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Chen Y, Schroeder JA, Gao C, Li J, Hu J, Shi Q. In vivo enrichment of genetically manipulated platelets for murine hemophilia B gene therapy. J Cell Physiol 2020; 236:354-365. [PMID: 32510630 DOI: 10.1002/jcp.29861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/23/2020] [Accepted: 05/27/2020] [Indexed: 01/05/2023]
Abstract
Our previous studies have demonstrated that platelet-targeted factor IX (FIX) gene therapy can introduce sustained platelet-FIX expression in hemophilia B (FIXnull ) mice. In this study, we aimed to enhance platelet-FIX expression in FIXnull mice with O6 -methylguanine-DNA-methyltransferase (MGMT)-mediated in vivo drug selection of transduced cells under nonmyeloablative preconditioning. We constructed a novel lentiviral vector (2bF9/MGMT lentivirus vector), which harbors dual genes, the FIX gene driven by the αIIb promoter (2bF9) and the MGMT P140K gene under the murine stem cell virus promoter. Platelet-FIX expression in FIXnull mice was introduced by 2bF9/MGMT-mediated hematopoietic stem cell transduction and transplantation. The 2bF9/MGMT-transduced cells were effectively enriched after drug selection by O6 -benzylguanine/1,3-bis-2-chloroethyl-1-nitrosourea. There were a 2.9-fold higher FIX antigen and a 3.7-fold higher FIX activity in platelets, respectively, posttreatment compared with pretreatment. When a 6-hr tail bleeding test was used to grade the bleeding phenotype, the clotting time in treated animals was 2.6 ± 0.5 hr. In contrast, none of the FIXnull control mice were able to clot within 6 hr. Notably, none of the recipients developed anti-FIX antibodies after gene therapy. One of four recipients developed a low titer of inhibitors when challenged with rhF9 together with adjuvant. In contrast, all FIXnull controls developed inhibitors after the same challenge. Anti-FIX immunoglobulin G were barely detectable in recipients (1.08 ± 0.54 µg/ml), an 875-fold lower level than in the FIXnull controls. Our data demonstrate that using the MGMT-mediated drug selection system in 2bF9 gene therapy can significantly enhance therapeutic platelet-FIX expression, resulting in sustained phenotypic correction and immune tolerance in FIXnull mice.
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Affiliation(s)
- Yingyu Chen
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.,Blood Research Institute, Versiti Wisconsin, Milwaukee, Wisconsin.,Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Jocelyn A Schroeder
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.,Blood Research Institute, Versiti Wisconsin, Milwaukee, Wisconsin.,Children's Research Institute, Children's Wisconsin, Milwaukee, Wisconsin.,Midwest Athletes Against Childhood Cancer (MACC) Fund Research Center, Milwaukee, Wisconsin
| | - Chunyan Gao
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.,Blood Research Institute, Versiti Wisconsin, Milwaukee, Wisconsin
| | - Jing Li
- Blood Research Institute, Versiti Wisconsin, Milwaukee, Wisconsin.,Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Jianda Hu
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Qizhen Shi
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.,Blood Research Institute, Versiti Wisconsin, Milwaukee, Wisconsin.,Children's Research Institute, Children's Wisconsin, Milwaukee, Wisconsin.,Midwest Athletes Against Childhood Cancer (MACC) Fund Research Center, Milwaukee, Wisconsin
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Hazendonk HCAM, van Moort I, Mathôt RAA, Fijnvandraat K, Leebeek FWG, Collins PW, Cnossen MH. Setting the stage for individualized therapy in hemophilia: What role can pharmacokinetics play? Blood Rev 2018; 32:265-271. [PMID: 29426727 DOI: 10.1016/j.blre.2018.01.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/16/2018] [Accepted: 01/23/2018] [Indexed: 02/06/2023]
Abstract
Replacement therapy with clotting factor concentrates (CFC) is the mainstay of treatment in hemophilia. Its widespread application has led to a dramatic decrease in morbidity and mortality in patients, with concomitant improvement of quality of life. However, dosing is challenging and costs are high. This review discusses benefits and limitations of pharmacokinetic (PK)-guided dosing of replacement therapy as an alternative for current dosing regimens. Dosing of CFC is now primarily based on body weight and based on its in vivo recovery (IVR). Benefits of PK-guided dosing include individualization of treatment with better targeting, more flexible blood sampling, increased insight into association of coagulation factor levels and bleeding, and potential overall lowering of overall costs. Limitations include a slight burden for the patient, and availability of closely collaborating, experienced clinical pharmacologists.
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Affiliation(s)
- H C A M Hazendonk
- Department of Pediatric Hematology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - I van Moort
- Department of Pediatric Hematology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - R A A Mathôt
- Hospital Pharmacy - Clinical Pharmacology, Academic Medical Center, Amsterdam, The Netherlands
| | - K Fijnvandraat
- Department of Pediatric Hematology, Academic Medical Center, Amsterdam, The Netherlands; Department of Plasma Proteins, Sanquin Research, Amsterdam, The Netherlands
| | - F W G Leebeek
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - P W Collins
- Department of Haematology, School of Medicine, Cardiff University, United Kingdom
| | - M H Cnossen
- Department of Pediatric Hematology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
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