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Rawley O, Swystun LL, Brown C, Nesbitt K, Rand M, Hossain T, Klaassen R, James PD, Carcao MD, Lillicrap D. Novel cysteine substitution p.(Cys1084Tyr) causes variable expressivity of qualitative and quantitative VWF defects. Blood Adv 2022; 6:2908-2919. [PMID: 35020809 PMCID: PMC9092401 DOI: 10.1182/bloodadvances.2021005928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/23/2021] [Indexed: 11/20/2022] Open
Abstract
von Willebrand factor (VWF) is an extremely cysteine-rich multimeric protein that is essential for maintaining normal hemostasis. The cysteine residues of VWF monomers form intra- and intermolecular disulfide bonds that regulate its structural conformation, multimer distribution, and ultimately its hemostatic activity. In this study, we investigated and characterized the molecular and pathogenic mechanisms through which a novel cysteine variant p.(Cys1084Tyr) causes an unusual, mixed phenotype form of von Willebrand disease (VWD). Phenotypic data including bleeding scores, laboratory values, VWF multimer distribution, and desmopressin response kinetics were investigated in 5 members (2 parents and 3 daughters) of a consanguineous family. VWF synthesis and secretion were also assessed in a heterologous expression system and in a transient transgenic mouse model. Heterozygosity for p.(Cys1084Tyr) was associated with variable expressivity of qualitative VWF defects. Heterozygous individuals had reduced VWF:GPIbM (<0.40 IU/mL) and VWF:CB (<0.35 IU/mL), as well as relative reductions in high-molecular-weight multimers, consistent with type 2A VWD. In addition to these qualitative defects, homozygous individuals also displayed reduced factor VIII (FVIII):C/VWF:Ag, leading to very low FVIII levels (0.03-0.1 IU/mL) and reduced VWF:Ag (<0.40 IU/mL) and VWF:GPIbM (<0.30 IU/mL). Accelerated VWF clearance and impaired VWF secretion contributed to the fully expressed homozygous phenotype with impaired secretion arising because of disordered disulfide connectivity.
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Affiliation(s)
- Orla Rawley
- Molecular Hemostasis Research Group, Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON, Canada
| | - Laura L. Swystun
- Molecular Hemostasis Research Group, Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON, Canada
| | - Christine Brown
- Molecular Hemostasis Research Group, Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON, Canada
| | - Kate Nesbitt
- Molecular Hemostasis Research Group, Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON, Canada
| | - Margaret Rand
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Taneya Hossain
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - Robert Klaassen
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada; and
| | - Paula D. James
- Department of Medicine, Queen’s University, Kingston, ON, Canada
| | - Manuel D. Carcao
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, ON, Canada
| | - David Lillicrap
- Molecular Hemostasis Research Group, Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON, Canada
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Bruter AV, Kalashnikova MV, Prytyko AP, Belyavsky AV. Maintenance of Plasmid Expression in vivo Depends Primarily on the CpG Contents of the Vector and Transgene. Mol Biol 2020. [DOI: 10.1134/s0026893320030048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Translational Advances of Hydrofection by Hydrodynamic Injection. Genes (Basel) 2018; 9:genes9030136. [PMID: 29494564 PMCID: PMC5867857 DOI: 10.3390/genes9030136] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 12/11/2022] Open
Abstract
Hydrodynamic gene delivery has proven to be a safe and efficient procedure for gene transfer, able to mediate, in murine model, therapeutic levels of proteins encoded by the transfected gene. In different disease models and targeting distinct organs, it has been demonstrated to revert the pathologic symptoms and signs. The therapeutic potential of hydrofection led different groups to work on the clinical translation of the procedure. In order to prevent the hemodynamic side effects derived from the rapid injection of a large volume, the conditions had to be moderated to make them compatible with its use in mid-size animal models such as rat, hamster and rabbit and large animals as dog, pig and primates. Despite the different approaches performed to adapt the conditions of gene delivery, the results obtained in any of these mid-size and large animals have been poorer than those obtained in murine model. Among these different strategies to reduce the volume employed, the most effective one has been to exclude the vasculature of the target organ and inject the solution directly. This procedure has permitted, by catheterization and surgical procedures in large animals, achieving protein expression levels in tissue close to those achieved in gold standard models. These promising results and the possibility of employing these strategies to transfer gene constructs able to edit genes, such as CRISPR, have renewed the clinical interest of this procedure of gene transfer. In order to translate the hydrodynamic gene delivery to human use, it is demanding the standardization of the procedure conditions and the molecular parameters of evaluation in order to be able to compare the results and establish a homogeneous manner of expressing the data obtained, as ‘classic’ drugs.
