, immunogenicity, short protein T 1 / 2 s and high-cost, creating a worldwide access-gap between those who can afford BRPTs versus those who cannot. Fabry disease (FD) is a monogenic deficiency disease caused by pathogenic-variants of the galactosidase-a (GLA) gene. FD damages heart, kidneys, CNS, gastrointestinal tract, and eyes. State-of-the-art anti-FD therapy, hGLA enzyme-replacement-therapy (ERT), requires bi-weekly IV infusions lifelong, costing ~ $200,000 per-patient per-year. High-lifetime costs can cause significant numbers of FD patients to permanently discontinue hGLA-ERT, thereby accelerating FD progression, which can lead to premature-death. Subcutaneously administered plasmid DNA alone has not been previously reported to transfect subcutaneous fat. Here we show one S ubcutaneous A dministration of H EDGES D NA vectors A lone ( SAHDA ) encoding the wildtype hGLA protein safely produces durable hGLA serum protein levels in the 1–10 ng/mL normal human hGLA range in immunocompetent mice. Unexpectedly, one administration of a highly-optimized SAHDA version encoding hGLA produced durable, ~ 100-fold higher hGLA serum protein levels than the 10 ng/mL high-normal human level. Importantly, components of the SADHA platform can be simply-modified to control the level and duration of hGLA serum protein-levels produced over a broad temporal-range in mice. Furthermore, one SAHDA-based administration of a HEDGES DNA-vector encoding a highly-neutralizing anti-SARS-CoV-2 monoclonal antibody (mAb) safely produces long-term protective serum mAb levels in immunocompetent-mice. SAHDA offers multiple advantages over BRPT, including not requiring an intact cold-chain and being readily freeze-dried. This combination enables SAHDA’s rapid deployment, then prolonged storage at ambient temperatures, even in equatorial-areas worldwide. SAHDA can readily be self-administered worldwide. It also obviates severe intravenous-infusion reactions. Taken-together, SAHDA may more effectively-, safely-, durably-, and cost-effectively-treat a spectrum of now poorly-treatable diseases worldwide.