LAUSR

Hemophilia A is an inherited bleeding disorder caused by defective or deficient coagulation factor-VIII (FVIII) activity. Until recently, the only treatment for prevention of bleeding involved intravenous administration of FVIII. Gene therapy with adeno associated vectors (AAV) has shown some efficacy in hemophilia A patients. However, limitations persist due to AAV-induced cellular stress, immunogenicity, and reduced durability of gene expression. Herein, we examined the efficacy of liver-directed gene transfer in FVIII knock out mice by AAV8-GFP. Surprisingly, compared to control mice, FVIII knockout (F8TKO) mice showed significant delay in AAV8-GFP transfer in the liver. We found that the delay in liver directed gene transfer in F8TKO mice was associated with absence of liver sinusoidal endothelial cell (LSEC) fenestration, which led to aberrant expression of several sinusoidal endothelial proteins causing increased capillarization and decreased permeability of LSECs. This is the first study to link impaired liver-directed gene transfer to liver-endothelium maladaptive structural changes associated with FVIII deficiency in mice.