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Portier I, Vanhoorelbeke K, Verhenne S, Pareyn I, Vandeputte N, Deckmyn H, Goldenberg DS, Samal HB, Singh M, Ivics Z, Izsvák Z, De Meyer SF. High and long-term von Willebrand factor expression after Sleeping Beauty transposon-mediated gene therapy in a mouse model of severe von Willebrand disease. J Thromb Haemost 2018; 16:592-604. [PMID: 29288565 DOI: 10.1111/jth.13938] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Indexed: 01/08/2023]
Abstract
Essentials von Willebrand disease (VWD) is the most common inherited bleeding disorder. Gene therapy for VWD offers long-term therapy for VWD patients. Transposons efficiently integrate the large von Willebrand factor (VWF) cDNA in mice. Liver-directed transposons support sustained VWF expression with suboptimal multimerization. SUMMARY Background Type 3 von Willebrand disease (VWD) is characterized by complete absence of von Willebrand factor (VWF). Current therapy is limited to treatment with exogenous VWF/FVIII products, which only provide a short-term solution. Gene therapy offers the potential for a long-term treatment for VWD. Objectives To develop an integrative Sleeping Beauty (SB) transposon-mediated VWF gene transfer approach in a preclinical mouse model of severe VWD. Methods We established a robust platform for sustained transgene murine VWF (mVWF) expression in the liver of Vwf-/- mice by combining a liver-specific promoter with a sandwich transposon design and the SB100X transposase via hydrodynamic gene delivery. Results The sandwich SB transposon was suitable to deliver the full-length mVWF cDNA (8.4 kb) and supported supra-physiological expression that remained stable for up to 1.5 years after gene transfer. The sandwich vector stayed episomal (~60 weeks) or integrated in the host genome, respectively, in the absence or presence of the transposase. Transgene integration was confirmed using carbon tetrachloride-induced liver regeneration. Analysis of integration sites by high-throughput analysis revealed random integration of the sandwich vector. Although the SB vector supported long-term expression of supra-physiological VWF levels, the bleeding phenotype was not corrected in all mice. Long-term expression of VWF by hepatocytes resulted in relatively reduced amounts of high-molecular-weight multimers, potentially limiting its hemostatic efficacy. Conclusions Although this integrative platform for VWF gene transfer is an important milestone of VWD gene therapy, cell type-specific targeting is yet to be achieved.
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Affiliation(s)
- I Portier
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - K Vanhoorelbeke
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - S Verhenne
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - I Pareyn
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - N Vandeputte
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - H Deckmyn
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - D S Goldenberg
- The Goldyne Savad Institute of Gene Therapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - H B Samal
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - M Singh
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Z Ivics
- Division of Medical Biotechnology, Paul Ehrlich Institute, Langen, Germany
| | - Z Izsvák
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - S F De Meyer
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
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Utility of a high VWF: FVIII ratio in preventing FVIII accumulation: a study in VWF-deficient mice. Blood Coagul Fibrinolysis 2015; 26:515-21. [PMID: 25767894 PMCID: PMC4500654 DOI: 10.1097/mbc.0000000000000269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Treatment of von Willebrand disease typically requires multiple infusions of von Willebrand factor (VWF)/factor VIII (FVIII) concentrate. Accumulation of FVIII is a clinical concern due to potential risk for thromboembolism. This study sought to determine whether VWF/FVIII concentrate of high VWF:FVIII ratio can prevent FVIII accumulation. VWF-deficient knockout mice received four 150 IU/kg VWF:ristocetin cofactor (RCo) infusions at 3-h intervals, with VWF/FVIII concentrates of a high (Haemate P/Humate-P) or low (Wilate) VWF:FVIII ratio. After each infusion, trough FVIII and VWF levels in plasma were determined. Separately, pharmacokinetic analysis was performed after single 250-IU/kg VWF:RCo infusions of each concentrate. Over the course of the four infusions, trough FVIII increased significantly in the group receiving Wilate (P < 0.001), but not Haemate P/Humate P (P = 0.058). After the first infusion, mean trough FVIII level in the Wilate group (31.7 IU/dl) was greater by 82% (P = 0.017) than that in the Haemate P/Humate P group (17.4 IU/dl). After the final infusion, mean trough FVIII of animals receiving Wilate (55.1 IU/dl) continued to exceed that of Haemate P/Humate P recipients (30.2 IU/dl) significantly (P < 0.001). Trough VWF levels were similar in the two groups. The VWF pharmacokinetics of the two concentrates coincided closely; however, the FVIII peak concentration and area under the curve were approximately twice as great in the mice treated with Wilate. In a murine model of severe von Willebrand disease, a VWF/FVIII concentrate with a high VWF:FVIII ratio prevented persistent exposure to elevated trough FVIII levels.
