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Molecular Therapy Nucleic Acids

Elsevier BV

Preprints posted in the last 30 days, ranked by how well they match Molecular Therapy Nucleic Acids's content profile, based on 39 papers previously published here. The average preprint has a 0.04% match score for this journal, so anything above that is already an above-average fit.

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Adeno-Associated Virus (AAV) Synthetic Inverted Terminal Repeats Enhance Tissue-Specific Transduction and Alter the Vector Induced Stress Response

Hasegawa, T.; Vridhachalam, N.; Nikolai, E. S.; Kalikiri, T.; Ross, M.; Toennisson, R.; Villanueva, P.; Chandler, A. M.; Song, L.; Bower, J. J.; Samulski, R. J.; Hirsch, M. L.

2026-07-13 molecular biology 10.64898/2026.07.10.737493 medRxiv
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While adeno-associated virus (AAV) vectors have shown therapeutic benefit in clinical applications, noted challenges include low transduction efficiencies, poor cellular targeting, and vector related adverse events. Recently, it was demonstrated that a rationally designed synthetic inverted terminal repeat (SynITR) altered the AAV vector-induced DNA damage response and abrogated apoptosis in human embryonic stem cells. To explore the utility of AAV-SynITR for diverse gene therapy applications, vector production, transduction, and the cellular response were evaluated in various contexts. Regarding production, SynITR preparations exhibited comparable titers to wtITR in a serotype/transgene-independent manner. Despite slightly decreased transduction efficiency in various cell lines, intravenous administration of AAV8 vectors showed SynITR enhanced transduction in a tissue-specific manner in liver (>7-fold) and kidney and pancreas (>2-fold) at equivalent vector copy numbers; however, no differences were observed in muscle/heart/spleen tissues. Interestingly, persistent {gamma}H2AX, a marker of aging/chronic inflammation, was abundant in the liver and spleen following wtITR (but not SynITR) transduction. In human corneas, SynITR enhanced transduction up to 16-fold over wtITRs. These data demonstrate that SynITRs elicit tissue-specific transduction enhancement and alter the cellular stress response. Importantly, the SynITRs offer an alternative context to elucidate wtITR biology for targeted, enhanced, and potentially safer human gene therapy.

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Sequence determinants of efficient exon 44 skipping in Duchenne muscular dystrophy define design principles for steric-blocking antisense oligonucleotides

Han, E.; Webster, K.; Stan, T. L.; Tanganyika-de Winter, C.; van der Pijl, E.; Tahquechi, J.; Heglar, B.; Koehler, C.; Papangeli, I.; Mackenzie, D.; Crawford, B. E.; Aartsma-Rus, A.; Hartl, T. A.

2026-07-09 molecular biology 10.64898/2026.06.29.735365 medRxiv
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Duchenne muscular dystrophy (DMD) is caused by mutations in the DMD gene that disrupt the reading frame and abolish expression of functional dystrophin protein. Antisense oligonucleotides (ASO) can restore production of partially functional dystrophins by inducing exon skipping to restore the reading frame of dystrophin transcripts. While exon skipping is an FDA approved therapeutic strategy, there are currently no approved therapies for patients amenable to exon 44 skipping (8% of DMD patients). Here, we carried out a discovery campaign to identify phosphorothioate (PS) ASOs that efficiently induce exon 44 skipping and to define key sequence and chemistry features associated with activity. A tiling and micro-tiling approach with 18mer fully PS and 2-O-methoxyethyl (2MOE) modified ASOs in patient-derived myotubes identified five exonic target regions that promote skipping. ASO activity was strongly correlated across skeletal muscle and iPSC-derived cardiomyocytes, indicating similar exon 44 splicing regulation across cell types. Optimization studies showed that for 2MOE PS ASOs, 16-20mers were generally most active, while longer ASOs often had reduced activity due in part to impaired productive uptake into cells. Swapping out 2MOE modifications at both terminal positions for locked nucleic acids (LNAs) rarely improved activity and could also reduce it. Finally, promising candidates were tested in a humanized mouse model with an exon 44 skippable deletion, where one ASO outperformed others, inducing dose-dependent exon 44 skipping and dystrophin restoration in mouse models. These findings define practical design rules for exon 44-targeted ASOs and provide a foundation for therapeutic development.

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Bovine AAV - a promising vector for pulmonary gene therapy

Ivan, D. C.; Dubost, V.; Israel, L.; Weinmann, J.; Ungan, D.; Carbonetti, N.; Stuber, N.; Jivkov, M.; Erard, E.; Biglieri, E.; De Girardi, F.; Mittermeier, S.; Syed, M.; Tigani, B.; Ouali-Alami, N.; Dreessen, K.; Deniston, C.; Sankar, K.; Bollepalli, L.; Cornacchione, V.; Traggiai, E.; Brees, D.; Karle, A.; Carballido, J. M.; Cirillo, A.

