Compositions and methods for treating alzheimer's disease in primates
Patent Information
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- NEUEXCELL THERAPEUTICS (SUZHOU) CO LTD
- Filing Date
- 2025-11-26
- Publication Date
- 2026-06-04
Smart Images

Figure PCTCN2025137806-FTAPPB-I100001 
Figure PCTCN2025137806-FTAPPB-I100002 
Figure PCTCN2025137806-FTAPPB-I100003
Abstract
Description
COMPOSITIONS AND METHODS FOR TREATING ALZHEIMER’S DISEASE IN PRIMATES1. CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of priority to International Patent Application No. PCT / CN2024 / 135726 filed on November 29, 2024, the content of which is incorporated by reference herein in its entirety. 2. SEQUENCE LISTING
[0002] This application contains an electronic Sequence Listing which has been submitted in XML file format with this application, the entire content of which is incorporated by reference herein in its entirety. The Sequence Listing XML file submitted with this application is entitled “14770-073-228_SEQLISTING. xml” , was created on November 21, 2025, and is 134, 844 bytes in size.3. FIELD OF THE INVENTION
[0003] The present disclosure provides and includes compositions for and methods of treating Alzheimer’s disease in a primate using an adeno-associated viral (AAV) vector comprising a nucleic acid molecule encoding Neuronal Differentiation 1 (NeuroD1) .4. BACKGROUND OF THE INVENTION
[0004] Alzheimer's disease (AD) is the most common form of dementia, responsible for 60-80%of all cases, and is a leading cause of disability and death in the elderly. See International., A.s.D. (2023) , 2023-World-Alzheimer-Report-2023; Association, A.s. (2023) , Alzheimer's &Dementia 19, 1598-1695. The disease typically manifests as progressive memory loss, but as it advances, cognitive functions such as learning, thinking, behavior, orientation, and judgment are significantly impaired. Pathologically, AD is characterized by amyloid-β (Aβ) plaque deposition and neurofibrillary tangles resulting from abnormal tau protein phosphorylation. Aβ aggregation is considered an early and central event in the onset of AD, often occurring decades before clinical symptoms emerge. See Knopman, D.S., et al. (2021) Nature Reviews Disease Primers 7. While current therapies for AD may alleviate symptoms, they do not halt disease progression. Recent advancements include FDA-approved drugs that target Aβ proteins, offering some hope in slowing cognitive decline, especially in early-stage patients. See Yeo-Teh, N.S.L. &Tang, B.L. (2023) Sci Eng Ethics 29, 2; van Dyck, C.H., et al. (2023) New England Journal of Medicine 388, 9-21 ; Sims, J.R., et al. (2023) JAMA 330 . However, these therapies present limited clinical benefits, significant safety concerns, and do not address the extensive neuronal loss seen in advanced cases. See Buccellato, F.R., et al. (2023) International Journal of Molecular Sciences 24. AD continues to pose a critical unmet medical need, particularly as the prevalence is projected to rise from 55 million cases globally today to 152 million by 2050. See International., A.s.D. (2023) , 2023-World-Alzheimer-Report-2023; Association, A.s. (2023) , Alzheimer's &Dementia 19, 1598-1695.
[0005] Hallmark of Alzheimer's disease is the progressive degeneration of neurons, particularly in areas of the brain responsible for memory and cognition such as the hippocampus, entorhinal cortex, and later, the cerebral cortex. See Selkoe, D. J. (2001) Physiological Reviews, 81 (2) , 741-766; De Strooper, B., &Karran, E. (2016) Cell, 164 (4) , 603-615. Neuronal death in these regions leads to profound synaptic dysfunction and neural network disruption. This neural degradation is exacerbated by the accumulation of amyloid plaques and tau tangles, which interfere with intracellular and extracellular signaling pathways. See Spires-Jones, T.L., &Hyman, B.T. (2014) Neuron, 82 (4) , 756-771. Over time, the loss of neurons results in cortical atrophy, brain shrinkage, and cognitive decline, contributing to the characteristic symptoms of AD. In early stages, synaptic dysfunction occurs before significant neuronal loss, suggesting that synapse preservation might offer a therapeutic window. However, as the disease advances, widespread neuronal death becomes the primary driver of the cognitive and behavioral symptoms seen in moderate to severe AD. See Boxer, A.L. &Sperling, R. (2023) , Cell 186, 4757-4772. Restoring lost neurons and reestablishing functional neural networks is a key challenge in developing treatments for late-stage AD, and current interventions remain unable to repair or reverse this neurodegeneration.
[0006] The multifactorial nature of AD, involving oxidative stress, inflammation, and mitochondrial dysfunction in addition to protein misfolding, further complicates treatment. Therefore, therapies aimed at directly addressing neurodegeneration and restoring neuronal function are crucial in combating the progression of AD, especially in its later stages See van Dyck, C.H., et al. (2023) , New England Journal of Medicine 388, 9-21; Buccellato, F.R., et al. (2023) , International Journal of Molecular Sciences 24.5. SUMMARY OF THE INVENTION
[0007] In one aspect, this disclosure provides and includes a method of treating or preventing Alzheimer’s disease in a primate. In some embodiments the method comprising administering to the primate a pharmaceutical composition comprising a recombinant adeno-associated viral (AAV) comprising a recombinant genome encoding a Neurogenic Differentiation 1 (NeuroD1) polypeptide, where the pharmaceutical composition is administered by injecting the brain of the primate. In some embodiments, the primate has suffered from Alzheimer’s disease. In some embodiments, the primate is at risk of developing Alzheimer’s disease.
[0008] In one aspect, this disclosure provides and includes a method of generating new neurons in the brain of a primate that is suffering from Alzheimer’s disease or is at risk of developing Alzheimer’s disease. In some embodiments, the method comprising administering to the primate a pharmaceutical composition comprising a recombinant adeno-associated viral (AAV) comprising a recombinant genome encoding a NeuroD1 polypeptide, where the new neurons are generated after the primate is administered the pharmaceutical composition. In some embodiments, the primate has suffered from Alzheimer’s disease. In some embodiments, the primate is at risk of developing Alzheimer’s disease.
[0009] In one aspect, this disclosure provides and includes a method of partially or fully restoring neuronal pathways in the brain of a primate that is suffering from Alzheimer’s disease or is at risk of developing Alzheimer’s disease. In some embodiments, the method comprising administering to the primate a pharmaceutical composition comprising a recombinant adeno-associated viral (AAV) comprising a recombinant genome encoding a NeuroD1 polypeptide, where the restoring occurs after the primate is administered the pharmaceutical composition. In some embodiments, the primate has suffered from Alzheimer’s disease. In some embodiments, the primate is at risk of developing Alzheimer’s disease.
[0010] In some embodiments, the NeuroD1 polypeptide encoded by the recombinant genome of the recombinant AAV comprises an amino acid sequence having at least 90%sequence identity to the sequence set forth in SEQ ID NO: 3. In some embodiments, the NeuroD1 polypeptide comprises the amino acid sequence set forth in SEQ ID NO: 3. In some embodiments, the recombinant genome of the recombinant AAV comprises a transgene comprising a coding sequence for the NeuroD1 polypeptide, and wherein the coding sequence comprises the nucleic acid sequence set forth in SEQ ID NO: 4 or a codon-optimized version thereof.
[0011] In some embodiments, the recombinant genome in the recombinant AAV further comprises one or more transcription regulatory elements operably linked to the coding sequence of the transgene. In some embodiments, wherein the one or more transcription regulatory elements comprise a chimeric intron. In some embodiments, the chimeric intron comprises the sequence of SEQ ID NO: 9. In some embodiments, the one or more transcription regulatory elements further comprise a GFAP promoter comprising the sequence of SEQ ID NO: 7. In some embodiments, the one or more transcription regulatory elements further comprise a CMV enhancer comprising the sequence of SEQ ID NO: 5. In some embodiments, the one or more transcription regulatory elements further comprise an optimized WPRE comprising the sequence of SEQ ID NO: 11. In some embodiments, the one or more transcription regulatory elements further comprise a polyadenylation (poly-A) signal comprising the sequence of SEQ ID NO: 13.
[0012] In some embodiments, the recombinant genome of the recombinant AAV further comprises a first inverted terminal repeat (ITR) of a first AAV genome. In some embodiments, the first ITR comprises the sequence set forth in SEQ ID NO: 23. In some embodiments, the recombinant genome further comprising a second ITR of a second AAV genome. In some embodiments, the second ITR comprises the sequence set forth in SEQ ID NO: 24.
[0013] In some embodiments, the recombinant genome of the recombinant AAV comprises the nucleic acid sequence set forth in SEQ ID NO: 25, or a nucleic acid sequence having at least 80%sequence identity thereto. In some embodiments, the recombinant genome of the recombinant AAV consists essentially of the nucleic acid sequence set forth in SEQ ID NO: 25.
[0014] In some embodiments, the recombinant AAV comprises an AAV serotype 6 (AAV9) capsid. In some embodiments, the AAV9 capsid comprises capsid proteins selected from the group of AAV9 VP1 polypeptides, AAV9 VP2 polypeptides and AAV9 VP3 polypeptides. In some embodiments, the AAV9 capsid comprises AAV9 VP1 comprising the amino acid sequence set forth in SEQ ID NO: 36. In some embodiments, the AAV9 capsid further comprises AAV9 VP2 comprising the amino acid sequence set forth in SEQ ID NO: 37. In some embodiments, the AAV9 capsid further comprises AAV9 VP3 comprising the amino acid sequence set forth in SEQ ID NO: 38.
[0015] In some embodiments, the pharmaceutical composition comprises about 1×1011 to about 1×1013 viral genomes (vg) of the recombinant AAV, wherein the pharmaceutical composition is administered by injecting to the brain of the primate.
[0016] In some embodiments, a vector genome concentration of the recombinant AAV in the pharmaceutical composition is in the range of about 5×1011 to about 2×1012 viral genomes per mL (vg / mL) ; optionally, wherein the vector genome concentration is about 5 ×1011 vg / mL, about 1 × 1012 vg / mL, or about 2 × 1012 vg / mL.
[0017] In some embodiments of the method for treating or preventing Alzheimer’s disease described herein, the pharmaceutical composition is administered to the subject intracerebrally. In some embodiments of the method for treating or preventing Alzheimer’s disease described herein, the pharmaceutical composition is administered to the hippocampus of the brain. In some embodiments of the method for treating or preventing Alzheimer’s disease described herein, and wherein the pharmaceutical composition is administered to the frontal cortex of the brain.
[0018] In some embodiments of the method for treating or preventing Alzheimer’s disease described herein, the subject is administered intracerebrally the pharmaceutical composition comprising about 1.5×1011 vg of the recombinant AAV once. In some embodiments, the subject is administered about 0.3 mL of the pharmaceutical composition comprising about 5×1011 vg / mL of the recombinant AAV intracerebrally. In some embodiments, the pharmaceutical composition is administered stereo-tactically. In some embodiments, the pharmaceutical composition is administered to unilateral hippocampus. In some embodiments, injection sites are in the hippocampal head region, the hippocampal body region, and the hippocampus cauda region. In some embodiments, the administration comprises a total of six injection sites, wherein two injection sites are located in each of the hippocampal head region, the hippocampus body region, and the hippocampus cauda region. In some embodiments, the pharmaceutical composition is administered to multiple injection sites, where the injection volume is about 50μl per injection site.
[0019] In some embodiments of the method for treating or preventing Alzheimer’s disease described herein, the subject is administered intracerebrally the pharmaceutical composition comprising about 3×1011 vg of the recombinant AAV once. In some embodiments, for each administration the subject is administered about 0.3 mL of the pharmaceutical composition comprising about 1×1012 vg / mL of the recombinant AAV intracerebrally. In some embodiments, the pharmaceutical composition is administered stereo-tactically. In some embodiments, the pharmaceutical composition is administered to unilateral hippocampus. In some embodiments, injection sites are in the hippocampal head region, the hippocampal body region, and the hippocampus cauda region. In some embodiments, the administration comprises a total of six injection sites, wherein two injection sites are located in each of the hippocampal head region, the hippocampus body region, and the hippocampus cauda region. In some embodiments, the pharmaceutical composition is administered to multiple injection sites, where the injection volume is about 50μl per injection site.
[0020] In some embodiments of the method for treating or preventing Alzheimer’s disease described herein, the subject is administered intracerebrally the pharmaceutical composition comprising about 6×1011 vg of the recombinant AAV once. In some embodiments, for each administration the subject is administered about 0.3 mL of the pharmaceutical composition comprising about 2×1012 vg / mL of the recombinant AAV intracerebrally. In some embodiments, the pharmaceutical composition is administered stereo-tactically. In some embodiments, injection sites are in the hippocampal head region, the hippocampal body region, and the hippocampus cauda region. In some embodiments, the administration comprises a total of six injection sites, wherein two injection sites are located in each of the hippocampal head region, the hippocampus body region, and the hippocampus cauda region. In some embodiments, the pharmaceutical composition is administered to multiple injection sites, where the injection volume is about 50μl per injection site.
[0021] In some embodiments of the method for treating or preventing Alzheimer’s disease described herein, the subject is administered intracerebrally the pharmaceutical composition comprising about 1.2×1012 vg of the recombinant AAV once. In some embodiments, for each administration the subject is administered about 0.6 mL of the pharmaceutical composition comprising about 2×1012 vg / mL of the recombinant AAV intracerebrally. In some embodiments, the pharmaceutical composition is administered stereo-tactically. In some embodiments, the pharmaceutical composition is administered to bilateral hippocampus. In some embodiments, injection sites are in the hippocampal head regions, the hippocampal body regions, and the hippocampus cauda regions of the left hippocampus and the right hippocampus. In some embodiments, the administration comprises a total of twelve injection sites, wherein two injection sites are located in each of the hippocampal head regions, the hippocampus body regions, and the hippocampus cauda regions. In some embodiments, the pharmaceutical composition is administered to multiple injection sites, where the injection volume is about 50μl per injection site.
[0022] In some embodiments of the method for treating Alzheimer’s disease described herein, the subject is a human.
[0023] The method of any one of embodiments 1–25, wherein an injection site is determined prior to the administering via a magnetic resonance imaging (MRI) scan. In some embodiments, coordinates of a pre-determined injection site are used for injecting the brain of the primate. In some embodiments, a surgical navigation system is used to target an injection site on the brain of the primate.
[0024] In some embodiments, the injection rate is no more than about 10μL / min.
[0025] In some embodiments, glial cells are converted to neurons in the brain of the primate after the primate is administered the pharmaceutical composition. In some embodiments, new neurons are generated in the brain of the primate after the primate is administered the pharmaceutical composition. In some embodiments, neuronal pathways are partially or fully restored in the brain of the primate after the primate is administered the pharmaceutical composition.
[0026] In some embodiments, the primate shows changes in biomarkers from baseline after the primate is administered the pharmaceutical composition; optionally wherein the biomarkers are selected from p-Tau181, p-Tau217, t-tau, NFL, GFAP, Aβ42 / Aβ40 and one or more neuroinflammatory factors; optionally wherein the one or more neuroinflammatory factors are selected from IL-4, IL-12 , IFN-γ, TNF-α, HIF-1α, YKL-40. In some embodiments, the biomarkers are measured from a cerebrospinal fluid sample or plasma sample take from the primate.
[0027] In some embodiments, the primate shows improvement of Clinical Dementia Rating Scale (CDR-SB) scores after the primate is administered the pharmaceutical composition. In some embodiments, the primate shows improvement of MMSE scores after the primate is administered the pharmaceutical composition.
[0028] In some embodiments, the primate has suffered from Alzheimer’s disease. In some embodiments, the primate has suffered from moderate to severe from Alzheimer’s disease. In some embodiments, the primate is at risk of developing Alzheimer’s disease.6. BRIEF DESCRIPTION OF THE DRAWINGS
[0029] The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing (s) will be provided by the Office upon request and payment of the necessary fee.
[0030] FIG. 1 shows astrocyte to neuron conversion in 5XFAD mice hippocampus 14 days post NXL-001 injection. At 14 dpi, immunofluorescence staining of GFP (green) , astrocyte marker GFAP (red) , and neuron marker NeuN (purple) of hippocampus area shows that in control group, GFP+ cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, panels A and C) , while in the NXL-001-treated group, significant converted neurons (GFP+ / GFAP- / NeuN+ panels B and D) were observed.
[0031] FIG. 2 shows astrocyte to neuron conversion in 5XFAD mice frontal cortex 14 days post NXL-001 injection. At 14 dpi, immunofluorescence staining of GFP (green) , astrocyte marker GFAP (red) , and neuron marker NeuN (purple) of shows that in control group, GFP+ cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, panel A) , while in the NXL-001-treated group, significant converted neurons (GFP+ / GFAP- / NeuN+ , panel B) were observed.
[0032] FIG. 3 shows astrocyte to neuron conversion in 5XFAD mice hippocampus 30 days post NXL-001 injection. At 30 dpi, immunofluorescence staining of GFP (green) , astrocyte marker GFAP (red) , and neuron marker NeuN (purple) of hippocampus area shows that in control group, GFP+ cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, panels A and C) , while in the NXL-001-treated group, significant converted neurons (GFP+ / GFAP- / NeuN+ , panels B and D) was observed.
[0033] FIG. 4 shows astrocyte to neuron conversion in 5XFAD mice frontal cortex 30 days post NXL-001 injection. At 30 dpi, immunofluorescence staining of GFP (green) , astrocyte marker GFAP (red) , and neuron marker NeuN (purple) of prefrontal cortex area shows that in control group, GFP+cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, panel A) , while in the NXL-001-treated group, significant converted neurons (GFP+ / GFAP- / NeuN+ , panel B) were observed.
[0034] FIG. 5 shows the sequence alignment of NeuroD1 proteins from various species, including mouse (SEQ ID NO: 46) , zebrafish (SEQ ID NO: 47) , human (SEQ ID NO: 2) , rat (SEQ ID NO: 48) , chicken (SEQ ID NO: 49) , cattle (SEQ ID NO: 50) , hamster (SEQ ID NO: 51) , pig (SEQ ID NO: 52) , frog (SEQ ID NO: 53) , dog (SEQ ID NO: 54) , chimpanzee (SEQ ID NO: 55) and sheep (SEQ ID NO: 56) .
[0035] FIG. 6 provides sequences of elements constituting the genomic sequence of a recombinant AAV vector encoding NeuroD1 (from left ITR to right ITR) .7. DETAILED DESCRIPTION
[0036] The present invention provides novel methods and compositions for treating or preventing Alzheimer's disease. Specifically, the invention relates to the surprising discovery of an efficient strategy for delivering and expressing a NeuroD1-encoding transgene in subjects has suffered from or at risk of developing Alzheimer's disease. The therapeutic approach involves converting glial cells to functional neurons in the primate brain through the expression of NeuroD1, thereby providing a novel mechanism for neural regeneration in the context of Alzheimer's disease.
[0037] Accordingly, in one aspect of the present disclosure, provided herein are regulatory elements (e.g., regulatory elements disclosed in Section 7.3.2 (Untranslated Regions) of the present disclosure) that confer a high level of expression of an encoding nucleic acid in glial cells. In a related aspect of the present disclosure, provided herein are also expression cassettes, (e.g., expression cassettes disclosed in Section 7.3 (NeuroD1 Expression Cassette) of the present disclosure) , artificial genome for recombinant AAV (e.g., AAV genomes disclosed in Section 7.4 (AAV genome) of the present disclosure) recombinant AAV (e.g., recombinant AAV disclosed in Section 7.5 (Recombinant AAV vectors) of the present disclosure) , plasmids and host cells (e.g., plasmids and host cells disclosed in Section 7.6 (Methods and Compositions for Making Recombinant AAV) of the present disclosure) . The present disclosure further provides pharmaceutical compositions and kits (e.g., pharmaceutical compositions and kits disclosed in Section 7.7 (Pharmaceutical Composition and Kit) of the present disclosure) comprising the presently disclosed recombinant AAV. Methods of using the presently disclosed recombinant AAV described herein (e.g., methods of Treatment disclosed in Section 7.8 (Method of Treatment) of the present disclosure) are also provided by the present disclosure. 7.1. General Techniques
[0038] Techniques and procedures described or referenced herein include those that are generally well understood and / or commonly employed using conventional methodology by those skilled in the art, such as, for example, the widely utilized methodologies described in Sambrook et al., Molecular Cloning: A Laboratory Manual (3d ed. 2001) ; Current Protocols in Molecular Biology (Ausubel et al. eds., 2003) . 7.2. Terminology
[0039] Unless described otherwise, all technical and scientific terms used herein have the same meaning as is commonly understood by one of ordinary skill in the art. For purposes of interpreting this specification, the following description of terms will apply and whenever appropriate, terms used in the singular will also include the plural and vice versa. All patents, applications, published applications, and other publications are incorporated by reference in their entirety. In the event that any description of terms set forth conflicts with any document incorporated herein by reference, the description of term set forth below shall control.
[0040] The term “AAV” or “adeno-associated virus” refers to a Dependoparvovirus within the Parvoviridae genus of viruses. The AAV can be an AAV derived from a naturally occurring “wild-type” virus, or a recombinant AAV (rAAV) that is derived from a naturally occurring AAV, but having all or part of the AAV genome replaced with heterologous nucleotide sequences (e.g., expression cassettes disclosed in Section 7.3 (NeuroD1 Expression Cassette) of the present disclosure comprising a coding sequence and regulatory elements) . In certain embodiments, the rAAV comprises an AAV genome (e.g., an artificial genome) in which part or all of the Rep (Replication) and / or Cap (Capsid) genes have been replaced with heterologous nucleotide sequences, such as a transgene. In the absence of Rep proteins, the heterologous nucleotide sequences encoded within the rAAV can persist as episomes in the nucleus of transduced cells and does not integrate into host genomes. In certain embodiments, the rAAV further comprises a capsid comprising capsid proteins encoded by a naturally occurring or non-naturally occurring Cap gene. In certain embodiments, the non-naturally occurring Cap gene encodes a capsid protein comprising an insertion, deletion, or modification of the amino acid sequence of the naturally occurring capsid protein. For example, a rAAV can have an artificial genome packaged in a capsid having a viral protein 1 (VP1) , viral protein 2 (VP2) , or viral protein 3 (VP3) , where the VP1 sequences is different from the wild-type sequence, while VP2 and VP3 both have wild-type sequences. As used herein, a rAAV that carries a heterologous transgene of interest in the genome is sometimes referred to as a “AAV vector. ”
[0041] The term “rep-cap packaging plasmid” refers to a plasmid that provides the viral rep and cap gene function and aids the production of AAVs from artificial genomes lacking functional rep and / or cap gene sequences.
[0042] The term “cap gene” refers to the nucleic acid sequences that encode capsid proteins that form or help form the capsid of the virus. In some embodiments, in a recombinant AAV virion, the capsid protein contains VP1, VP2, and / or VP3.
[0043] The term “rep gene” refers to the nucleic acid sequences that encode the non-structural proteins needed for replication and production of virus.
[0044] The term “polynucleotide” or “nucleic acid, ” as used interchangeably herein, refers to polymers of nucleotides of any length and includes, e.g., DNA and RNA. The nucleotides can be deoxyribonucleotides, ribonucleotides, modified nucleotides or bases, and / or their analogs, or any substrate that can be incorporated into a polymer by DNA or RNA polymerase or by a synthetic reaction. A polynucleotide may comprise modified nucleotides, such as methylated nucleotides and their analogs. Nucleic acid can be in either single-or double-stranded forms. As used herein and unless otherwise specified, “nucleic acid” also includes nucleic acid mimics such as locked nucleic acids (LNAs) , peptide nucleic acids (PNAs) , and morpholinos. “Oligonucleotide, ” as used herein, refers to short synthetic polynucleotides that are generally, but not necessarily, fewer than about 200 nucleotides in length. The terms “oligonucleotide” and “polynucleotide” are not mutually exclusive. The description above for polynucleotides is equally and fully applicable to oligonucleotides. Unless specified otherwise, the left-hand end of any single-stranded polynucleotide sequence disclosed herein is the 5’ end; the left-hand direction of double-stranded polynucleotide sequences is referred to as the 5’direction. The direction of 5’ to 3’ addition of nascent RNA transcripts is referred to as the transcription direction; sequence regions on the DNA strand having the same sequence as the RNA transcript that are 5’ to the 5’ end of the RNA transcript are referred to as “upstream sequences” ; sequence regions on the DNA strand having the same sequence as the RNA transcript that are 3’ to the 3’ end of the RNA transcript are referred to as “downstream sequences. ”
[0045] As used herein, the term “wild-type” refers to organisms, cells, genes, proteins, oligonucleotides, and the like that are found in Nature and are unchanged relative to these components found in Nature (native or in the wild) .
[0046] As used herein, the term “non-naturally occurring” when used in reference to a nucleic acid molecule as described herein is intended to mean that the nucleic acid molecule is not found in nature. A non-naturally occurring nucleic acid encoding a protein (e.g., NeuroD1) contains at least one genetic alternation or chemical modification not normally found in a naturally occurring nucleic acid, including a wild-type nucleic acid. Genetic alterations include, for example, modifications to an expressible nucleic acid sequences encoding heterologous peptides or polypeptides, other nucleic acid additions, nucleic acid deletions, nucleic acid substitution, and / or other functional disruption of a coding sequence. Such modifications include, for example, modifications in the coding regions and functional fragments thereof, for heterologous, homologous or both heterologous and homologous polypeptides. Additional modifications include, for example, modifications in non-coding regulatory regions in which the modifications alter expression of a gene or operon. Additional modifications also include, for example, incorporation of a nucleic acid sequence into a vector, such as a plasmid or an artificial chromosome. Chemical modifications include, for example, one or more functional nucleotide analog as described herein.
[0047] An “isolated nucleic acid” is a nucleic acid, for example, an RNA, DNA, or a mixed nucleic acids, which is substantially separated from other genome DNA sequences as well as proteins or complexes such as ribosomes and polymerases, which naturally accompany a native sequence. An “isolated” nucleic acid molecule is one which is separated from other nucleic acid molecules which are present in the natural source of the nucleic acid molecule. Moreover, an “isolated” nucleic acid molecule, such as a plasmid, can be substantially free of other cellular material, or culture medium when produced by recombinant techniques, or substantially free of chemical precursors or other chemicals when chemically synthesized. In a specific embodiment, one or more nucleic acid molecules encoding a polypeptide as described herein are isolated or purified. The term embraces nucleic acid sequences that have been removed from their naturally occurring environment, and includes recombinant or cloned DNA or RNA isolates and chemically synthesized analogues or analogues biologically synthesized by heterologous systems. A substantially pure molecule may include isolated forms of the molecule.
[0048] The term “encoding nucleic acid, ” “nucleic acid encoding” or other grammatical equivalents thereof as it is used in reference to nucleic acid molecule encompasses (a) a nucleic acid molecule in its native state or when manipulated by methods well known to those skilled in the art that can be transcribed to produce mRNA which is then translated into a peptide and / or polypeptide, and (b) the mRNA molecule itself. The antisense strand is the complement of such a nucleic acid molecule, and the encoding sequence can be deduced therefrom. The term “coding region” or “coding sequence” refers to a portion in an encoding nucleic acid sequence that is translated into a peptide or polypeptide. The term “intron” refers to the portion of an encoding nucleic acid that is not transcribed into an mRNA. The term “untranslated region” or “UTR” refers to the portion of an encoding nucleic acid that is not translated into a peptide or polypeptide. Depending on the orientation of a UTR with respect to the coding region of a nucleic acid molecule, a UTR is referred to as the 5’-UTR if located to the 5’-end of a coding region, and a UTR is referred to as the 3’-UTR if located to the 3’-end of a coding region. In some embodiments, an encoding nucleic acid described herein is a transgene encoding a NeuroD1 polypeptide. In some embodiments, the transgene encoding a NeuroD1 polypeptide is a DNA molecule.
[0049] An encoding nucleic acid can be mono-cistronic or multi-cistronic. A “mono-cistronic sequence” refers to a polynucleotide that comprises coding sequence for a single peptide or polypeptide chain. A “multi-cistronic sequence” refers to a polynucleotide that comprises coding sequences for two or more peptide and / or polypeptide chains.