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Lillicrap D. Translational medicine advances in von Willebrand disease. J Thromb Haemost 2013; 11 Suppl 1:75-83. [PMID: 23809112 PMCID: PMC3934368 DOI: 10.1111/jth.12257] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 04/13/2013] [Indexed: 02/01/2023]
Abstract
Following the recognition of von Willebrand disease (VWD) in 1926 and the cloning of the gene for von Willebrand factor (VWF) in 1985, significant advances have been made in our fundamental knowledge of both the disease and the protein. Some of this new knowledge has also begun to impact the clinical management of VWD. First, the progressive increase in our understanding of the molecular genetic basis of VWD has resulted in rational applications of molecular testing to complement the current range of phenotypic tests for VWD. These molecular genetic strategies are most effectively directed at the prenatal diagnosis of type 3 VWD and confirmatory testing for types 2B and 2N disease. In contrast, the use of molecular testing to clarify the diagnosis of type 1 VWD is of marginal benefit, at best. In terms of VWD therapies, a new recombinant VWF concentrate has recently completed successful clinical trials and is now awaiting more widespread application. There have even been some preclinical successes with VWF gene transfer although the clinical rationale for this therapeutic strategy needs careful consideration. Much more remains to be learnt about the biology of VWF and further translational advances for the enhancement of VWD care will inevitably be realized.
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Affiliation(s)
- D Lillicrap
- Department of Pathology and Molecular Medicine, Richardson Laboratory, Queen's University, Kingston, ON, Canada.
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Poirault-Chassac S, Nguyen KA, Pietrzyk A, Casari C, Veyradier A, Denis CV, Baruch D. Terminal platelet production is regulated by von Willebrand factor. PLoS One 2013; 8:e63810. [PMID: 23737952 PMCID: PMC3667798 DOI: 10.1371/journal.pone.0063810] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 04/07/2013] [Indexed: 12/21/2022] Open
Abstract
It is established that proplatelets are formed from mature megakaryocytes (MK) as intermediates before platelet production. Recently, the presence of proplatelets was described in blood incubated in static conditions. We have previously demonstrated that platelet and proplatelet formation is upregulated by MK exposure to high shear rates (1800 s−1) on immobilized von Willebrand factor (VWF). The purpose of the present study was to investigate whether VWF is involved in the regulation of terminal platelet production in blood. To this end, Vwf −/− mice, a model of severe von Willebrand disease, were used to create a situation in which blood cells circulate in a vascular tree that is completely devoid of VWF. Murine platelets were isolated from Vwf −/− and Vwf +/+ blood, exposed to VWF at 1800 s−1 in a microfluidic platform, and examined by means of videomicroscopy, as well as fluorescence and activation studies. Proplatelets became visible within 5 minutes, representing 38% of all platelets after 12 minutes and 46% after 28 min. The proportion of proplatelets was 1.8-fold higher in blood from Vwf−/− mice than from Vwf+/+ mice, suggesting a role of VWF in vivo. Fragmentation of these proplatelets into smaller discoid platelets was also observed in real-time. Platelets remained fully activatable by thrombin. Compensation of plasmatic VWF following hydrodynamic gene transfer in Vwf−/− mice reduced the percentage of proplatelets to wild-type levels. A thrombocytopenic mouse model was studied in the flow system, 7 days after a single 5-FU injection. Compared to untreated mouse blood, a 2-fold increase in the percentage of proplatelets was detected following exposure to 1800 s−1 on VWF of samples from mice treated with 5-FU. In conclusion, VWF and shear stress together appear to upregulate proplatelet reorganization and platelet formation. This suggests a new function for VWF in vivo as regulator of bloodstream thrombopoiesis.
