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BI-TfR1 CapX rapidly transits the blood-brain barrier for efficient, low-dose gene delivery throughout the CNS

Chan, K. Y.; Lin, C.-Y.; Huang, Q.; Pacouret, S.; Zheng, Q.; Harvey, J. W.; Brauer, P. P.; Johnston, J.; Serack, F.; Davis, J. R.; Kamath, N. G.; Jereb, S.; Sprague, D. A.; Svanbergsson, A.; Boucher, M.; Minikel, E. V.; Vallabh, S. M.; Deverman, B. E.

2026-09-29 neuroscience
10.64898/2026.09.23.753669 bioRxiv
Show abstract

Safe, efficient gene delivery throughout the CNS remains a central obstacle to treating genetic diseases of the brain and spinal cord. We describe BI-TfR1 CapX, a human transferrin receptor (TfR1)-binding AAV capsid that, after a low intravenous dose in adult humanized TFRC mice, transduced more than 80% of cortical and spinal neurons and ~60% of cortical astrocytes, with reduced distribution and expression in several peripheral tissues relative to AAV9. Unlike other engineered BBB-crossing capsids, CapX bound the CNS vasculature within minutes and a large fraction of its genomes reached parenchymal nuclei within 24 hours. Delivering a Prnp-targeted epigenetic silencer (Prnp-CHARM), CapX reduced brain Prnp mRNA by over 95% requiring 18-fold fewer vector genomes per brain cell than AAV-PHP.eB for 50% lowering. A CapX delivered dual-vector cytosine base editor installed a protein-truncating PRNP stop codon lowering brain prion protein by 80%. These properties make CapX an attractive vehicle for human CNS gene therapy.

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