[0050] The term “mRNA” as used herein refers to a message RNA molecule comprising one or more open reading frame (ORF) that can be translated by a cell or an organism provided with the mRNA to produce one or more peptide or protein product. The region containing the one or more ORFs is referred to as the coding region of the mRNA molecule. In certain embodiments, the mRNA molecule further comprises one or more untranslated regions (UTRs) . In certain embodiments, the mRNA is or is part of a linear RNA molecule. In other embodiments, the mRNA is or is part of a circular RNA molecule.
[0051] In certain embodiments, the mRNA is a monocistronic mRNA that comprises only one ORF. In certain embodiments, the monocistronic mRNA encodes a peptide or protein comprising at least one epitope of a selected polypeptide (e.g., transcription factor) . In other embodiments, the mRNA is a multicistronic mRNA that comprises two or more ORFs. In certain embodiments, the multiecistronic mRNA encodes two or more peptides or proteins that can be the same or different from each other.
[0052] As used herein, the term “ribosomal skipping element” refers to a nucleotide sequence capable of causing generation of two polypeptide chains from translation of one RNA molecule. In some embodiments, the ribosomal skipping element can terminate translation of the first polypeptide chain and re-initiating translation of the second polypeptide chain from the RNA molecule. In alternative embodiments, the ribosomal skipping element encodes a protease cleavage site in the polypeptide encoded by the RNA molecule, so that the polypeptide can be cleaved by an intrinsic protease activity of its own, or by another protease in its environment to produce two polypeptide chains. In specific embodiments, the ribosomal skipping element encodes thosea-asigna virus 2A peptide (T2A) , porcine teschovirus-1 2 A peptide (P2A) , foot-and-mouth disease virus 2 A peptide (F2A) , equine rhinitis A vims 2A peptide (E2A) , cytoplasmic polyhedrosis vims 2A peptide (BmCPV 2A) , or flacherie vims of B. mori 2A peptide (BmIFV 2A) .
[0053] The term “nucleobases” encompasses purines and pyrimidines, including natural compounds adenine, thymine, guanine, cytosine, uracil, inosine, and natural or synthetic analogs or derivatives thereof.
[0054] The term “functional nucleotide analog” as used herein refers to a modified version of a canonical nucleotide A, G, C, U or T that (a) retains the base-pairing properties of the corresponding canonical nucleotide, and (b) contains at least one chemical modification to (i) the nucleobase, (ii) the sugar group, (iii) the phosphate group, or (iv) any combinations of (i) to (iii) , of the corresponding natural nucleotide. As used herein, “base pairing” encompasses not only the canonical Watson-Crick adenine-thymine, adenine-uracil, or guanine-cytosine base pairs, but also base pairs formed between canonical nucleotides and functional nucleotide analogs or between a pair of functional nucleotide analogs, wherein the arrangement of hydrogen bond donors and hydrogen bond acceptors permits hydrogen bonding between a modified nucleobase and a canonical nucleobase or between two complementary modified nucleobase structures. For example, a functional analog of guanosine (G) retains the ability to base-pair with cytosine (C) or a functional analog of cytosine. One example of such non-canonical base pairing is the base pairing between the modified nucleotide inosine and adenine, cytosine, or uracil. As described herein, a functional nucleotide analog can be either naturally occurring or non-naturally occurring. Accordingly, a nucleic acid molecule containing a functional nucleotide analog can have at least one modified nucleobase, sugar group and / or internucleoside linkage. Exemplary chemical modifications to the nucleobases, sugar groups, or internucleoside linkages of a nucleic acid molecule are provided herein.
[0055] The terms “complement” or “complementary” can be determined by the Watson-Crick base pairing between nucleotides and specifically refers to nucleotides hydrogen bonded to one another with thymine or uracil residues linked to adenine residues by two hydrogen bonds and cytosine and guanine residues linked by three hydrogen bonds. In general, a nucleic acid includes a nucleotide sequence described as having a “percent complementarity” to a specified second nucleotide sequence. For example, a nucleotide sequence may have 80%, 90%, or 100%complementarity to a specified second nucleotide sequence, indicating that 8 of 10, 9 of 10 or 10 of 10 nucleotides of a sequence are complementary to the specified second nucleotide sequence. For instance, the nucleotide sequence 3’-TCGA-5’ is 100%complementary to the nucleotide sequence 5’-AGCT-3’. Further, the nucleotide sequence 3’-TCGA-is 100%complementary to a region of the nucleotide sequence 5’-TTAGCTGG-3’.
[0056] The term “reverse complementary” means two nucleic acid sequences complement to each other when read in opposite directions. A pair of reverse complementary sequences can be in separated nucleic acid molecules or in different regions of a single nucleic acid molecule. In the latter case, the nucleic acid molecule is considered “self-complementary. ” As used herein a “self-complementary” nucleic acid molecule can have at least two regions that are complementary or substantially complementary to each other when read in opposite directions. Under a suitable condition, a pair of reverse-complementary regions are capable of base-pairing with each other to form a double-stranded duplex, and the sequence between the reverse-complementary regions is bend into an unpaired loop. The resulting structure is referred to as a “stem-loop, ” a “hairpin, ” or a “hairpin loop, ” which is a secondary structure found in many self-complementary molecules.
[0057] The terms “duplexed, ” “double-stranded, ” or “hybridized” as used herein refer to multiple nucleic acid molecules or a region of a single nucleic acid molecule (e.g., the stem region in a stem-loop structure) that is formed by hybridization of two single strands of nucleic acids containing complementary sequences. As described herein, a pair of complementary sequences can be fully complementary or partially complementary.
[0058] The terms “hybridization” and “hybridizes” refer to pairing and binding of complementary nucleic acids. Hybridization occurs to varying extents between two nucleic acids depending on factors such as the degree of complementarity of the nucleic acids, the melting temperature, Tm, of the nucleic acids and the stringency of hybridization conditions, as is well known in the art. The term “stringency of hybridization conditions” refers to conditions of temperature, ionic strength, and composition of a hybridization medium with respect to particular common additives such as formamide and Denhardt's solution. Determination of particular hybridization conditions relating to a specified nucleic acid is routine and is well known in the art, for instance, as described in J. Sambrook and D.W. Russell, Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory Press; 3rd Ed., 2001; and F.M. Ausubel, Ed., Short Protocols in Molecular Biology, Current Protocols; 5th Ed., 2002. High stringency hybridization conditions are those which only allow hybridization of substantially complementary nucleic acids. Typically, nucleic acids having about 85-100%complementarity are considered highly complementary and hybridize under high stringency conditions. Intermediate stringency conditions are exemplified by conditions under which nucleic acids having intermediate complementarity, about 50-84%complementarity, as well as those having a high degree of complementarity, hybridize. In contrast, low stringency hybridization conditions are those in which nucleic acids having a low degree of complementarity hybridize.
[0059] The term “operably linked” as used herein refers to a nucleic acid sequence in functional relationship with a second nucleic acid sequence. The term “operably linked” encompasses functional connection of two or more nucleic acid sequences, such as a nucleic acid to be transcribed and a regulatory element. The term “regulatory element” as used herein refers to a nucleotide sequence which controls some aspect of the expression of an operably linked nucleic acid coding sequence. Exemplary regulatory elements include an enhancer, such as, but not limited to: woodchuck hepatitis virus posttranscriptional regulatory element (WPRE) ; an internal ribosome entry site (IRES) or a 2A domain; an intron (e.g., a group I intron) ; an origin of replication; a polyadenylation signal (pA) ; a promoter; a transcription termination sequence; and an upstream regulatory domain, which contribute to the replication, transcription, posttranscriptional processing of an operably linked nucleic acid sequence. Those of ordinary skill in the art are capable of selecting and using these and other regulatory elements in an expression vector with no more than routine experimentation.
[0060] The terms “translational enhancer element, ” “TEE” and “translational enhancers” as used herein refers to a region in a nucleic acid molecule that functions to promotes translation of a operably linked coding sequence of the nucleic acid into a protein or peptide product, such as via cap-dependent or cap-independent translation. A TEE typically locates in the UTR region of a nucleic acid molecule (e.g., mRNA) and enhance the translational level of a coding sequence located either upstream or downstream. For example, a TEE in a 5’-UTR of a nucleic acid molecule can locate between the promoter and the starting codon of the nucleic acid molecule. Various TEE sequences are known in the art (Wellensiek et al. Genome-wide profiling of human cap-independent translation-enhancing elements, Nature Methods, 2013 Aug; 10 (8) : 747–750; Chappell et al. PNAS June 29, 2004 101 (26) 9590-9594) . Some TEEs are known to be conserved across multiple species (Pánek et al. Nucleic Acids Research, Volume 41, Issue 16, 1 September 2013, Pages 7625–7634) . In particular embodiments, a TEE is a promoter.
[0061] The term “promoter” is a term of art and is used herein to refer to a nucleic acid sequence operably linked to a nucleic acid sequence to be transcribed such as a nucleic acid sequence encoding a NeuroD1 polypeptide as described herein. In some embodiments, a promoter is positioned upstream of a nucleic acid sequence to be transcribed and provides a site for specific binding by RNA polymerase and other transcription factors.
[0062] In some embodiments, a promoter specifically enhances expression of an operably linked nucleic acid in a given cell type, and such promoter is referred to as a “cell type-specific promoter. ” In certain embodiments, a cell type-specific promoter is a glial cell specific promoter. Non-limiting examples of glial cell-specific promoters that can be used in connection with the present disclosure include but are not limited to glial fibrillary acidic protein (GFAP) promoter and aldehyde dehydrogenase 1 family, member L1 (AldhlL1) promoter, a lipocalin 2 (lcn2) promoter, a S100 calcium-binding protein B (S100β) promoter, a SRY-box transcription factor 9 (Sox9) promoter. A non-limiting example of an NG2 cell-specific promoter is the promoter of the chondroitin sulfate proteoglycan 4 gene, also known as neuron-glial antigen 2 (NG2) .
[0063] In alternative embodiments, a promoter generally enhances expression of an operably linked nucleic acid in various different cell types, such as at least 5 different cell types, and such promoter is referred to as an “ubiquitous promoter. ” Non-limiting examples of ubiquitous promoters that can be used in connection with the present disclosure include but are not limited to the CAG promoter which combines the cytomegalovirus CMV early enhancer element and chicken beta-actin promoter, a CMV promoter, a ubiquitin promoter, an EF-1a promoter.
[0064] As used herein, an “internal ribosome entry site” or “IRES” refers to an RNA sequence or structural element ranging in size from 10 nt to 1000 nt or more, capable of initiating translation of a polypeptide in the absence of a typical RNA cap structure. An IRES is typically about 500 nt to about 700 nt in length.
[0065] Codon substitution or codon replacement in the context of codon optimization refer to replacing a codon present in a candidate nucleotide sequence (e.g., an mRNA encoding a therapeutic agent) with another codon. Thus, a codon can be substituted in a candidate nucleic acid sequence, for example, via chemical peptide synthesis or through recombinant methods known in the art. Accordingly, references to a “substitution” or “replacement” at a certain location in a nucleic acid sequence (e.g., an mRNA) or within a certain region or subsequence of a nucleic acid sequence (e.g., an mRNA) refer to the substitution of a codon at such location or region with an alternative codon. As used herein, the term “codon-optimized variant” refers to a synonymous nucleotide sequence that encodes the same polypeptide sequence encoded by a candidate nucleotide sequence (e.g., a nucleotide sequence encoding a NeuroD1 polypeptide) . Thus, there are no amino acid substitutions in the polypeptide encoded by the codon optimized nucleotide sequence with respect to the polypeptide encoded by the candidate nucleotide sequence. A candidate nucleic acid sequence can be codon-optimized by replacing all or part of its codons according to a substitution table map. According to the present disclosure, a candidate nucleotide sequence can be codon-optimized, for example, to improve its translation efficacy of the encoded polypeptide. In some embodiments, the candidate nucleotide sequence is codon-optimized for improved translation efficacy after in vivo administration, e.g., administration as part of a recombinant AAV virion.
[0066] The terms “polypeptide” and “protein” are used interchangeably herein to refer to a polymer of at least two (2) , but typically greater than fifty (50) , amino acid residues linked by covalent peptide bonds. That is, a description directed to a polypeptide applies equally to a description of a protein, and vice versa. The terms apply to naturally occurring amino acid polymers as well as amino acid polymers in which one or more amino acid residues is a non-naturally occurring amino acid (e.g., an amino acid analog) . As used herein, the terms encompass amino acid chains of any length, including full length proteins (e.g., NeuroD1) .
[0067] As used herein, the term “NeuroD1 polypeptide” refers to NeuroD1 or a functional derivative of NeuroD1.
[0068] The term “neurogenic differentiation 1 protein” or “NeuroD1” as used herein, refers to any native NeuroD1 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats) , unless otherwise indicated. The term encompasses unprocessed NeuroD1 as well as any form of NeuroD1 that results from processing in the cell. The term also encompasses naturally occurring variants of NeuroD1, e.g., splice variants or allelic variants. The amino acid sequence of an exemplary human NeuroD1 is MTKSYSESGLMGEPQPQGPPSWTDECLSSQDEEHEADKKEDDLETMNAEEDSLRNGGEEED EDEDLEEEEEEEEEDDDQKPKRRGPKKKKMTKARLERFKLRRMKANARERNRMHGLNAAL DNLRKVVPCYSKTQKLSKIETLRLAKNYIWALSEILRSGKSPDLVSFVQTLCKGLSQPTTNLV AGCLQLNPRTFLPEQNQDMPPHLPTASASFPVHPYSYQSPGLPSPPYGTMDSSHVFHVKPPPH AYSAALEPFFESPLTDCTSPSFDGPLSPPLSINGNFSFKHEPSAEFEKNYAFTMHYPAATLAGA QSHGSIFSGTAAPRCEIPIDNIMSFDSHSHHERVMSAQLNAIFHD (SEQ ID NO: 1; GenBank Accession NP_002491.3) . A “full-length” NeuroD1 as used herein refers to the mature, natural length NeuroD1 molecule. For example, full-length human NeuroD1 refers to a molecule that has 356 amino acids (see e.g., SEQ ID NO: 1) . For example, a functional derivative of NeuroD1 is SEQ ID NO: 3, which has 357 amino acids.
[0069] An ortholog is a gene or genes that are related by vertical descent and are responsible for substantially the same or identical functions in different organisms. For example, mouse NeuroD1 and human NeuroD1 can be considered orthologs for the biological function of regulating neuronal differentiation and neurogenesis. See e.g., Cho, J. H. et al., Mol, Neurobiol., 30: 35-47, 2004; Kuwabara, T. et al., Nature Neurosci., 12: 1097-1105, 2009; and Gao, Z. et al., Nature Neurosci., 12: 1090-1092, 2009. Genes are related by vertical descent when, for example, they share sequence similarity of sufficient amount to indicate they are homologous, or related by evolution from a common ancestor. Genes can also be considered orthologs if they share three-dimensional structure but not necessarily sequence similarity, of a sufficient amount to indicate that they have evolved from a common ancestor to the extent that the primary sequence similarity is not identifiable. Genes that are orthologous can encode proteins with sequence similarity of about 25%to 100%amino acid sequence identity. Genes encoding proteins sharing an amino acid similarity less than 25%can also be considered to have arisen by vertical descent if their three-dimensional structure also shows similarities. Orthologs include genes or their encoded gene products that through, for example, evolution, have diverged in structure or overall activity. For example, where one species encodes a gene product exhibiting two functions and where such functions have been separated into distinct genes in a second species, the three genes and their corresponding products are considered to be orthologs. Those skilled in the art will understand how to identify orthologous genes harboring a biological function of interest. For example, a list of orthologous NeuroD1 genes and encoded NeuroD1 protein sequences can be found on GenBank website: www. ncbi. nlm. nih. gov / gene / 4760 / ortholog / ? scope=89593&term=NEUROD1. Non-exhaustive examples of NeuroD1 proteins from various non-human organisms as identified by their respective GenBank accession numbers include Mus musculus (hose mouse) NP_035024.1, Danio rerio (zebrafish) NP_571053.1, Gallus gallus (chicken) NP_990251.2, Bos taurus (cattle) NP_001096758.1, Mesocricetus auratus (golden hamster) XP_005065174.1, Sus scrofa (pig) XP_020931169.1, Xenopus tropicalis (frog) NP_001090868.1, Canis lupus familiaris (dog) XP_005640434.2, Pan troglodytes (chimpanzee) XP_001158946.1, Ovis aries (sheep) XP_011987527.1. In some embodiments, A group orthologs genes encode protein products that can be considered functional derivatives of one another.
[0070] NeuroD1 is highly conserved in the vertebrate family. FIG. 5 shows the sequence alignment of NeuroD1 proteins from various species, including mouse, zebrafish, human, rat, chicken, cattle, hamster, pig, frog, dog, chimpanzee and sheep. As shown, at least 95%amino acid residues in the NeuroD1 sequences are conserved across NeuroD1 orthologs from various species.
[0071] A “modification” of an amino acid residue / position refers to a change of a primary amino acid sequence as compared to a starting amino acid sequence, wherein the change results from a sequence alteration involving said amino acid residue / position. For example, typical modifications include substitution of the residue with another amino acid (e.g., a conservative or substantial substitution) , insertion of one or more (e.g., generally fewer than 5, 4, or 3) amino acids adjacent to said residue / position, and / or deletion of said residue / position.
[0072] Conservative amino acid substitutions are ones in which the amino acid residue is replaced with an amino acid residue having a similar side chain. Families of amino acid residues having similar side chains have been generally defined in the art, including basic side chains (e.g., lysine, arginine, histidine) , acidic side chains (e.g., aspartic acid, glutamic acid) , uncharged polar side chains (e.g., glycine, asparagine, glutamine, serine, threonine, tyrosine, cysteine) , nonpolar side chains (e.g., alanine, valine, leucine, isoleucine, proline, phenylalanine, methionine, tryptophan) , beta-branched side chains (e.g., threonine, valine, isoleucine) and aromatic side chains (e.g., tyrosine, phenylalanine, tryptophan, histidine) . For example, substitution of a phenylalanine for a tyrosine is a conservative substitution. Alternatively, naturally occurring residues may be divided into groups based on common side-chain properties: (1) hydrophobic: Norleucine, Met, Ala, Val, Leu, Ile; (2) neutral hydrophilic: Cys, Ser, Thr, Asn, Gln; (3) acidic: Asp, Glu; (4) basic: His, Lys, Arg; (5) residues that influence chain orientation: Gly, Pro; and (6) aromatic: Trp, Tyr, Phe. Generally, conservative substitutions in the sequences of the peptides or polypeptides the disclosure do not abrogate the biological activity of interest of the peptide or polypeptide. Amino acid substitutions may be introduced into a polypeptide of interest and the products screened for a desired activity of interest, e.g., retained / improved ability of a NeuroD1 variant in producing one or more neuronal phenotypes in a glia cell, and methods for measuring such desired activity are well-known in the art.
[0073] In contrast, substantial modifications in the biological properties of a polypeptide are accomplished by selecting substitutions that differ significantly in their effect on maintaining (a) the structure of the polypeptide backbone in the area of the substitution, for example, as a sheet or helical conformation, (b) the charge or hydrophobicity of the molecule at the target site, or (c) the bulk of the side chain.
[0074] In the context of a peptide or polypeptide, the term “derivative” as used herein refers to a peptide or polypeptide that comprises an amino acid sequence of the peptide or polypeptide, or a fragment of a peptide or polypeptide, which has been altered by the introduction of amino acid residue substitutions, deletions, or additions. The term “derivative” as used herein also refers to a peptide or polypeptide, or a fragment of a peptide or polypeptide, which has been chemically modified, e.g., by the covalent attachment of any type of molecule to the polypeptide. For example, but not by way of limitation, a peptide or polypeptide or a fragment of the peptide or polypeptide may be chemically modified, e.g., by glycosylation, acetylation, pegylation, phosphorylation, amidation, derivatization by known protecting / blocking groups, proteolytic cleavage, chemical cleavage, formulation, metabolic synthesis of tunicamycin, linkage to a cellular ligand or other protein, etc. The derivatives are modified in a manner that is different from naturally occurring or starting peptide or polypeptides, either in the type or location of the molecules attached. Derivatives further include deletion of one or more chemical groups which are naturally present on the peptide or polypeptide. Further, a derivative of a peptide or polypeptide or a fragment of a peptide or polypeptide may contain one or more non-classical amino acids. In specific embodiments, a derivative is a functional derivative of the native or unmodified peptide or polypeptide (e.g., a wild-type protein) from which it was derived. For example, a functional derivative of human NeuroD1 contains one or more modifications in its amino acid sequence with respect to the sequence shown in SEQ ID NO: 1. For example, in some embodiments, a functional derivative of human NeuroD1 comprises the amino acid sequence set forth in SEQ ID NO: 3.
[0075] The term “functional derivative” refers to a derivative that retains one or more functions or activities of the naturally occurring or starting peptide or polypeptide (e.g. a wild-type protein) from which it is derived. For example, in some embodiments, a functional derivative of a reprograming protein factor as described herein (e.g., NeuroD1) may retain the activity of producing a neuronal phenotype in a glial cell after being expressed in a sufficient amount by the glial cell. In some embodiments, a functional derivative of a reprogramming protein factor may retain the activity of the reprogramming protein factor in reprogramming the glial cell to trans-differentiate into a neuron after being expressed in a sufficient amount by the glial cell. In some embodiments, a functional derivative of a peptide or polypeptide described herein shares at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity with respect to the starting (e.g., wild-type) peptide or polypeptide.
[0076] A derivative of polypeptide can be prepared using methods well-known in the art, e.g., by modifying the corresponding nucleic acid molecules encoding the derivative. For example, derivatives may be a substitution, deletion, or insertion of one or more codons encoding the polypeptide that results in a change in the amino acid sequence as compared with the wild-type sequence of the polypeptide. The derivatives can be made using methods well-known in the art such as DNA synthesis, oligonucleotide-mediated (site-directed) mutagenesis, alanine scanning, and PCR mutagenesis. Site-directed mutagenesis (see, e.g., Carter, 1986, Biochem J. 237: 1-7; and Zoller et al., 1982, Nucl. Acids Res. 10: 6487-500) , cassette mutagenesis (see, e.g., Wells et al., 1985, Gene 34: 315-23) , or other known techniques can be performed on the cloned DNA to produce the derivatives DNA.
[0077] Those skilled in the art can determine the site (s) in an amino acid sequence of a given protein, where a modification (s) can be made in order to produce functional derivatives. In some embodiments, a functional derivative of a polypeptide comprises one or more modifications to one or more predicted non-essential amino acid residues in its sequence. In some embodiments, modifications made to non-essential amino acid residues can be a conservative substation as described herein. In some embodiments, modifications made to non-essential amino acid residues can be a substantial substation described herein. In some embodiments, modifications made to non-essential amino acid residues can be a deletion of the non-essential amino acid residue. In alternative embodiments, one or more modifications can be made to one or more predicted essential amino acid residues in its sequence. In particularly embodiments, the modifications made to essential amino acid residues in a protein sequence can be a conservative substitution as described herein. Methods well-known in the art can be used to analyze a protein (e.g., NeuroD1) sequence to identify essential and non-essential amino acid residues of the protein. For example, in some embodiments, an amino acid residue of a protein that is not conserved among orthologous gene products is predicted to be a non-essential amino acid residue, while another amino acid residue that is conserved among orthologous gene products is predicted to be an essential amino acid residue. For example, an alignment of twelve NeuroD1 orthologs is shown in FIG. 5, and the conserved residues and non-conserved residues are marked with different shades, respectively.
[0078] In some embodiments, after making one or more modifications to the sequence of a polypeptide (e.g., by making insertions, deletions, or substitutions of amino acids in the original amino acid sequence either systematically, randomly, or at selected sites) , functional derivatives of the polypeptide can be identified by testing the resulting derivatives for activity exhibited by the original sequence. For example, to identify functional derivative of a reprograming protein factor (e.g., NeuroD1) as described herein, nucleic acid molecules encoding the derivative polypeptides can be delivered into a population of starting glial cells under a suitable condition to be expressed at a sufficient level, and assays can be conducted to detect and / or measure one or more neuronal phenotypes in the population of cells and compared the level at which the neuronal phenotype of interest is demonstrated by the population of cells to a control group of glial cells that express the original, unmodified (e.g., wild-type) reprogramming protein factor, and those derivatives that induce the neuronal phenotype in the testing cell population at a comparable level to that of the control population can be selected as functional derivatives. Alternatively, the comparison can be made to a control group of glial cells that do not express the reprogramming protein factor (e.g. transduced with a blank vector) , and those derivatives that induce the neuronal phenotype in the testing cell population at a greater level than that of the control population can be selected as functional derivatives.
[0079] The term “sequence identity” refers to a relationship between the sequences of two or more biological molecules (e.g., a pair of polynucleotides or multiple polypeptides) , as determined by aligning and comparing the respective sequences. “Percent (%) amino acid sequence identity” with respect to a reference amino acid sequence (e.g., a reference polypeptide) is defined as the percentage of amino acid residues in a candidate sequence that are identical with the amino acid residues in the reference amino acid sequence, after aligning the two sequences and introducing gaps, if necessary, to achieve the maximum percent sequence identity. Alignment for purposes of determining percent amino acid sequence identity can be achieved in various ways that are within the skill in the art, for instance, using publicly available computer software such as BLAST, BLAST-2, ALIGN, or MEGALIGN (DNAStar, Inc. ) software. Those skilled in the art can determine appropriate parameters for aligning sequences, including any algorithms needed to achieve maximal alignment over the full length of the sequences being compared. Exemplary parameters for determining relatedness of two or more sequences using the BLAST algorithm, for example, can be as set forth below. Briefly, amino acid sequence alignments can be performed using BLASTP version 2.0.8 (Jan-05-1999) and the following parameters: Matrix: 0 BLOSUM62; gap open: 11; gap extension: 1; x_dropoff: 50; expect: 10.0; wordsize: 3; filter: on. Nucleic acid sequence alignments can be performed using BLASTN version 2.0.6 (Sept-16-1998) and the following parameters: Match: 1; mismatch: -2; gap open: 5; gap extension: 2; x_dropoff: 50; expect: 10.0; wordsize: 11; filter: off. Those skilled in the art will know what modifications can be made to the above parameters to either increase or decrease the stringency of the comparison, for example, and determine the relatedness of two or more sequences.
[0080] The term “vector” refers to a substance that is used to carry or include a nucleic acid sequence, including for example, a nucleic acid sequence encoding a peptide or protein as described herein, in order to introduce a nucleic acid sequence into a host cell, or serve as a transcription template to carry out in vitro transcription reaction in a cell-free system to produce mRNA. Vectors applicable for use include, for example, expression vectors, plasmids, phage vectors, viral vectors, episomes, and artificial chromosomes, which can include selection sequences or markers operable for stable integration into a host cell’s chromosome. Additionally, the vectors can include one or more selectable marker genes and appropriate transcription or translation control sequences. Selectable marker genes that can be included, for example, provide resistance to antibiotics or toxins, complement auxotrophic deficiencies, or supply critical nutrients not in the culture media. Transcription or translation control sequences can include constitutive and inducible promoters, transcription enhancers, transcription terminators, and the like, which are well known in the art. When two or more nucleic acid molecules are to be co-transcribed or co-translated (e.g., nucleic acid molecules encoding two or more different peptides or proteins) , both nucleic acid molecules can be inserted, for example, into a single expression vector or in separate expression vectors. For single vector transcription and / or translation, the encoding nucleic acids can be operationally linked to one common transcription or translation control sequence or linked to different transcription or translation control sequences, such as one inducible promoter and one constitutive promoter. The introduction of nucleic acid molecules into a host cell can be confirmed using methods well known in the art. Such methods include, for example, nucleic acid analysis such as Northern blots or polymerase chain reaction (PCR) amplification of mRNA, immunoblotting for expression of gene products, or other suitable analytical methods to test the expression of an introduced nucleic acid sequence or its corresponding gene product. It is understood by those skilled in the art that the nucleic acid molecules are expressed in a sufficient amount to produce a desired product (e.g., a mRNA transcript of the nucleic acid as described herein) , and it is further understood that expression levels can be optimized to obtain sufficient expression using methods well known in the art.