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Affiliation(s)
- Sonia Poirault-Chassac
- INSERM UMR 765, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Kim Anh Nguyen
- INSERM UMR 765, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Audrey Pietrzyk
- INSERM UMR 765, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Caterina Casari
- INSERM UMR 770, Le Kremlin-Bicetre, France
- Univ Sud Paris, Le Kremlin-Bicetre, France
| | - Agnes Veyradier
- INSERM UMR 770, Le Kremlin-Bicetre, France
- Univ Sud Paris, Le Kremlin-Bicetre, France
- Antoine Béclère Hospital and National Reference Center for von Willebrand disease, Clamart, France
| | - Cecile V. Denis
- INSERM UMR 770, Le Kremlin-Bicetre, France
- Univ Sud Paris, Le Kremlin-Bicetre, France
| | - Dominique Baruch
- INSERM UMR 765, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- * E-mail:
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Wang L, Rosenberg JB, De BP, Ferris B, Wang R, Rivella S, Kaminsky SM, Crystal RG. In vivo gene transfer strategies to achieve partial correction of von Willebrand disease. Hum Gene Ther 2012; 23:576-88. [PMID: 22482515 DOI: 10.1089/hum.2011.238] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
von Willebrand disease (VWD), the most common hereditary coagulation disorder, results from mutations in the 52-exon gene for von Willebrand factor (VWF), which encodes an 8.4-kB cDNA. Studies with VWF cDNA plasmids have demonstrated that in vivo gene transfer to the liver will correct the coagulation dysfunction in VWF(-/-) mice, but the correction is transient. To develop gene therapy for VWF that would mediate long-term expression of the VWF cDNA in liver, we first evaluated segmental pre-mRNA trans-splicing (SPTS) with two adeno-associated virus (AAV) serotype 8 vectors, each delivering one-half of the VWF cDNA. However, although the two vectors functioned well to generate VWF multimers after infection of cells in vitro, the efficiency of SPTS was insufficient to correct the VWF(-/-) mouse in vivo. As an alternative, we assessed the ability of a lentiviral vector to transfer the intact murine VWF cDNA in vivo directly to the neonatal liver of VWF(-/-) mice, using generation of VWF multimers, bleeding time, and bleeding volume as efficacy parameters. The VWF lentivirus generated VWF multimers and partially or completely corrected the coagulation defect on a persistent basis in 33% of the treated VWF-deficient mice. On the basis of the concept that partial persistent correction with gene transfer could be beneficial in VWD patients, these observations suggest that lentiviral delivery of VWF cDNA should be explored as a candidate for gene therapy in patients with a severe form of VWD.
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Affiliation(s)
- Lan Wang
- Department of Genetic Medicine, Weill Cornell Medical College, New York, NY 10065, USA
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Favaloro EJ, Franchini M, Lippi G. Biological therapies for von Willebrand disease. Expert Opin Biol Ther 2012; 12:551-64. [DOI: 10.1517/14712598.2012.667398] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Rapidly regulating platelet activity in vivo with an antidote controlled platelet inhibitor. Mol Ther 2011; 20:391-7. [PMID: 22086230 DOI: 10.1038/mt.2011.226] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Millions of individuals are prescribed platelet inhibitors, such as aspirin and clopidogrel, to reduce their risk of thrombosis-related clinical events. Unfortunately many platelet inhibitors are contraindicated in surgical settings because of their inherent bleeding risk complicating the treatment of patients who require surgery. We describe the development of a potent antiplatelet agent, an RNA aptamer-termed Ch-9.14-T10 that binds von Willebrand factor (VWF) with high affinity and inhibits thrombosis in a murine carotid artery damage model. As expected, when this potent antiplatelet agent is administered, it greatly increases bleeding from animals that are surgically challenged. To improve this antiplatelet agent's safety profile, we describe the generation of antidotes that can rapidly reverse the activity of Ch-9.14-T10 and limit blood loss from surgically challenged animals. Our work represents the first antidote controllable antiplatelet agent, which could conceivably lead to improved medical management of patients requiring antiplatelet medication who also need surgery.
