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A minimally invasive endovascular approach to the cerebellopontine angle cistern enables broad CNS biodistribution of scAAV9-CB-GFP

Benatti, Hector Ribeiro
Anagnostakou, Vania
Taghian, Toloo
Hall, Erin F
Nath, Sarah
Heilman, Carl B
Beneduce, Brandon M
Leporati, Anita
Raskett, Christopher M
Epshtein, Mark
... show 4 more
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Abstract

Neurological disorders pose a challenge for targeted therapy due to restricted access of therapeutic agents to the central nervous system (CNS). Current methods are limited by procedure-related risks, invasiveness, and insufficient CNS biodistribution. A novel percutaneous transvenous technology, currently in clinical trials for communicating hydrocephalus, offers a minimally invasive approach by providing endovascular access to the cerebrospinal fluid-filled cerebellopontine angle (CPA) cistern. We hypothesized that drug delivery to the CPA cistern could yield widespread CNS distribution. Using an ovine model, we compared the biodistribution of scAAV9-CB-GFP following CPA cistern infusion with previously reported cisterna magna (CM) administration. Targeting both the CPA cistern and CM in sheep, we employed a lumbar spine-inserted microcatheter under fluoroscopy. CPA delivery of AAV9 demonstrated biodistribution and transduction in the cerebral cortices, striatum, thalamus, midbrain, cerebellum, and spinal cord, with minor liver distribution comparable to CM. The favorable safety profile in humans with hydrocephalus suggests that percutaneous endovascular injection into the CPA could offer a clinically safer and minimally invasive delivery system for CNS gene and cell-based therapies.

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Benatti HR, Anagnostakou V, Taghian T, Hall EF, Nath S, Heilman CB, Beneduce BM, Leporati A, Raskett C, Epshtein M, King R, Gounis MJ, Malek AM, Gray-Edwards HL. A minimally invasive endovascular approach to the cerebellopontine angle cistern enables broad CNS biodistribution of scAAV9-CB-GFP. Mol Ther. 2024 Aug 26:S1525-0016(24)00546-X. doi: 10.1016/j.ymthe.2024.08.024. Epub ahead of print. PMID: 39192584.

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10.1016/j.ymthe.2024.08.024
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39192584
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The PDF available for download is the corrected proof. Corrected proofs are Articles in Press that contain the author’s corrections. Final citation details (e.g., volume and/or issue number, publication year, and page numbers) still need to be added and the text might change before final publication.

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Copyright © 2024. Published by Elsevier Inc. Under a Creative Commons License, http://creativecommons.org/licenses/by-nc-nd/4.0/.