2026-07-15 molecular biology 10.64898/2026.07.14.738418 medRxiv
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Efficient systemic delivery to the lung remains a major barrier for adeno-associated virus (AAV)-mediated pulmonary gene therapy, particularly when pre-existing immunity limits the use of conventional capsids. Here, we evaluated Bovine AAV, a phylogenetically divergent capsid, as candidate vector for lung-directed gene transfer. In adult C57BL/6J mice, intravenous delivery of Bovine AAV resulted in robust and preferential lung transduction comparable to AAV4, with predominant targeting of alveolar type I pneumocytes and pulmonary endothelial cells. In primary human lung-resident cells, Bovine AAV was particularly effective in microvascular endothelial cells, a target poorly transduced by AAV4 in vitro. Bovine AAV demonstrated scalable production with yield, purification performance, capsid quality, and genome integrity comparable to AAV9. In sera from healthy adults from the United States and Switzerland, Bovine AAV showed intermediate neutralization frequencies, lower than AAV2 and AAV4 but higher than AAV5 and AAV9. Of relevance, Bovine AAV maintained in vivo transduction efficiency in mice previously immunized with a pool of human and non-human primate-derived AAV capsids, including AAV4. Together, these results position Bovine AAV as a promising lung-tropic and immune-distinct vector for pulmonary gene therapy, with particular relevance for applications requiring systemic delivery in the presence of pre-existing immunity to conventional serotypes.

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Targeting the 3' splice site by a decoy oligonucleotide attenuates U2AF1 splicing activity and inhibits leukemia

Azar-Koussa, C.; Sakran, M.; Rahamim, E.; Prabhu, A. V.; Salem, S.; Ben-David-Naim, M.; Heinberg, A.; Siegfried, Z.; Zimran, E.; Levanon, E. Y.; Granot, Z. Y.; Karni, R.

2026-07-07 molecular biology 10.64898/2026.06.30.735457 medRxiv
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Recurrent mutations in spliceosomal genes are a hallmark of myeloid malignancies, with SF3B1, SRSF2, U2AF1 and ZRSR2 among the most frequently affected. These alterations are typically heterozygous, mutually exclusive missense mutations targeting highly conserved residues, reflecting a selective pressure to maintain a dysregulated yet essential splicing machinery. This constraint suggests that leukemic cells remain dependent on residual splicing activity, exposing a potential therapeutic vulnerability that extends beyond genetically defined subsets. For example, a previously developed therapeutic, Pladienolide B, is a potent cancer cell growth inhibitor targeting the SF3B1 subunit of the spliceosome. Here we present an RNA decoy- based strategy to disrupt 3' splice site recognition by competitively engaging components of the spliceosomal machinery. We engineered a chemically stabilized RNA decoy that mimics the 3' splice site (3'SS decoy), thereby sequestering proteins involved in 3' splice site recognition from endogenous pre-mRNA targets. Although the decoy is expected to engage multiple components of the 3' splice site recognition complex, U2AF1 was used as the primary molecular readout to assess target engagement and downstream effects. To enable intracellular delivery, decoys were encapsulated in lipid nanoparticles (LNPs), facilitating efficient uptake in leukemic systems. We show that LNP-encapsulated decoys are efficiently delivered into leukemic cells, including established cell lines and patient-derived blasts, and directly engage components of the splicing machinery. Decoy treatment induces widespread alterations in RNA splicing programs and impairs leukemic cell fitness in vitro. Importantly, systemic administration of the 3'SS decoy significantly reduces leukemia burden in an in vivo xenograft model. Notably, these effects are observed independently of spliceosomal mutational status, supporting a broader dependency of leukemic cells on intact splicing factor function. Together, our findings establish decoy-mediated disruption of splicing factor activity as a mechanistically targeted therapeutic strategy and identify LNPs as an effective platform for the delivery of RNA-based modulators of essential RNA-protein interactions in myeloid malignancies.

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AAV VP1 unique region (VP1u) determines GPR108 dependence for AAV transduction of human airway epithelium and its rescue by Doxorubicin

Hao, S.; Habib, A.; Zhang, X.; Ning, K.; Park, S. Y.; Mcfarlin, S.; Kuz, C. A.; Richart, D.; Cheng, F.; Yan, Z.; Qiu, J.