[0081] The term “administer” or “administration” refers to the act of injecting or otherwise physically delivering a substance as it exists outside the body (e.g., a recombinant AAV as described herein) into a patient, such as by intracranial, mucosal, intradermal, intravenous, intramuscular delivery, and / or any other method of physical delivery described herein or known in the art. When a disease, disorder, condition, or a symptom thereof, is being treated, administration of the substance typically occurs after the onset of the disease, disorder, condition, or symptoms thereof. When a disease, disorder, condition, or symptoms thereof, are being prevented, administration of the substance typically occurs before the onset of the disease, disorder, condition, or symptoms thereof.
[0082] An “effective amount” is generally an amount sufficient to produce a desirable outcome, such as, producing one or more neuronal phenotypes in a population of cells, or in the context of disease management, to reduce the severity and / or frequency of symptoms, eliminate the symptoms and / or underlying cause, prevent the occurrence of symptoms and / or their underlying cause, and / or improve or remediate the damage that results from or is associated with a disease, disorder, or condition, including, for example, Alzheimer’s disease.
[0083] The term “therapeutically effective amount” as used herein refers to the amount of an agent (e.g., a recombinant AAV described herein or any other agent described herein) that is sufficient to reduce and / or ameliorate the severity and / or duration of a given disease, disorder or condition, and / or a symptom related thereto. A therapeutically effective amount of an agent, including a therapeutic agent, can be an amount necessary for (i) reduction, delay or amelioration of the advancement or progression of a given disease, disorder, or condition, (ii) reduction, delay or amelioration of the recurrence, development or onset of a given disease, disorder or conditions, and / or (iii) to improve or enhance the prophylactic or therapeutic effect of another therapy (e.g., a therapy other than the administration of an agent described herein) . A “therapeutically effective amount” of a substance / molecule / agent of the present disclosure (e.g., a recombinant AAV) may vary according to factors such as the disease state, age, sex, and weight of the individual, and the ability of the substance / molecule / agent, to elicit a desired response in the individual. A therapeutically effective amount encompasses an amount in which any toxic or detrimental effects of the substance / molecule / agent are outweighed by the therapeutically beneficial effects. In certain embodiments, the term “therapeutically effective amount” refers to an amount of a recombinant AAV effective to “treat” a disease, disorder, or condition, in a subject or mammal.
[0084] The term “treating” or any grammatical variation thereof refers to reducing and / or ameliorating the severity and / or duration of a given disease, disorder or condition, and / or a symptom related thereto, such as (i) reduction, delay or amelioration of the advancement or progression of a given disease, disorder, or condition, (ii) reduction, delay or amelioration of the recurrence, development or onset of a given disease, disorder or conditions, and / or (iii) to improve or enhance the prophylactic or therapeutic effect of another therapy (e.g., a therapy other than the administration of a recombinant AAV described herein) .
[0085] A “prophylactically effective amount” is an amount of a pharmaceutical composition that, when administered to a subject, will have the intended prophylactic effect, e.g., preventing or delaying the onset (or reoccurrence) of a disease, disorder or condition, or reducing the likelihood of the onset (or reoccurrence) of a disease, disorder, or condition or associated symptom (s) .
[0086] The terms “subject” and “patient” may be used interchangeably. As used herein, in certain embodiments, a subject is a mammal, such as a non-primate (e.g., cow, pig, horse, cat, dog, rat, etc. ) or a primate (e.g., monkey and human) . In specific embodiments, the subject is a human. In one embodiment, the subject is a mammal (e.g., a human) having an infectious disease or neoplastic disease. In another embodiment, the subject is a mammal (e.g., a human) at risk of developing an infectious disease or neoplastic disease.
[0087] The term “phenotype” refers to well-known detectable characteristics of the cells referred to herein. The neuronal phenotype can be, but is not limited to, one or more of: neuronal morphology, expression of one or more neuronal markers, electrophysiological characteristics of neurons, synapse formation and release of neurotransmitter. For example, neuronal phenotype encompasses but is not limited to: characteristic morphological aspects of a neuron such as presence of dendrites, an axon and dendritic spines; characteristic neuronal protein expression and distribution, such as presence of synaptic proteins in synaptic puncta, presence of MAP2 in dendrites; and characteristic electrophysiological signs such as spontaneous and evoked synaptic events. Phenotypes that distinguish a neuron from a non-neuron cell (e.g., a glial cell) as well as method for detecting and measuring such phenotypes are known to those of ordinary skill in the art.
[0088] As used herein, and unless otherwise specified, the term “optional” or “optionally” (e.g., optionally substituted) means that the subsequently described event of circumstances may or may not occur, and that the description includes instances where said event or circumstance occurs and instances in which it does not. For example, “optionally wherein” means that the features following the wherein may or may not be present and that the description includes either situation when such features are present or absent.
[0089] The term “composition” is intended to encompass a product containing the specified ingredients (e.g., a recombinant AAV) in, optionally, the specified amounts.
[0090] “Substantially all” refers to at least about 60%, at least about 65%, at least about 70%, at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 95%, at least about 98%, at least about 99%, or about 100%.
[0091] As used herein, and unless otherwise indicated, the term “about” or “approximately” means an acceptable error for a particular value as determined by one of ordinary skill in the art, which depends in part on how the value is measured or determined. In certain embodiments, the term “about” or “approximately” means within 1, 2, 3, or 4 standard deviations. In certain embodiments, the term “about” or “approximately” means within 20%, 15%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.05%, or less of a given value or range. As used herein, when “about” is used in connection with a numerical range, the term “about” is meant to apply to both ends of such modified range (e.g., “about 5 to 10” means “about 5 to about 10” ) .
[0092] The singular terms “a, ” “an, ” and “the” as used herein include the plural reference unless the context clearly indicates otherwise.
[0093] All publications, patent applications, accession numbers, and other references cited in this specification are herein incorporated by reference in their entirety as if each individual publication or patent application were specifically and individually indicated to be incorporated by reference. The publications discussed herein are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the present invention is not entitled to antedate such publication by virtue of prior invention. Further, the dates of publication provided can be different from the actual publication dates which can need to be independently confirmed.
[0094] A number of embodiments of the invention have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the invention. Accordingly, the descriptions in the Experimental section and examples are intended to illustrate but not limit the scope of invention described in the claims. 7.3. NeuroD1 Expression Cassette
[0095] In one aspect, provided herein are functional nucleic acid molecules for treating Alzheimer’s disease. In some embodiments, the functional nucleic acid comprises an expression cassette encoding a NeuroD1 polypeptide, which upon contacting with the glial cell, is expressed by the glial cell to produce the encoded NeuroD1 polypeptide. In some embodiment, the expression cassette comprises at least one coding region encoding a NeuroD1 polypeptide (e.g., an open reading frame (ORF) ) . In some embodiment, the expression cassette further comprises at least one untranslated region (UTR) . In some embodiments, the UTR comprises one or more regulatory elements as described herein. In some embodiments, the expression cassette can comprise any coding sequences as described in this Section 7.3.1 (Coding Region) . In some embodiments, the expression cassette can comprise any regulatory elements described in Section 7.3.2 (Untranslated Regions (UTRs) ) .
[0096] In some embodiments, the NeuroD1 expression cassette is part of a single-stranded nucleic acid molecule, including a single-stranded DNA molecule. In some embodiments, the single-stranded DNA molecule is an artificial AAV genome that can be packaged into a recombinant AAV capsid.
[0097] In other embodiments, the NeuroD1 expression cassette is part of a nucleic acid molecule that is configured to produce a linear nucleic acid molecule, including a single-stranded DNA molecule. In some embodiments, the NeuroD1 expression cassette is part of a vector (e.g., a plasmid) that can be processed into a linear recombinant AAV genome in a host cell in the presence of sufficient adenovirus helper functions to permit replication and packaging of the linear recombinant AAV genome by the AAV capsid proteins. 7.3.1. Coding Region
[0098] In some embodiments, the NeuroD1 expression cassette of the present disclosure comprises at least one coding region. In some embodiments, the coding region is an open reading frame (ORF) that encodes for a NeuroD1 polypeptide. In some embodiments, the coding region comprises at least two ORFs, each encoding a NeuroD1 polypeptide. In those embodiments where the coding region comprises more than one ORFs, the encoded NeuroD1 polypeptides can be the same as or different from each other. In some embodiments, the multiple ORFs in a coding region are separated by non-coding sequences.
[0099] In specific embodiments, the coding sequences or amino acid sequences of NeuroD1 polypeptides can be any NeuroD1 polypeptide as described herein. Table 7.3.1 shows exemplary NeuroD1 polypeptides and encoding nucleic acid sequences thereof. Table 7.3.1 Exemplary NeuroD1 polypeptide and encoding nucleic acid sequences.
[0100] In particular embodiments, the NeuroD1 expression cassette encodes a NeuroD1 polypeptide. In some embodiments, the encoded NeuroD1 polypeptide is a wild-type NeuroD1. In some embodiments, the encoded NeuroD1 is human NeuroD1 having the amino acid sequence of SEQ ID NO: 1. In some embodiments, the encoded NeuroD1 is human NeuroD1 having the amino acid sequence of SEQ ID NO: 57. In some embodiments, the encoded NeuroD1 is a NeuroD1 polypeptide having the amino acid sequence of SEQ ID NO: 3, where an extra V is located at the second residue.
[0101] In alternative embodiments, the encoded NeuroD1 polypeptide is a functional derivative of NeuroD1. In some embodiments, a functional derivative of NeuroD1 shares at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity with respect to the native (e.g., wild-type) NeuroD1 protein from which it derives.
[0102] In some embodiments, a functional derivative of NeuroD1 comprises one or more modifications to one or more predicted non-essential amino acid residues in the NeuroD1 sequence. Methods well-known in the art can be used to analyze a protein (e.g., NeuroD1) sequence to identify essential and non-essential amino acid residues of the protein. For example, in some embodiments, an amino acid residue of a protein that is not conserved among orthologous gene products is predicted to be a non-essential amino acid residue, while another amino acid residue that is conserved among orthologous gene products is predicted to be an essential amino acid residue. An exemplary alignment of NeuroD1 orthologs is shown in FIG. 5, and the conserved residues and non-conserved residues are marked with different shades, respectively.
[0103] In specific embodiments, a functional derivative of NeuroD1 comprises one or more conservative amino acid substitutions at one or more predicted non-essential amino acid residues of NeuroD1. In specific embodiments, a functional derivative of NeuroD1 comprises one or more conservative amino acid substitutions at one or more predicted essential amino acid residues of NeuroD1.
[0104] In some embodiments, a functional derivative of NeuroD1 retains the NeuroD1 function in producing one or more neuronal phenotypes in a glial cell, which neuronal phenotypes include but are not limited to neuronal morphology, expression of one or more neuronal marker, electrophysiologic characteristics of neurons, synapse formation and release of neurotransmitters. Methods disclosed herein (see e.g., Example section) and / or well-known in the art can be used to measure the one or more neuronal phenotypes. In some embodiments, a functional derivative of NeuroD1 retains the NeuroD1 function in reprogramming a glial cell to trans-differentiate into a neuron.
[0105] In specific embodiments, a functional derivative of NeuroD1 comprises one or more conservative amino acid substitutions at one or more predicted non-essential amino acid residues, and shares at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity with respect to a wild-type NeuroD1 protein. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having SEQ ID NO: 1. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having SEQ ID NO: 57. In some embodiments, the NeuroD1 protein from which the functional derivative is derived is a NeuroD1 polypeptide having the amino acid sequence of SEQ ID NO: 3.
[0106] In specific embodiments, a functional derivative of NeuroD1 comprises one or more conservative amino acid substitutions at one or more predicted non-essential amino acid residues, and shares at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity with respect to the native (e.g., wild-type) NeuroD1 protein from which it derives, and further retains the function in producing one or more neuronal phenotypes in a glial cell when expressed in a sufficient amount by the glial cell. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 1. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 57. In some embodiments, the NeuroD1 protein from which the functional derivative is derived is a NeuroD1 polypeptide having the amino acid sequence of SEQ ID NO: 3.
[0107] In specific embodiments, a functional derivative of NeuroD1 comprises one or more conservative amino acid substitutions at one or more predicted non-essential amino acid residues, and shares at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity with respect to the native (e.g., wild-type) NeuroD1 protein from which it derives, and further retains the function in reprogramming a glial cell to trans-differentiate into a neuron when expressed in a sufficient amount by the glial cell. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 1. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 57. In some embodiments, the NeuroD1 protein from which the functional derivative is derived is a NeuroD1 polypeptide having the amino acid sequence of SEQ ID NO: 3.
[0108] In specific embodiments, a functional derivative of NeuroD1 comprises one or more conservative amino acid substitutions at one or more predicted essential amino acid residues, and shares at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity with respect to the native (e.g., wild-type) NeuroD1 protein from which it derives, and further retains the function in producing one or more neuronal phenotypes in a glial cell when expressed in a sufficient amount by the glial cell. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 1. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 57. In some embodiments, the NeuroD1 protein from which the functional derivative is derived is a NeuroD1 polypeptide having the amino acid sequence of SEQ ID NO: 3.
[0109] In specific embodiments, a functional derivative of NeuroD1 comprises one or more conservative amino acid substitutions at one or more predicted essential amino acid residues, and shares at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity with respect to the native (e.g., wild-type) NeuroD1 protein from which it derives, and further retains the function in reprogramming a glial cell to trans-differentiate into a neuron when expressed in a sufficient amount by the glial cell. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 1. In some embodiments, the wild-type NeuroD1 protein from which the functional derivative is derived is a wild-type human NeuroD1 having the amino acid sequence of SEQ ID NO: 57. In some embodiments, the NeuroD1 protein from which the functional derivative is derived is a NeuroD1 polypeptide having the amino acid sequence of SEQ ID NO: 3.
[0110] In some embodiments, the encoded NeuroD1 polypeptide is encoded by (a) a DNA sequence of SEQ ID NO: 4, SEQ ID NO: 2, or SEQ ID NO: 58, (b) a codon-optimized variant of (a) , or (c) a transcribed RNA sequence of (a) or (b) . In some embodiments, the codon-optimized variant shares at least about 50%, at least about 55%, at least about 60%, at least about 65%, at least about 70%, at least about 75%, at least about 80%, at least about 85%, at least about 90%, or at least about 95%sequence identity to SEQ ID NO: 4. In some embodiments, the codon-optimized variant shares at least about 50%, at least about 55%, at least about 60%, at least about 65%, at least about 70%, at least about 75%, at least about 80%, at least about 85%, at least about 90%, or at least about 95%sequence identity to SEQ ID NO: 2. In some embodiments, the codon-optimized variant shares at least about 50%, at least about 55%, at least about 60%, at least about 65%, at least about 70%, at least about 75%, at least about 80%, at least about 85%, at least about 90%, or at least about 95%sequence identity to SEQ ID NO: 58. In some embodiments, the transcribed RNA sequence has the same sequence as the DNA coding sequences except that thymine bases in the DNA sequence are replaced by uracil bases in the RNA sequence. In particular embodiments, the NeuroD1 expression cassette is mono-cistronic and encodes only one NeuroD1 polypeptide as described herein.
[0111] In alternative embodiments, the NeuroD1 expression cassette is multi-cistronic and encodes multiple NeuroD1 polypeptides as described herein. In some embodiments, a multi-cistronic expression sequence encoding at least two NeuroD1 polypeptides further encodes an internal ribosome entry site (IRES) that separate two ORFs. Without being bound by the theory, it is contemplated that an internal ribosome entry sites (IRES) can act as the sole ribosome binding site, or serve as one of multiple ribosome binding sites of an mRNA. An mRNA molecule containing more than one functional ribosome binding site can encode several peptides or proteins that are translated independently by the ribosomes (e.g., multicistronic mRNA) . Accordingly, in some embodiments, the nucleic acid molecule of the present disclosure (e.g., mRNA) comprises one or more internal ribosome entry sites (IRES) . Examples of IRES sequences that can be used in connection with the present disclosure include, without limitation, those from picomaviruses (e.g., FMDV) , pest viruses (CFFV) , polio viruses (PV) , encephalomyocarditis viruses (ECMV) , foot-and-mouth disease viruses (FMDV) , hepatitis C viruses (HCV) , classical swine fever viruses (CSFV) , murine leukemia virus (MLV) , simian immune deficiency viruses (SIV) or cricket paralysis viruses (CrPV) .
[0112] In particular embodiments, the IRES has a sequence of an IRES from Taura syndrome virus, Triatoma virus, Theiler's encephalomyelitis virus, Simian Virus 40, Solenopsis invicta virus 1, Rhopalosiphum padi virus, Reticuloendotheliosis virus, Human poliovirus 1, Plautia stall intestine virus, Kashmir bee virus, Human rhinovirus 2, Homalodisca coagulata virus-1, Human Immunodeficiency Virus type 1, Homalodisca coagulata virus-1, Himetobi P virus, Hepatitis C virus, Hepatitis A virus, Hepatitis GB virus, Foot and mouth disease virus, Human enterovirus 71, Equine rhinitis virus, Ectropis obliqua picorna-like virus, Encephalomyocarditis virus, Drosophila C Virus, Human coxsackievirus B3, Crucifer tobamovirus, Cricket paralysis virus, Bovine viral diarrhea virus 1, Black Queen Cell Virus, Aphid lethal paralysis virus, Avian encephalomyelitis virus, Acute bee paralysis virus, Hibiscus chlorotic ringspot virus, Classical swine fever virus, Human FGF2, Human SFTPA1, Human AML1 / RUNX1, Drosophila antennapedia, Human AQP4, Human AT1R, Human BAG-1, Human BCL2, Human BiP, Human c-IAP1, Human c-myc, Human eIF4G, Mouse NDST4L, Human LEF1, Mouse HIF1 alpha, Human n. myc, Mouse Gtx, Human p27kip1, Human PDGF2 / c-sis, Human p53, Human Pim-1, Mouse Rbm3, Drosophila reaper, Canine Scamper, Drosophila Ubx, Human UNR, Mouse UtrA, Human VEGF-A, Human XIAP, Drosophila hairless, S. cerevisiae TFIID, S. cerevisiae YAP1, tobacco etch virus, turnip crinkle virus, EMCV-A, EMCV-B, EMCV-Bf, EMCV-Cf, EMCV pEC9, Picobirnavirus, HCV QC64, Human Cosavirus E / D, Human Cosavirus F, Human Cosavirus JMY, Rhinovirus NAT001, HRV14, HRV89, HRVC-02, HRV-A21, Salivirus A SH1, Salivirus FHB, Salivirus NG-J1, Human Parechovirus 1, Crohivirus B, Yc-3, Rosavirus M-7, Shanbavirus A, Pasivirus A, Pasivirus A 2, Echovirus E14, Human Parechovirus 5, Aichi Virus, Hepatitis A Virus HA16, Phopivirus, CVA10, Enterovirus C, Enterovirus D, Enterovirus J, Human Pegivirus 2, GBV-C GT110, GBV-C K1737, GBV-C Iowa, Pegivirus A 1220, Pasivirus A 3, Sapelovirus, Rosavirus B, Bakunsa Virus, Tremovirus A, Swine Pasivirus 1, PLV-CHN, Pasivirus A, Sicinivirus, Hepacivirus K, Hepacivirus A, BVDV1, Border Disease Virus, BVDV2, CSFV-PK15C, SF573 Dicistrovirus, Hubei Picorna-like Virus, CRPV, Apodemus Agrarius Picornavirus, Caprine Kobuvirus, Parabovirus, Salivirus A BN5, Salivirus A BN2, Salivirus A 02394, Salivirus A GUT, Salivirus A CH, Salivirus A SZ1, Salivirus FHB, CVB3, CVB1, Echovirus 7, CVB5, EVA71, CVA3, CVA12, EV24, or an aptamer to eIF4G. 7.3.2. Untranslated Regions (UTRs)
[0113] In some embodiments, the NeuroD1 expression cassette comprises one or more untranslated regions (UTRs) .
[0114] In the particular embodiments, the untranslated region (UTR) located upstream (to the 5’-end) of the coding region is referred to herein as the 5’-UTR, and the UTR located upstream (to the 3’-end) of the coding region is referred to herein as the 3’-UTR. In particular embodiments, the NeuroD1 expression cassette comprises both a 5’-UTR and a 3’-UTR. In some embodiments, the NeuroD1 expression cassette comprises a Kozak sequence (e.g., in the 5’-UTR) . In some embodiments, the NeuroD1 expression cassette comprises a polyadenylation signal (e.g., in the 3’-UTR) . In particular embodiments, the NeuroD1 expression cassette comprises a polyadenylation signal having the sequence set forth in SEQ ID NO: 13 located in the 3’-UTR. In particular embodiments, the NeuroD1 expression cassette comprises a SV40 polyadenylation signal having the sequence set forth in SEQ ID NO: 14 located in the 3’-UTR. In some embodiments, the NeuroD1 expression cassette comprises stabilizing region (e.g., in the 3’-UTR) . In some embodiments, the NeuroD1 expression cassette comprises a woodchuck hepatitis virus posttranscriptional regulatory element (WPRE) having the sequence set forth in SEQ ID NO: 11 located in the 3’-UTR. In some embodiments, the NeuroD1 expression cassette comprises a woodchuck hepatitis virus posttranscriptional regulatory element (WPRE) having the sequence set forth in SEQ ID NO: 12 located in the 3’-UTR. In some embodiments, the NeuroD1 expression cassette comprises one or more intronic regions capable of being excised during splicing (e.g., in the 5’-UTR) . In one specific embodiment, the NeuroD1 expression cassette comprises a chimeric intron comprising the sequence set forth in SEQ ID NO: 8 located in the 5’-UTR. In one specific embodiment, the NeuroD1 expression cassette comprises a chimeric intron comprising the sequence set forth in SEQ ID NO: 9 located in the 5’-UTR. In one specific embodiment, the NeuroD1 expression cassette comprises a chimeric intron comprising the sequence set forth in SEQ ID NO: 10 located in the 5’-UTR. In some embodiments, the NeuroD1 expression cassette comprises a promoter (e.g., in the 5’-UTR) . In a specific embodiment, the NeuroD1 expression cassette comprises a glial fibrillary acid protein (GFAP) promoter comprising the sequence set forth in SEQ ID NO: 7 located in the 5’-UTR. In some embodiments, the NeuroD1 expression cassette comprises a transcription enhancer element (e.g., in the 5’-UTR or 3’-UTR) . In a specific embodiment, the NeuroD1 expression cassette comprises a CMV enhancer comprising the sequence set forth in SEQ ID NO: 5 located in the 5’-UTR. In a specific embodiment, the NeuroD1 expression cassette comprises a EF1α enhancer comprising the sequence set forth in SEQ ID NO: 6 located in the 5’-UTR. In a specific embodiment, the nucleic acid molecule comprises one or more region selected from a 5’-UTR, and a coding region. In a specific embodiment, the nucleic acid molecule comprises a coding region and one or more region selected from a 3’-UTR. In a specific embodiment, the nucleic acid molecule comprises one or more region selected from a 5’-UTR, a coding region, and one or more region selected from a 3’-UTR.
[0115] In some embodiments, the sequence of an UTR can be homologous or heterologous to the sequence of the coding region found in a nucleic acid molecule. Multiple UTRs can be included in a nucleic acid molecule and can be of the same or different sequences, and / or genetic origin. According to the present disclosure, any portion of UTRs in a nucleic acid molecule (including none) can be codon optimized and any may independently contain one or more different structural or chemical modification, before and / or after codon optimization.
[0116] In some embodiments, a NeuroD1 expression cassette of the present disclosure comprises UTRs and coding regions that are homologous with respect to each other. In other embodiments, a NeuroD1 expression cassette of the present disclosure comprises UTRs and coding regions that are heterologous with respect to each other. In some embodiments, to monitor the activity of a UTR sequence, a nucleic acid molecule comprising the UTR and a coding sequence of a detectable probe can be administered in vitro (e.g., cell or tissue culture) or in vivo (e.g., to a subject) , and an effect of the UTR sequence (e.g., modulation on the expression level, cellular localization of the encoded product, or half-life of the encoded product) can be measured using methods known in the art.
[0117] Combinations of regulatory elements may be used to drive expression of an operably linked coding sequence. According to the present disclosure, homologues and functional variants of ubiquitous or cell type-specific promoters may be used in expressing the operably linked coding sequence as described herein. The terms “promoter homologue” and “promoter variant” refer to a promoter which has substantially similar functional properties to confer the desired type of expression, such as cell type-specific expression of the NeuroD1 polypeptide or ubiquitous expression of the NeuroD1 polypeptide, of an operably linked coding sequence of the NeuroD1 polypeptide compared to a given promoter disclosed herein. For example, a promoter homologue or promoter variant has substantially similar functional properties to confer cell type-specific expression of an operably linked coding sequence encoding the NeuroD1 polypeptide compared to any of a GFAP, AldhlL1, NG2, lcn2, S100b, Sox9, CAG, CMV, ubiquitin, or EF-1a promoter.
[0118] One of skill in the art will recognize that one or more nucleic acid mutations can be introduced without altering the functional properties of a given promoter. Mutations can be introduced using standard molecular biology techniques, such as DNA synthesis, site-directed mutagenesis and PCR-mediated mutagenesis, to produce promoter variants. As used herein, the term “promoter variant” refers to either an isolated naturally occurring or a recombinantly prepared variation of a reference promoter, such as, but not limited to GFAP, AldhlL1, NG2, lcn2, S100b, Sox9, CAG, CMV, ubiquitin, or EF-1a promoter.
[0119] It is known in the art that promoters from other species are functional, e.g. the mouse AldhlLl promoter is known to be functional in human cells. Homologues and homologous promoters from other species can be identified using bioinformatics tools known in the art, see for example, Xuan et al., 2005, Genome Biol 6: R72; Zhao et al., 2005, Nucl Acid Res 33: D103-107; and Halees et al.2003, Nucl. Acids. Res. 2003 31: 3554-3559.
[0120] Structurally, homologues and variants of a cell type-specific promoter or an ubiquitous promoter can have at least about 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or greater, nucleic acid sequence identity to the reference promoter and include a site for binding of RNA polymerase and, optionally, one or more binding sites for transcription factors.
[0121] In some embodiments, the UTR of a nucleic acid molecule of the present disclosure (e.g., NeuroD1 expression cassette) comprises at least one translation enhancer element (TEE) that functions to increase the amount of polypeptide or protein produced from the nucleic acid molecule. In some embodiments, the TEE is located in the 5’-UTR of the nucleic acid molecule. In other embodiments, the TEE is located at the 3’-UTR of the nucleic acid molecule. In yet other embodiments, at least two TEE are located at the 5’-UTR and 3’-UTR of the nucleic acid molecule respectively. In some embodiments, a nucleic acid molecule of the present disclosure can comprise one or more copies of a TEE sequence or comprise more than one different TEE sequences. In some embodiments, different TEE sequences that are present in a nucleic acid molecule of the present disclosure can be homologues or heterologous with respect to one another.
[0122] In some embodiments, the TEE sequence is derived from a promoter sequence of a gene. In some embodiments, a promoter can be derived entirely from a single gene. In other embodiments, a promoter can be chimeric, having portions derived from more than one gene.
[0123] In some embodiments, the TEE sequence used in connection with the present disclosure can drive expression of an operably linked expression sequence preferentially in glial cells. In some embodiments, the TEE sequence drives expression of an operably linked expression sequence preferentially in astrocytes. In some embodiments, the TEE sequence drives expression of an operably linked expression sequence preferentially in reactive astrocytes. In some embodiments, the TEE sequence drives expression of an operably linked expression sequence preferentially in NG2 cells. In some embodiments, the TEE sequence drives expression of an operably linked expression sequence preferentially in reactive NG2 cells. In some embodiments, the TEE sequence drives expression of an operably linked expression sequence preferentially in Müller glia cells.
