Modulation of mammalian digit regeneration with viral gene therapy

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  • Background: A primary focus of regenerative medicine is to understand the cellular mechanisms governing tissue regeneration across various species. Mammals generally possess a restricted regenerative capacity compared to species like zebrafish or axolotls. Notably, all studied mammalian species, including humans, demonstrate the ability to regenerate digit tips following amputation at the level of the distal phalanx (P3), but not at the middle phalanx (P2). In adult mice, this process involves intramembranous bone regrowth and predominantly scarless healing, rendering them a valuable model for investigating mechanisms of mammalian regeneration. Previous work from our group has identified enhancer elements that are active upon tissue injury and return to their inactive state after healing. These tissue regeneration enhancer elements, or TREEs, allow for spatiotemporal regulation of gene delivery with systemic administration of adeno-associated viruses (AAVs). We asked whether AAVs driven by an injury-specific enhancer could deliver pro-regenerative genes to injured digit tips to improve the regeneration of the distal phalanx. Methods: In this study, we evaluated the expression patterns of two adeno-associated virus (AAV) constructs containing either fibroblast growth factor 8 (Fgf8) and green fluorescent protein (GFP) or GFP alone. To target gene delivery to the injury site, we administered the cc47 AAV with an injury-specific enhancer element, LEN, upstream of the genes of interest. Wild-type mice underwent left paw amputations at either level of the second phalanx (n=12) or the third phalanx (n=12). The right paws served as uninjured controls. AAVs were delivered systemically via retroorbital injection 10 days post-amputation. Within each amputation group, half received Hsp68-LEN::Fgf8-P2A-GFP while the other half received a construct with Hsp68-LEN::GFP. Results: Immunofluorescent imaging of the regenerating digits at 14 days post-amputation confirmed that the viral construct allowed the successful transduction of GFP in both P2 and P3 amputated digits, but not in the uninjured control digits. Micro CT imaging of P2 amputated digits showed similar bone length and volume between the Hsp68-LEN::Fgf8 and the Hsp68-LEN::GFP reporter groups after 28 days. Digits with P3 amputations had similar bone length but significantly greater bone volume in the Hsp68-LEN::Fgf8 group than in the Hsp68-LEN:GFP controls. Conclusions: Here, we show that systemic delivery of AAVs allows for targeted, timely gene expression in the regenerating mouse digit tip. We harnessed the LEN-AAV system for viral delivery of pro-regenerative genes to amputated digits to enhance bone regeneration. This work may represent a potential pathway for gene therapy applications in limb loss and tissue repair.
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  • 0000-0002-3743-3534
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