2026-07-10 microbiology 10.64898/2026.07.10.737643 medRxiv
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rAAV2.5T was identified through directed evolution of an AAV capsid library in polarized human airway epithelium (HAE) cultured at an air-liquid interface (ALI). The capsid gene of rAAV2.5T is a chimera of the N-terminal unique region of AAV2 VP1 (VP1u) and the VP2 and VP3 regions of AAV5 with a single A581T substitution at the variable region (VR) VIII of the capsids. GPR108, a G protein-coupled receptor, is known as an essential host factor for the transduction of rAAV2 but not of rAAV5. Both AAV2 and AAV5 VP1u colocalized well with GPR108 and, to a lesser extent, with the trans-Golgi network (TGN). GPR108 knockout (KO) abolished rAAV2.5T transduction in both HeLa cells and HAE-ALI cultures. Remarkably, short-term treatment with doxorubicin (DOX) at 2 {micro}M completely restored transduction, indicating that DOX can compensate for the loss of GPR108 function. DOX enhanced rAAV2.5T transduction by 50-100-fold in wild-type HAE-ALI cultures and by over 300-fold in the GPR108-deficient cultures. Mechanistic studies demonstrated that this enhancement resulted from altered intracellular trafficking that promoted efficient vector nuclear import, rather than increased vector internalization, proteasome inhibition, or activation of the DNA damage response. Importantly, we identified that the N-terminal 15 amino acids of AAV2 VP1u as the primary determinant of rAAV2.5T dependence on GPR108 for transduction. Collectively, these findings demonstrate that productive transduction of rAAV2.5T in polarized HAE cultures depends on GPR108-mediated intracellular trafficking that limits efficient nuclear entry, and that DOX can relieve this constraint by promoting efficient vector import. SignificanceAAV2.5T is an airway-tropic vector with considerable promise for pulmonary gene therapy. We found that host factor GPR108 is required for rAAV2.5T trafficking from the TGN to the nucleus and that this step constitutes a major bottleneck to productive transduction in polarized HAE. In contrast, KIAA0319L (AAVR) plays a key role in AAV intracellular trafficking from the endosome to the TGN but not in internalization into polarized HAE during apical transduction. Transient treatment with low-dose doxorubicin (DOX, 2 {micro}M) enhanced rAAV2.5T transduction in HAE by 50-100-fold through a significant increase in vector nuclear import. Notably, DOX can overcome the transduction deficit caused by GPR108 deficiency, but not that caused by AAVR deficiency. Mechanistically, the N-terminal 15 amino acids of the VP1u confer GPR108 dependence during rAAV2.5T apical transduction of polarized HAE. DOX bypasses this requirement by promoting efficient nuclear import without affecting vector internalization, inhibiting proteasomes, or inducing DNA damage response.

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Gene Supplementation of MYO7A or activation of Myo7b for treatment of Usher syndrome 1B

Mittas, D. M.; Otify, D. Y.; Gavrilov, Z.; Heigl, T.; Suchomski, J.; Deltuvaite, P.; Hinrichsmeyer, K.; Mercey, O.; Kynast, F.; Motlik, J.; Ellederova, Z.; Ardan, T.; Klingl, A.; Grünert, J.; Mehlfeld, V.; Kolesnikova, A.; Nyshchuk, R.; Juhasova, J.; Juhas, S.; Drutovic, S.; Fischer, M. D.; Veith, M.; Stranak, Z.; Boon, N.; Wijnholds, J.; Wiest, A.; Kielkowski, P.; Gökce, G.; Guichard, P.; Hamel, V.; Ammer, H.; Michalakis, S.; Koch, S.; Biel, M.; Becirovic, E.

2026-07-10 molecular biology 10.64898/2026.07.02.736025 medRxiv
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Mutations in MYO7A result in the most severe subtype of Usher syndrome, the leading genetic cause of deafblindness. The large size of MYO7A requires dual adeno-associated virus (AAV) vectors for gene transfer or alternative methods to treat retinal defects. Here, we evaluated two treatment approaches: i) Supplementation of the human MYO7A gene via dual mRNA trans-splicing AAVs, and ii) CRISPR/Cas-mediated activation of the related murine Myo7b gene. Upon MYO7A supplementation, the transgenic MYO7A transcript and protein were expressed and correctly localized in retinal pigment epithelial (RPE) and photoreceptors of mice, pigs, and human retinal organoids. In RPE-and photoreceptor-specific Myo7a knockout mice, we could restore MYO7A expression and localization of melanosomes in RPE cells to wild-type levels. Myo7b activation led to partial restoration of melanosome localization, and the localization of MYO7B protein was largely comparable to MYO7A. These findings indicate that both approaches are in principle suitable for the therapy of Usher syndrome.

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Study design and rationale of Boxed-Breathing-Heart: a translational ex vivo study evaluating virus-mediated gene delivery for gene therapy in normothermic machine-perfused human hearts

Branzei, I.; Amr, A.; Rapti, K.; Schraft, L.; Lindenhofer, D.; Leo, A.; Romano, G.; Sedaghat-Hamedani, F.; Reich, C.; Koelemen, J.; Haas, J.; Munoz Verdu, A.; Beckendorf, J.; Schlegel, P.; Te Gussinklo, W. H.; Meyer, A.; Arif, R.; Karck, M.; Frey, N.; Steinmetz, L.; Grimm, D.; Meder, B.

2026-07-14 genetic and genomic medicine 10.64898/2026.07.13.26357866 medRxiv
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Research on targeted genetic therapies for myocardial diseases, such as cardiomyopathies, currently focuses on (r)AAVs as the delivery method. Despite substantial efforts and advances in animal trials, predicting biodistribution and transduction efficacy in human tissue remains challenging due to interspecies differences in tissue tropism and the difficulty of accurately assessing alternative delivery routes and vector differences. The application in humans has also proven challenging, in part due to severe adverse events associated with systemic administration of (r)AAVs. This necessitates implementing alternative trial designs and stringent evaluation methods that minimize harm or risk to patients. Applying a predesigned vector carrying a gene-editing tool to a normothermic machine-perfused living beating heart in an ex vivo setting could overcome conventional obstacles and limitations. This can serve as a basis for safe and effective gene-therapy testing and assist in evaluating effects at the molecular level. Boxed-Breathing-Heart is a translational trial assessing the feasibility of ex vivo gene editing and gene translation in normothermic machine-perfused human hearts. Human hearts explanted from cardiomyopathy patients undergoing heart transplantation are donated for research and immediately placed in an Organ Care System, where they are surgically connected. The viability of the heart is maintained through normothermic perfusion of system solutions and donor blood. A predesigned AAV containing a CRISPR-Cas system is infused into the circulation and dispersed throughout the tissue via coronary perfusion. The changes at the cellular and molecular levels are assessed continuously via frequent sequential myocardial biopsies. Furthermore, after the pre-planned 72-hour perfusion, the heart is sectioned and analyzed using spatial and single-cell omics. The aim is to provide a proof-of-concept for genetic therapeutic options delivered to the human heart via AAV in an ex vivo perfusion setup. In summary, Boxed-Breathing-Heart provides an ex vivo translational platform for evaluating targeted cardiac gene therapies, enabling molecular analysis directly in human hearts and accelerating clinical translation without posing risks to patients.