[0124] Additionally, various TEE sequences that are known in the art and can be used in connection with the present disclosure. For example, in some embodiments, the TEE can be an internal ribosome entry site (IRES) , HCV-IRES or an IRES element. Chappell et al. Proc. Natl. Acad. Sci. USA 101: 9590-9594, 2004; Zhou et al. Proc. Natl. Acad. Sci. 102: 6273-6278, 2005. Additional internal ribosome entry site (IRES) that can be used in connection with the present disclosure include but are not limited to those described in U.S. Patent No. 7,468,275, U.S. Patent Publication No. 2007 / 0048776 and U.S. Patent Publication No. 2011 / 0124100 and International Patent Publication No. WO2007 / 025008 and International Patent Publication No. WO2001 / 055369, the content of each of which is enclosed herein by reference in its entirety. In some embodiments, the TEE can be those described in Supplemental Table 1 and in Supplemental Table 2 of Wellensiek et al Genome-wide profiling of human cap-independent translation-enhancing elements, Nature Methods, 2013 Aug; 10 (8) : 747–750; the content of which is incorporated by reference in its entirety.
[0125] Additional exemplary TEEs that can be used in connection with the present disclosure include but are not limited to the TEE sequences disclosed in U.S. Patent No. 6,310,197, U.S. Patent No. 6,849,405, U.S. Patent No. 7,456,273, U.S. Patent No. 7,183,395, U.S. Patent Publication No. 2009 / 0226470, U.S. Patent Publication No. 2013 / 0177581, U.S. Patent Publication No. 2007 / 0048776, U.S. Patent Publication No. 2011 / 0124100, U.S. Patent Publication No. 2009 / 0093049, International Patent Publication No. WO2009 / 075886, International Patent Publication No.WO2012 / 009644, and International Patent Publication No. WO1999 / 024595, International Patent Publication No. WO2007 / 025008, International Patent Publication No. WO2001 / 055371, European Patent No. 2610341, European Patent No. 2610340, the content of each of which is enclosed herein by reference in its entirety.
[0126] In various embodiments, a nucleic acid molecule of the present disclosure (e.g., an NeuroD1 expression cassette) comprises at least one UTR that comprises at least 1, at least 2, at least 3, at least 4, at least 5, at least 6, at least 7, at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18 at least 19, at least 20, at least 21, at least 22, at least 23, at least 24, at least 25, at least 30, at least 35, at least 40, at least 45, at least 50, at least 55 or more than 60 TEE sequences. In some embodiments, the TEE sequences in the UTR of a nucleic acid molecule are copies of the same TEE sequence. In other embodiments, at least two TEE sequences in the UTR of a nucleic acid molecule are of different TEE sequences. In some embodiments, multiple different TEE sequences are arranged in one or more repeating patterns in the UTR region of a nucleic acid molecule. For illustrating purpose only, a repeating pattern can be, for example, ABABAB, AABBAABBAABB, ABCABCABC, or the like, where in these exemplary patterns, each capitalized letter (A, B, or C) represents a different TEE sequence. In some embodiments, at least two TEE sequences are consecutive with one another (i.e., no spacer sequence in between) in a UTR of a nucleic acid molecule. In other embodiments, at least two TEE sequences are separated by a spacer sequence. In some embodiments, a UTR can comprise a TEE sequence-spacer sequence module that is repeated at least once, at least twice, at least 3 times, at least 4 times, at least 5 times, at least 6 times, at least 7 times, at least 8 times, at least 9 times, or more than 9 times in the UTR. In any of the embodiments described in this paragraph, the UTR can be a 5’-UTR, a 3’-UTR or both 5’-UTR and 3’-UTR of a nucleic acid molecule.
[0127] In some embodiments, the UTR of a nucleic acid molecule of the present disclosure comprises at least one translation suppressing element that functions to decrease the amount of polypeptide or protein produced from the nucleic acid molecule. In some embodiments, the UTR of the nucleic acid molecule comprises one or more miR sequences or fragment thereof (e.g., miR seed sequences) that are recognized by one or more microRNA. Other mechanisms for suppressing translational activities associated with nucleic acid molecules are known in the art. In some of the embodiments described in this paragraph, the nucleic acid molecule is linear, and the UTR can be a 5’-UTR, a 3’-UTR or both 5’-UTR and 3’-UTR of a nucleic acid molecule.
[0128] Table 7.3.2 (A) shows exemplary 5’-UTR and 3’-UTR sequences that can be operably linked to a NeuroD1 coding sequence as described herein. Table 7.3.2 (A) Examples of UTRs.
[0129] In some embodiments, the expression cassette is mono-cistronic and encodes one copy of a NeuroD1 polypeptide. In some embodiments, the encoded NeuroD1 polypeptide can be any NeuroD1 polypeptide as described in Section 7.3.1 (Coding Region) . In some embodiments, the encoded NeuroD1 polypeptide comprises an amino acid sequence having at least 95%sequence identity to the sequence set forth in SEQ ID NO: 1. In some embodiments, the encoded NeuroD1 polypeptide comprises an amino acid sequence having at least 95%sequence identity to the sequence set forth in SEQ ID NO: 57. In some embodiments, the encoded NeuroD1 polypeptide comprises an amino acid sequence set forth in SEQ ID NO: 3. In some embodiments, coding sequence that encodes the NeuroD1 polypeptide comprises the nucleic acid sequence as set forth in SEQ ID NO: 2 or a codon-optimized variant thereof. In some embodiments, coding sequence that encodes the NeuroD1 polypeptide comprises the nucleic acid sequence as set forth in SEQ ID NO: 58 or a codon-optimized variant thereof. In some embodiments, coding sequence that encodes the NeuroD1 polypeptide comprises the nucleic acid sequence as set forth in SEQ ID NO: 4 or a codon-optimized variant thereof.
[0130] In some embodiments, the expression cassette further comprises one or more untranslated regions (UTRs) . In some embodiments, the UTR comprises one or more regulatory elements operably linked to the coding sequence that encodes the NeuroD1 polypeptide. In some embodiments, the UTRs can be any UTR as described in Section 7.3.2 (Untranslated Regions (UTRs) ) . In some embodiments, the expression cassette comprises a 5’ UTR located upstream (to the 5’ end) of the coding sequence that encodes the NeuroD1 polypeptide. In some embodiments, the 5’-UTR comprises, from the 5’ to 3’ direction, a CMV enhancer, a glial fibrillary acid protein (GFAP) promoter, and a chimeric intron. In some embodiments, the 5’-UTR comprises, from the 5’ to 3’ direction, an EF1α enhancer, a GFAP promoter, and a chimeric intron.
[0131] In some embodiments, the CMV enhancer comprises the sequence set forth in SEQ ID NO: 5, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the CMV enhancer consists of the sequence set forth in SEQ ID NO: 5.
[0132] In some embodiments, the EF1α enhancer comprises the sequence set forth in SEQ ID NO: 6, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the EF1α enhancer consists of the sequence set forth in SEQ ID NO: 6.
[0133] In some embodiments, the GFAP promoter comprises the sequence set forth in SEQ ID NO: 7, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the GFAP promoter consists of the sequence set forth in SEQ ID NO: 7.
[0134] In some embodiments, the chimeric intron comprises the sequence set forth in SEQ ID NO: 8, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the chimeric intron consists of the sequence set forth in SEQ ID NO: 8.
[0135] In some embodiments, the chimeric intron comprises the sequence set forth in SEQ ID NO: 9, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the chimeric intron consists of the sequence set forth in SEQ ID NO: 9.
[0136] In some embodiments, the chimeric intron comprises the sequence set forth in SEQ ID NO: 10, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the chimeric intron consists of the sequence set forth in SEQ ID NO: 10.
[0137] In some embodiments, the 5’ UTR of the expression cassette comprises the sequence set forth in SEQ ID NO: 15. In some embodiments, the expression cassette comprises a 5’ UTR comprising the sequence set forth in SEQ ID NO: 15, wherein the 5’ UTR is linked to the 5’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence having at least 95%sequence identity to the sequence set forth in SEQ ID NO: 1. In some embodiments, the expression cassette comprises a 5’ UTR comprising the sequence set forth in SEQ ID NO: 15, wherein the 5’ UTR is linked to the 5’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence having at least 95%sequence identity to the sequence set forth in SEQ ID NO: 57. In some embodiments, the expression cassette comprises a 5’ UTR comprising the sequence set forth in SEQ ID NO: 15, wherein the 5’ UTR is linked to the 5’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence set forth in SEQ ID NO: 3. In some embodiments, the expression cassette comprises a 5’ UTR comprising the sequence set forth in SEQ ID NO: 15, wherein the 5’ UTR is linked to the 5’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising the nucleic acid sequence set forth in SEQ ID NO: 2, or a codon optimized variant thereof. In some embodiments, the expression cassette comprises a 5’ UTR comprising the sequence set forth in SEQ ID NO: 15, wherein the 5’ UTR is linked to the 5’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising the nucleic acid sequence set forth in SEQ ID NO: 58, or a codon optimized variant thereof. In some embodiments, the expression cassette comprises a 5’ UTR comprising the sequence set forth in SEQ ID NO: 15, wherein the 5’ UTR is linked to the 5’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising the nucleic acid sequence set forth in SEQ ID NO: 4, or a codon optimized variant thereof.
[0138] In some embodiments, the expression cassette comprises a 3’ UTR located downstream (to the 3’ end) of the coding sequence that encodes the NeuroD1 polypeptide.
[0139] In some embodiments, the 3’-UTR comprises a woodchuck hepatitis virus posttranscriptional regulatory element (WPRE) . In some embodiments, a WPRE nucleic acid sequence is an optimized version of WPRE. In some embodiments, the optimized WPRE comprises the sequence set forth in SEQ ID NO: 11, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the optimized WPRE consists of the sequence set forth in SEQ ID NO: 11. In some embodiments, the optimized WPRE comprises the sequence set forth in SEQ ID NO: 12, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the chimeric intron consists of the sequence set forth in SEQ ID NO: 12.
[0140] In some embodiments, the 3’-UTR comprises a polyadenylation signal comprising the sequence set forth in SEQ ID NO: 13, or a functional variant having at least 90%sequence identity thereof. In some embodiments, the polyadenylation signal consists of the sequence set forth in SEQ ID NO: 13. In some embodiments, the polyadenylation signal comprises a SV40 polyadenylation signal. In some embodiments, the SV40 polyadenylation signal comprising the sequence set forth in SEQ ID NO: 14, or a functional variant having at least 90%sequence identity thereof. In some embodiments, the SV40 polyadenylation signal consists of the sequence set forth in SEQ ID NO: 14. In some embodiments, the polyadenylation signal comprises a human beta globin polyadenylation signal. In some embodiments, the polyadenylation signal comprises a polyadenylation signal originated from a human gene. In some embodiments, the polyadenylation signal comprises a polyadenylation signal originated from a non-human gene.
[0141] In some embodiments, the 3’ UTR of the expression cassette comprises the sequence set forth in SEQ ID NO: 16. In some embodiments, the expression cassette comprises a 3’ UTR comprising the sequence set forth in SEQ ID NO: 16, wherein the 3’ UTR is linked to the 3’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence having at least 95%sequence identity to the sequence set forth in SEQ ID NO: 1. In some embodiments, the expression cassette comprises a 3’ UTR comprising the sequence set forth in SEQ ID NO: 16, wherein the 3’ UTR is linked to the 3’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence having at least 95%sequence identity to the sequence set forth in SEQ ID NO: 57. In some embodiments, the expression cassette comprises a 3’ UTR comprising the sequence set forth in SEQ ID NO: 16, wherein the 3’ UTR is linked to the 3’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence set forth in SEQ ID NO: 3. In some embodiments, the expression cassette comprises a 3’ UTR comprising the sequence set forth in SEQ ID NO: 16, wherein the 3’ UTR is linked to the 3’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising the nucleic acid sequence set forth in SEQ ID NO: 2, or a codon optimized variant thereof. In some embodiments, the expression cassette comprises a 3’ UTR comprising the sequence set forth in SEQ ID NO: 16, wherein the 3’ UTR is linked to the 3’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising the nucleic acid sequence set forth in SEQ ID NO: 58, or a codon optimized variant thereof. In some embodiments, the expression cassette comprises a 3’ UTR comprising the sequence set forth in SEQ ID NO: 16, wherein the 3’ UTR is linked to the 3’ end of a coding sequence that encodes a NeuroD1 polypeptide comprising the nucleic acid sequence set forth in SEQ ID NO: 4 or codon-optimized variant thereof.
[0142] Table 7.3.2 (B) below lists the sequences of functional fragments in a NeuroD1 expression cassette according to some embodiments described herein. In some embodiments, the expression cassette comprises, from the 5’ to 3’ direction, a CMV enhancer (SEQ ID NO: 5) , a GFAP promoter (SEQ ID NO: 7) , a chimeric intron (SEQ ID NO: 9) , a coding sequence (SEQ ID NO: 4) that encodes a NeuroD1 polypeptide (SEQ ID NO: 3) , an optimized WPRE (SEQ ID NO: 11) and a polyadenylation signal (SEQ ID NO: 13) . In specific embodiments, the CMV enhancer (SEQ ID NO: 5) , GFAP promoter (SEQ ID NO: 7) , chimeric intron (SEQ ID NO: 9) , coding sequence that encodes a NeuroD1 polypeptide (SEQ ID NO: 4) , optimized WPRE (SEQ ID NO: 11) and polyadenylation signal (SEQ ID NO: 13) are connected directly to each other in the 5’ to 3’ order. In specific embodiments, the CMV enhancer (SEQ ID NO: 5) , GFAP promoter (SEQ ID NO: 7) , chimeric intron (SEQ ID NO: 9) , coding sequence that encodes a NeuroD1 polypeptide (SEQ ID NO: 4) , optimized WPRE (SEQ ID NO: 11) and polyadenylation signal (SEQ ID NO: 13) are connected to each other in the 5’ to 3’ order via linkers. Table 7.3.2 (B) Example of a NeuroD1 Expression Cassette 7.4. AAV Genome
[0143] In some embodiments, the expression cassette described herein is part of a single-stranded nucleic acid molecule. In some embodiments, the single-stranded nucleic acid molecule is a DNA molecule. In some embodiments, the single-stranded nucleic acid molecule is an artificial AAV genome that can be packaged into a recombinant AAV capsid.
[0144] In some embodiments, the single-stranded nucleic acid molecule comprises a first inverted terminal repeat (ITR) of a first AAV genome located at 5’ UTR. In some embodiments, the single-stranded nucleic acid molecule comprises a second inverted terminal repeat (ITR) of a second AAV genome located at 3’ UTR. In some embodiments, the first and the second ITRs are selected from the genomic ITR sequences of AAV serotypes AAV1, AAV2, AAV2tYF, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAVrh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, rAAV. 7m8, AAV. PHP. B, AAV. PHP. eB, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10 , AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16. In some embodiments, the first and the second ITRs are selected from the genomic ITR sequences of the same AAV serotype.
[0145] In some embodiments, the first ITR is selected from the genomic ITR sequences of AAV serotypes 1 to 8. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV1 genome. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV2 genome. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV3 genome. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV4 genome. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV5 genome. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV6 genome. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV7 genome. In some embodiments, the first ITR comprises the 5’ ITR sequence from the AAV8 genome. In some embodiments, the first ITR comprises the full-length ITR sequence from the AAV genome. In some embodiments, the first ITR comprises a truncated version of the ITR sequence from the AAV genome. In some embodiments, the first ITR comprises the wild-type ITR sequence from the AAV genome. In some embodiments, the first ITR comprises a mutated ITR sequence from the AAV genome. In some embodiments, the first ITR comprises the sequence set forth in SEQ ID NO: 23, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the first ITR consists of the sequence set forth in SEQ ID NO: 23. In some embodiments, the first ITR comprises the sequence set forth in SEQ ID NO: 26, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the first ITR consists of the sequence set forth in SEQ ID NO: 26.
[0146] In some embodiments, the single-stranded nucleic acid molecule comprises a second inverted terminal repeat (ITR) of a second AAV genome located at 3’ UTR. In some embodiments, the second ITR is selected from the genomic ITR sequences of AAV serotypes 1 to 8. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV1 genome. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV2 genome. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV3 genome. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV4 genome. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV5 genome. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV6 genome. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV7 genome. In some embodiments, the second ITR comprises the 3’ ITR sequence from the AAV8 genome. In some embodiments, the second ITR comprises the full-length ITR sequence from the AAV genome. In some embodiments, the second ITR comprises a truncated version of the ITR sequence from the AAV genome. In some embodiments, the second ITR comprises the wild-type ITR sequence from the AAV genome. In some embodiments, the second ITR comprises a mutated ITR sequence from the AAV genome.
[0147] In some embodiments, the second ITR comprises the sequence set forth in SEQ ID NO: 24, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the second ITR consists of the sequence set forth in SEQ ID NO: 24. In some embodiments, the second ITR comprises the sequence set forth in SEQ ID NO: 27, or a functional variant having at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%sequence identity thereof. In some embodiments, the second ITR consists of the sequence set forth in SEQ ID NO: 27.
[0148] ITR sequences for various AAV serotypes are known in the art. See, for example, GenBank: ITR1: NC_002077.1, nts 1-143, nts 4574-4718, ITR2: NC_001401.2, nts 1-145, nts 4535-4679, ITR3: NC_001729, nts 1-143, 4582-4726, ITR4: NC_001829.1, nts 1-146, nts 4623-4767, ITR5: NC_006152, nts 1-145, nts 4498-4642, ITR6: AF028704.1, nts 1-145, nts 4539-4683, ITR7: NC_006260.1, nts 1-145, nts 4577-4721 for the 5’ (left) ITR sequences. Table 7.4 Example of a recombinant AAV genome encoding NeuroD1 (AAV-NeuroD1) 7.5. Recombinant AAV Vectors
[0149] In some embodiments, the single-stranded nucleic acid molecule is an artificial AAV genome that can be packaged into a AAV capsid to produce a recombinant AAV virion. In some embodiments, such recombinant AAV carries a transgene encoding NeuroD1 in its genome and is sometimes referred to as a AAV vector encoding NeuroD1 in the present disclosure.
[0150] In certain embodiments, the AAV vector encoding NeuroD1 further comprises an AAV capsid protein. In certain embodiments, the AAV capsid protein has a serotype selected from the group consisting of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15 and AAV16, AAV. rh8, AAV. rh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, AAV. 7m8, AAV. PHP. B, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10, AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16, derivatives thereof, modifications thereof, pseudotypes thereof, and combinations thereof. In certain embodiments, the AAV capsid protein comprises or consists of an amino acid sequence that is at least about 80%, at least about 85%, at least about 86%, at least about 87%, at least about 88%, at least about 89%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%or at least about 99.5%, or 100%homologous or identical to the amino acid sequence of viral protein 1 (VP1) , viral protein 2 (VP2) , or viral protein 3 (VP3) of an AAV capsid serotype selected from the group consisting of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15 and AAV16, AAV. rh8, AAV. rh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, AAV. 7m8, AAV. PHP. B, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10, AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16.
[0151] In specific embodiments, the AAV vector encoding NeuroD1 further comprises a AAV serotype 9 (AAV9) capsid. In some embodiments, the AAV9 capsid comprises at least one capsid protein comprises or consists of an amino acid sequence that is about 80%, at least about 85%, at least about 86%, at least about 87%, at least about 88%, at least about 89%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%or at least about 99.5%, or 100%homologous or identical to the amino acid sequence of viral protein 1 (VP1) , viral protein 2 (VP2) , or viral protein 3 (VP3) of AAV9.
[0152] In some embodiments, the AAV9 capsid comprises a capsid protein that is a functional derivative of AAV9 VP1 having at least about 80%, at least about 85%, at least about 86%, at least about 87%, at least about 88%, at least about 89%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%or at least about 99.5%, or 100%sequence identity to SEQ ID NO: 36. These functional derivative of AAV9 VP1 is collected referred to as “AAV9 VP1 polypeptides. ” In specific embodiments, the AAV9 capsid comprises a capsid protein comprising the amino acid sequence set forth in SEQ ID NO: 36.
[0153] In some embodiments, the AAV9 capsid comprises a capsid protein that is a functional derivative of AAV9 VP2 having at least about 80%, at least about 85%, at least about 86%, at least about 87%, at least about 88%, at least about 89%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%or at least about 99.5%, or 100%sequence identity to SEQ ID NO: 37. These functional derivative of AAV9 VP2 is collected referred to as “AAV9 VP2 polypeptides. ” In specific embodiments, the AAV9 capsid comprises a capsid protein comprising the amino acid sequence set forth in SEQ ID NO: 37.
[0154] In some embodiments, the AAV9 capsid comprises a capsid protein that is a functional derivative of AAV9 VP3 having at least about 80%, at least about 85%, at least about 86%, at least about 87%, at least about 88%, at least about 89%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%or at least about 99.5%, or 100%sequence identity to SEQ ID NO: 38. These functional derivative of AAV9 VP3 is collected referred to as “AAV9 VP3 polypeptides. ” In specific embodiments, the AAV9 capsid comprises a capsid protein comprising the amino acid sequence set forth in SEQ ID NO: 38.
[0155] In some embodiments, the AAV9 capsid comprises an AAV VP1 polypeptide and an AAV VP2 polypeptide. In some embodiments, the AAV9 capsid comprises an AAV VP1 polypeptide and an AAV VP3 polypeptide. In some embodiments, the AAV9 capsid comprises an AAV VP2 polypeptide and an AAV VP3 polypeptide. In some embodiments, the AAV9 capsid comprises an AAV VP1 polypeptide, an AAV VP2 polypeptide, and an AAV VP3 polypeptide.
[0156] In yet a particular embodiment, the AAV vector encoding NeuroD1 further comprises a AAV9 capsid, wherein the AAV9 capsid comprises a VP1 polypeptide comprising the amino acid sequence set forth in SEQ ID NO: 36, a VP2 polypeptide comprising the amino acid sequence set forth in SEQ ID NO: 37, and a VP3 polypeptide comprising the amino acid sequence set forth in SEQ ID NO: 38.
[0157] In certain embodiments, the AAV vector comprises capsid of Anc80 or Anc80L65, as described in Zinn et al., 2015, Cell Rep. 12 (6) : 1056-1068, the content of which is incorporated by reference in its entirety. In certain embodiments, the AAV vector comprises the capsid with one of the following amino acid insertions: LGETTRP or LALGETTRP, as described in U.S. Patent Nos. 9,193,956; 9,458,517; and 9,587,282 and U.S. patent application publication no. 2016 / 0376323, the content of each of which is incorporated herein by reference in its entirety. In certain embodiments, the AAV vector comprises the capsid of AAV. 7m8, as described in U.S. Patent Nos. 9,193,956; 9,458,517; and 9,587,282 and U.S. patent application publication no. 2016 / 0376323, the content of each of which is incorporated herein by reference in its entirety. In certain embodiments, the AAV vector comprises any AAV capsid disclosed in U.S. Patent No. 9,585,971 (e.g., AAV-PHP. B) , the content of which is incorporated by reference in its entirety. In certain embodiments, the AAV vector comprises any AAV capsid disclosed in U.S. Patent No. 9,840,719 and WO 2015 / 013313, such as AAV. Rh74 and RHM4-1, the content of each of which is incorporated herein by reference in its entirety. In certain embodiments, the AAV vector comprises any AAV capsid disclosed in International Publication No. WO 2014 / 172669, such as AAV rh. 74, the content of which is incorporated herein by reference in its entirety. In certain embodiments, the AAV vector comprises the capsid of AAV2 / 5, as described in Georgiadis et al., 2016, Gene Therapy 23: 857-862 and Georgiadis et al., 2018, Gene Therapy 25: 450, the content of each of which is incorporated by reference in its entirety. In certain embodiments, the AAV vector comprises any AAV capsid disclosed in International Publication No. WO 2017 / 070491, such as AAV2tYF, the content of which is incorporated herein by reference in its entirety. In certain embodiments, the AAV vector comprises the capsids of AAVLK03 or AAV3B, as described in Puzzo et al., 2017, Sci. Transl. Med. 29 (9) : 418, the content of which is incorporated by reference in its entirety. In certain embodiments, the AAV vector comprises any AAV capsid disclosed in U.S. Patent Nos. 8,628,966; 8,927,514; and 9,923,120 and International Publication No. WO 2016 / 049230, such as HSC1, HSC2, HSC3, HSC4, HSC5, HSC6, HSC7, HSC8, HSC9, HSC10, HSC11, HSC12, HSC13, HSC14, HSC15, or HSC16, the content of each of which is incorporated by reference in its entirety.
[0158] In certain embodiments, the AAV vector comprises an AAV capsid disclosed in any of the following patents and patent applications, the content of each of which is incorporated herein by reference in its entirety: U.S. Patent Nos. 7,282,199; 7,906,111; 8,524,446; 8,999,678; 8,628,966; 8,927,514; 8,734,809; 9,284,357; 9,409,953; 9,169,299; 9,193,956; 9458517; and 9,587,282; U.S. Patent Publication Nos. 2015 / 0374803; 2015 / 0126588; 2017 / 0067908; 2013 / 0224836; 2016 / 0215024; 2017 / 0051257; and International Patent Publication Nos. WO2015191508; WO2015121501. In certain embodiments, the AAV vector comprises a capsid protein that is at least about 80%, at least about 85%, at least about 86%, at least about 87%, at least about 88%, at least about 89%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%or at least about 99.5%, or 100%homologous or identical to the amino acid sequence of the VP1, VP2, or VP3 of an AAV capsid disclosed in any of the following patents and patent applications, the content each of which is incorporated herein by reference in its entirety: U.S. Patent Nos. 7,282,199; 7,906,111; 8,524,446; 8,999,678; 8,628,966; 8,927,514; 8,734,809; 9,284,357; 9,409,953; 9,169,299; 9,193,956; 9458517; and 9,587,282; U.S. Patent Publication Nos. 2015 / 0374803; 2015 / 0126588; 2017 / 0067908; 2013 / 0224836; 2016 / 0215024; 2017 / 0051257; and International Patent Publication Nos. WO2015191508; WO2015121501.
[0159] In certain embodiments, the AAV vector comprises a capsid protein disclosed in International Patent Publication Nos. WO 2003 / 052051 (see, e.g., SEQ ID NO: 2 of WO 2003 / 052051) , WO 2005 / 033321 (see, e.g., SEQ ID NOs: 123 and 88 of WO 2005 / 033321) , WO 03 / 042397 (see, e.g., SEQ ID NOs: 2, 81, 85, and 97 of WO 03 / 042397) , WO 2006 / 068888 (see, e.g., SEQ ID NOs: 1 and 3-6 of WO 2006 / 068888) , WO 2006 / 110689 (see, e.g., SEQ ID NOs: 5-38 of WO 2006 / 110689) , WO2009 / 104964 (see, e.g., SEQ ID NOs: 1-5, 7, 9, 20, 22, 24 and 31 of WO2009 / 104964) , WO 2010 / 127097 (see, e.g., SEQ ID NOs: 5-38 of WO 2010 / 127097) , and WO 2015 / 191508 (see, e.g., SEQ ID NOs: 80-294 of WO 2015 / 191508) , and U.S. Patent Publication No. 20150023924 (see, e.g., SEQ ID NOs: 1, 5-10 of 20150023924) , the contents of each of which is herein incorporated by reference in its entirety. In certain embodiments, the AAV vector comprises a capsid protein at least about 80%, at least about 85%, at least about 86%, at least about 87%, at least about 88%, at least about 89%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, at least about 99%or at least about 99.5%, or 100%homologous or identical to the amino acid sequence of the VP1, VP2, or VP3 protein of an AAV capsid disclosed in International Patent Publication Nos. WO 2003 / 052051 (see, e.g., SEQ ID NO: 2 of WO 2003 / 052051) , WO 2005 / 033321 (see, e.g., SEQ ID NOs: 123 and 88 of WO 2005 / 033321) , WO 03 / 042397 (see, e.g., SEQ ID NOs: 2, 81, 85, and 97 of WO 03 / 042397) , WO 2006 / 068888 (see, e.g., SEQ ID NOs: 1 and 3-6 of WO 2006 / 068888) , WO 2006 / 110689 (see, e.g., SEQ ID NOs: 5-38 of WO 2006 / 110689) , WO2009 / 104964 (see, e.g., SEQ ID NOs: 1-5, 7, 9, 20, 22, 24 and 31 of WO2009 / 104964) , WO 2010 / 127097 (see, e.g., SEQ ID NOs: 5-38 of WO 2010 / 127097) , and WO 2015 / 191508 (see, e.g., SEQ ID NOs: 80-294 of WO 2015 / 191508) , and U.S. Patent Publication No. 20150023924 (see, e.g., SEQ ID NOs: 1, 5-10 of 20150023924) .
