Yousefpour, P.; Gregory, J. R.; Si, K.; Lonzaric, J.; Li, Y.; Wang, J.; Qureshi, K.; Ledbetter, A.; Melo, M. B.; Lemnios, A. A.; Dye, J.; Remba, T. K.; Yeung, R.; Rodriguez, L.; Guereca, M.; Wu, S.; Zhang, Y.; Dong, Y.; Weiss, R.; Irvine, D. J.

The design of gene therapies with drug-regulatable expression of therapeutic payloads is of interest for diverse applications. We hypothesized that a regulated expression platform based on alphavirus-derived self-amplifying RNAs (saRNAs), which encode 4 non-structural proteins (nsPs) that copy the RNA backbone to enable sustained expression, would have advantages in safety and simplicity of delivery over existing approaches. Here we designed saRNAs where payload expression is regulated by an FDA-approved drug, trimethoprim (TMP), by fusing TMP-responsive degradation domains (DDs) to nsPs to regulate RNA self-amplification. Screening a library of nsP-DD fusions, we identified an optimal design with DDs fused to nsP2, nsP3, and the payload gene, achieving robust TMP-mediated control of expression between a fully \'off\' state (no TMP) and an \'on\' state (with TMP) matching expression levels of unregulated saRNA. In mice, this saRNA circuit showed reversible gene expression and enabled diverse gene expression patterns, including escalating and oscillating profiles in response to orally delivered TMP. Implementing this circuit to control the expression of an HIV immunogen for vaccination, we show that an escalating TMP regimen significantly enhanced germinal center responses critical for B cell affinity maturation compared to constitutively-expressing saRNA. This drug-regulated RNA platform may be broadly useful for vaccines, immunotherapies, and gene replacement therapies.