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Restoring Parkin Function: An AAV Gene Therapy Approach for Early-Onset Parkinson's Disease

Basu, S.; Demarest, T. G.; Gattone, N. J.; Gilsrud, A. J.; Wicks, B.; Khatiwada, A.; Nayal, M.; Gentzel, R.; Cohen, D.; Kostuk, E. W.; Narendra, D. P.; Alegre, P. G.; Biferi, M.-G.; Ramsburg, E. A.

2026-07-13 neuroscience 10.64898/2026.07.09.737487 medRxiv
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BackgroundBiallelic loss-of-function mutations in PRKN gene (encoding Parkin protein) cause early-onset Parkinsons disease (EOPD). Parkin is a crucial component of PINK1-Parkin pathway, which marks damaged mitochondria for degradation via mitophagy. Without functional Parkin, damaged mitochondria accumulate, causing oxidative stress and neurodegeneration. ObjectiveInvestigate Parkin gene replacement via AAV gene therapy as a potential treatment for Parkin-dependent EOPD. MethodsWe initially validated phosphorylated ubiquitin Ser65 (pUbSer65) as an indicator of Parkin-mediated mitophagy initiation. We evaluated AAV-mediated PRKN replacement (hereafter, AAV-Parkin) in a Parkin knockout neuroblastoma cell line (SH-SY5Y cells) and feasibility of delivery in mouse and rat models. ResultsOur research showed pUbSer65 signal was reduced in Parkin-KO SH-SY5Y cells when compared to wild-type cells after mitochondrial stress, indicating deficiency in initiation of mitophagy. AAV-mediated human PRKN gene replacement successfully restored these pUbSer65 levels in knockout cells. We saw restoration in patient-derived fibroblasts following AAV-Parkin overexpression. We developed a translatable gene therapy approach using rodents. We demonstrated the feasibility of delivering AAV-Parkin directly into the substantia nigra (SN) of wild-type rats. Using an AAV1 capsid with Ef1a promoter, we achieved dose-dependent Parkin expression and identified a well-tolerated dose. We also evaluated multiple promoters in a proprietary Spark100 capsid, finding Ef1a and Synapsin1 (Syn1) were most effective for transducing dopaminergic neurons in the SN of mice without causing adverse effects. These findings established a well-tolerated vector dose and an optimal capsid-promoter combination. ConclusionsOur results support the potential of AAV-Parkin gene therapy as a disease-modifying approach for Parkin-deficient EOPD. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=132 SRC="FIGDIR/small/737487v1_ufig1.gif" ALT="Figure 1"> View larger version (33K): org.highwire.dtl.DTLVardef@16dd13corg.highwire.dtl.DTLVardef@c3dfcdorg.highwire.dtl.DTLVardef@19a310dorg.highwire.dtl.DTLVardef@a66f2_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Rett syndrome lifespan extension in mice via AI-guided ADAR editing

Savva, Y. A.; Booth, B. J.; Shumaker, L.; Fasnacht, R.; Burleigh, S. M.; Jiang, Y.; Cao, Y.; Johnson, B.; Bagepalli, L. R.; Golic, F.; Enger, N.; Feiring, R.; Sadowski, A.; Rich, S.; Lakshmanan, A.; Milani, N.; Chadwick, E. M.; Hauskins, C.; Works, M. G.; Huss, D. J.; Briggs, A. W.; VanSchoiack, A. A.

2026-06-28 neuroscience 10.64898/2026.06.23.734060 medRxiv
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Rett syndrome is a severe neurodevelopmental disorder primarily caused by mutations in the MECP2 gene. A significant subset of severe cases are driven by nonsense mutations that generate premature stop codons, leading to loss of functional MeCP2 protein. Here, we describe a novel therapeutic strategy that uses endogenous adenosine deaminase acting on RNA (ADAR) enzymes to correct the R168X mutation at the RNA level. Using generative artificial intelligence trained on large empirical datasets, we engineered guide RNAs (gRNAs) that recruit endogenous ADAR to convert the mutant stop codon (UGA) into a tryptophan (UGG) to restore full-length MeCP2. Once incorporated into an optimized expression system based on endogenous small nuclear RNA regulatory elements and packaged into adeno-associated virus, these gRNAs enabled precise RNA editing at the target site with minimal off-target activity across the transcriptome while restoring full-length MeCP2 protein expression in patient-derived induced pluripotent stem cell neurons. Delivered intravenously to an R168X mouse model, the gRNAs achieved ~70% targeted RNA editing and substantially restored MeCP2 throughout the brain resulting in markedly improved Rett-like phenotypes and significantly extended lifespan. These findings demonstrate that AI-guided ADAR-mediated RNA editing is a precise and efficient technology for correcting nonsense mutations, with therapeutic potential for Rett syndrome and other genetic diseases.

