Novel AAV843 Vector-Mediated Gene Replacement Therapy Rescues Primary Hyperoxaluria Type I in Mice

cDNA was delivered via the liver-tropic, low-immunogenic AAV843 vector, which has been employed in clinical trials for hemophilia. Gene therapy resulted in normalization of urinary oxalate levels, restoration of hepatic AGT expression, and significant attenuation of renal injury and nephrocalcinosis. These therapeutic effects were accompanied by significant suppression of key mediators involved in renal inflammation, necroptosis, and fibrosis. Moreover, transgene expression was highly specific to the liver and was not associated with hepatotoxicity. These results demonstrate that AAV843-mediated AGXT gene replacement is a safe and effective approach that achieves phenotypic correction in a murine model of PH1, warranting further evaluation in preclinical studies.