Abstract
Erythropoietic protoporphyria (EPP) is an inherited defect of the ferrochelatase (FECH) gene characterized by the accumulation of toxic protoporphyrin in the liver and bone marrow resulting in severe skin photosensitivity. We previously described successful gene therapy of an animal model of the disease with erythroid-specific lentiviral vectors in the absence of preselection of corrected cells. However, the high-level of gene transfer obtained in mice is not translatable to large animal models and humans if there is no selective advantage for genetically modified hematopoietic stem cells (HSCs) in vivo. We used bicistronic SIN-lentiviral vectors coexpressing EGFP or FECH and the G156A-mutated O6-methylguanine-DNA-methyltransferase (MGMT) gene, which allowed efficient in vivo selection of transduced HSCs after O6-benzylguanine and BCNU treatment. We demonstrate for the first time that the correction and in vivo expansion of deficient transduced HSC population can be obtained by this dual gene therapy, resulting in a progressive increase of normal RBCs in EPP mice and a complete correction of skin photosensitivity. Finally, we developed a novel bipromoter SIN-lentiviral vector with a constitutive expression of MGMT gene to allow the selection of HSCs and with an erythroid-specific expression of the FECH therapeutic gene.
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Acknowledgements
We thank Dr D Trono, (University of Geneva, Switzerland) for providing the SIN lentiviral backbone pRRL-PGK-WPRE, Dr D Kohn (Children's Hospital, Los Angeles, CA) for providing MND promoter, Dr P Malik for critical comments on the manuscript, Prof. H Fleury for providing RCR assays, Dr J Plassa and Dr A Chemin from Bergonié Institute Bordeaux for help in mice irradiation, and Isabelle Lamrissi-Garcia and Magalie Lalanne for technical assistance. This work has been supported by grants from Association Française contre les Myopathies (AFM) and Conseil Régional d’Aquitaine.
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Richard, E., Robert, E., Cario-André, M. et al. Hematopoietic stem cell gene therapy of murine protoporphyria by methylguanine-DNA-methyltransferase-mediated in vivo drug selection. Gene Ther 11, 1638–1647 (2004). https://doi.org/10.1038/sj.gt.3302335
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DOI: https://doi.org/10.1038/sj.gt.3302335
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