[0160] In certain embodiments, the AAV vector comprises a pseudotyped AAV capsid. In certain embodiments, the pseudotyped AAV capsids are rAAV2 / 8 or rAAV2 / 9 pseudotyped AAV capsids. Methods for producing and using pseudotyped AAV vectors are known in the art (see, e.g., Duan et al., J. Virol., 75: 7662-7671 (2001) ; Halbert et al., J. Virol., 74: 1524-1532 (2000) ; Zolotukhin et al., Methods 28: 158-167 (2002) ; and Auricchio et al., Hum. Molec. Genet. 10: 3075-3081, (2001) , the content of each of which is incorporated by reference in its entirety) .
[0161] In certain embodiments, the AAV vector comprises a capsid comprising a capsid protein chimeric of two or more AAV capsid serotypes. In certain embodiments, the capsid protein is a chimeric of two or more AAV capsid proteins of AAV serotypes selected from the group consisting of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15 and AAV16, AAV. rh8, AAV. rh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, AAV. 7m8, AAV. PHP. B, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10, AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16.
[0162] In certain embodiments, the AAV vector comprises an AAV capsid protein chimeric of AAV8 capsid protein and one or more AAV capsid proteins from an AAV serotype selected from the group consisting of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15 and AAV16, AAV. rh8, AAV. rh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, AAV. 7m8, AAV. PHP. B, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10, AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16. In certain embodiments, the AAV vector comprises an AAV capsid protein chimeric of AAV8 capsid protein and one or more AAV capsid proteins from an AAV serotype selected from the group consisting of AAV1, AAV2, AAV5, AAV6, AAV7, AAV9, AAV10, AAVrh. 8, and AAVrh. 10.
[0163] In certain embodiments, the AAV vector comprises an AAV capsid protein chimeric of AAV9 capsid protein the capsid protein of one or more AAV capsid serotypes selected from the group consisting of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15 and AAV16, AAV. rh8, AAV. rh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, AAV. 7m8, AAV. PHP. B, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10, AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16
[0164] In certain embodiments, the AAV vectors comprises a mosaic capsid. In certain embodiments, the mosaic capsid comprises a mixture of viral capsid proteins from different AAV serotypes. In certain embodiments, the mosaic capsid comprises capsid proteins of serotypes selected from the group consisting of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15 and AAV16, AAV. rh8, AAV. rh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, AAV. 7m8, AAV. PHP. B, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10, AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16. In certain embodiments, the mosaic capsid comprises capsid proteins of serotypes selected from the group consisting of AAV1, AAV2, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAVrh. 8, and AAVrh. 10.
[0165] In certain embodiments, the AAV vector comprises a pseudotyped AAV vector. In certain embodiments, the pseudotyped AAV vector comprises a capsid protein of an AAV serotype selected from the group consisting of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15 and AAV16, AAV. rh8, AAV. rh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, AAV. 7m8, AAV. PHP. B, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10, AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16. In certain embodiments, the pseudotyped AAV vector are AAV2 / 8 or AAV2 / 9 pseudotyped vectors. Methods for producing and using pseudotyped AAV vectors are known in the art (see, e.g., Duan et al., J. Virol., 75: 7662-7671 (2001) ; Halbert et al., J. Virol., 74: 1524-1532 (2000) ; Zolotukhin et al., Methods 28: 158-167 (2002) ; and Auricchio et al., Hum. Molec. Genet. 10: 3075-3081, (2001, the content of each of which is incorporated herein by reference in its entirety) .
[0166] Nucleotide sequences of AAV vectors and methods of making thereof are taught, for example, in U.S. Patent Nos. 7,282,199; 7,906,111; 8,524,446; 8,999,678; 8,628,966; 8,927,514; 8,734,809; US 9,284,357; 9,409,953; 9,169,299; 9,193,956; 9458517; and 9,587,282; U.S. Patent Publication Nos. 2015 / 0374803; 2015 / 0126588; 2017 / 0067908; 2013 / 0224836; and 2016 / 0215024; 2017 / 0051257; 2015 / 0023924; International Patent Publication Nos. WO2015191508; WO2015121501; WO 2003 / 052051, WO 2005 / 033321, WO 03 / 042397, WO 2006 / 068888, WO 2006 / 110689, WO2009 / 104964, WO 2010 / 127097, and WO 2015 / 191508, the content of each of which is incorporated herein by reference in its entirety. 7.6. Methods and Compositions for Making Recombinant AAV
[0167] In one aspect, the present disclosure provides plasmids comprising a presently disclosed expression cassettes (e.g., expression cassettes disclosed in Section 7.3 (NeuroD1 Expression Cassette) of the present disclosure) . The presently disclosed plasmids can be used for producing AAV vectors (e.g., AAV vectors disclosed in Section 7.5 (Recombinant AAV Vectors) of the present disclosure) by being delivered into host cell for AAV packaging.
[0168] In some embodiments, provided herein is a gene-of-interest (GOI) plasmid that carries a transgene encoding a NeuroD1 polypeptide. In some embodiments, the GOI plasmid comprises a NeuroD1 expression cassette as described in Section 7.3 (NeuroD1 Expression Cassette) and a pair of AAV ITR sequences flanking the NeuroD1 expression cassette.
[0169] In some embodiments, the pair of AAV ITRs are independently selected from the genomic ITR sequences of AAV serotypes AAV1, AAV2, AAV2tYF, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAVrh10, AAV. rh20, AAV. rh39, AAV. Rh74, AAV. RHM4-1, AAV. hu37, AAV. Anc80, AAV. Anc80L65, rAAV. 7m8, AAV. PHP. B, AAV. PHP. eB, AAV2.5, AAV2tYF, AAV3B, AAV. LK03, AAV. HSC1, AAV. HSC2, AAV. HSC3, AAV. HSC4, AAV. HSC5, AAV. HSC6, AAV. HSC7, AAV. HSC8, AAV. HSC9, AAV. HSC10 , AAV. HSC11, AAV. HSC12, AAV. HSC13, AAV. HSC14, AAV. HSC15, and AAV. HSC16.
[0170] In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette comprises the full-length 5’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette comprises the wild-type 5’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette is a truncated version of the 5’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette is a mutated version of the 5’ ITR sequence of the AAV genome.
[0171] In some embodiments, the ITR sequence located 3’ to the NeuroD1 expression cassette comprises the wild-type 3’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 3’ to the NeuroD1 expression cassette is a truncated version of the 3’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 3’ to the NeuroD1 expression cassette is a mutated version of the 3’ ITR sequence of the AAV genome.
[0172] In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette (i.e., the 5’ ITR sequence in the plasmid) is selected from the genomic ITR sequences of AAV serotypes 1 to 8. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV1 genome. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV2 genome. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV3 genome. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV4 genome. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV5 genome. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV6 genome. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV7 genome. The 5’ ITR sequence in the plasmid comprises the 5’ ITR sequence from the AAV8 genome. In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette comprises the full-length 5’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette comprises the wild-type 5’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 5’ to the NeuroD1 expression cassette is a truncated version of the 5’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 5’to the NeuroD1 expression cassette is a mutated version of the 5’ ITR sequence of the AAV genome.
[0173] In some embodiments, the ITR sequence located 3’ to the NeuroD1 expression cassette (i.e., the 3’ ITR sequence in the plasmid) is selected from the genomic ITR sequences of AAV serotypes 1 to 8. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV1 genome. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV2 genome. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV3 genome. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV4 genome. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV5 genome. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV6 genome. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV7 genome. In some embodiments, the 3’ ITR sequence in the plasmid comprises the 3’ ITR sequence from the AAV8 genome. In some embodiments, the ITR sequence located 3’ to the NeuroD1 expression cassette comprises the wild-type 3’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 3’ to the NeuroD1 expression cassette is a truncated version of the 3’ ITR sequence of the AAV genome. In some embodiments, the ITR sequence located 3’ to the NeuroD1 expression cassette is a mutated version of the 3’ ITR sequence of the AAV genome.
[0174] ITR sequences for various AAV serotypes are known in the art. See, for example, GenBank: ITR1: NC_002077.1, nts 1-143, ITR2: NC_001401.2, nts 1-145, ITR3: JB292182.1, nts 1-143, ITR4: NC_001829.1, nts 1-146, ITR6: AF028704.1, nts 1-145, ITR7: NC_006260.1, nts 1-145, for the 5’ (left) ITR sequences.
[0175] In specific embodiments, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence selected from SEQ ID NO: 23 and SEQ ID NO: 26, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence selected from SEQ ID NO: 24, and SEQ ID NO: 27, and wherein the NeuroD1 expression cassette comprises a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence having at least 90%sequence identity to the sequence set forth in SEQ ID NO: 1, SEQ ID NO: 57, SEQ ID NO: 3.
[0176] In specific embodiments, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence having at least 90%sequence identity to the sequence set forth in SEQ ID NO: 1.
[0177] In specific embodiments, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence that encodes a NeuroD1 polypeptide comprising an amino acid sequence having at least 90%sequence identity to the sequence set forth in SEQ ID NO: 57.
[0178] In specific embodiments, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence that encodes a NeuroD1 polypeptide comprising the amino acid sequence set forth in SEQ ID NO: 3.
[0179] In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence comprising the sequence set forth in SEQ ID NO: 2 or codon-optimized variant thereof.
[0180] In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence comprising the sequence set forth in SEQ ID NO: 58 or codon-optimized variant thereof.
[0181] In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence comprising the sequence set forth in SEQ ID NO: 4 or codon-optimized variant thereof.
[0182] In yet a specific embodiment, the NeuroD1 expression cassette further comprises one or more regulatory elements operably linked to the coding sequence. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence, a GFAP promoter sequence, a chimeric intron, an optimized WPRE, and a polyadenylation signal. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence comprising the sequence set forth in SEQ ID NO: 5, a GFAP promoter sequence comprising the sequence set forth in SEQ ID NO: 7, a chimeric intron comprising the sequence set forth in SEQ ID NO: 9, an optimized WPRE comprising the sequence set forth in SEQ ID NO: 11, and a polyadenylation signal comprising the sequence set forth in SEQ ID NO: 13.
[0183] In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence comprising the sequence set forth in SEQ ID NO: 58 or codon-optimized variant thereof. In yet a specific embodiment, the NeuroD1 expression cassette further comprises one or more regulatory elements operably linked to the coding sequence. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence, a GFAP promoter sequence, a chimeric intron, an optimized WPRE, and a polyadenylation signal. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence comprising the sequence set forth in SEQ ID NO: 5, a GFAP promoter sequence comprising the sequence set forth in SEQ ID NO: 7, a chimeric intron comprising the sequence set forth in SEQ ID NO: 9, an optimized WPRE comprising the sequence set forth in SEQ ID NO: 11, and a polyadenylation signal comprising the sequence set forth in SEQ ID NO: 13.
[0184] In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence comprising the sequence set forth in SEQ ID NO: 2 or codon-optimized variant thereof. In yet a specific embodiment, the NeuroD1 expression cassette further comprises one or more regulatory elements operably linked to the coding sequence. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence, a GFAP promoter sequence, a chimeric intron, an optimized WPRE, and a polyadenylation signal. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence comprising the sequence set forth in SEQ ID NO: 5, a GFAP promoter sequence comprising the sequence set forth in SEQ ID NO: 7, a chimeric intron comprising the sequence set forth in SEQ ID NO: 9, an optimized WPRE comprising the sequence set forth in SEQ ID NO: 11, and a polyadenylation signal comprising the sequence set forth in SEQ ID NO: 13.
[0185] In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises a coding sequence comprising the sequence set forth in SEQ ID NO: 4 or codon-optimized variant thereof. In yet a specific embodiment, the NeuroD1 expression cassette further comprises one or more regulatory elements operably linked to the coding sequence. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence, a GFAP promoter sequence, a chimeric intron, an optimized WPRE, and a polyadenylation signal. In specific embodiments, the regulatory elements are one or more selected from a CMV enhancer sequence comprising the sequence set forth in SEQ ID NO: 5, a GFAP promoter sequence comprising the sequence set forth in SEQ ID NO: 7, a chimeric intron comprising the sequence set forth in SEQ ID NO: 9, an optimized WPRE comprising the sequence set forth in SEQ ID NO: 11, and a polyadenylation signal comprising the sequence set forth in SEQ ID NO: 13.
[0186] In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette comprises the sequence set forth in SEQ ID NO: 22. In yet a specific embodiment, the plasmid comprises a pair of ITR sequences located on each end of an NeuroD1 expression cassette, and wherein the ITR located 5’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 23, and the ITR located 3’ to the NeuroD1 expression cassette comprises the sequence of SEQ ID NO: 24, and wherein the NeuroD1 expression cassette consists of the sequence set forth in SEQ ID NO: 22.
[0187] In some embodiments, the plasmid further comprises a backbone sequence. Any suitable plasmid backbone known in the art for the production of AAV vectors can be used with the presently disclosed subject matter, and an exemplary plasmid backbone sequence is provided in Table 8.1 (A) (see e.g., SEQ ID NO: 28) .
[0188] The present disclosure provides host cells comprising a presently disclosed plasmid. Any suitable host cells for AAV vector production can be used with the presently disclosed subject matter. In certain embodiments, the host cell is a mammalian cell. In certain embodiments, the host cell from humans, monkeys, mice, rats, rabbits, or hamsters. In certain embodiments, the host cell is an insect cell.
[0189] Non-limiting examples of suitable host cells that can be used with the presently disclosed subject matter include A549 cells, WEHI cells, 10T1 / 2 cells, MDCK cells, COS1 cells, COS7 cells, BSC 1 cells, BSC 40 cells, BMT 10 cells, VERO cells, W138 cells, Saos cells, C2C12 cells, L cells, HT1080 cells, HepG2 cells, HeLa cells, HEK293 cells, HEK293 derived cells (e.g., HEK293T cells, HEK293F cells) , CHO cells, CHO-K1 cells, CHO derived cells, EB66 cells, BSC cells, HepG2 cells, LLC-MK cells, CV-1 cells, COS cells, MDBK cells, MDCK cells, CRFK cells, RAF cells, RK cells, TCMK-1 cells, LLCPK cells, PK15 cells, LLC-RK cells, BHK cells, BHK-21 cells, NS-1 cells, MRC-5 cells, WI-38 cells, 3T3 cells, 293 cells, RK cells, Per. C6 cells, chicken embryo cells, SF-9 cells, primary fibroblasts, primary hepatocytes, primary myoblast cells, primary hippocampal neurons, primary cerebral cortical neurons, primary cerebellar neurons, and primary striatal neurons.
[0190] Any suitable methods known in the art for producing recombinant AAV can be used with the presently disclosed subject matter for producing the recombinant AAV as described herein (e.g., recombinant AAV disclosed in Section 7.5 (Recombinant AAV Vectors) of the present disclosure) . In certain embodiments, the methods comprise: (a) transfecting a host cell described herein with a presently disclosed GOI plasmid, (b) culturing the host cell in a culturing medium; and (c) isolating the recombinant AAV virions from the culturing medium. In certain embodiments, the methods further comprise transfecting the host cell with a plasmid comprising an expression cassette encoding AAV rep proteins and capsid proteins. In certain embodiments, the methods further comprise transfecting the host cell with a plasmid encoding adenovirus regions (e.g., VA, E2A and E4) that mediate AAV vector replication. In certain embodiments, the methods comprise: (a) culturing a host cell comprising a cis expression cassette (e.g., expression cassettes disclosed in Section 7.3 (NeuroD1 Expression Cassette) of the present disclosure) in a culture medium, and (b) isolating the recombinant AAV virions from the cell culture. In certain embodiments, the host cell further comprises (ii) a trans expression cassette encoding one or more AAV rep proteins and capsid proteins. In certain embodiments, the host cell further comprises (iii) nucleic acid sequence encoding adenovirus regions (e.g., VA, E2A and E4) that mediate AAV vector replication. Exemplary plasmid sequences for the GOI plasmid, rep-cap packaging plasmid and helper plasmid that can be used in connection with the present disclosure are provided in Table 8.1 (B) and Table 8.1 (C) .
[0191] Exemplary methods of producing recombinant AAV vectors are disclosed in International Patent Publication Nos. WO20220033842 and WO2019079496, the content of each of which is incorporated by reference in its entirety.
[0192] Genome copy titers of the recombinant AAV vectors may be determined, for example, by analysis. Virions may be recovered, for example, by CsCl2 sedimentation. Alternatively, baculovirus expression systems in insect cells may be used to produce AAV vectors. For a review, see Aponte-Ubillus et al., 2018, Appl. Microbiol. Biotechnol. 102: 1045-1054, which is incorporated by reference herein in its entirety for manufacturing techniques.
[0193] In vitro assays, e.g., cell culture assays, can be used to measure coding nucleotide sequence expression from the recombinant AAV vector, thus indicating, e.g., potency of the recombinant vector. For example, the HeLa cell, a cell line derived from human cervical cancer cells (available from ) , can be used to assess coding nucleotide sequence expression. Alternatively, cell lines derived from liver or muscle or other cell types may be used, for example, but not limited, to HuH-7, HEK293, fibrosarcoma HT-1080, HKB-11, C2C12 myoblasts, and CAP cells. Once expressed, characteristics of the expressed product (e.g., protein) can also be determined, including serum half-life, functional activity of the protein (e.g., enzymatic activity or binding to a target) , determination of the glycosylation and tyrosine sulfation patterns, and other assays known in the art for determining protein characteristics. 7.7. Pharmaceutical Composition and Kit
[0194] In one aspect, the present disclosure provides a pharmaceutical composition comprising a recombinant AAV vector (e.g., recombinant AAV vectors disclosed in Section 7.5 (Recombinant AAV Vectors) ) and a pharmaceutically acceptable carrier.
[0195] In certain embodiments, the term “pharmaceutically acceptable” means approved by a regulatory agency of the Federal or a state government or listed in the U.S. Pharmacopeia or other generally recognized pharmacopeia for use in animals, and more particularly in humans. As used herein, the term “carrier” refers to a diluent, an adjuvant (e.g., Freund’s complete and incomplete adjuvant) , an excipient, or vehicle with which the AAV vector is administered. Such pharmaceutical carriers can be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable, or synthetic origin, including, e.g., peanut oil, soybean oil, mineral oil, sesame oil or the like. Water is a common carrier when the pharmaceutical composition is administered intravenously. Saline solutions and aqueous dextrose and glycerol solutions can also be employed as liquid carriers, particularly for injectable solutions. Suitable pharmaceutical excipients include but not limited to starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol and the like. Additional examples of pharmaceutically acceptable carriers, excipients, and stabilizers include, but are not limited to, buffers such as phosphate, citrate, and other organic acids; antioxidants including ascorbic acid; low molecular weight polypeptides; proteins, such as serum albumin and gelatin; hydrophilic polymers such as polyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, arginine or lysine; monosaccharides, disaccharides, and other carbohydrates including glucose, mannose, or dextrins; chelating agents such as EDTA; sugar alcohols such as mannitol or sorbitol; salt-forming counterions such as sodium; and / or nonionic surfactants such as TWEENTM, polyethylene glycol (PEG) , and PLURONICSTM as known in the art. In certain embodiments, the pharmaceutical composition further comprises a lubricant, a wetting agent, a sweetener, a flavoring agent, an emulsifier, a suspending agent, or a preservative, in addition to the above ingredients. These compositions can take the form of solutions, suspensions, emulsion, tablets, pills, capsules, powders, sustained-release formulations or the like.
[0196] In certain embodiments, the pharmaceutical composition is provided for use in accordance with the presently disclosed methods of treatment (e.g., methods of treatment disclosed in Section 7.8 (Method of Treatment) of the present disclosure) , said pharmaceutical compositions comprise a therapeutically and / or prophylactically effective amount of the presently disclosed recombinant AAV vector and a pharmaceutically acceptable carrier.
[0197] In certain embodiments, the AAV vector is substantially purified (i.e., substantially free from substances that limit its effect or produce undesired side-effects) . In certain embodiments, the subject receiving the pharmaceutical composition is a mammal such as non-primate (e.g., cows, pigs, horses, cats, dogs, rats etc. ) and a primate (e.g., monkey such as, a cynomolgus monkey and a human) . In certain embodiments, the subject is a human.
[0198] In some embodiments, the pharmaceutical composition is in a fluidic formulation. In some embodiments, the pharmaceutical composition is a solution. In some embodiments, the pharmaceutical composition comprises a recombinant AAV described in Section 7.5 (Recombinant AAV Vectors) , and further comprises: (a) potassium chloride, (b) potassium phosphate monobasic, (c) sodium chloride, (d) sodium phosphate dibasic anhydrous, and (e) poloxamer 188, polysorbate 20, or polysorbate 80.
[0199] In some embodiments, the pharmaceutical composition comprises a recombinant AAV described in Section 7.5 (Recombinant AAV Vectors) , and further comprises: (a) sodium chloride at a concentration of about 180 mM; (b) sodium phosphate at a concentration of about 10 mM; and (c) poloxamer 188 at a concentration of about 0.001%weight / volume (0.01 g / L) ; and wherein the pH of the pharmaceutical composition is about 7.3.
[0200] In some embodiments, the pharmaceutical composition comprises a recombinant AAV described in Section 7.5 (Recombinant AAV Vectors) , and further comprises: (a) sodium chloride at a concentration of about 200 mM; (b) magnesium chloride at a concentration of about 1 mM; (c) Tris hydrochloride at a concentration of about 20 mM, and (d) poloxamer 188 at a concentration of about 0.005%weight / volume (0.05 g / L) ; and wherein the pH of the pharmaceutical composition is about 8.0.
[0201] In some embodiments, the pharmaceutical composition comprises a recombinant AAV described in Section 7.5 (Recombinant AAV Vectors) , and further comprises: (a) sodium chloride at a concentration of about 150 mM; (b) calcium chloride at a concentration of about 1.4 mM; (c) magnesium chloride at a concentration of about 0.8 mM, (d) sodium phosphate at a concentration of about 1 mM, and (e) poloxamer 188 at a concentration of about 0.001%weight / volume (0.01 g / L) ; and wherein the pH of the pharmaceutical composition is about 7.4.
[0202] The present disclosure also provides kits for treating Alzheimer’s disease in a subject in need thereof.
[0203] In certain embodiment, the kit comprises the presently disclosed recombinant AAV vector, e.g., in a container. Such containers can be boxes, ampules, bottles, vials, tubes, bags, pouches, blister-packs, or other suitable container forms known in the art. Such containers can be made of plastic, glass, laminated paper, metal foil, or other materials suitable for holding medicaments. Optionally associated with such container (s) can be a notice in the form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceuticals or biological products, which notice reflects approval by the agency of manufacture, use, or sale for human administration.
[0204] In certain embodiments, the kit further comprises instructions for administering to a subject having Alzheimer’s disease. In certain embodiments, the kit further comprises instructions for administering to a subject at the risk of having Alzheimer’s disease. The instructions generally include information about the use of the composition for the treatment and / or prevention of Alzheimer’s disease. In certain embodiments, the instructions include at least one of the following: description of the therapeutic agent; dosage schedule and administration for treatment or prevention of Alzheimer’s disease or symptoms thereof; precautions; warnings; indications; counter-indications; over-dosage information; adverse reactions; animal pharmacology; clinical studies; and / or references. The instructions may be printed directly on the container (when present) , or as a label applied to the container, or as a separate sheet, pamphlet, card, or folder supplied in or with the container. 7.8. Method of Treatment
[0205] The present disclosure provides methods for selectively expressing an encoding nucleic acid in glial cells. The present disclosure also provides methods for treating neurological condition in a subject in need thereof. In certain embodiments, the methods comprise delivering to the subject a presently disclosed recombinant AAV (e.g., AAV vectors disclosed in Section 7.5 (Recombinant AAV Vectors) of the present disclosure) . In certain embodiments, the methods comprise delivering to the subject a presently disclosed pharmaceutical composition comprising recombinant AAV (e.g., pharmaceutical composition disclosed in Section 7.7 (Pharmaceutical Composition and Kit) of the present disclosure) .
[0206] In one aspect, a neurological condition is Alzheimer’s disease. In some embodiments, the method disclosed herein treats Alzheimer’s disease in a subject suffering from said disease. In some embodiments, the method disclosed herein prevents or delays the development of Alzheimer’s disease in a subject at risk of developing said disease.
[0207] In some embodiments, the methods described herein delays, prevents, treats or manages Alzheimer’s disease. In certain embodiments, the methods prevent occurrence or recurrence of Alzheimer’s disease. In certain embodiments, the methods alleviate one or more symptoms associated with Alzheimer’s disease. In certain embodiments, the methods diminish any direct or indirect pathological consequences of Alzheimer’s disease. In certain embodiments, the methods decrease the rate of disease progression for Alzheimer’s disease. In certain embodiments, the methods delay remission or improves prognosis of Alzheimer’s disease.
[0208] In some embodiments, the method for treating or preventing Alzheimer’s disease comprises administering to a subject in need thereof a therapeutically effective amount of a pharmaceutical composition comprising a recombinant AAV, wherein the recombinant AAV comprises a genome comprising a transgene encoding a NeuroD1 polypeptide. In some embodiments, the genome is a single-stranded DNA molecule. In some embodiments, the genome is one described in Section 7.4 (AAV Genome) of the present disclosure. In some embodiments, the genome comprises the sequence set forth in SEQ ID NO: 25 or a sequence that is at least about 75%, at least about 80%, at least about 85%, at least about 90%, at least about 91%, at least about 92%, at least about 93%, at least about 94%, at least about 95%, at least about 96%, at least about 97%, at least about 98%, or at least about 99%sequence identity to SEQ ID NO: 25. In some embodiments, the genome comprises the sequence set forth in SEQ ID NO: 25. In some embodiments, the genome consists of the sequence set forth in SEQ ID NO: 25.
[0209] effective amount of a pharmaceutical composition comprising a recombinant AAV, wherein the recombinant AAV comprises a genome comprising a transgene encoding a NeuroD1 polypeptide and further comprises a AAV capsid protein. In some embodiments, the AAV capsid protein is one described in Section 7.5 (Recombinant AAV Vectors) of the present disclosure. In some embodiments, the AAV capsid is AAV9.
[0210] In some embodiments, the method for treating or preventing Alzheimer’s disease comprises administering to a subject in need thereof a pharmaceutical composition comprising from about 1×1011 viral genomes (vg) to about 1×1013 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.5×1011 vg of the recombinant AAV. In some embodiments, the method comprisesadministering to the subject a pharmaceutical composition comprising about 1.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.1×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.2×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.3×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.4×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.5×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.6×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.7×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.8×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.9×1011 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 2.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 3.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.0×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 4.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5×1012 vg of the recombinant AAV. In some embodiments, the method for treating or preventing Alzheimer’s disease comprises administering to the subject a pharmaceutical composition comprising about 5.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 5.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 6.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 7.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 8.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.1×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.2×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.3×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.4×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.5×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.6×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.7×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.8×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 9.9×1012 vg of the recombinant AAV. In some embodiments, the method comprises administering to the subject a pharmaceutical composition comprising about 1×1013 vg of the recombinant AAV.
