But the study, as designed, showed a basic flaw (IMO) that might be the subject of a revised study. I first did a search on "liver immune system" which verified what I already believed from my basic immunology. The liver is the source of antibody production for the immune system. Antibodies are among all the proteins that are manufactured by the liver and secreted into the bloodstream. If a vaccination is performed peripherally, the antigen (foreign protein/substance in the vaccine) is picked up by T-lymphocytes, transported back to the liver and the foreign substance elicits an antibody response. So the study begs the question, why vaccinate peripherally if you want to get a maximum response in the liver. Peripherally circulating Hepatits C RNA is only an indirect marker of the liver viral load.
I next looked up "liver biopsy procedure" which is performed as an outpatient procedure under ultrasound guided biopsy needle placement. This technique is used to take tiny pieces of tissue to diagnose liver diseases and cancers.
So put the two techniques together. Place a small reusable cather in the liver and use it up to a month for repeated, direct vaccinations of the liver. The use of implanted catheters and shunts to facilitate various medical treatments in humans is now fairly common. Hemodialysis patients, cancer patients, patients with infections have inplanted catherers. Why not one for liver vaccination and electroporation? The techniques for keeping it free of contamination on the outside of the skin (or subcutaneously implanted) is well established. The catheter or skin is always disinfected before use and the location can always be comfirmed by ultrasound. But this would seat the vaccination in the target organ.
Alternatively, they could use the same techniques for the spleen. That is the primary organ for all B-cell and T-cell lymphocytes in the body.
Of course - its not bad news for INO. Its somewhat good news, in that the delivery method is proven. The problem is of course, that INO still owns part of the drug. So they could have gained more had the interim results been better.