CMV-beta-actin promoter directs higher expression from an adeno-associated viral vector in the liver than the cytomegalovirus or elongation factor 1 alpha promoter and results in therapeutic levels of human factor X in mice

Hum Gene Ther. 2001 Mar 20;12(5):563-73. doi: 10.1089/104303401300042500.


Although AAV vectors show promise for hepatic gene therapy, the optimal transcriptional regulatory elements have not yet been identified. In this study, we show that an AAV vector with the CMV enhancer/chicken beta-actin promoter results in 9.5-fold higher expression after portal vein injection than an AAV vector with the EF1 alpha promoter, and 137-fold higher expression than an AAV vector with the CMV promoter/enhancer. Although induction of the acute-phase response with the administration of lipopolysaccharide (LPS) activated the CMV promoter/enhancer from the context of an adenoviral vector in a previous study, LPS resulted in only a modest induction of this promoter from an AAV vector in vivo. An AAV vector with the CMV-beta-actin promoter upstream of the coagulation protein human factor X (hFX) was injected intravenously into neonatal mice. This resulted in expression of hFX at 548 ng/ml (6.8% of normal) for up to 1.2 years, and 0.6 copies of AAV vector per diploid genome in the liver at the time of sacrifice. Neonatal intramuscular injection resulted in expression of hFX at 248 ng/ml (3.1% of normal), which derived from both liver and muscle. We conclude that neonatal gene therapy with an AAV vector with the CMV-beta-actin promoter might correct hemophilia due to hFX deficiency.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Actins / genetics*
  • Animals
  • Binding Sites
  • Blotting, Southern
  • Chickens
  • Cytomegalovirus / genetics*
  • DNA / metabolism
  • DNA, Complementary / metabolism
  • Dependovirus / genetics*
  • Enhancer Elements, Genetic
  • Enzyme-Linked Immunosorbent Assay
  • Factor X / genetics*
  • Female
  • Genetic Therapy / methods
  • Genetic Vectors
  • Hemophilia A / genetics*
  • Hemophilia A / therapy*
  • Humans
  • Interleukin-6 / metabolism
  • Lipopolysaccharides / metabolism
  • Liver / metabolism*
  • Mice
  • Mice, Inbred C57BL
  • Peptide Elongation Factor 1 / genetics*
  • Promoter Regions, Genetic*
  • RNA / metabolism
  • Reverse Transcriptase Polymerase Chain Reaction
  • Time Factors
  • Transcription, Genetic


  • Actins
  • DNA, Complementary
  • Interleukin-6
  • Lipopolysaccharides
  • Peptide Elongation Factor 1
  • RNA
  • Factor X
  • DNA