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AptViralDB: A Repository of Experimentally Validated Antiviral Aptamers

Bajiya, N.; Singh, S.; Gahlot, P. S.; Raghava, G. P. S.

2026-07-11 bioinformatics 10.64898/2026.07.08.737144 medRxiv
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In an era of increasing drug resistance, exploring alternative molecules is crucial for the efficient management and treatment of viral diseases. Nucleic acid aptamers have emerged as highly promising candidates due to their exceptional target specificity, low immunogenicity, and versatile mechanisms for viral blocking. This manuscript describes AptViralDB, a manually curated database providing comprehensive information on experimentally validated antiviral aptamers. It contains 1,768 entries of antiviral aptamers against 40 viral species and 104 molecular targets, compiled from literature and existing databases. Each entry provides detailed annotations, including sequence, aptamer type, target, chemical modifications, binding affinity, antiviral activity, stability, and cytotoxicity. We also provide predicted secondary structures and their corresponding minimum free energy (MFE) values. Additionally, a knowledge graph created using ArcadeDB/openCypher enables users to seamlessly explore connections among aptamers, viruses, molecular targets, and biological activities. Finally, the platform offers advanced search and browsing tools, BLAST-based sequence similarity searches, GC-content analysis, downloadable datasets, and REST API access to support computational applications. (https://webs.iiitd.edu.in/raghava/aptviraldb/).

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Engineering of CAR-less lentiviral vectors via ER retention-mediated CAR blockade

Ma, L.; Wang, J.; Huang, M.; Yao, M.; Yi, S.; Zhang, K.; Ma, X.; Sun, H. J.

2026-06-23 bioengineering 10.64898/2026.06.21.733647 medRxiv
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Chimeric antigen receptor (CAR)-T cell therapies have transformed the treatment of various tumor types by redirecting and activating T cells against tumor cells. However, CAR-T cell manufacturing approaches remain challenging and limit their widespread use in clinical settings. In vivo CAR-T therapy bypasses ex vivo cell manufacturing and patient preconditioning limitations; however, it faces a significant safety concern as CAR proteins on viral packaging cells are incorporated into budding virions, leading to off-target transduction of tumor cells. Here, we address this risk by developing the CAR-Less ER-Anchor Vector (CLEAN-V) system. By exploiting endoplasmic reticulum (ER) retention, CLEAN-V prevents the CAR protein from trafficking to the cell surface during viral packaging, thereby blocking its incorporation into the viral envelope. CLEAN-V particles exhibit near-complete loss of CAR-mediated tumor cell transduction. Furthermore, CLEAN-V integrates seamlessly into existing third-generation LVV workflows in four- or five-plasmid formats and generates CAR-T cells with preserved phenotypic and functional integrity. These results establish CLEAN-V as a robust platform for developing safe, targeted lentiviral vectors for in vivo CAR-T therapy.

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Preclinical translation of Neurofibromatosis type 1 (NF1) exon 17 skipping using targeted U7-SnRNA packaged into engineered AAV serotypes.

Moore, M.; Rayat-Sanati, K.; Zhang, X.; Liu, H.; Rostamitehrani, Z.; Vijayasarathy, T.; Westin, E.; Esteves, M.; Maguire, C. A.; Kesterson, R. A.; Popplewell, L.; Wallis, D.

2026-07-02 genetics 10.64898/2026.06.29.734312 medRxiv
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To facilitate the translation of NF1 exon 17 skipping as a mutation-specific therapy for Neurofibromatosis type 1 into in vivo testing, we have continued to develop more efficient antisense oligonucleotides (ASOs), humanized mouse models, and explored multiple delivery platforms including an adeno-associated virus (AAV)-U7-SnRNA vector approach. We evaluated both biodistribution and exon skipping efficacy of a U7-SnRNA targeting NF1 exon 17 with an SFFV-driven cassette containing T2A-linked Luciferase (Luc) and eGFP packaged in AAV-9, AAV-F and AAV-B1 capsids. We show that AAV-F is superior to AAV-9 and AAV-B1 for mouse brain delivery based on DNA transduction, GFP expression, and luciferase activity, but AAV-B1 delivers 2-4 fold more to sciatic nerve (SCN). In terms of exon skipping, AAV-F appears to induce the most skipping in liver and optic nerve (ON), while AAV-B1 mediates highest skipping in the liver, SCN, and ON. The identification of AAV serotypes that allow efficient transduction and delivery of transgenes to the mouse CNS and PNS is impactful for preclinical research in murine models of other diseases. Furthermore, this is both the first report of NF1 exon skipping efficacy in vivo and the first successful application of an U7-SnRNA for the restoration of functional neurofibromin for NF1.

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Single-cell transcriptomics reveals chondrocyte state transitions and ECM remodeling in osteoarthritic knee cartilage

Bo, Z.; Xu, H.; Liang, Y.

