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Vinent Genestar J, Auvity S, Christiansen N, Ekelund H, Huys L, McNulty HBØ, Pani M, Pires V, Pourroy B, Stoner N. European Association of Hospital Pharmacists (EAHP) guidance on the pharmacy handling of in vivo gene therapy medicinal products. Eur J Hosp Pharm 2024:ejhpharm-2023-004062. [PMID: 38821721 DOI: 10.1136/ejhpharm-2023-004062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/06/2024] [Indexed: 06/02/2024] Open
Abstract
Gene therapy is becoming increasingly prevalent, with new gene therapy medicinal products (GTMPs) being approved for use every year. Hospital pharmacists are expected to prepare and dispense these products, but there is substantial heterogeneity in the availability of up-to-date, practical guidance at a national level in Europe. Many institutions have no or very limited experience in handling GTMPs. As such, there is a need for updated, practical guidance to aid hospital pharmacy teams in developing institutional standard operating procedures (SOPs) for the safe handling of GTMPs across the entire workflow. Here, we present the European Association of Hospital Pharmacists' updated guidance on the handling of GTMPs, developed by a team of recognised experts from around Europe. Each aspect of the GTMP handling process is addressed, including receipt and storage, dispensing and reconstitution, transportation, administration, waste disposal, decontamination of spills and accidental exposure. A series of figures are provided to aid the development of practical workflows. This guidance document is intended as a framework to help develop institutional SOPs and should always be used in conjunction with local regulations.
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Affiliation(s)
| | - Sylvain Auvity
- Necker Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Nanna Christiansen
- Women's and Children's Services, Guy's and St Thomas' NHS Trust, London, UK
| | - Heidi Ekelund
- ATMP Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Liesbeth Huys
- Ghent University Hospital, Gent, Oost-Vlaanderen, Belgium
| | | | - Marcello Pani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Vera Pires
- Portugese Institute of Oncology, Lisbon, Portugal
| | - Bertrand Pourroy
- Oncopharma Unit-Pharmacy department, La Timone Unversity Teaching Hospital, Marseille, France
| | - Nicola Stoner
- Pharmacy, Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UK
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Timotievich ED, Shilovskiy IP, Khaitov MR. Cell-Penetrating Peptides as Vehicles for Delivery of Therapeutic Nucleic Acids. Mechanisms and Application in Medicine. BIOCHEMISTRY. BIOKHIMIIA 2023; 88:1800-1817. [PMID: 38105200 DOI: 10.1134/s0006297923110111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 12/19/2023]
Abstract
Currently, nucleic acid therapeutics are actively developed for the treatment and prophylactic of metabolic disorders and oncological, inflammatory, and infectious diseases. A growing number of approved nucleic acid-based drugs evidences a high potential of gene therapy in medicine. Therapeutic nucleic acids act in the cytoplasm, which makes the plasma membrane the main barrier for the penetration of nucleic acid-based drugs into the cell and requires development of special vehicles for their intracellular delivery. The optimal carrier should not only facilitate internalization of nucleic acids, but also exhibit no toxic effects, ensure stabilization of the cargo molecules, and be suitable for a large-scale and low-cost production. Cell-penetrating peptides (CPPs), which match all these requirements, were found to be efficient and low-toxic carriers of nucleic acids. CPPs are typically basic peptides with a positive charge at physiological pH that can form nanostructures with negatively charged nucleic acids. The prospects of CPPs as vehicles for the delivery of therapeutic nucleic acids have been demonstrated in numerous preclinical studies. Some CPP-based drugs had successfully passed clinical trials and were implemented into medical practice. In this review, we described different types of therapeutic nucleic acids and summarized the data on the use of CPPs for their intracellular delivery, as well as discussed, the mechanisms of CPP uptake by the cells, as understanding of these mechanisms can significantly accelerate the development of new gene therapy approaches.
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Affiliation(s)
- Ekaterina D Timotievich
- Institute of Immunology, National Research Center, Federal Medical-Biological Agency of the Russian Federation, Moscow, 115522, Russia
| | - Igor P Shilovskiy
- Institute of Immunology, National Research Center, Federal Medical-Biological Agency of the Russian Federation, Moscow, 115522, Russia.
| | - Musa R Khaitov
- Institute of Immunology, National Research Center, Federal Medical-Biological Agency of the Russian Federation, Moscow, 115522, Russia.
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Salafutdinov II, Gatina DZ, Markelova MI, Garanina EE, Malanin SY, Gazizov IM, Izmailov AA, Rizvanov AA, Islamov RR, Palotás A, Safiullov ZZ. A Biosafety Study of Human Umbilical Cord Blood Mononuclear Cells Transduced with Adenoviral Vector Carrying Human Vascular Endothelial Growth Factor cDNA In Vitro. Biomedicines 2023; 11:2020. [PMID: 37509661 PMCID: PMC10377014 DOI: 10.3390/biomedicines11072020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The biosafety of gene therapy remains a crucial issue for both the direct and cell-mediated delivery of recombinant cDNA encoding biologically active molecules for the pathogenetic correction of congenital or acquired disorders. The diversity of vector systems and cell carriers for the delivery of therapeutic genes revealed the difficulty of developing and implementing a safe and effective drug containing artificial genetic material for the treatment of human diseases in practical medicine. Therefore, in this study we assessed changes in the transcriptome and secretome of umbilical cord blood mononuclear cells (UCB-MCs) genetically modified using adenoviral vector (Ad5) carrying cDNA encoding human vascular endothelial growth factor (VEGF165) or reporter green fluorescent protein (GFP). A preliminary analysis of UCB-MCs transduced with Ad5-VEGF165 and Ad5-GFP with MOI of 10 showed efficient transgene expression in gene-modified UCB-MCs at mRNA and protein levels. The whole transcriptome sequencing of native UCB-MCs, UCB-MC+Ad5-VEGF165, and UCB-MC+Ad5-GFP demonstrated individual sample variability rather than the effect of Ad5 or the expression of recombinant vegf165 on UCB-MC transcriptomes. A multiplex secretome analysis indicated that neither the transduction of UCB-MCs with Ad5-GFP nor with Ad5-VEGF165 affects the secretion of the studied cytokines, chemokines, and growth factors by gene-modified cells. Here, we show that UCB-MCs transduced with Ad5 carrying cDNA encoding human VEGF165 efficiently express transgenes and preserve transcriptome and secretome patterns. This data demonstrates the biosafety of using UCB-MCs as cell carriers of therapeutic genes.
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Affiliation(s)
- Ilnur I Salafutdinov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Dilara Z Gatina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Maria I Markelova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Ekaterina E Garanina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Sergey Yu Malanin
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Ilnaz M Gazizov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
| | - Andrei A Izmailov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
| | - Albert A Rizvanov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Rustem R Islamov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
| | - András Palotás
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
- Asklepios-Med (Private Medical Practice and Research Center), H-6722 Szeged, Hungary
- Tokaj-Hegyalja University, H-3910 Tokaj, Hungary
| | - Zufar Z Safiullov
- Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan 420012, Russia
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