rAAVrh74.MCK.GALGT2 demonstrates safety and widespread muscle glycosylation after intravenous delivery in C57Bl/6J mice and increased muscle glycosylation after intramuscular delivery in Cmah-/- mice

rAAVrh74.MCK. is a surrogate gene therapy that inhibits muscular dystrophy in multiple animal models. Here, we report on a dose-response study of functional muscle  expression as well as toxicity and biodistribution studies after systemic intravenous (i.v.) delivery of rAAVrh74.MCK.. A dose of 4.3 × 10vg/kg (measured with linear DNA standard) resulted in -induced glycosylation in the majority of skeletal myofibers throughout the body and in almost all cardiomyocytes, while several lower doses also showed significant muscle glycosylation. No adverse clinical signs or treatment-dependent changes in tissue or organ pathology were noted at 1 or 3 months post-treatment. Blood cell and serum enzyme chemistry measures in treated mice were all within the normal range except for alkaline phosphatase (ALP) activity, which was elevated in serum but not in tissues. Some anti-rAAVrh74 capsid T cell responses were noted at 4 weeks post-treatment, but all such responses were not present at 12 weeks. Using intramuscular delivery, -induced muscle glycosylation was increased in -deficient mice, which have a humanized sialoglycome, relative to wild-type mice, suggesting that use of mice may underestimate activity in human muscle. These data demonstrate safety and high transduction of muscles throughout the body plan with i.v. delivery of rAAVrh74.MCK..