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Post-translational Ligation and Functional Multimerization of von Willebrand Factor After Intein-mediated Tri-fragmental Gene Delivery in Eukaryotic Cell*. PROG BIOCHEM BIOPHYS 2011. [DOI: 10.3724/sp.j.1206.2010.00399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nichols TC, Bellinger DA, Merricks EP, Raymer RA, Kloos MT, DeFriess N, Ragni MV, Griggs TR. Porcine and canine von Willebrand factor and von Willebrand disease: hemostasis, thrombosis, and atherosclerosis studies. THROMBOSIS 2011; 2010:461238. [PMID: 22091368 PMCID: PMC3211078 DOI: 10.1155/2010/461238] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Accepted: 12/29/2010] [Indexed: 02/04/2023]
Abstract
Use of animal models of inherited and induced von Willebrand factor (VWF) deficiency continues to advance the knowledge of VWF-related diseases: von Willebrand disease (VWD), thrombotic thrombocytopenic purpura (TTP), and coronary artery thrombosis. First, in humans, pigs, and dogs, VWF is essential for normal hemostasis; without VWF bleeding events are severe and can be fatal. Second, the ADAMTS13 cleavage site is preserved in all three species suggesting all use this mechanism for normal VWF multimer processing and that all are susceptible to TTP when ADAMTS13 function is reduced. Third, while the role of VWF in atherogenesis is debated, arterial thrombosis complicating atherosclerosis appears to be VWF-dependent. The differences in the VWF gene and protein between humans, pigs, and dogs are relatively few but important to consider in the design of VWF-focused experiments. These homologies and differences are reviewed in detail and their implications for research projects are discussed. The current status of porcine and canine VWD are also reviewed as well as their potential role in future studies of VWF-related disorders of hemostasis and thrombosis.
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Affiliation(s)
- Timothy C. Nichols
- Department of Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
- Pathology and Laboratory Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
| | - Dwight A. Bellinger
- Pathology and Laboratory Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
- Division of Laboratory Animal Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
| | - Elizabeth P. Merricks
- Pathology and Laboratory Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
| | - Robin A. Raymer
- Pathology and Laboratory Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
| | - Mark T. Kloos
- Pathology and Laboratory Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
| | - Natalie DeFriess
- Pathology and Laboratory Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
| | - Margaret V. Ragni
- Medicine/Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA
- Hemophilia Center of Western PA, Pittsburgh, PA 15213, USA
| | - Thomas R. Griggs
- Department of Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
- Pathology and Laboratory Medicine, Francis Owen Blood Research Laboratory, University of North Carolina, Chapel Hill, NC 27516, USA
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Chen MC, Lin CF, Lei HY, Lin SC, Liu HS, Yeh TM, Anderson R, Lin YS. Deletion of the C-Terminal Region of Dengue Virus Nonstructural Protein 1 (NS1) Abolishes Anti-NS1-Mediated Platelet Dysfunction and Bleeding Tendency. THE JOURNAL OF IMMUNOLOGY 2009; 183:1797-803. [DOI: 10.4049/jimmunol.0800672] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Abstractvon Willebrand factor (VWF) is a large multimeric adhesive glycoprotein with complex roles in thrombosis and hemostasis. Abnormalities in VWF give rise to a variety of bleeding complications, known as von Willebrand disease (VWD), the most common inherited bleeding disorder in humans. Current treatment of VWD is based on the replacement of the deficient or dysfunctional protein either by endogenous release from endothelial Weibel-Palade bodies or by administration of plasma-derived VWF concentrates. During the last years, several efforts have been made to optimize existing therapies for VWD, but also to devise new approaches, such as inducing endogenous expression with interleukin-11, administering exogenous recombinant VWF, or introducing the protein via gene delivery. Clearly, the efficacy of any strategy will depend on several factors, including, for example, the quantity, activity, and stability of the delivered VWF. The inherent complexity of VWF biosynthesis, which involves extensive posttranslational processing, may be limiting in terms of producing active VWF outside of its native cellular sources. This review summarizes recent progress in the development of different treatment strategies for VWD, including those that are established and those that are at the experimental stage. Potential pitfalls and benefits of each strategy are discussed.
