Compositions and methods for treating non-age-associated hearing impairment in a human subject

1. A plurality of recombinant adeno-associated (rAAV) vectors comprising:

a) a first rAAV vector comprising, in order of 5′ to 3′:

(i) a 5′ ITR sequence of SEQ ID NO: 97;

(ii) a CAG promoter;

(iii) a 5′ OTOF coding region comprising exons 1 to (and through) 21 of OTOF cDNA, wherein the 5′OTOF coding region is at least 80% identical to SEQ ID NO: 101 and encodes the same amino acid sequence as encoded by SEQ ID NO: 101;

(iv) a SD intron sequence of SEQ ID NO: 102;

(v) an AK recombinogenic sequence of SEQ ID NO: 103; and

(vi) a 3′ ITR sequence of SEQ ID NO: 104; and

b) a second rAAV vector comprising, in order of 5′ to 3′:

(i) a 5′ ITR sequence of SEQ ID NO: 97;

(ii) an AK recombinogenic sequence of SEQ ID NO: 103;

(iii) a SA intron sequence of SEQ ID NO: 106;

(iv) a 3′ OTOF coding region that comprises exons 22 to (and through) exon 48 of OTOF cDNA, wherein the 3′OTOF coding region is at least 80% identical to SEQ ID NO: 107 and encodes the same amino acid sequence as encoded by SEQ ID NO: 107;

(v) a polyA sequence; and

(vi) a 3′ ITR sequence of SEQ ID NO: 104.

2. The plurality of rAAV vectors of claim 1 , wherein the CAG promoter comprises the CMV early enhancer element of SEQ ID NO: 98, the chicken beta actin gene sequence of SEQ ID NO: 99, and the chimeric intron of SEQ ID NO: 100.

3. The plurality of rAAV vectors of claim 1 , wherein the polyA is a bGH poly A having the sequence of SEQ ID NO: 108.

4. The plurality of rAAV vectors of claim 1 , wherein the 5′ OTOF coding region comprises SEQ ID NO: 101.

5. The plurality of rAAV vectors of claim 1 , wherein the 3′ OTOF coding region comprises SEQ ID NO: 107.

6. The plurality of rAAV vectors of claim 1 , wherein the first rAAV vector comprises the nucleic acid sequence according to SEQ ID NO: 96.

7. The plurality of rAAV vectors of claim 1 , wherein the second rAAV vector comprises the nucleic acid sequence according to SEQ ID NO: 105.

8. The plurality of rAAV vectors of claim 1 , wherein the first and second rAAV vectors are each encapsulated by an AAV capsid.

9. The plurality of rAAV vectors of claim 8 , wherein the AAV capsid encapsulating the first rAAV vector is a serotype selected from any one of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAVrh8, AAVrh10, AAVrh39, AAVrh43, or Anc80.

10. The plurality of rAAV vectors of claim 8 , wherein the AAV capsid encapsulating the second rAAV vector is a serotype selected from any one of AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAVrh8, AAVrh10, AAVrh39, AAVrh43, or Anc80.

11. The plurality of rAAV vectors of claim 8 , wherein the first rAAV vector is encapsidated by an Anc80 capsid and the second rAAV vector is encapsidated by an Anc80 capsid.

12. The plurality of rAAV vectors of claim 11 , wherein the Anc80 capsid comprises a polypeptide with at least 85% sequence identity to the polypeptide represented by SEQ ID NO: 109.

13. The plurality of rAAV vectors of claim 11 , wherein the Anc80 capsid comprises a polypeptide of SEQ ID NO: 109.

14. A composition comprising the plurality of rAAV vectors of claim 1 , further comprising one or more pharmaceutically acceptable carriers, diluents, or excipients.

15. The composition of claim 14 , wherein the composition is formulated for intra-cochlear administration.

16. The composition of claim 14 , wherein the composition is formulated to comprise a synthetic perilymph solution.

17. A composition comprising a first rAAV vector encapsidated by an Anc80 capsid and a second rAAV vector encapsidated by an Anc80 capsid, wherein:

a) the first rAAV vector comprises, in order of 5′ to 3′:

(i) a 5′ ITR sequence of SEQ ID NO: 97,

(ii) a CAG promoter,

(iii) a 5′ OTOF coding region that comprises exons 1 to (and through) 21 of OTOF cDNA, wherein the 5′ OTOF coding region is at least 80% identical to SEQ ID NO: 101 and encodes the same amino acid sequence as encoded by SEQ ID NO: 101,

(iv) a SD intron sequence of SEQ ID NO: 102,

(v) an AK recombinogenic sequence of SEQ ID NO: 103, and

(vi) a 3′ ITR sequence of SEQ ID NO: 104; and

b) the second rAAV vector comprises, in order of 5′ to 3′:

(i) a 5′ ITR sequence of SEQ ID NO: 97,

(ii) an AK recombinogenic sequence of SEQ ID NO: 103,

(iii) a SA intron sequence of SEQ ID NO: 106,

(iv) a 3′ OTOF coding region that comprises exons 22 to (and through) exon 48 of OTOF cDNA, wherein the 3′ OTOF coding region is at least 80% identical to SEQ ID NO: 107 and encodes the same amino acid sequence as encoded by SEQ ID NO: 107,

(v) a polyA sequence, and

(vi) a 3′ ITR sequence of SEQ ID NO: 104;

wherein the composition further comprises one or more pharmaceutically acceptable carriers, diluents, or excipients.

18. The composition of claim 17 , wherein the CAG promoter comprises the CMV early enhancer element of SEQ ID NO: 98, the chicken beta actin gene sequence of SEQ ID NO: 99, and the chimeric intron of SEQ ID NO: 100.

19. The composition of claim 17 , wherein the polyA is a bGH polyA having the sequence of SEQ ID NO: 108.

20. The composition of claim 17 , wherein the 5′ OTOF coding region comprises SEQ ID NO: 101.

21. The composition of claim 17 , wherein the 3′ OTOF coding region comprises SEQ ID NO: 107.

22. The composition of claim 17 , wherein the first rAAV vector comprises the nucleic acid sequence of SEQ ID NO: 96; and the second rAAV vector comprises the nucleic acid sequence of SEQ ID NO: 105.

23. The composition of claim 17 , wherein the Anc80 capsid encapsidating the first rAAV vector comprises a polypeptide having at least 85% sequence identity to SEQ ID NO: 109; and the Anc80 capsid encapsidating the second rAAV vector comprises a polypeptide having at least 85% sequence identity to SEQ ID NO: 109.

24. The composition of claim 17 , wherein the composition is formulated for intra-cochlear administration.

25. The composition of claim 17 , wherein the composition comprises a synthetic perilymph solution.