2026-06-29 bioinformatics 10.64898/2026.06.24.734199 medRxiv
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BackgroundOsteoarthritis cartilage contains heterogeneous chondrocyte states, but molecular programs linked to state transitions within human cartilage remain incompletely resolved using public single-cell data. MethodsA retrospective reanalysis was conducted of a public human knee cartilage single-cell RNA sequencing dataset (GSE255460) including 8 osteoarthritis donors and 3 non-osteoarthritis donors (19 samples). Cells underwent sample-wise quality control and doublet removal, followed by batch-corrected clustering, chondrocyte subclustering with marker-based annotation, and trajectory inference using Slingshot. Regulatory chondrocytes were prioritized for osteoarthritis versus control differential expression, with downstream Gene Ontology/KEGG enrichment (Benjamini-Hochberg false discovery rate <0.05) and protein-protein interaction network hub screening. ResultsAfter quality control, 27,036 cells were retained. Chondrocytes formed multiple transcriptional states with branching-like continuous relationships, and regulatory chondrocytes localized near the main manifold and adjacent to multiple inferred branches, consistent with a transition-adjacent state. In regulatory chondrocytes, osteoarthritis versus control differential expression was enriched for collagen-containing extracellular matrix and extracellular matrix organization, endoplasmic reticulum lumen-associated secretory/proteostasis processes, cell-matrix adhesion (including focal adhesion), and transforming growth factor beta/SMAD-related signaling. Protein-protein interaction analysis of regulatory-chondrocyte differential genes identified five high-connectivity hub genes: COL5A1, COL5A2, COL6A1, COL1A2, and COL3A1. ConclusionThis public-dataset reanalysis supports a transition-adjacent regulatory chondrocyte program in osteoarthritis characterized by coordinated extracellular matrix remodeling with concurrent secretory/proteostasis and adhesion-transforming growth factor beta signatures, nominating collagen-network hubs as candidates for downstream validation.

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Clinical Relevant Immunosuppressive Drugs Differentially Modulate Axonal Outgrowth from Human Stem Cell Derived Neurons

Poplawski, G. H. D.; Weinholtz, C.; Woodruff, G.; Ahmad, R.; Bunner, W.; Gonzales, R.; Tuszynski, M. H.

2026-07-03 neuroscience 10.64898/2026.06.29.735084 medRxiv
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Neural stem cell (NSC) transplantation is a promising strategy for repairing the injured spinal cord, but transplanted cells typically require immunosuppressive therapy to prevent rejection, even for induced pluripotent stem cell (iPSC)-derived autologous grafts. However, the effects of immunosuppressive drugs on neurite outgrowth and axonal regeneration, processes critical for neural circuit reconstruction, have not been fully characterized. In this study, we tested nine clinically relevant immunosuppressants on human iPSC-derived neurons and primary human spinal cord NSCs in vitro at concentrations approximating clinical exposure levels. The drug panel included FK-506 (tacrolimus), cyclosporine A (CsA), rapamycin, belatacept (Nulojix), etanercept (Enbrel), mycophenolate mofetil (CellCept), cyclophosphamide (Cytoxan), prednisone, and azathioprine (Imuran). Neurite outgrowth was quantified via automated high-content imaging. Multiple agents, including CsA, Imuran, Nulojix, and CellCept, induced significant reductions in neurite outgrowth in a cell type- and dose-dependent manner, with CsA producing the most robust and consistent inhibition across both cell lines. In contrast, FK-506 showed no significant effect on neurite extension at clinically relevant concentrations. Consistent with the in vitro results, human neural progenitor cell grafts in a rodent spinal cord injury model exhibited significantly reduced graft-derived axon extension in the host spinal cord when hosts were treated with CsA rather than FK-506. These findings demonstrate that immunosuppressant choice can profoundly influence neural graft integration and axonal regeneration. Our study underscores the importance of preclinical evaluation of immunosuppressive regimens and suggests that selecting agents such as FK-506 over CsA may improve outcomes in future stem cell-based therapeutic trials for spinal cord injury and related disorders of the central nervous system.

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Microfluidic Osteoarthritis-on-a-Chip for Evaluating Joint-Cell Responses to Tanezumab, a Humanized Anti-NGF Monoclonal Antibody

Mirazi, H.; Wood, S. T.