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De Meyer SF, Vandeputte N, Pareyn I, Petrus I, Lenting PJ, Chuah MKL, VandenDriessche T, Deckmyn H, Vanhoorelbeke K. Restoration of plasma von Willebrand factor deficiency is sufficient to correct thrombus formation after gene therapy for severe von Willebrand disease. Arterioscler Thromb Vasc Biol 2008; 28:1621-6. [PMID: 18556568 DOI: 10.1161/atvbaha.108.168369] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Gene therapy for severe von Willebrand disease (vWD) seems an interesting treatment alternative with long-term therapeutic potential. We investigated the feasibility of targeting the liver for ectopic expression of physiologically active von Willebrand factor (vWF). METHODS AND RESULTS The capacity of transgene-encoded murine vWF to restore vWF function was studied in a mouse model of severe vWD after liver-specific gene transfer by hydrodynamic injection. By using a hepatocyte-specific alpha1 antitrypsin promoter, a considerably higher and longer-lasting vWF expression was obtained when compared with a cytomegalovirus promoter, reaching maximum vWF plasma levels that are 10+/-1 times higher than the wild-type level. Liver-expressed vWF showed the full range of multimers, including the high molecular weight multimers, and restored factor VIII plasma levels, consistent with correction of the bleeding time 3 but not 7 days after gene transfer. Importantly, transgene encoded plasma vWF restored proper platelet adhesion and aggregation in a FeCl(3) induced thrombosis model. CONCLUSIONS High ectopic expression of transgene encoded plasma vWF can be obtained after gene transfer to the liver. Liver-expressed vWF was fully multimerized and able to restore proper platelet plug formation in severe vWD. The liver therefore seems an attractive target for gene therapy for severe vWD.
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Affiliation(s)
- Simon F De Meyer
- Laboratory for Thrombosis Research, K.U. Leuven Campus Kortrijk, Belgium
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Marx I, Lenting PJ, Adler T, Pendu R, Christophe OD, Denis CV. Correction of Bleeding Symptoms in von Willebrand Factor–Deficient Mice by Liver-Expressed von Willebrand Factor Mutants. Arterioscler Thromb Vasc Biol 2008; 28:419-24. [DOI: 10.1161/atvbaha.107.159442] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Isabelle Marx
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U770 (I.M., T.A., O.D.C., C.V.D.), Le Kremlin-Bicêtre, F-94276 France; Univ Paris-Sud, Le Kremlin-Bicêtre, F-94276 France; and the Laboratory for Thrombosis and Haemostasis (P.J.L., R.P.), Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, The Netherlands
| | - Peter J. Lenting
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U770 (I.M., T.A., O.D.C., C.V.D.), Le Kremlin-Bicêtre, F-94276 France; Univ Paris-Sud, Le Kremlin-Bicêtre, F-94276 France; and the Laboratory for Thrombosis and Haemostasis (P.J.L., R.P.), Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, The Netherlands
| | - Thure Adler
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U770 (I.M., T.A., O.D.C., C.V.D.), Le Kremlin-Bicêtre, F-94276 France; Univ Paris-Sud, Le Kremlin-Bicêtre, F-94276 France; and the Laboratory for Thrombosis and Haemostasis (P.J.L., R.P.), Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, The Netherlands
| | - Ronan Pendu
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U770 (I.M., T.A., O.D.C., C.V.D.), Le Kremlin-Bicêtre, F-94276 France; Univ Paris-Sud, Le Kremlin-Bicêtre, F-94276 France; and the Laboratory for Thrombosis and Haemostasis (P.J.L., R.P.), Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, The Netherlands
| | - Olivier D. Christophe
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U770 (I.M., T.A., O.D.C., C.V.D.), Le Kremlin-Bicêtre, F-94276 France; Univ Paris-Sud, Le Kremlin-Bicêtre, F-94276 France; and the Laboratory for Thrombosis and Haemostasis (P.J.L., R.P.), Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, The Netherlands
| | - Cécile V. Denis
