Recently, miraculous therapy approaches involving adeno-associated
virus (AAV) for incurable diseases such as spinal muscular atrophy
and inherited retinal dysfunction have been introduced. Nonreplicative,
nonpathogenic, low rates of chromosome insertional properties and
the existence of neutralizing antibodies are main safety reasons why
the FDA approved its use in gene delivery. To date, AAV production
always results in a mixture of nontherapeutic (empty) and therapeutic
(DNA-loaded) full capsids (10–98%). Such existence of empty
viral particles inevitably increases viral doses to human. Thus, the
rapid monitoring of empty capsids and reducing the empty-to-full ratio
are critical in AAV science. However, transmission electron microscopy
(TEM) is the primary tool for distinguishing between empty and full
capsids, which creates a research bottleneck because of instrument
accessibility and technical difficulty. Herein, we demonstrate that
atomic force microscopy (AFM) can be an alternative tool to TEM. The
simple, noncontact-mode imaging of AAV particles allows the distinct
height difference between full capsids (∼22 nm) and empty capsids
(∼16 nm). The sphere-to-ellipsoidal morphological distortion
observed for empty AAV particles clearly distinguishes them from full
AAV particles. Our study indicates that AFM imaging can be an extremely
useful, quality-control tool in AAV particle monitoring, which is
beneficial for the future development of AAV-based gene therapy.