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Gene therapy Progress and Prospects: Gene therapy for the hemophilias

Abstract

Recent gene transfer trials for hemophilia A and B, bleeding disorders lacking either functional factor VIII or IX, respectively, have produced tantalizing results, suggesting that the potential to correct these bleeding disorders at a molecular level may be at hand. Genetic correction of the hemophilias represents a model system to develop a basic understanding of how gene therapy will be achieved. The goals for hemophilia gene transfer require the long-term therapeutic production of the coagulant protein without stimulating an immune response to the transgene product or the vector. Based on a scientific understanding of the molecular and cellular defects, leading to the bleeding phenotype, impressive strides have been made in the last 2 years.

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References

  1. Kaufman R, Antonarakis S . Structure, biology, and genetics of factor VIII, In: Hoffman R, Benz EJ, Shattil S, Furie B, Cohen H, Silberstein L, McGlave P (eds). Hematology: Basic Principles and Practice, Vol. VIII-108, 3rd edn. Church Livingstone: New York, 2000, pp 1850–1868.

    Google Scholar 

  2. Lillicrap D . Hemophilia treatment. Gene therapy, factor VIII antibodies and immune tolerance: hopes and concerns. Haematologica 85 (Suppl 10): 2000.

  3. Monahan P, Samulski R . AAV vectors: is clinical success on the horizon? Gene Therapy 2000;7:24–30.

    Article  CAS  Google Scholar 

  4. Chao H et al. Several log increase in therapeutic transgene delivery by distinct adeno-associated viral serotype vectors. Mol Ther 2000;2:619–623.

    Article  CAS  Google Scholar 

  5. Chao H et al. Sustained and complete phenotype correction of hemophilia b mice following intramuscular injection of aav1 serotype vectors. Mol Ther 2001;4:217–222.

    Article  CAS  Google Scholar 

  6. Gao G et al. Novel adeno-associated viruses from rhesus monkeys as vectors for human gene therapy. Proc Natl Acad Sci USA 2002;99:11854–11859.

    Article  CAS  Google Scholar 

  7. Park F, Ohashi K, Kay M . Therapeutic levels of human factor VIII and IX using HIV-1-based lentiviral vectors in mouse liver. Blood 2000;96:1173–1176.

    CAS  Google Scholar 

  8. Yant S et al. Somatic integration and long-term transgene expression in normal and haemophilic mice using a DNA transposon system. Nat Genet 2000;25:35–41.

    Article  CAS  Google Scholar 

  9. Krebsbach P, Zhang K, Malik A, Kurachi K . Bone marrow stromal cells as a genetic platformfor systemic delivery of therapeutic proteins in vivo: human factor IX model. J Gene Med 2003;5:11–17.

    Article  CAS  Google Scholar 

  10. Lin Y et al. Use of blood outgrowth endothelial cells for gene therapy for hemophilia A. Blood 2002;99:457–462.

    Article  CAS  Google Scholar 

  11. Chuah M et al. Long-term persistence of human bone marrow stromal cells transduced with factor VIII-retroviral vectors and transient production of therapeutic levels of human factor VIII in nonmyeloablated immunodeficient mice. Hum Gene Ther 2000;11:729–738.

    Article  CAS  Google Scholar 

  12. Poon M . Use of recombinant factor VIIa in hereditary bleeding disorders. Curr Opin Hematol 2001;8:312–318.

    Article  CAS  Google Scholar 

  13. Chao H, Walsh C . Induction of tolerance to human factor VIII in mice. Blood 2001;97:3311–3312.

    Article  CAS  Google Scholar 

  14. Qian J, Collins M, Sharpe A, Hoyer L . Prevention and treatment of factor VIII inhibitors in murine hemophilia A. Blood 2000;95:1324–1329.

    CAS  Google Scholar 

  15. Brown B, Lillicrap D . Dangerous liaisons: the role of ‘danger’ signals in the immune response to gene therapy. Blood 2002;100:1133–1140.

    Article  CAS  Google Scholar 

  16. Kay M et al. Evidence for gene transfer and expression of factor IX in haemophilia B patients treated with an AAV vector. Nat Genet 2000;24:257–261.

    Article  CAS  Google Scholar 

  17. Manno C et al. AAV-mediated factor IX gene transfer to skeletal muscle in patients with severe hemophilia B. Blood, Prepublished online Dec. 19, 2002.

  18. Roth D et al. Nonviral transfer of the gene encoding coagulation factor VIII in patients with severe hemophilia A. N Engl J Med 2001;344:1735–1742.

    Article  CAS  Google Scholar 

  19. Wang L et al. Sustained expression of therapeutic level of factor IX in hemophilia B dogs by AAV-mediated gene therapy in liver. Mol Ther 2000;1:154–158.

    Article  CAS  Google Scholar 

  20. Nathwani A et al. Sustained high-level expression of human factor IX (hFIX) after liver-targeted delivery of recombinant adeno-associated virus encoding the hFIX gene in rhesus macaques. Blood 2002;100:1662–1669.

    Article  CAS  Google Scholar 

  21. Mount J et al. Sustained phenotypic correction of hemophilia B dogs with a factor IX null mutation by liver-directed gene therapy. Blood 2002;99:2670–2676.

    Article  CAS  Google Scholar 

  22. Puttaraju M et al. Messenger RNA repair and restoration of protein function by spliceosome-mediated RNA trans-splicing. Mol Ther 2001;4:105–114.

    Article  CAS  Google Scholar 

  23. Jiang Y et al. Pluripotency of mesenchymal stem cells derived from adult marrow. Nature 2002;418:41–49.

    Article  CAS  Google Scholar 

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Walsh, C. Gene therapy Progress and Prospects: Gene therapy for the hemophilias. Gene Ther 10, 999–1003 (2003). https://doi.org/10.1038/sj.gt.3302024

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