[0211] In some embodiments, the subject is administered the pharmaceutical composition comprising about 1×1011 viral genomes (vg) to about 1×1013 vg once. In some embodiments, each time the pharmaceutical composition that is administered to the subject comprises about 1×1011 vg, about 1.1×1011 vg, about 1.2×1011 vg, about 1.3×1011 vg, about 1.4×1011 vg, about 1.5×1011 vg, about 1.6×1011 vg, about 1.7×1011 vg, about 1.8×1011 vg, about 1.9×1011 vg, about 2×1011 vg, about 2.1×1011 vg, about 2.2×1011 vg, about 2.3×1011 vg, about 2.4×1011 vg, about 2.5×1011 vg, about 2.6×1011 vg, about 2.7×1011 vg, about 2.8×1011 vg, about 2.9×1011 vg, 3×1011 vg, about 3.1×1011 vg, about 3.2×1011 vg, about 3.3×1011 vg, about 3.4×1011 vg, about 3.5×1011 vg, about 3.6×1011 vg, about 3.7×1011 vg, about 3.8×1011 vg, about 3.9×1011 vg, 4×1011 vg, about 4.1×1011 vg, about 4.2×1011 vg, about 4.3×1011 vg, about 4.4×1011 vg, about 4.5×1011 vg, about 4.6×1011 vg, about 4.7×1011 vg, about 4.8×1011 vg, about 4.9×1011 vg, 5×1011 vg, about 5.1×1011 vg, about 5.2×1011 vg, about 5.3×1011 vg, about 5.4×1011 vg, about 5.5×1011 vg, about 5.6×1011 vg, about 5.7×1011 vg, about 5.8×1011 vg, about 5.9×1011 vg, about 6×1011 vg, about 6.1×1011 vg, about 6.2×1011 vg, about 6.3×1011 vg, about 6.4×1011 vg, about 6.5×1011 vg, about 6.6×1011 vg, about 6.7×1011 vg, about 6.8×1011 vg, about 6.9×1011 vg, about 7.0×1011 vg, about 7.1×1011 vg, about 7.2×1011 vg, about 7.3×1011 vg, about 7.4×1011 vg, about 7.5×1011 vg, about 7.6×1011 vg, about 7.7×1011 vg, about 7.8×1011 vg, about 7.9×1011 vg, about 8×1011 vg, about 8.1×1011 vg, about 8.2×1011 vg, about 8.3×1011 vg, about 8.4×1011 vg, about 8.5×1011 vg, about 8.6×1011 vg, about 8.7×1011 vg, about 8.8×1011 vg, about 8.9×1011 vg, about 9×1011 vg, about 9.1×1011 vg, about 9.2×1011 vg, about 9.3×1011 vg, about 9.4×1011 vg, about 9.5×1011 vg, about 9.6×1011 vg, about 9.7×1011 vg, about 9.8×1011 vg, about 9.9×1011 vg, about 1×1012 vg, about 1.1×1012 vg, about 1.2×1012 vg, about 1.3×1012 vg, about 1.4×1012 vg, about 1.5×1012 vg, about 1.6×1012 vg, about 1.7×1012 vg, about 1.8×1012 vg, about 1.9×1012 vg, about 2×1012 vg, about 2.1×1012 vg, about 2.2×1012 vg, about 2.3×1012 vg, about 2.4×1012 vg, about 2.5×1012 vg, about 2.6×1012 vg, about 2.7×1012 vg, about 2.8×1012 vg, about 2.9×1012 vg, about 3×1012 vg, about 3.1×1012 vg, about 3.2×1012 vg, about 3.3×1012 vg, about 3.4×1012 vg, about 3.5×1012 vg, about 3.6×1012 vg, about 3.7×1012 vg, about 3.8×1012 vg, about 3.9×1012 vg, about 4×1012 vg, about 4.1×1012 vg, about 4.2×1012 vg, about 4.3×1012 vg, about 4.4×1012 vg, about 4.5×1012 vg, about 4.6×1012 vg, about 4.7×1012 vg, about 4.8×1012 vg, about 4.9×1012 vg, about 5×1012 vg, about 5.1×1012 vg, about 5.2×1012 vg, about 5.3×1012 vg, about 5.4×1012 vg, about 5.5×1012 vg, about 5.6×1012 vg, about 5.7×1012 vg, about 5.8×1012 vg, about 5.9×1012 vg, about 6×1012 vg, about 6.1×1012 vg, about 6.2×1012 vg, about 6.3×1012 vg, about 6.4×1012 vg, about 6.5×1012 vg, about 6.6×1012 vg, about 6.7×1012 vg, about 6.8×1012 vg, about 6.9×1012 vg, about 7×1012 vg, about 7.1×1012 vg, about 7.2×1012 vg, about 7.3×1012 vg, about 7.4×1012 vg, about 7.5×1012 vg, about 7.6×1012 vg, about 7.7×1012 vg, about 7.8×1012 vg, about 7.9×1012 vg, about 8×1012 vg, about 8.1×1012 vg, about 8.2×1012 vg, about 8.3×1012 vg, about 8.4×1012 vg, about 8.5×1012 vg, about 8.6×1012 vg, about 8.7×1012 vg, about 8.8×1012 vg, about 8.9×1012 vg, about 9×1012 vg, about 9.1×1012 vg, about 9.2×1012 vg, about 9.3×1012 vg, about 9.4×1012 vg, about 9.5×1012 vg, about 9.6×1012 vg, about 9.7×1012 vg, about 9.8×1012 vg, about 9.9×1012 vg, or about 1×1013 vg of the recombinant AAV described herein.
[0212] In some embodiments, the fluid formulation of the pharmaceutical composition is a solution. In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL and further comprises potassium chloride, potassium phosphate monobasic, sodium chloride, sodium phosphate dibasic anhydrous, and a surfactant selected from poloxamer 188, polysorbate 20, or polysorbate 80. In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL, and further comprises potassium chloride, potassium phosphate monobasic, sodium chloride, sodium phosphate dibasic anhydrous, and poloxamer 188.
[0213] In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL, and further comprises sodium chloride, sodium phosphate, and poloxamer 188. In specific embodiments, the fluid formulation of the pharmaceutical composition comprises sodium chloride at a concentration of about 180 mM. In some embodiments, the fluid formulation comprises sodium phosphate at a concentration of about 10 mM. In some embodiments, the fluid formulation comprises poloxamer 188 at a concentration of about 0.001%weight / volume (0.01 g / L) . In some embodiments, the pH of the pharmaceutical composition is about 7.3.
[0214] In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011vg / mL to about 1×1013 vg / mL, sodium chloride at a concentration of about 180 mM, sodium phosphate at a concentration of about 10 mM, poloxamer 188 at a concentration of about 0.001%weight / volume (0.01 g / L) , and the pH of the pharmaceutical composition is about 7.3.
[0215] In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL, and further comprises sodium chloride, magnesium chloride, Tris hydrochloride, and poloxamer 188. In some embodiments, the fluid formulation of the pharmaceutical composition comprises sodium chloride at a concentration of about 200 mM. In some embodiments, the fluid formulation of the pharmaceutical composition comprises magnesium chloride at a concentration of about 1 mM. In some embodiments, the fluid formulation of the pharmaceutical composition comprises Tris hydrochloride at a concentration of about 20 mM. In some embodiments, the fluid formulation of the pharmaceutical composition comprises poloxamer 188 at a concentration of about 0.005%weight / volume (0.05 g / L) . In some embodiments, and wherein the pH of the pharmaceutical composition is about 8.0.
[0216] In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL, sodium chloride at a concentration of about 200 mM, magnesium chloride at a concentration of about 1 mM, Tris hydrochloride at a concentration of about 20 mM, poloxamer 188 at a concentration of about 0.005%weight / volume (0.05 g / L) , and wherein the pH of the pharmaceutical composition is about 8.0.
[0217] In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL, and further comprises sodium chloride, calcium chloride, magnesium chloride, sodium phosphate, and poloxamer 188. In some embodiments, the fluid formulation of the pharmaceutical composition comprises sodium chloride at a concentration of about 150 mM. In some embodiments, the fluid formulation of the pharmaceutical composition comprises calcium chloride at a concentration of about 1.4 mM. In some embodiments, the fluid formulation of the pharmaceutical composition comprises magnesium chloride at a concentration of about 0.8 mM. In some embodiments, the fluid formulation of the pharmaceutical composition comprises sodium phosphate at a concentration of about 1 mM. In some embodiments, the fluid formulation of the pharmaceutical composition comprises poloxamer 188 at a concentration of about 0.001%weight / volume (0.01 g / L) . In some embodiments, the pH of the pharmaceutical composition is about 7.4.
[0218] In some embodiments, the fluid formulation of the pharmaceutical composition comprises the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL, sodium chloride at a concentration of about 150 mM; calcium chloride at a concentration of about 1.4 mM; magnesium chloride at a concentration of about 0.8 mM, sodium phosphate at a concentration of about 1 mM, and poloxamer 188 at a concentration of about 0.001%weight / volume (0.01 g / L) ; and wherein the pH of the pharmaceutical composition is about 7.4.
[0219] In some embodiments, the pharmaceutical composition is administered to the subject intracerebrally. In some embodiments, the pharmaceutical composition is administered to the subject by intracerebral injection of a fluid formulation of the pharmaceutical composition. In some embodiments, the pharmaceutical composition is delivered to a brain of a subject who has suffered an Alzheimer’s disease. In some embodiments, the pharmaceutical composition is delivered to a brain of a subject who is at risk of developing an Alzheimer’s disease.
[0220] In some embodiments, the pharmaceutical composition is delivered to hippocampus of the brain. In some embodiments, the pharmaceutical composition is delivered to unilateral hippocampus. In some embodiments, the pharmaceutical composition is delivered to bilateral hippocampus. In some embodiments, the pharmaceutical composition is delivered to hippocampal head. In some embodiments, the pharmaceutical composition is delivered to hippocampal body. In some embodiments, the pharmaceutical composition is delivered to hippocampus cauda. In some embodiments, the pharmaceutical composition is delivered to frontal cortex of the brain. In some embodiments, the pharmaceutical composition is delivered to prefrontal cortex. In some embodiments, an injection site is determined prior to the injecting via a magnetic resonance imaging (MRI) scan.
[0221] In some embodiments, the pharmaceutical composition comprising the recombinant AAV as described herein is administered intracerebrally to the subject, wherein the intracerebral administration is performed by injecting a fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL. In some embodiments, the fluid formulation of the pharmaceutical composition administered intracerebrally comprises the recombinant AAV at a concentration of about 1×1011 vg / mL, about 1.1 ×1011 vg / mL, about 1.2 ×1011 vg / mL, about 1.3 ×1011 vg / mL, about 1.4 ×1011 vg / mL, about 1.5 ×1011 vg / mL, about 1.6 ×1011 vg / mL, about 1.7 ×1011 vg / mL, about 1.8 ×1011 vg / mL, about 1.9 ×1011 vg / mL, about 2 ×1011 vg / mL, about 2.1 ×1011 vg / mL, about 2.2 ×1011 vg / mL, about 2.3 ×1011 vg / mL, about 2.4 ×1011 vg / mL, about 2.5 ×1011 vg / mL, about 2.6 ×1011 vg / mL, about 2.7 ×1011 vg / mL, about 2.8 ×1011 vg / mL, about 2.9 ×1011 vg / mL, about 3×1011 vg / mL, about 3.1×1011 vg / mL, about 3.2×1011 vg / mL, about 3.3×1011 vg / mL, about 3.4×1011 vg / mL, about 3.5×1011 vg / mL, about 3.6×1011 vg / mL, about 3.7×1011 vg / mL, about 3.8×1011 vg / mL, about 3.9×1011 vg / mL, 4×1011 vg / mL, about 4.1×1011 vg / mL, about 4.2×1011 vg / mL, about 4.3×1011 vg / mL, about 4.4×1011 vg / mL, about 4.5×1011 vg / mL, about 4.6×1011 vg / mL, about 4.7×1011 vg / mL, about 4.8×1011 vg / mL, about 4.9×1011 vg / mL, 5×1011 vg / mL, about 5.1×1011 vg / mL, about 5.2×1011 vg / mL, about 5.3×1011 vg / mL, about 5.4×1011 vg / mL, about 5.5×1011 vg / mL, about 5.6×1011 vg / mL, about 5.7×1011 vg / mL, about 5.8×1011 vg / mL, about 5.9×1011 vg / mL, about 6×1011 vg / mL, about 6.1×1011 vg / mL, about 6.2×1011 vg / mL, about 6.3×1011 vg / mL, about 6.4×1011 vg / mL, about 6.5×1011 vg / mL, about 6.6×1011 vg / mL, about 6.7×1011 vg / mL, about 6.8×1011 vg / mL, about 6.9×1011 vg / mL, about 7×1011 vg / mL, about 7.1×1011 vg / mL, about 7.2×1011 vg / mL, about 7.3×1011 vg / mL, about 7.4×1011 vg / mL, about 7.5×1011 vg / mL, about 7.6×1011 vg / mL, about 7.7×1011 vg / mL, about 7.8×1011 vg / mL, about 7.9×1011 vg / mL, about 8×1011 vg / mL, about 8.1×1011 vg / mL, about 8.2×1011 vg / mL, about 8.3×1011 vg / mL, about 8.4×1011 vg / mL, about 8.5×1011 vg / mL, about 8.6×1011 vg / mL, about 8.7×1011 vg / mL, about 8.8×1011 vg / mL, about 8.9×1011 vg / mL, about 9×1011 vg / mL, about 9.1×1011 vg / mL, about 9.2×1011 vg / mL, about 9.3×1011 vg / mL, about 9.4×1011 vg / mL, about 9.5×1011 vg / mL, about 9.6×1011 vg / mL, about 9.7×1011 vg / mL, about 9.8×1011 vg / mL, about 9.9×1011 vg / mL, about 1×1012 vg / mL, about 1.1×1012 vg / mL, about 1.2×1012 vg / mL, about 1.3×1012 vg / mL, about 1.4×1012 vg / mL, about 1.5×1012 vg / mL, about 1.6×1012 vg / mL, about 1.7×1012 vg / mL, about 1.8×1012 vg / mL, about 1.9×1012 vg / mL, about 2×1012 vg / mL, about 2.1×1012 vg / mL, about 2.2×1012 vg / mL, about 2.3×1012 vg / mL, about 2.4×1012 vg / mL, about 2.5×1012 vg / mL, about 2.6×1012 vg / mL, about 2.7×1012 vg / mL, about 2.8×1012 vg / mL, about 2.9×1012 vg / mL, about 3×1012 vg / mL, about 3.1×1012 vg / mL, about 3.2×1012 vg / mL, about 3.3×1012 vg / mL, about 3.4×1012 vg / mL, about 3.5×1012 vg / mL, about 3.6×1012 vg / mL, about 3.7×1012 vg / mL, about 3.8×1012 vg / mL, about 3.9×1012 vg / mL, about 4×1012 vg / mL, about 4.1×1012 vg / mL, about 4.2×1012 vg / mL, about 4.3×1012 vg / mL, about 4.4×1012 vg / mL, about 4.5×1012 vg / mL, about 4.6×1012 vg / mL, about 4.7×1012 vg / mL, about 4.8×1012 vg / mL, about 4.9×1012 vg / mL, about 5×1012 vg / mL, about 5.1×1012 vg / mL, about 5.2×1012 vg / mL, about 5.3×1012 vg / mL, about 5.4×1012 vg / mL, about 5.5×1012 vg / mL, about 5.6×1012 vg / mL, about 5.7×1012 vg / mL, about 5.8×1012 vg / mL, about 5.9×1012 vg / mL, about 6×1012 vg / mL, about 6.1×1012 vg / mL, about 6.2×1012 vg / mL, about 6.3×1012 vg / mL, about 6.4×1012 vg / mL, about 6.5×1012 vg / mL, about 6.6×1012 vg / mL, about 6.7×1012 vg / mL, about 6.8×1012 vg / mL, about 6.9×1012 vg / mL, about 7×1012 vg / mL, about 7.1×1012 vg / mL, about 7.2×1012 vg / mL, about 7.3×1012 vg / mL, about 7.4×1012 vg / mL, about 7.5×1012 vg / mL, about 7.6×1012 vg / mL, about 7.7×1012 vg / mL, about 7.8×1012 vg / mL, about 7.9×1012 vg / mL, about 8×1012 vg / mL, about 8.1×1012 vg / mL, about 8.2×1012 vg / mL, about 8.3×1012 vg / mL, about 8.4×1012 vg / mL, about 8.5×1012 vg / mL, about 8.6×1012 vg / mL, about 8.7×1012 vg / mL, about 8.8×1012 vg / mL, about 8.9×1012 vg / mL, about 9×1012 vg / mL, about 9.1×1012 vg / mL, about 9.2×1012 vg / mL, about 9.3×1012 vg / mL, about 9.4×1012 vg / mL, about 9.5×1012 vg / mL, about 9.6×1012 vg / mL, about 9.7×1012 vg / mL, about 9.8×1012 vg / mL, about 9.9×1012 vg / mL, or about 1×1013 vg / mL.
[0222] In some embodiments, the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is administered intracerebrally once. In some embodiments, the intracerebral injection volume of the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is about 0.1 mL to about 1 mL. In some embodiments, each time the intracerebral injection volume of the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is about 0.1 mL, 0.2 mL, 0.3 mL, about 0.4 mL, about 0.5 mL, about 0.6 mL, about 0.7 mL, about 0.8 mL, about 0.9 mL, or about 1 mL.In specific embodiments, 0.3 mL of a fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration of about 5×1011 vg / mL is injected intracerebrally. In specific embodiments, 0.3 mL of a fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration of about 1×1012 vg / mL is injected intracerebrally. In specific embodiments, 0.3 mL of a fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration of about 2×1012 vg / mL is injected intracerebrally. In specific embodiments, 0.6 mL of a fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration of about 2×1012 vg / mL is injected intracerebrally.
[0223] In some embodiments, the subject has Alzheimer’s disease, and wherein the pharmaceutical composition is administered into the hippocampus of the subject. In some embodiments, the subject is at risk of developing Alzheimer’s disease, and wherein the pharmaceutical composition is administered into the hippocampus of the subject. In some embodiments, the pharmaceutical composition is administered into the unilateral hippocampus of the subject. In some embodiments, the pharmaceutical composition is administered into the bilateral hippocampus of the subject. In some embodiments, the pharmaceutical composition is administered into the hippocampal head region within the hippocampus. In some embodiments, the pharmaceutical composition is administered into the hippocampal body region within the hippocampus. In some embodiments, the pharmaceutical composition is administered into the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered into the hippocampal head region, the hippocampal body region, and the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered into the hippocampal head region, the hippocampal body region, and the hippocampus cauda region within the left hippocampus. In some embodiments, the pharmaceutical composition is administered into the hippocampal head region, the hippocampal body region, and the hippocampus cauda region within the right hippocampus. In some embodiments, the pharmaceutical composition is administered into the hippocampal head regions, the hippocampal body regions, and the hippocampus cauda regions of both the left and right hippocampi. In some embodiments, the administration is by injecting a fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL. In some embodiments, the fluid formulation of the pharmaceutical composition administered into the hippocampus comprises the recombinant AAV at a concentration of about 1×1011 vg / mL, about 1.1×1011 vg / mL, about 1.2×1011 vg / mL, about 1.3×1011 vg / mL, about 1.4×1011 vg / mL, about 1.5×1011 vg / mL, about 1.6×1011 vg / mL, about 1.7×1011 vg / mL, about 1.8×1011 vg / mL, about 1.9×1011 vg / mL, about 2×1011 vg / mL, about 2.1×1011 vg / mL, about 2.2×1011 vg / mL, about 2.3×1011 vg / mL, about 2.4×1011 vg / mL, about 2.5×1011 vg / mL, about 2.6×1011 vg / mL, about 2.7×1011 vg / mL, about 2.8×1011 vg / mL, about 2.9×1011 vg / mL, about 3×1011 vg / mL, about 3.1×1011 vg / mL, about 3.2×1011 vg / mL, about 3.3×1011 vg / mL, about 3.4×1011 vg / mL, about 3.5×1011 vg / mL, about 3.6×1011 vg / mL, about 3.7×1011 vg / mL, about 3.8×1011 vg / mL, about 3.9×1011 vg / mL, 4×1011 vg / mL, about 4.1×1011 vg / mL, about 4.2×1011 vg / mL, about 4.3×1011 vg / mL, about 4.4×1011 vg / mL, about 4.5×1011 vg / mL, about 4.6×1011 vg / mL, about 4.7×1011 vg / mL, about 4.8×1011 vg / mL, about 4.9×1011 vg / mL, 5×1011 vg / mL, about 5.1×1011 vg / mL, about 5.2×1011 vg / mL, about 5.3×1011 vg / mL, about 5.4×1011 vg / mL, about 5.5×1011 vg / mL, about 5.6×1011 vg / mL, about 5.7×1011 vg / mL, about 5.8×1011 vg / mL, about 5.9×1011 vg / mL, about 6×1011 vg / mL, about 6.1×1011 vg / mL, about 6.2×1011 vg / mL, about 6.3×1011 vg / mL, about 6.4×1011 vg / mL, about 6.5×1011 vg / mL, about 6.6×1011 vg / mL, about 6.7×1011 vg / mL, about 6.8×1011 vg / mL, about 6.9×1011 vg / mL, about 7×1011 vg / mL, about 7.1×1011 vg / mL, about 7.2×1011 vg / mL, about 7.3×1011 vg / mL, about 7.4×1011 vg / mL, about 7.5×1011 vg / mL, about 7.6×1011 vg / mL, about 7.7×1011 vg / mL, about 7.8×1011 vg / mL, about 7.9×1011 vg / mL, about 8×1011 vg / mL, about 8.1×1011 vg / mL, about 8.2×1011 vg / mL, about 8.3×1011 vg / mL, about 8.4×1011 vg / mL, about 8.5×1011 vg / mL, about 8.6×1011 vg / mL, about 8.7×1011 vg / mL, about 8.8×1011 vg / mL, about 8.9×1011 vg / mL, about 9×1011 vg / mL, about 9.1×1011 vg / mL, about 9.2×1011 vg / mL, about 9.3×1011 vg / mL, about 9.4×1011 vg / mL, about 9.5×1011 vg / mL, about 9.6×1011 vg / mL, about 9.7×1011 vg / mL, about 9.8×1011 vg / mL, about 9.9×1011 vg / mL, about 1×1012 vg / mL, about 1.1×1012 vg / mL, about 1.2×1012 vg / mL, about 1.3×1012 vg / mL, about 1.4×1012 vg / mL, about 1.5×1012 vg / mL, about 1.6×1012 vg / mL, about 1.7×1012 vg / mL, about 1.8×1012 vg / mL, about 1.9×1012 vg / mL, about 2×1012 vg / mL, about 2.1×1012 vg / mL, about 2.2×1012 vg / mL, about 2.3×1012 vg / mL, about 2.4×1012 vg / mL, about 2.5×1012 vg / mL, about 2.6×1012 vg / mL, about 2.7×1012 vg / mL, about 2.8×1012 vg / mL, about 2.9×1012 vg / mL, about 3×1012 vg / mL, about 3.1×1012 vg / mL, about 3.2×1012 vg / mL, about 3.3×1012 vg / mL, about 3.4×1012 vg / mL, about 3.5×1012 vg / mL, about 3.6×1012 vg / mL, about 3.7×1012 vg / mL, about 3.8×1012 vg / mL, about 3.9×1012 vg / mL, about 4×1012 vg / mL, about 4.1×1012 vg / mL, about 4.2×1012 vg / mL, about 4.3×1012 vg / mL, about 4.4×1012 vg / mL, about 4.5×1012 vg / mL, about 4.6×1012 vg / mL, about 4.7×1012 vg / mL, about 4.8×1012 vg / mL, about 4.9×1012 vg / mL, about 5×1012 vg / mL, about 5.1×1012 vg / mL, about 5.2×1012 vg / mL, about 5.3×1012 vg / mL, about 5.4×1012 vg / mL, about 5.5×1012 vg / mL, about 5.6×1012 vg / mL, about 5.7×1012 vg / mL, about 5.8×1012 vg / mL, about 5.9×1012 vg / mL, about 6×1012 vg / mL, about 6.1×1012 vg / mL, about 6.2×1012 vg / mL, about 6.3×1012 vg / mL, about 6.4×1012 vg / mL, about 6.5×1012 vg / mL, about 6.6×1012 vg / mL, about 6.7×1012 vg / mL, about 6.8×1012 vg / mL, about 6.9×1012 vg / mL, about 7×1012 vg / mL, about 7.1×1012 vg / mL, about 7.2×1012 vg / mL, about 7.3×1012 vg / mL, about 7.4×1012 vg / mL, about 7.5×1012 vg / mL, about 7.6×1012 vg / mL, about 7.7×1012 vg / mL, about 7.8×1012 vg / mL, about 7.9×1012 vg / mL, about 8×1012 vg / mL, about 8.1×1012 vg / mL, about 8.2×1012 vg / mL, about 8.3×1012 vg / mL, about 8.4×1012 vg / mL, about 8.5×1012 vg / mL, about 8.6×1012 vg / mL, about 8.7×1012 vg / mL, about 8.8×1012 vg / mL, about 8.9×1012 vg / mL, about 9×1012 vg / mL, about 9.1×1012 vg / mL, about 9.2×1012 vg / mL, about 9.3×1012 vg / mL, about 9.4×1012 vg / mL, about 9.5×1012 vg / mL, about 9.6×1012 vg / mL, about 9.7×1012 vg / mL, about 9.8×1012 vg / mL, about 9.9×1012 vg / mL, or about 1×1013 vg / mL.
[0224] In some embodiments, the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is administered into the hippocampus once. In some embodiments, the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is administered into the unilateral hippocampus once. In some embodiments, the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is administered into the bilateral hippocampus once.