2026-07-14 bioengineering 10.64898/2026.07.13.738227 medRxiv
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Osteoarthritis (OA) drug development remains constrained by preclinical models that fail to recapitulate the multicellular interactions that regulate human joint inflammation and extracellular matrix degeneration in response to investigational drugs. Tanezumab, a humanized anti-nerve growth factor monoclonal antibody developed for non-opioid pain relief, advanced to late-stage clinical trials but was discontinued due to unresolved joint-localized safety concerns, including rapidly progressive OA. This study evaluated whether a human microfluidic joint-on-a-chip co-culture system could detect early biomarker responses to tanezumab exposure that were not apparent in conventional chondrocyte monoculture. Tanezumab was first tested in human chondrocyte monoculture under untreated and disease-like (i.e., IL-1{beta}-treated) conditions. Across a 20-analyte panel of inflammatory and matrix-remodeling biomarkers, statistically significant monoculture responses to tanezumab were limited to decreased IL-1{beta} from 335 to 132 pg/mL ([~]0.39-fold) and increased IL-8 from 575 to 675 pg/mL ([~]1.17-fold). Major OA-associated matrix-remodeling markers, including MMP-1, MMP-3, and MMP-13, remained largely unchanged, indicating that monoculture conditions are insufficiently sensitive to detect clinically predictive drug-related molecular changes. Tanezumab was then evaluated in co-cultures containing chondrocytes, osteoblasts, fibroblast-like cells, and macrophages under low-inflammation (i.e., M0 macrophage-based) and high-inflammation (i.e., M1 macrophage-based) conditions. In the M0-based co-culture, tanezumab increased MMP-1 from [~]4.20 x 104 to [~]6.20 x 104 pg/mL ([~]1.48-fold), MMP-3 from [~]8.00 x 104 to [~]1.20 x 105 pg/mL ([~]1.50-fold), and MCP-1 from 2.85 x 103 to 4.31 x 103 pg/mL ([~]1.51-fold). In contrast, the M1-based co-culture showed decreases in MMP-13 from [~]1.66 x 104 to [~]1.17 x 104 pg/mL ([~]0.70-fold) and IFN-{gamma} from [~]1.95 x 104 to [~]1.56 x 104 pg/mL ([~]0.80-fold), changes that may appear beneficial despite the drugs known clinical risks. Collectively, these findings show that low-inflammation multicellular co-culture revealed coordinated matrix remodeling and inflammatory responses to NGF blockade that were missed in monoculture and were partly obscured in highly stimulated disease-like conditions. This platform may provide a useful, human-relevant approach for safety signal assessment and early evaluation of OA therapeutics within a defined context of use focused on joint-specific, tissue-level drug-response testing.

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An engineered IdeS variant with enhanced activity and performance for IgG degradation

Zhang, K.; Ma, W.; Wu, Z.; Ren, Z.; Chen, C.; Xia, Y.; He, D.; Yu, Z.; Niu, H.; Qin, J.; Gao, P.; Yang, W.; Dai, Y.; Li, X.; Dong, Z.; Wang, Y.; Dong, X.; Chen, C.; Wu, X. N.

2026-07-01 bioengineering 10.64898/2026.06.26.734701 medRxiv
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IgG-degrading enzymes have emerged as innovative therapeutic agents for treating conditions driven by pathogenic antibodies. Here, we used structure-guided rational design to engineer IdeSM33, a double mutant (K167R/D226E) of the IgG-specific bacterial protease IdeS from Streptococcus pyogenes, with improved catalytic efficiency. Biolayer interferometry revealed a fourfold increase in binding affinity relative to wild-type IdeS (IdeSWT). This enhancement is likely attributable to mutations that strengthen hydrogen bonding at the enzyme-IgG Fc interface. In vitro, IdeSM33 has higher performance than IdeSWT in cleaving serum IgG. In vivo studies in rabbits demonstrated that IdeSM33 effectively depleted circulating IgG and showed better performance at a dose of 0.005 mg/kg than the IdeSWT. Although doses greater than 0.2 mg/kg demonstrated higher plasma concentrations of IdeS and a larger AUC 0 to last, they did not show a significant enhancement in the pharmacodynamics of IgG degradation. Importantly, a single dose of IdeSM33 (0.2 mg/kg) potently degraded binding and neutralizing antibodies against AAV9 within 1-2 days and restored hepatic AAV9 transduction in pre-immunized animals. Together, these findings highlight IdeSM33 as a potent and safe engineered enzyme with therapeutic potential for autoimmune disorders, transplant rejection, and overcoming pre-existing humoral immunity in gene therapy.

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Deoxyribonucleotide incorporation reshapes mRNA design beyond canonical ribonucleotide boundaries

Ding, X.; Liao, R.; Bampi, G. B.; Zhang, D.; Guan, S.; Rosenecker, J.

2026-07-10 synthetic biology 10.64898/2026.07.09.737403 medRxiv
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Messenger RNA (mRNA) is canonically composed of ribonucleotides, with sporadic incorporation of deoxyribonucleotides into natural RNA transcripts being traditionally regarded as a rare, deleterious error arising from transcriptional infidelity. Here, we challenge this paradigm by demonstrating controlled partial substitution of ribonucleotides with deoxyribonucleotides during in vitro transcription (IVT) generates intact, stable and fully translationally competent IVT-mRNA. Unexpectedly, chimeric DNA-RNA backbone modification exhibits markedly enhanced IVT-mRNA translation several fold across multiple cell types and in vivo via diverse dosing routes relative to their ribonucleotide-based counterparts. 25% substitution of cytidine triphosphate with deoxycytidine triphosphate achieved best-performing translational output, surpassing the current gold-standard N1-methylpseudouridine (m1{Psi})-modified IVT-mRNA in a B16-OVA tumor vaccination model. These findings identify nucleotide class composition as a previously unrecognized parameter governing IVT-mRNA function and establish hybrid ribonucleotide-deoxyribonucleotide backbone engineering as a versatile strategy to expand the chemical space for next-generation mRNA therapeutics.

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AI-Informed neoantigen prioritization enables a multi-epitope mRNA/LNP vaccine with antigen-specific immunogenicity and antitumor activity

Verma, A.; Kim, S. H.; Lee, B. S.; Lee, J. H.; Kim, H.; Now, H.; Choi, Y.; Lee, D.-S.; Park, W.-Y.; Young Ae, P.