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U770 (I.M., T.A., O.D.C., C.V.D.), Le Kremlin-Bicêtre, F-94276 France; Univ Paris-Sud, Le Kremlin-Bicêtre, F-94276 France; and the Laboratory for Thrombosis and Haemostasis (P.J.L., R.P.), Department of Clinical Chemistry & Haematology, University Medical Center Utrecht, The Netherlands
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Abstract
Despite nearly two decades of research, the successful application of systemically delivered non-viral gene therapies to treat human disease is still limited by poor transfection efficiency. The major barriers in the circulation and in the cell that limit transfection efficiency have been identified and the field has entered a phase of design and testing of more sophisticated carrier systems that attempt to circumvent these barriers. These studies are increasingly conducted in vivo using rapid quantitative measures of gene transfer efficiency as a guide. Although there has been steady progress in developing DNA nanoparticles that navigate the circulation, enter the target cell and escape lysosomal targeting, the final goal of efficiently traversing the nuclear membrane remains the most significant challenge. The ultimate goal is to develop elegant delivery systems that work in concert to deliver DNA from the needle to the nucleus.
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Affiliation(s)
- Garrett R Rettig
- Division of Medicinal and Natural Products Chemistry, College of Pharmacy, The University of Iowa, Iowa City, IA 52242, USA
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Lavenu-Bombled C, Izac B, Legrand F, Cambot M, Vigier A, Massé JM, Dubart-Kupperschmitt A. Glycoprotein Ibalpha promoter drives megakaryocytic lineage-restricted expression after hematopoietic stem cell transduction using a self-inactivating lentiviral vector. Stem Cells 2007; 25:1571-7. [PMID: 17379771 DOI: 10.1634/stemcells.2006-0321] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Megakaryocytic (MK) lineage is an attractive target for cell/gene therapy approaches, aiming at correcting platelet protein deficiencies. However, MK cells are short-lived cells, and their permanent modification requires modification of hematopoietic stem cells with an integrative vector such as a lentiviral vector. Glycoprotein (Gp) IIb promoter, the most studied among the MK regulatory sequences, is also active in stem cells. To strictly limit transgene expression to the MK lineage after transduction of human CD34(+) hematopoietic cells with a lentiviral vector, we looked for a promoter activated later during MK differentiation. Human cord blood, bone marrow, and peripheral-blood mobilized CD34(+) cells were transduced with a human immunodeficiency virus-derived self-inactivating lentiviral vector encoding the green fluorescent protein (GFP) under the transcriptional control of GpIbalpha, GpIIb, or EF1alpha gene regulatory sequences. Both GpIbalpha and GpIIb promoters restricted GFP expression (analyzed by flow cytometry and immunoelectron microscopy) in MK cells among the maturing progeny of transduced cells. However, only the GpIbalpha promoter was strictly MK-specific, whereas GpIIb promoter was leaky in immature progenitor cells not yet engaged in MK cell lineage differentiation. We thus demonstrate the pertinence of using a 328-base-pair fragment of the human GpIbalpha gene regulatory sequence, in the context of a lentiviral vector, to tightly restrict transgene expression to the MK lineage after transduction of human CD34(+) hematopoietic cells. Disclosure of potential conflicts of interest is found at the end of this article.
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Affiliation(s)
- Cécile Lavenu-Bombled
- Institut Cochin, Department of Hematology, Hôpital de Port-Royal, 123 Bd de Port-Royal, Paris 75014, France
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21
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Lenting PJ, de Groot PG, De Meyer SF, Vanhoorelbeke K, Pruss C, Lillicrap D, Marx I, Denis CV. Correction of the bleeding time in von Willebrand factor (VWF)–deficient mice using murine VWF. Blood 2007; 109:2267-8. [PMID: 17312004 DOI: 10.1182/blood-2006-10-054718] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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