[0225] In some embodiments, the subject has Alzheimer’s disease, and wherein the pharmaceutical composition is administered into the frontal cortex of the subject. In some embodiments, the subject is at risk of developing Alzheimer’s disease, and wherein the pharmaceutical composition is administered into the frontal cortex of the subject. In some embodiments, the subject has Alzheimer’s disease, and wherein the pharmaceutical composition is administered into the prefrontal cortex of the subject. In some embodiments, the subject is at risk of developing Alzheimer’s disease, and wherein the pharmaceutical composition is administered into the prefrontal cortex of the subject. In some embodiments, the administration is by injecting a fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL. In some embodiments, the fluid formulation of the pharmaceutical composition administered into the frontal cortex comprises the recombinant AAV at a concentration of about 1×1011 vg / mL, about 1.1×1011 vg / mL, about 1.2×1011 vg / mL, about 1.3×1011 vg / mL, about 1.4×1011 vg / mL, about 1.5×1011 vg / mL, about 1.6×1011 vg / mL, about 1.7×1011 vg / mL, about 1.8×1011 vg / mL, about 1.9×1011 vg / mL, about 2×1011 vg / mL, about 2.1×1011 vg / mL, about 2.2×1011 vg / mL, about 2.3×1011 vg / mL, about 2.4×1011 vg / mL, about 2.5×1011 vg / mL, about 2.6×1011 vg / mL, about 2.7×1011 vg / mL, about 2.8×1011 vg / mL, about 2.9×1011 vg / mL, about 3×1011 vg / mL, about 3.1×1011 vg / mL, about 3.2×1011 vg / mL, about 3.3×1011 vg / mL, about 3.4×1011 vg / mL, about 3.5×1011 vg / mL, about 3.6×1011 vg / mL, about 3.7×1011 vg / mL, about 3.8×1011 vg / mL, about 3.9×1011 vg / mL, 4×1011 vg / mL, about 4.1×1011 vg / mL, about 4.2×1011 vg / mL, about 4.3×1011 vg / mL, about 4.4×1011 vg / mL, about 4.5×1011 vg / mL, about 4.6×1011 vg / mL, about 4.7×1011 vg / mL, about 4.8×1011 vg / mL, about 4.9×1011 vg / mL, 5×1011 vg / mL, about 5.1×1011 vg / mL, about 5.2×1011 vg / mL, about 5.3×1011 vg / mL, about 5.4×1011 vg / mL, about 5.5×1011 vg / mL, about 5.6×1011 vg / mL, about 5.7×1011 vg / mL, about 5.8×1011 vg / mL, about 5.9×1011 vg / mL, about 6×1011 vg / mL, about 6.1×1011 vg / mL, about 6.2×1011 vg / mL, about 6.3×1011 vg / mL, about 6.4×1011 vg / mL, about 6.5×1011 vg / mL, about 6.6×1011 vg / mL, about 6.7×1011 vg / mL, about 6.8×1011 vg / mL, about 6.9×1011 vg / mL, about 7×1011 vg / mL, about 7.1×1011 vg / mL, about 7.2×1011 vg / mL, about 7.3×1011 vg / mL, about 7.4×1011 vg / mL, about 7.5×1011 vg / mL, about 7.6×1011 vg / mL, about 7.7×1011 vg / mL, about 7.8×1011 vg / mL, about 7.9×1011 vg / mL, about 8×1011 vg / mL, about 8.1×1011 vg / mL, about 8.2×1011 vg / mL, about 8.3×1011 vg / mL, about 8.4×1011 vg / mL, about 8.5×1011 vg / mL, about 8.6×1011 vg / mL, about 8.7×1011 vg / mL, about 8.8×1011 vg / mL, about 8.9×1011 vg / mL, about 9×1011 vg / mL, about 9.1×1011 vg / mL, about 9.2×1011 vg / mL, about 9.3×1011 vg / mL, about 9.4×1011 vg / mL, about 9.5×1011 vg / mL, about 9.6×1011 vg / mL, about 9.7×1011 vg / mL, about 9.8×1011 vg / mL, about 9.9×1011 vg / mL, about 1×1012 vg / mL, about 1.1×1012 vg / mL, about 1.2×1012 vg / mL, about 1.3×1012 vg / mL, about 1.4×1012 vg / mL, about 1.5×1012 vg / mL, about 1.6×1012 vg / mL, about 1.7×1012 vg / mL, about 1.8×1012 vg / mL, about 1.9×1012 vg / mL, about 2×1012 vg / mL, about 2.1×1012 vg / mL, about 2.2×1012 vg / mL, about 2.3×1012 vg / mL, about 2.4×1012 vg / mL, about 2.5×1012 vg / mL, about 2.6×1012 vg / mL, about 2.7×1012 vg / mL, about 2.8×1012 vg / mL, about 2.9×1012 vg / mL, about 3×1012 vg / mL, about 3.1×1012 vg / mL, about 3.2×1012 vg / mL, about 3.3×1012 vg / mL, about 3.4×1012 vg / mL, about 3.5×1012 vg / mL, about 3.6×1012 vg / mL, about 3.7×1012 vg / mL, about 3.8×1012 vg / mL, about 3.9×1012 vg / mL, about 4×1012 vg / mL, about 4.1×1012 vg / mL, about 4.2×1012 vg / mL, about 4.3×1012 vg / mL, about 4.4×1012 vg / mL, about 4.5×1012 vg / mL, about 4.6×1012 vg / mL, about 4.7×1012 vg / mL, about 4.8×1012 vg / mL, about 4.9×1012 vg / mL, about 5×1012 vg / mL, about 5.1×1012 vg / mL, about 5.2×1012 vg / mL, about 5.3×1012 vg / mL, about 5.4×1012 vg / mL, about 5.5×1012 vg / mL, about 5.6×1012 vg / mL, about 5.7×1012 vg / mL, about 5.8×1012 vg / mL, about 5.9×1012 vg / mL, about 6×1012 vg / mL, about 6.1×1012 vg / mL, about 6.2×1012 vg / mL, about 6.3×1012 vg / mL, about 6.4×1012 vg / mL, about 6.5×1012 vg / mL, about 6.6×1012 vg / mL, about 6.7×1012 vg / mL, about 6.8×1012 vg / mL, about 6.9×1012 vg / mL, about 7×1012 vg / mL, about 7.1×1012 vg / mL, about 7.2×1012 vg / mL, about 7.3×1012 vg / mL, about 7.4×1012 vg / mL, about 7.5×1012 vg / mL, about 7.6×1012 vg / mL, about 7.7×1012 vg / mL, about 7.8×1012 vg / mL, about 7.9×1012 vg / mL, about 8×1012 vg / mL, about 8.1×1012 vg / mL, about 8.2×1012 vg / mL, about 8.3×1012 vg / mL, about 8.4×1012 vg / mL, about 8.5×1012 vg / mL, about 8.6×1012 vg / mL, about 8.7×1012 vg / mL, about 8.8×1012 vg / mL, about 8.9×1012 vg / mL, about 9×1012 vg / mL, about 9.1×1012 vg / mL, about 9.2×1012 vg / mL, about 9.3×1012 vg / mL, about 9.4×1012 vg / mL, about 9.5×1012 vg / mL, about 9.6×1012 vg / mL, about 9.7×1012 vg / mL, about 9.8×1012 vg / mL, about 9.9×1012 vg / mL, or about 1×1013 vg / mL.
[0226] In some embodiments, the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is administered into the frontal cortex once. In some embodiments, the fluid formulation of the pharmaceutical composition comprising the recombinant AAV at a concentration in the range of from about 1×1011 vg / mL to about 1×1013 vg / mL is administered into the prefrontal cortex once.
[0227] In specific embodiments, the subject is administered intracerebrally the pharmaceutical composition comprising about 1.5×1011 vg of the recombinant AAV once. In specific embodiments, the subject receives intracerebral injection of 0.3 mL of the pharmaceutical composition comprising about 5×1011 vg / mL of the recombinant AAV. In some embodiments, the pharmaceutical composition is administered intracerebrally through intracerebral stereotaxic injection. In some embodiments, the pharmaceutical composition is administered to unilateral hippocampus of the subject. In some embodiments, the pharmaceutical composition is administered to multiple regions within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal body region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region, the hippocampal body region, and the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered through a single trajectory for each hippocampal region. In some embodiments, the administration comprises a total of three injection trajectories. In some embodiments, each trajectory comprises two injection sites. In some embodiments, each trajectory comprises two injection sites, wherein the first injection site is located in a superficial layer of the hippocampus and the second injection site is located in a deep layer of the hippocampus. In some embodiments, the administration comprises a total of six injection sites, wherein two injection sites are located in each of the hippocampal head region, the hippocampus body region, and the hippocampus cauda region. In some embodiments, the injection sites are selected based on MRI scan. In some embodiments, the pharmaceutical composition is administered at a controlled rate and volume at each injection site. In some embodiments, the injection volume of each site is approximately 50 μL. In some embodiments, the injection rate is no more than 10μL / min.
[0228] In specific embodiments, the subject is administered intracerebrally the pharmaceutical composition comprising about 3.0×1011 vg of the recombinant AAV once. In specific embodiments, the subject receives intracerebral injection of 0.3 mL of the pharmaceutical composition comprising about 1×1012 vg / mL of the recombinant AAV. In some embodiments, the pharmaceutical composition is administered intracerebrally through intracerebral stereotaxic injection. In some embodiments, the pharmaceutical composition is administered to unilateral hippocampus of the subject. In some embodiments, the pharmaceutical composition is administered to multiple regions within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal body region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region, the hippocampal body region, and the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered through a single trajectory for each hippocampal region. In some embodiments, the administration comprises a total of three injection trajectories. In some embodiments, each trajectory comprises two injection sites. In some embodiments, each trajectory comprises two injection sites, wherein the first injection site is located in a superficial layer of the hippocampus and the second injection site is located in a deep layer of the hippocampus. In some embodiments, the administration comprises a total of six injection sites, wherein two injection sites are located in each of the hippocampal head region, the hippocampus body region, and the hippocampus cauda region. In some embodiments, the injection sites are selected based on MRI scan. In some embodiments, the pharmaceutical composition is administered at a controlled rate and volume at each injection site. In some embodiments, the injection volume of each site is approximately 50 μL. In some embodiments, the injection rate is no more than 10μL / min.
[0229] In specific embodiments, the subject is administered intracerebrally the pharmaceutical composition comprising about 6×1011 vg of the recombinant AAV once. In specific embodiments, the subject receives intracerebral injection of 0.3 mL of the pharmaceutical composition comprising about 2×1012 vg / mL of the recombinant AAV. In some embodiments, the pharmaceutical composition is administered intracerebrally through intracerebral stereotaxic injection. In some embodiments, the pharmaceutical composition is administered to unilateral hippocampus of the subject. In some embodiments, the pharmaceutical composition is administered to multiple regions within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal body region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region, the hippocampal body region, and the hippocampus cauda region within the hippocampus. In some embodiments, the pharmaceutical composition is administered through a single trajectory for each hippocampal region. In some embodiments, the administration comprises a total of three injection trajectories. In some embodiments, each trajectory comprises two injection sites. In some embodiments, each trajectory comprises two injection sites, wherein the first injection site is located in a superficial layer of the hippocampus and the second injection site is located in a deep layer of the hippocampus. In some embodiments, the administration comprises a total of six injection sites, wherein two injection sites are located in each of the hippocampal head region, the hippocampus body region, and the hippocampus cauda region. In some embodiments, the injection sites are selected based on MRI scan. In some embodiments, the pharmaceutical composition is administered at a controlled rate and volume at each injection site. In some embodiments, the injection volume of each site is approximately 50 μL. In some embodiments, the injection rate is no more than 10μL / min.
[0230] In specific embodiments, the subject is administered intracerebrally the pharmaceutical composition comprising about 1.2×1012 vg of the recombinant AAV once. In specific embodiments, the subject receives intracerebral injection of 0.6 mL of the pharmaceutical composition comprising about 2×1012 vg / mL of the recombinant AAV. In some embodiments, the pharmaceutical composition is administered intracerebrally through intracerebral stereotaxic injection. In some embodiments, the pharmaceutical composition is administered to bilateral hippocampus of the subject. In some embodiments, the pharmaceutical composition is administered to multiple regions within each hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region within each hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal body region within each hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampus cauda region within each hippocampus. In some embodiments, the pharmaceutical composition is administered to the hippocampal head region in the left hippocampus, the hippocampal body region in the left hippocampus, the hippocampus cauda region in the left hippocampus, the hippocampal head region in the right hippocampus, the hippocampal body region in the right hippocampus, and the hippocampus cauda region in the right hippocampus. In some embodiments, the pharmaceutical composition is administered through a single trajectory for each hippocampal region. In some embodiments, the administration comprises a total of six injection trajectories. In some embodiments, each trajectory comprises two injection sites. In some embodiments, each trajectory comprises two injection sites, wherein the first injection site is located in a superficial layer of the hippocampus and the second injection site is located in a deep layer of the hippocampus. In some embodiments, the administration comprises a total of twelve injection sites, wherein two injection sites are located in each of the hippocampal head region in the left hippocampus, the hippocampus body region in the left hippocampus, the hippocampus cauda region in the left hippocampus, the hippocampal head region in the right hippocampus, the hippocampus body region in the right hippocampus, and the hippocampus cauda region in the right hippocampus. In some embodiments, the injection sites are selected based on MRI scan. In some embodiments, the pharmaceutical composition is administered at a controlled rate and volume at each injection site. In some embodiments, the injection volume of each site is approximately 50 μL. In some embodiments, the injection rate is no more than 10μL / min.
[0231] As a non-limiting example, injecting can comprise the use of a syringe and needle. In an aspect, an AAV vector or composition is injected into a subject, e.g., into the brain of a subject. In an aspect, an AAV vector or composition is injected using a 33-gauge needle that is 1.5 inches in length and has a 30° bevel. In an aspect, an AAV vector or composition is injected using a 100 μL syringe equipped with a 33-gauge needle, 1.5 in length, with a 30° bevel. In an aspect, an AAV vector or composition is injected using a syringe pump. In an aspect, an AAV vector or composition is injected using a syringe pump mounted on a stereotaxic arm. In an aspect, an injection site is determined prior to the injecting via a magnetic resonance imaging (MRI) scan. In an aspect, coordinates of the determined injection site are used for the injecting, such for injecting the brain of a subject. In an aspect, an AAV vector or composition is injected using a surgical navigation system to target an injection site.
[0232] In one aspect, injection sites are within frontal cortex and are determined by MRI scan. In one aspect, injection sites are within hippocampus and are determined by MRI scan. The injection volume of each site is approximately 25-50 μL. The injection rate is no more than 10 μL / min.
[0233] In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to a subject suffering from Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject. In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to a subject at risk of developing Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject. In an aspect, the present disclosure provides, and includes, methods of treating or preventing Alzheimer’s disease in a subject by converting glial cells into neurons via the expression of NeuroD1 in the glial cells. In some embodiments, the neurons are selected from glutamatergic neurons, GABAergic neurons, dopaminergic neurons; motor neurons, glycinergic neurons, serotonergic neurons, norepinephrinergic neurons, and sensory neurons.
[0234] In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to the subject suffering from Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject, and the population of glial cells is converted into neurons. In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to the subject at risk of developing Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject, and the population of glial cells is converted into neurons. In specific embodiments, at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 95%of the glial cells are converted into neurons. In some embodiments, the conversion of glial cells into neurons is measure by the expression level of neuronal marker. In some embodiments, conversion of a glial cell into a neuron is measured via the detection of the expression level of neuronal marker, such as DCX, TUJ1, NeuN, MAP2, or Parvalbumin, in the converted cells. Additionally, SMI312 and SMI32 antibodies can be used to confirm the neuronal or neuron-like characteristics of the converted cells. In specific embodiments, conversion of glial cells into neurons occurs in less than about 30 days, less than about 21 days, less than about 14 days, less than about 13 days, less than about 12 days, less than about 11 days, less than about 10 days, less than about 9 days, less than about 8 days, less than about 7 days, less than about 6 days, less than about 5 days, less than about 4 days, less than about 3 days, less than about 2 days, or less than about 1 day after the subject received administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof.
[0235] In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to the subject suffering from Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject, and the population of glial cells start to exhibit one or more neuronal phenotypes. In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to the subject at risk of developing Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject, and the population of glial cells start to exhibit one or more neuronal phenotypes. In some embodiments, the one or more neuronal phenotypes comprise expression of one or more neuronal markers selected from DCX, TUJ1, NeuN, MAP2, and Parvalbumin. In specific embodiments, at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 95%of the glial cells in the population start to exhibit one or more neuronal phenotypes. In specific embodiments, the population of glial cells start to exhibit one or more neuronal phenotypes in less than about 30 days, in less than about 21 days, less than about 14 days, less than about 13 days, less than about 12 days, less than about 11 days, less than about 10 days, less than about 9 days, less than about 8 days, less than about 7 days, less than about 6 days, less than about 5 days, less than about 4 days, less than about 3 days, less than about 2 days, or less than about 1 day after the subject received administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof.
[0236] In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to the subject suffering from Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject, and the population of glial cells stop expressing one or more glial markers. In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to the subject at risk of developing Alzheimer’s disease, the NeuroD1 polypeptide encoded by the recombinant AAV genome is expressed in a population of glial cells in the subject, and the population of glial cells stop expressing one or more glial markers. In some embodiments, the one or more glial markers is selected from GFAP, Aldh1l1, S100β and Sox9. In specific embodiments, at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 95%of the glial cells in the population stop to express one or more glial markers. In specific embodiments, the population of glial cells stop to express one or more glial markers in less than about 30 days, in less than about 21 days, less than about 14 days, less than about 13 days, less than about 12 days, less than about 11 days, less than about 10 days, less than about 9 days, less than about 8 days, less than about 7 days, less than about 6 days, less than about 5 days, less than about 4 days, less than about 3 days, less than about 2 days, or less than about 1 day after the subject received administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof.
[0237] In certain embodiments, the subject is a mammal. In certain embodiments, the subject is a primate (e.g., a monkey such as, a cynomolgus monkey and a human) or a non-primate (e.g., a cow, a pig, a horse, a cat, a dog, a rat, a mouse) . In certain embodiments, the subject is a mouse or a rat. In certain embodiments, the subject is a human.
[0238] In some embodiments, the population of glial cells are located in the brain of a subject who has Alzheimer’s disease or is at risk of developing Alzheimer’s disease. In some embodiments, the population of glial cells are located in the grey matter of the brain. In some embodiments, the population of glial cells are located in the white matter of the brain. In some embodiments, the population of glial cells are located in the brain striatum. In some embodiments, the population of glial cells are located in the cortex of the brain. In some embodiments, the population of glial cells are located in the frontal cortex of the brain. In some embodiments, the population of glial cells are located in the prefrontal cortex of the brain. In some embodiments, the population of glial cells are located in the hippocampus of the brain. In some embodiments, the population of glial cells are located in the hippocampal head of the brain. In some embodiments, the population of glial cells are located in the hippocampal body of the brain. In some embodiments, the population of glial cells are located in the hippocampus cauda of the brain. In some embodiments, the population of glial cells are located in the cerebellum of the brain. In some embodiments, the population of glial cells are located around the infarct lesion of the brain. In some embodiments, the population of glial cells are located in the peri-infarct motor cortex of the brain. In some embodiments, the population of glial cells comprises one or more glial cell types selected from astrocytes, reactive astrocytes, NG-2 cells, reactive NG-2 cells, and microglial cells that are undergoing pathogenic neoplasm.
[0239] In one aspect, a method provided herein converts glial cells to functional neurons in the brain of a subject who has Alzheimer’s disease or is at risk of developing Alzheimer’s disease. In an aspect, a method provided herein converts glial cells to functional neurons in a cerebral cortex of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in a striatum of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in a dorsal striatum of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in a spinal cord of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in a putamen of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in a caudate nucleus of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in a substantia nigra of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in the primary motor cortex. In one aspect, a method provided herein converts glial cells to functional neurons in the hippocampus of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in the hippocampal head of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in the hippocampal body of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in the hippocampus cauda of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in the frontal cortex of the brain. In one aspect, a method provided herein converts glial cells to functional neurons in the prefrontal cortex of the brain.
[0240] In one aspect, a method provided herein converts astrocytes to functional neurons in the brain of a subject who has Alzheimer’s disease or is at risk of developing Alzheimer’s disease. In an aspect, a method provided herein converts astrocytes to functional neurons in a cerebral cortex of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in a striatum of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in a dorsal striatum of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in a spinal cord of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in a putamen of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in a caudate nucleus of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in a substantia nigra of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in the primary motor cortex. In one aspect, a method provided herein converts astrocytes to functional neurons in the hippocampus of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in the hippocampal head of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in the hippocampal body of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in the hippocampus cauda of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in the frontal cortex of the brain. In one aspect, a method provided herein converts astrocytes to functional neurons in the prefrontal cortex of the brain.
[0241] In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the brain of a subject who has Alzheimer’s disease or is at risk of developing Alzheimer’s disease. In an aspect, a method provided herein converts reactive astrocytes to functional neurons in a cerebral cortex of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in a striatum of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in a dorsal striatum of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in a spinal cord of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in a putamen of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in a caudate nucleus of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in a substantia nigra of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the primary motor cortex. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the hippocampus of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the hippocampal head of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the hippocampal body of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the hippocampus cauda of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the frontal cortex of the brain. In one aspect, a method provided herein converts reactive astrocytes to functional neurons in the prefrontal cortex of the brain.
[0242] In an aspect, the present disclosure provides, and includes, methods of partially or fully restoring neuronal pathways in the brain of a subject who has suffered from Alzheimer’s disease. In an aspect, the present disclosure provides, and includes, methods of partially or fully restoring neuronal pathways in the brain of a subject who is at risk of developing Alzheimer’s disease.
[0243] In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to a subject suffering from Alzheimer’s disease, partially or fully neuronal pathways are restored in the brain of the subject. In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to a subject who is at risk of developing Alzheimer’s disease, partially or fully neuronal pathways are restored in the brain of the subject.
[0244] In an aspect, the present disclosure provides, and includes, methods of partially or fully restoring neuronal pathways in the brain of a subject who has suffered from Alzheimer’s disease by converting glial cells into neurons. In an aspect, the present disclosure provides, and includes, methods of partially or fully restoring neuronal pathways in the brain of a subject who is at risk of developing Alzheimer’s disease by converting glial cells into neurons.
[0245] In an aspect, the present disclosure provides, and includes, methods of partially or fully restoring neuronal pathways in the brain of a subject who has suffered from Alzheimer’s disease by converting glial cells into neurons via the expression of NeuroD1 in the glial cells. In an aspect, the present disclosure provides, and includes, methods of partially or fully restoring neuronal pathways in the brain of a subject who is at risk of developing Alzheimer’s disease by converting glial cells into neurons via the expression of NeuroD1 in the glial cells.
[0246] In an aspect, the partial or full restoration of the neuronal pathways in the brain of the subject can be assessed by MRI. In an aspect, the partial or full restoration of the neuronal pathways in the brain of the subject can be assessed by Diffusion Tensor Imaging (DTI) .
[0247] In some embodiments, the life span of the subject suffering from Alzheimer’s disease is increased. In some embodiments, the life span of the subject suffering from Alzheimer’s disease is increased for at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 95%.
[0248] In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to a subject suffering from Alzheimer’s disease, one or more symptoms of Alzheimer’s disease are eliminated, reduced, slowed or delayed. In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, to a subject is at risk of developing Alzheimer’s disease, one or more neurological condition symptoms are eliminated, reduced, slowed or delayed. In some embodiments, the one or more symptoms of Alzheimer’s disease are eliminated, reduced, slowed or delayed for at least about 10%, at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, or at least about 95%.
[0249] Non-limiting examples of symptoms of Alzheimer’s disease include short-term memory loss, difficulty learning new information, forgetting recent events, repeatedly asking the same questions, frequently misplacing items, impaired judgment, difficulty with planning and organization, struggles with abstract thinking, poor problem-solving abilities, language difficulties such as trouble finding words, and disorientation to time and place, mood swings, agitation, aggression, depression, anxiety, social withdrawal, significant personality changes, and various sleep disturbances affecting both night rest and daytime alertness, problems with walking, balance issues, decreased coordination, general slowness of movement, and difficulties with fine motor control such as writing or using utensils, struggles with routine tasks, problems managing finances, getting lost in familiar places, deteriorating personal hygiene, and increasing difficulty with household tasks, profound memory loss, complete dependence on caregivers, severe communication difficulties, increased physical complications, and problems with basic functions like swallowing.
[0250] Non-limiting examples of tests to evaluate the elimination, reduction, slow, or delay, of symptoms of Alzheimer’s disease include tests to evaluate cognitive function include Mini-Mental State Examination (MMSE) , and Clinical Dementia Rating Scale (CDR-SB) , biomarker tests include Cerebrospinal fluid (CSF) tests for p-Tau181, p-Tau217, t-tau, NFL, GFAP, Aβ42 / Aβ40, neuroinflammatory factors (IL-4, IL-12 , IFN-γ, TNF-α, HIF-1α, YKL-40 ) , blood tests for specific AD markers, e.g. p-Tau181, p-Tau217, t-tau, NFL, GFAP, Aβ42 / Aβ40, neuroinflammatory factors (IL-4, IL-12, IFN-γ, TNF-α, HIF-1α, YKL-40, positron emission tomography (PET) imaging for tau-PET and FDG -PET, and magnetic resonance imaging (MRI) for changes in total hippocampal volume, MTA score changes, DTI, functional MRI (fMRI) , MRS.
[0251] In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, the subject shows improvement of Clinical Dementia Rating Scale (CDR-SB) scores. In some embodiments, upon administration of the recombinant AAV encoding a NeuroD1 polypeptide as described herein, or a pharmaceutical composition thereof, the subject shows improvement of MMSE scores after the primate is administered the pharmaceutical composition. In some embodiments, the subject is a human patient suffering from Alzheimer’s disease. In some embodiments, the subject is a human patient at the risk of developing Alzheimer’s disease.
[0252] In some embodiments, the subject meets the National Institute of Aging-Alzheimer's Association (NIA-AA) core clinical criteria for probable AD dementia. In some embodiments, the subject has a positive biomarker for brain amyloid pathology as indicated by PET. In some embodiments, the subject has a positive biomarker for brain amyloid pathology as indicated by cerebrospinal fluid assessment. In some embodiments, the subject presents with moderate to severe AD. In some embodiments, moderate to severe AD are characterized by an MMSE score of 20 points or less at baseline. In some embodiments, the subject has a Hachinski Ischemia Index Scale (HIS) total score of 4 points or less. In some embodiments, the subject maintains sufficient organ function, including neutrophil count ≥1500 / mm3, platelets ≥100,000 / mm3, hemoglobin ≥9.0 g / dL, serum creatinine ≤1.5 times ULN, eGFR≥60mL / min / 1.73m2, liver enzymes ≤2.5 times ULN, and coagulation parameters ≤1.3 times ULN.
[0253] In some embodiments, the subject does not have a history of Lewy body dementia. In some embodiments, the subject does not have a history of frontotemporal dementia. In some embodiments, the subject does not have a history of Huntington's disease. In some embodiments, the subject does not have a history of Parkinson's disease. In some embodiments, the subject does not have a history of Creutzfeldt-Jakob disease. In some embodiments, the subject does not have a history of vascular dementia. In some embodiments, the subject does not have a history of brain traumatic dementia. In some embodiments, the subject does not have other infectious, metabolic or systemic diseases affecting the central nervous system, such as syphilis, hypothyroidism, folate and / or vitamin B12 deficiency. In some embodiments, the subject does not have psychiatric diagnoses. In some embodiments, the subject does not have GDS score ≥8. In some embodiments, the subject does not have history of TIA. In some embodiments, the subject does not have a history of stroke. In some embodiments, the subject does not have a history of seizures. In some embodiments, the subject does not have a history of encephalitis. In some embodiments, the subject does not have a history of meningitis. In some embodiments, the subject does not have a history of multiple sclerosis. In some embodiments, the subject does not have a history of primary intracranial hemorrhage. In some embodiments, the subject does not have a history of subarachnoid hemorrhage. In some embodiments, the subject does not have a history of severe head trauma. In some embodiments, the subject does not have significant pathological findings on brain MRI at Screening, including but not limited to: hemorrhage or infarction lesions >1cm in diameter, cerebral contusion, encephalomalacia, aneurysm, vascular malformation, subdural hematoma, hydrocephalus, and infectious lesions; Multiple lacunar infarcts, severe small vessel disease, or white matter lesions involving major vascular territories; or space-occupying lesions (brain tumors or brain abscesses) . In some embodiments, the subject does not have any contraindications to enhanced MRI scanning (such as implantation of a pacemaker, infusion pump, or allergy to enhancement agents. In some embodiments, the subject has no serum anti-AAV9 antibody. In some embodiments, the subject has serum anti-AAV9 antibody at a titer less than 1: 100. In some embodiments, the subject does not have a history of malignant tumors (except for adequately treated cervical carcinoma in situ, basal cell or squamous epithelial cell skin cancer, localized prostate cancer after radical surgery, and breast ductal carcinoma in situ) . In some embodiments, the subject does not have active infections. In some embodiments, the subject does not have human immunodeficiency virus (HIV) . In some embodiments, the subject does not have hepatitis A, hepatitis B or hepatitis C. In some embodiments, the subject does not have syphilis. In some embodiments, the subject is treatment for cell or gene therapies for AD. In some embodiments, the subject is not pregnant or lactating. In some embodiments, the subject does not have medical conditions which are not stably and adequately controlled, including cardiovascular system (decompensated heart failure (NYHA classification III and IV) , unstable angina, acute myocardial infarction) , respiratory System, digestive system, endocrine and metabolic system, neuropsychiatric system, blood system and immune system diseases.
[0254] In certain embodiments, the recombinant AAV vector may be administered alone or in combination with other prophylactic and / or therapeutic agents. In certain embodiments, the presently disclosed AAV vectors are administered intravenously and may be administered together with other biologically active agents.
[0255] The dosage amounts and frequencies of administration provided herein are encompassed by the terms therapeutically effective and prophylactically effective. The dosage and frequency typically vary according to factors specific for each patient depending on the specific therapeutic or prophylactic AAV vectors administered, the severity and type of disease, the route of administration, as well as age, body weight, response, and the past medical history of the patient, and should be decided according to the judgment of the practitioner and each patient’s circumstances. Suitable regimens can be selected by one skilled in the art by considering such factors and by following, for example, dosages reported in the literature and recommended in the Physician’s Desk Reference. Prophylactic and / or therapeutic AAV vectors can be administered repeatedly. Several aspects of the procedure may vary such as the temporal regimen of administering the prophylactic or therapeutic AAV vectors, and whether such AAV vectors are administered separately or as an admixture.