2026-07-10 immunology 10.64898/2026.07.06.736667 medRxiv
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Personalized neoantigen vaccines are an emerging strategy for cancer immunotherapy, but their effectiveness depends on selecting tumor-specific antigens capable of inducing functional T-cell responses. The VACINUS AI-informed neoantigen prioritization framework previously identified and peptide-validated three immunogenic Tier 1 neoantigens in the B16F10 melanoma model. In this study, we extended that framework by translating these validated neoantigens into a multi-epitope messenger RNA vaccine formulated with lipid nanoparticles and evaluating its preclinical immunogenicity and antitumor activity. The three VACINUS-prioritized B16F10 neoantigens were encoded within a single multi-epitope construct, BF-V1_27-Ser, and formulated to generate BF-RNA-P. In B16F10 tumor-bearing mice, BF-RNA-P induced neoantigen-specific CD8+T-cell responses, with the strongest response directed against the B16F10-1-4 epitope. Combination with anti-PD-1 further enhanced vaccine-induced CD44+IFN-{gamma}+ CD8+ T-cell activation, whereas anti-PD-1 alone did not induce detectable peptide-specific responses. BF-RNA-P also suppressed tumor growth in vivo, and combination treatment produced the strongest antitumor effect, reflected by reduced tumor volume and lower endpoint tumor burden. Together, these findings demonstrate that VACINUS-prioritized and peptide-validated neoantigens can be reformatted into a multi-epitope messenger RNA/lipid nanoparticle vaccine while retaining antigen-specific immunogenicity and antitumor activity. This study provides preclinical proof-of-concept for integrating AI-informed, TCR-aware neoantigen prioritization with messenger RNA/lipid nanoparticle delivery as a translational strategy for personalized cancer vaccine development.

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OTTR-CLASH: improved biochemical and bioinformatic identification of Argonaute 2-mediated microRNA-target RNA interactions

Kaufman, P. D.; Liu, H.; Hu, K.; Ferguson, L.; Collins, K.; Zhu, L. J.; Pederson, T.

2026-07-15 molecular biology 10.64898/2026.07.14.738487 medRxiv
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Various methods have detected miRNA-target interactions via immunoprecipitation of UV-crosslinked Argonaute ribonucleoprotein complexes, followed by intermolecular ligation of bound miRNAs to target strands, forming chimeric RNAs. To date, these methods have relied on conventional viral reverse transcriptases (RTs) to generate cDNAs for sequencing. However, crosslinked RNAs often retain adducts after purification, which can make them poor templates for viral RTs. Here, we adapted OTTR (Ordered Two-Template Relay) techniques to generate cDNAs from Ago2-bound RNAs. OTTR makes use of a modified retroelement-encoded RT, which is strongly processive even on templates with modifications or adducts. We show that this "OTTR-CLASH" method increases the frequency of generating chimeric RNAs compared to previous methods. We also developed an improved bioinformatic pipeline for analysis of these data, and we use this to catalog miRNA-target interactions not previously described in the literature. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=147 HEIGHT=200 SRC="FIGDIR/small/738487v1_ufig1.gif" ALT="Figure 1"> View larger version (24K): org.highwire.dtl.DTLVardef@13bc276org.highwire.dtl.DTLVardef@5beb41org.highwire.dtl.DTLVardef@b204e5org.highwire.dtl.DTLVardef@15f747d_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Systemic, RPE-directed AAV-Tyrosinase therapy restores ocular pigmentation in an OCA1 mouse model

Larimer-Picciani, A. M.; Jacob, L. B.; Sullinger, K. J.; Kriebel, W. G.; Sahel, J.-A.; Byrne, L. C.

2026-07-09 molecular biology 10.64898/2026.07.01.735814 medRxiv
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Oculocutaneous albinism type 1 (OCA1) is a pigmentation disorder caused by biallelic tyrosinase (TYR) mutations, an essential enzyme for melanin synthesis. TYR inactivity results in loss of hair, skin, and eye pigment, which is detrimental for ocular function. Hypopigmentation of iris, retinal pigment epithelium (RPE), and choroid results in severe photosensitivity and low visual acuity. There are currently no FDA-approved pigment restoring therapies for OCA1, making therapeutic development an unmet clinical need. To address this gap, we have advanced an adeno-associated viral (AAV)-mediated Tyr replacement approach for OCA1 ocular pigment restoration. We evaluated the optimal viral delivery strategy and vector cell-type specificity for iris, RPE, and choroid pigmentation in an OCA1 mouse model, testing intraocular and systemic viral delivery methods in conjunction with viral constructs of varying RPE-specificity. Early, systemic delivery of an RPE-directed AAV-Tyr construct, AAV9.2yf-VMD2-Tyr, achieved widespread ocular pigment rescue with minimal off-target expression in non-ocular tissues. Animals treated with AAV9.2yf-VMD2-Tyr demonstrated reduced photophobic behavior compared to untreated controls, indicating that ocular pigmentation restores a debilitating functional consequence of OCA1. Our findings establish a foundation for clinical translation of an AAV-TYR therapy aimed at improving light sensitivity, glare, and low vision through pigment restoration in patients with OCA1.