[0256] Effective doses of the AAV vector can be determined by standard clinical techniques. Effective doses may be extrapolated from dose-response curves derived from in vitro or animal model test systems. In certain embodiments, the therapeutically effective dose can be estimated initially from cell culture assays.
[0257] The presently disclosed AAV vectors, as well as combinations thereof, can be tested in suitable animal model systems prior to use in humans. Such animal model systems include, but are not limited to, rats, mice, chicken, cows, monkeys, pigs, dogs, rabbits, etc. Any animal system known in the art may be used. Such model systems are widely used and well known to the skilled artisan. In certain embodiments, animal model systems for a CNS condition are used that are based on rats, mice, or other small mammal other than a primate.
[0258] Once the presently disclosed AAV vectors have been tested in an animal model, they can be tested in clinical trials to establish their efficacy. Establishing clinical trials will be done in accordance with common methodologies known to one skilled in the art, and the optimal dosages and routes of administration as well as toxicity profiles of the presently disclosed AAV vectors can be established. For example, a clinical trial can be designed to test the presently disclosed AAV vectors for efficacy and toxicity in human patients.
[0259] Toxicity and efficacy of the presently disclosed AAV vectors can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD50 (the dose lethal to 50%of the population) and the ED50 (the dose therapeutically effective in 50%of the population) . The dose ratio between toxic and therapeutic effects is the therapeutic index and it can be expressed as the ratio LD50 / ED50. AAV vectors that exhibit large therapeutic indices are preferred. While AAV vectors that exhibit toxic side effects may be used, care should be taken to design a delivery system that targets such AAV vectors to the site of affected tissue in order to minimize potential damage to uninfected cells and, thereby, reduce side effects.
[0260] The presently disclosed AAV vectors generally will be administered for a time and in an amount effective for obtain a desired therapeutic and / or prophylactic benefit. The data obtained from the cell culture assays and animal studies can be used in formulating a range and / or schedule for dosage of the presently disclosed AAV vectors for use in humans. The dosage of such AAV vectors lies preferably within a range of circulating concentrations that include the ED50 with little or no toxicity. The dosage may vary within this range depending upon the dosage form employed and the route of administration utilized. 8. Examples 8.1. Example 1. Adeno-Associated Virus (AAV) Production
[0261] AAV9-GFAP-NeuroD1 (aka AAV-NeuroD1) was produced from plasmid CE-pGfa681-CRGI-hND1-oWPRE-bGHpA and packaged by Packgene. The stock viral titer of AAV9-GFAP-NeuroD1 is 1 × 1013 vg / mL. A reporter vector, AAV9-GFAP-GFP was produced from plasmid pGfaABC1D: GFP and packaged by Packgene. The stock viral titer of AAV9-GFAP-GFP was 1 ×1013 vg / mL.
[0262] AAV particles were produced by the triple transfection method using a HEK293 production cell line. Production and quality control of viral preparations for clinical use strictly followed cGMP standards. Particularly, HEK293 cells were seeded and expanded, and co-transfected with three plasmids: (1) a gene of interest (GOI) plasmid containing the transgene expression elements flanked by AAV ITRs; (2) a helper plasmid encoding adenovirus regions (VA, E2A and E4) that mediate AAV vector replication; and (3) a rep-cap packaging plasmid encoding the AAV capsid proteins (VP1, VP2, and VP3) through alternative splicing and initiation of translation, and AAV life cycle machinery Rep proteins (Rep78, Rep68, Rep52 and Rep40) through two promoters and alternative splicing.
[0263] Table 8.1 (A) shows the sequences of functional fragments of the GOI plasmid used to produce AAV encoding NeuroD1 (AAV-NeuroD1) , and the full-length sequence of the GOI plasmid used in the study. Table 8.1 (A) GOI Plasmid
[0264] Rep genes from AAV2 serotype were used for packaging AAV9 serotype virus, while capsid protein genes were serotype specific. Rep gene and encoded Rep protein sequences can be found in Table 8.1 (B) , SEQ ID NOS: 30-34. Cap gene and encoded capsid protein sequences for serotype 9 AAV virus can be found in Table 8.1 (B) , SEQ ID NOS: 35-38. The full-length sequence of a Rep (serotype 2) / Cap (serotype 9) packaging plasmid used in the study can be found in Table 8.1 (C) , SEQ ID NO: 39. Helper plasmid sequences used in this study can be found in Table 8.1 (C) SEQ ID NO: 40 and SEQ ID NO: 41. Table 8.1 (B) Rep / Cap sequences Table 8.1 (C) Packaging and Helper Plasmids
[0265] After triple-transfection, the cells were harvested in lysis buffer at 48-72 hours post transfection. For clinical use, the viral particles were purified by affinity purification, followed by ultracentrifugation, and ion exchange filtration after treatment of Benzonase and clear out cell debris. For research use, viral particles were purified by PEG as a preliminary purification step, followed by ultracentrifugation, and Ultrafiltration after treatment of Benzonase and clear out cell debris.
[0266] Final virus suspensions were produced after buffer exchange, concentration, and sterile filtration steps and were ready for in vitro or in vivo applications. The viral preparations were aliquoted before use. 8.2. Example 2 In vivo Astrocyte-to-Neuron Conversion in 5xFAD Transgenic Mice Using AAV-NeuroD1
[0267] Method: The study utilized nine months old 5xFAD transgenic mice as the experimental model. For the control group, mice received an injection of 1.5 μL control virus (AAV9-hGFAP: : GFP) at a concentration of 1E12 vg / mL. The treatment group received a mixture of 0.75 μL AAV-NeuroD1 (1E12 vg / mL) mixed with 0.75 μL control virus (1E12 vg / mL) . The viral injections were administered at two brain regions: the prefrontal cortex (AP 1.9 mm, ML + / -0.5 mm, and DP -2.55mm) , and the hippocampus, (AP -2 mm, ML + / -1.5 mm, and DV -2 mm) . Brain tissues were collected and processed at 14 and 30 days post-injection (dpi) . The processed tissues were analyzed with immunofluorescence staining of GFP (green) , GFAP (red) as an astrocyte marker, and NeuN (purple) as a neuron marker to evaluate the astrocyte-to-neuron conversion induced by NeuroD1.
[0268] Results: Analysis of the hippocampus region at 14 dpi (FIG. 1, panels A-D) revealed that in the control group, GFP+ cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, FIG. 1, panels A and C) . In contrast, the AAV-NeuroD1-treated group exhibited a significant population of converted neurons, identified by their GFP+ / GFAP- / NeuN+ expression profile (H1B and 1D) .
[0269] Analysis of the prefrontal cortex at 14 dpi (FIG. 2 panels A and B) demonstrated similar results. In control group, GFP+ cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, FIG. 2A) , while the AAV-NeuroD1-treated group displayed significant conversion to neurons (GFP+ / GFAP- / NeuN+, FIG. 2B) .
[0270] At the extended time point of 30 dpi, analysis of the hippocampus region (FIG. 3 panels A-D) showed that, in control group, GFP+ cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, FIG. 3, panels A and C) , whereas the AAV-NeuroD1-treated group showed significant population of converted neurons, identified by their GFP+ / GFAP- / NeuN+ expression profile (FIG. 3, panels B and D) .
[0271] Similarly, in the prefrontal cortex at 30 dpi (FIG. 4 panels A and B) , in control group, GFP+ cells were primarily glial in morphology (GFP+ / GFAP+ / NeuN-, FIG. 4, panel A) , while the AAV-NeuroD1-treated group displayed significant conversion to neurons (GFP+ / GFAP- / NeuN+, FIG. 4, panel B) .
[0272] These results demonstrate the successful and significant conversion of astrocytes to neurons using AAV-NeuroD1 in both the hippocampus and prefrontal cortex regions of 5xFAD transgenic mice. 8.3. Example 3. An exploratory clinical study to evaluate safety and preliminary efficacy of a recombinant AAV encoding NeuroD1 (NXL-001) for the treatment of Alzheimer’s disease.
[0273] Number of Sites and Product. This is a single-site trial studying NXL-001, a gene therapy that uses an AAV9 vector to deliver and express the NeuroD1 gene in astrocytes, converting them into neurons.
[0274] Objectives and Trial Design. The study aims to evaluate the safety and tolerability of a single intracerebral injection of NXL-001in patients with moderate to severe Alzheimer's disease (AD) , while preliminarily assessing its efficacy. The trial is designed as an open-label, single-center, dose-escalation clinical study.
[0275] Patient Population.
[0276] Inclusion criteria: ● Age ≥50, ≤70 years old, male or female patients; ● Meet the National Institute of Aging-Alzheimer’s Association (NIA-AA) core clinical criteria for probable AD dementia; ● Positive biomarker for brain amyloid pathology as indicated by PET or cerebrospinal fluid assessment. Use of a historical amyloid positive PET or CSF is acceptable. ● Moderate to severe AD, defined as MMSE score ≤ 20 points at baseline. ● Hachinski Ischemia Index Scale (HIS) total score ≤4 points; ● If receiving an approved AD treatment, such as cholinesterase inhibitors and / or glutamate receptor antagonists (such as memantine) and / or GV971 to treat AD, must be on a stable dose for at least 4 weeks prior to baseline; ● Subjects must have been on stable doses of all other (non-AD related) , permitted concomitant medications for at least 4 weeks prior to baseline ; ● Have a stable and reliable caregiver who can be with the subject at least 8 hours a week (at least 4 days a week, at least 2 hours a day) , and who can provide adequate support to the subject during the study. The caregiver must be willing and able to provide the subject's follow-up information during the study, and accompany the subject during visits where clinical assessment of CDR-SB and other assessments where information must be provided by the informant take place; ● Have adequate education and are capable of completing cognitive assessments and other assessments specified in the protocol; ● Provide written informed consent. If a subject lacks capacity to consent in the investigator's opinion, the subject's assent should be obtained, if required in accordance with laws, regulations, and customs, plus the written informed consent of a guardian / legal representative should be obtained; ● Male and female subjects must agree to take effective contraceptive measures and continue them for 6 months after administration; or the female subjects are postmenopausal women (menopause >24 months) or have undergone surgical sterilization; ● Sufficient reserved functions of liver, kidney and bone marrow. Neutrophil count ≥1500 / mm 3 ;platelets ≥100 000 / mm 3 ; hemoglobin ≥9.0 g / dL; serum creatinine ≤1.5 times the upper limit of normal range (ULN) ; renal function eGFR≥60mL / min / 1.73m 2 ; Bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 times ULN; activated partial prothrombin time (APTT) or international normalized ratio (INR) ≤1.3 times ULN , if the patient is receiving anticoagulation therapy, APTT / INR ≤1.3 times ULN must be confirmed before surgery.
[0277] Exclusion criteria: ● Any neurological condition that may be contributing to cognitive impairment above and beyond that caused by the subject’s AD: ○ Lewy body dementia, frontotemporal dementia, Huntington 's disease, Parkinson's disease, Creutzfeldt-Jakob disease, vascular dementia, brain traumatic dementia; ○ Other infectious, metabolic or systemic diseases affecting the central nervous system, such as syphilis, hypothyroidism, folate and / or vitamin B12 deficiency, etc. ● Any psychiatric diagnosis or symptoms that may interfere with the subject's research procedures (such as hallucinations, severe depression, or delusions) ; ● Geriatric Depression Scale (GDS) score ≥8 at screening; ● History of transient ischemia (TIA) , stroke or epileptic seizure within 12 months of screening; ● Previous history of encephalitis, meningitis, multiple sclerosis or other central nervous system infections; previous history of primary intracranial hemorrhage, subarachnoid hemorrhage; history of severe head trauma within the past 5 years; ● Other significant pathological findings on brain MRI at Screening, including but not limited to:hemorrhage or infarction lesions >1cm in diameter, cerebral contusion, encephalomalacia, aneurysm, vascular malformation, subdural hematoma, hydrocephalus, and infectious lesions; Multiple lacunar infarcts, severe small vessel disease, or white matter lesions involving major vascular territories; or space-occupying lesions (brain tumors or brain abscesses) ; ● Have any contraindications to enhanced MRI scanning (such as implantation of a pacemaker, infusion pump, or allergy to enhancement agents, etc. ) ; ● Known or suspected history of drug or alcohol abuse or dependence; ● Anti-AAV9 antibody titer > 1: 100; ● Subjects with malignant tumors within 5 years of screening (except for adequately treated cervical carcinoma in situ, basal cell or squamous epithelial cell skin cancer, localized prostate cancer after radical surgery, and breast ductal carcinoma in situ) ; ● Current clinically significant infections, including but not limited to human immunodeficiency virus (HIV) , hepatitis A, hepatitis B or hepatitis C, syphilis, etc.; ● Have received any other investigational products or drugs within 3 months of screening (or 5 half-lives of the investigational drug, whichever is longer) ; ● Patients who have previously received other cell and / or gene therapies; ● Pregnant or lactating female subjects; ● Any other medical conditions which are not stably and adequately controlled, including cardiovascular system (decompensated heart failure (NYHA classification III and IV) , unstable angina, acute myocardial infarction) , respiratory System, digestive system, endocrine and metabolic system, neuropsychiatric system, blood system and immune system diseases, etc.; ● Based on the medical history and the investigator's judgment, the subject is at significant risk for suicide; ● Patients who, in the investigator's judgment, have any other factors deemed inappropriate for participation in this trial.
[0278] Sample Size. The total number of patients to be enrolled are based on the observed toxicity and efficacy of the treatment. At least 7 patients are expected to be enrolled.
[0279] Treatment groups. The study includes 4 cohorts at escalating doses, with 1-2 subjects in each cohort, all receiving a single intracerebral stereotaxic injection of NXL-001.
[0280] Cohort 1: 1.5x1011 vg (5.0x1011 vg / mL x 0.3mL, n=1)
[0281] Cohort 2: 3.0x1011 vg (1.0x1012 vg / mL x 0.3mL, n=2)
[0282] Cohort 3: 6.0x1011 vg (2.0x1012 vg / mL x 0.3mL, n=2)
[0283] Cohort 4: 1.2x1012 vg (2.0x1012 vg / mL x 0.6mL, n=2)
[0284] Treatment Administration. The injection sites are determined before surgery based on MRI scan; Intracerebral stereotaxic injection is conducted by experienced neuro-surgeons.
[0285] In cohort 1-3, NXL-001are delivered to unilateral hippocampus. Injection sites are in the hippocampal head, hippocampus, and hippocampus cauda, with 1 trajectory and 2 sites in each region, one site in the superficial and another in deep layers of the hippocampus.
[0286] In cohort 4, subjects receive NXL-001 in bilateral hippocampus. The injection trajectory and site selection are the same as the unilateral injection. There is a total of 6 injection trajectories and 12 injection sites.
[0287] Burr holes are drilled in the skull under general anesthesia. With a stereotaxic / navigation device, NXL-001is injected to targeted sites; The injection volume of each site is approximately 50 μL, and the injection rate is no more than 10μL / min.
[0288] Study Procedures. Subjects are screened at baseline, and those who meet the inclusion criteria are hospitalized and receive medication within 28 days of screening.
[0289] NXL-001 is administered by intracerebral injection at four escalating dose levels.
[0290] There are at least a 2-week interval between dosing of patients to allow review of the safety analysis.
[0291] Additional subjects may be enrolled at a given dose level based on the occurrence of AE / DLT.
[0292] Dose escalation is based on dose-limiting toxicity (DLT) .
[0293] Subjects are followed up for 1 year after dosing to evaluate safety and efficacy.
[0294] Endpoints.
[0295] The primary endpoint focuses on safety and tolerability of NXL-001injection in patients with moderate to severe AD.
[0296] Incidence of adverse events (AE) and serious adverse events (SAE) are according to CTCAE 5.0.
[0297] Secondary endpoints evaluate the efficacy of NXL-001in patients with moderate to severe AD: ● Changes in biomarkers from baseline: ○ MRI : changes in total hippocampal volume, MTA score changes, DTI, functional MRI (fMRI) , MRS, etc. ○ PET: tau-PET, FDG -PET ○ CSF (only in patients who agree receive lumbar puncture and collect cerebrospinal fluid samples) : p-Tau181, p-Tau217, t-tau, NFL, GFAP, Aβ42 / Aβ40, neuroinflammatory factors (IL-4, IL-12 , IFN-γ, TNF-α, HIF-1α, YKL-40) ○ Plasma: p-Tau181, p-Tau217, t-tau, NFL, GFAP, Aβ42 / Aβ40, neuroinflammatory factors (IL-4, IL-12, IFN-γ, TNF-α, HIF-1α, YKL-40) ● Cognitive function assessment ● Changes in Clinical Dementia Rating Scale (CDR-SB) scores ● Changes in MMSE scores
[0298] Estimated study duration. Subjects are expected to be in the study for approximately 13 months, including screening period (≤28 days) , surgery and administration (d0) , and follow-up (12 months) : Clinical and imaging information are collected on d1, d7 and 1, 3, 6, and 12 months after dosing. In addition, patients receive telephone follow-up on days 14, 21, and 2 and 9 months after administration.
[0299] Statistical Methods. This study adopted a single-arm design, so the analysis of the results was primarily a summary of descriptive statistics and did not involve formal hypothesis testing.
[0300] Statistical analysis set.
[0301] Full analysis set (FAS) : According to the intention-to-treat analysis (ITT) principle, all subjects who are enrolled and receive at least 1 study drug. FAS will be mainly used to report the distribution, demographic and baseline characteristics of subjects and efficacy analysis.
[0302] mITT analysis set: subjects who were enrolled and received at least 1 dose of study drug and had at least 1 post-baseline efficacy assessment. This analysis set is used for the analysis of efficacy endpoints.
[0303] Safety analysis set (SS) : All subjects who are enrolled and receive at least one dose of study drug, and for whom post-medication safety data are collected. This analysis set is used for analysis of safety data.
[0304] General principles of statistical analysis:
[0305] In this study, unless otherwise stated, the data is analyzed with descriptive statistics in accordance with the following general principles. Measurement data is summarized by calculating the number of non-missing cases, mean, standard deviation, quartile, median, maximum value, and minimum value; count data will be calculated by frequency and percentage.
[0306] All adverse events (AEs) will be coded using MedDRA and graded according to the NCI CTCAE v5.0 grading system. The analysis of adverse events are based on the safety analysis set, and the AE data of different dose groups / stratifications are summarized in terms of number of subjects and incidence rates; and the above are analyzed according to system organ classification and preferred terminology, as well as severity. Adverse events are summarized separately. 9. SEQUENCE TABLE
Claims
A method of treating or preventing Alzheimer’s disease in a primate, the method comprising administering to the primate a pharmaceutical composition comprising a recombinant adeno-associated viral (AAV) comprising a recombinant genome encoding a Neurogenic Differentiation 1 (NeuroD1) polypeptide, wherein the pharmaceutical composition comprises from about 1×1011 to about 1×1013 viral genomes (vg) of the recombinant AAV, wherein the pharmaceutical composition is administered by injecting to the brain of the primate.The method of claim 1, wherein the primate is a human.The method of claim 1 or 2, wherein the pharmaceutical composition is injected into the hippocampus of the brain.The method of claim 3, wherein the pharmaceutical composition is injected into the unilateral hippocampus of the brain.The method of claim 4, wherein the pharmaceutical composition is injected into the hippocampal head region, the hippocampal body region, and / or the hippocampus cauda region within the hippocampus.The method of claim 5, wherein the pharmaceutical composition is administered through a single trajectory for each hippocampal region.The method of claim 6, wherein the administration comprises a total of three injection trajectories.The method of claim 7, wherein each trajectory comprises two injection sites.The method of claim 8, wherein the first injection site is located in a superficial layer of the hippocampus and the second injection site is located in a deep layer of the hippocampus.The method of any one of claims 1-9, wherein the administration comprises a total of six injection sites, wherein two injection sites are located in each of the hippocampal head region, the hippocampus body region, and the hippocampus cauda region.The method of any one of claims 1-10, wherein the pharmaceutical composition has a concentration of the recombinant AAV of about 5.0x10 11 vg / mL.The method of claim 11, wherein the pharmaceutical composition is administered for a total volume of about 0.3mL; optionally wherein the total volume is administered through multiple injection sites of about 50 μL per injection site.The method of any one of claims 1-10, wherein the pharmaceutical composition has a concentration of the recombinant AAV of about 1.0x10 12 vg / mL.The method of claim 13, wherein the pharmaceutical composition is administered for a total volume of about 0.3mL; optionally wherein the total volume is administered through multiple injection sites of about 50 μL per injection site.The method of any one of claims 1-10, wherein the pharmaceutical composition has a concentration of the recombinant AAV of about 2.0x10 12 vg / mL.The method of claim 15, wherein the pharmaceutical composition is administered for a total volume of about 0.3mL; optionally wherein the total volume is administered through multiple injection sites of about 50 μL per injection site.The method of claim 3, wherein the pharmaceutical composition is injected into the bilateral hippocampus of the brain.The method of claim 17, wherein the pharmaceutical composition is injected into the hippocampal head region of the left hippocampus, the hippocampal body region of the left hippocampus, the hippocampus cauda region of the left hippocampus, the hippocampal head region of the right hippocampus, the hippocampal body region of the right hippocampus, and / or the hippocampus cauda region of the right hippocampus.The method of claim 18, wherein the pharmaceutical composition is administered through a single trajectory for each hippocampal region.The method of claim 19, wherein the administration comprises a total of six injection trajectories.The method of claim 20, wherein each trajectory comprises two injection sites.The method of claim 21, wherein the first injection site is located in a superficial layer of the hippocampus and the second injection site is located in a deep layer of the hippocampus.The method of any one of claims 17-22, wherein the administration comprises a total of twelve injection sites, wherein two injection sites are located in each of the hippocampal head region of the left hippocampus, the hippocampal body region of the left hippocampus, the hippocampus cauda region of the left hippocampus, the hippocampal head region of the right hippocampus, the hippocampal body region of the right hippocampus, and the hippocampus cauda region of the right hippocampus.The method of any one of claims 17-23, wherein the pharmaceutical composition has a concentration of the recombinant AAV of about 2.0x10 12 vg / mL.The method of claim 24, wherein the pharmaceutical composition is administered for a total volume of 0.6mL; optionally wherein the total volume is administered through multiple injection sites of about 50 μL per injection site.The method of any one of claims 1–25, wherein an injection site is determined prior to the administering via a magnetic resonance imaging (MRI) scan.The method of claim 26, wherein coordinates of a pre-determined injection site are used for injecting the brain of the primate.The method of any one of claims 1–27, wherein a surgical navigation system is used to target an injection site on the brain of the primate.The method of any one of claims 1–28, wherein the injection rate is no more than about 10μL / min.The method of any one of claims 1–29, wherein glial cells are converted to neurons in the brain of the primate after the primate is administered the pharmaceutical composition.The method of any one of claims 1–29, wherein new neurons are generated in the brain of the primate after the primate is administered the pharmaceutical composition.The method of any one of claims 1–29, wherein neuronal pathways are partially or fully restored in the brain of the primate after the primate is administered the pharmaceutical composition.The method of any one of claims 1–32, wherein the primate shows changes in biomarkers from baseline after the primate is administered the pharmaceutical composition; optionally wherein the biomarkers are selected from p-Tau181, p-Tau217, t-tau, NFL, GFAP, Aβ42 / Aβ40 and one or more neuroinflammatory factors; optionally wherein the one or more neuroinflammatory factors are selected from IL-4, IL-12 , IFN-γ, TNF-α, HIF-1α, YKL-40; optionally wherein the biomarkers are measured from a cerebrospinal fluid sample or plasma sample take from the primate.The method of any one of claims 1–32, wherein the primate shows improvement of Clinical Dementia Rating Scale (CDR-SB) scores after the primate is administered the pharmaceutical composition.The method of any one of claims 1–32, wherein the primate shows improvement of MMSE scores after the primate is administered the pharmaceutical composition.The method of any one of claims 1–32, wherein the primate has suffered from Alzheimer’s disease.The method of any one of claims 1–32, wherein the primate has suffered from moderate to severe from Alzheimer’s disease.The method of any one of claims 1–32, wherein the primate is at risk of developing Alzheimer’s disease.A method of partially or fully restoring neuronal pathways in the brain of a primate suffering from Alzheimer’s disease or is at risk of developing Alzheimer’s disease, the method comprising administering to the primate a pharmaceutical composition comprising a recombinant adeno-associated viral (AAV) comprising a recombinant genome encoding Neurogenic Differentiation 1 (NeuroD1) polypeptide, wherein the restoring occurs after the primate is administered the pharmaceutical composition.A method of generating new neurons in the brain of a primate suffering from Alzheimer or is at risk of developing Alzheimer, the method comprising administering to the primate a pharmaceutical composition comprising a recombinant adeno-associated viral (AAV) comprising a recombinant genome encoding Neurogenic Differentiation 1 (NeuroD1) polypeptide, wherein the new neurons are generated after the primate is administered the pharmaceutical composition.The method of any one of claims 1 to 40, wherein the NeuroD1 polypeptide encoded by the recombinant genome of the recombinant AAV comprises an amino acid sequence having at least 90%sequence identity to the sequence set forth in SEQ ID NO: 3.The method of claim 41, wherein the NeuroD1 polypeptide comprises the amino acid sequence set forth in SEQ ID NO: 3.The method of claim 41, wherein the recombinant genome of the recombinant AAV comprises a transgene comprising a coding sequence for the NeuroD1 polypeptide, and wherein the coding sequence comprises the nucleic acid sequence set forth in SEQ ID NO: 4 or a codon-optimized version thereof.The method of claim 43, wherein the recombinant genome in the recombinant AAV further comprises one or more transcription regulatory elements operably linked to the coding sequence of the transgene.The method of claim 44, wherein the one or more transcription regulatory elements comprise a chimeric intron.The method of claim 45, wherein the chimeric intron comprises the sequence of SEQ ID NO: 9.The method of any one of claims 44 to 46, wherein the one or more transcription regulatory elements further comprise a GFAP promoter comprising the sequence of SEQ ID NO: 7.The method of any one of claims 44 to 47, wherein the one or more transcription regulatory elements further comprise a CMV enhancer comprising the sequence of SEQ ID NO: 5.The method of any one of claims 44 to 48, wherein the one or more transcription regulatory elements further comprise an optimized WPRE comprising the sequence of SEQ ID NO: 11.The method of any one of claims 44 to 49, wherein the one or more transcription regulatory elements further comprise a polyadenylation (poly-A) signal comprising the sequence of SEQ ID NO: 13.The method of any one of claims 44 to 50, wherein the recombinant genome of the recombinant AAV further comprises a first inverted terminal repeat (ITR) of a first AAV genome.The method of claim 51, wherein the first ITR comprises the sequence set forth in SEQ ID NO: 23.The method of claim 51 or 52 further comprising a second ITR of a second AAV genome.The method of claim 53, wherein the second ITR comprises the sequence set forth in SEQ ID NO: 24.The method of any one of claims 1 to 40, wherein the recombinant genome of the recombinant AAV comprises the nucleic acid sequence set forth in SEQ ID NO: 25, or a nucleic acid sequence having at least 80%sequence identity thereto.The method of claim 55, wherein the recombinant genome of the recombinant AAV consists essentially of the nucleic acid sequence set forth in SEQ ID NO: 25.The method of any one of claims 1 to 56, wherein the recombinant AAV comprises an AAV serotype 9 (AAV9) capsid.The method of claim 57, wherein the AAV9 capsid comprises capsid proteins selected from the group of AAV9 VP1 polypeptides, AAV9 VP2 polypeptides and AAV9 VP3 polypeptides.The method of claim 58, wherein the AAV9 capsid comprises AAV9 VP1 comprising the amino acid sequence set forth in SEQ ID NO: 36.The method of claim 58 or 59, wherein the AAV9 capsid further comprises AAV9 VP2 comprising the amino acid sequence set forth in SEQ ID NO: 37.The method of any one of claims 58 to 60, wherein the AAV9 capsid further comprises AAV9 VP3 comprising the amino acid sequence set forth in SEQ ID NO:38.