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Ellison S, Buckland K, Learmonth Y, Day V, Kalra S, Howe L, Roman-Rodriguez FJ, Bonafont J, Booth L, Holley R, Smythe J, Jones S, Thrasher A, Booth C, Bigger BW. Design and validation of a GMP stem cell manufacturing protocol for MPSII hematopoietic stem cell gene therapy. Mol Ther Methods Clin Dev 2024; 32:101271. [PMID: 38946936 PMCID: PMC11214401 DOI: 10.1016/j.omtm.2024.101271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/17/2024] [Indexed: 07/02/2024]
Abstract
Hematopoietic stem cell gene therapy (HSCGT) is a promising therapeutic strategy for the treatment of neurodegenerative, metabolic disorders. The approach involves the ex vivo introduction of a missing gene into patients' own stem cells via lentiviral-mediated transduction (TD). Once transplanted back into a fully conditioned patient, these genetically modified HSCs can repopulate the blood system and produce the functional protein, previously absent or non-functional in the patient, which can then cross-correct other affected cells in somatic organs and the central nervous system. We previously developed an HSCGT approach for the treatment of Mucopolysaccharidosis type II (MPSII) (Hunter syndrome), a debilitating pediatric lysosomal disorder caused by mutations in the iduronate-2-sulphatase (IDS) gene, leading to the accumulation of heparan and dermatan sulfate, which causes severe neurodegeneration, skeletal abnormalities, and cardiorespiratory disease. In HSCGT proof-of-concept studies using lentiviral IDS fused to a brain-targeting peptide ApoEII (IDS.ApoEII), we were able to normalize brain pathology and behavior of MPSII mice. Here we present an optimized and validated good manufacturing practice hematopoietic stem cell TD protocol for MPSII in preparation for first-in-man studies. Inclusion of TEs LentiBOOST and protamine sulfate significantly improved TD efficiency by at least 3-fold without causing adverse toxicity, thereby reducing vector quantity required.
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Affiliation(s)
- Stuart Ellison
- Stem Cell & Neurotherapies Group, University of Manchester, Manchester, UK
| | - Karen Buckland
- UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Yuko Learmonth
- Stem Cell & Neurotherapies Group, University of Manchester, Manchester, UK
| | - Victoria Day
- Cellular and Molecular Therapies, NHSBT Barnsley, Barnsley, UK
| | - Spandan Kalra
- Cellular and Molecular Therapies, NHSBT Barnsley, Barnsley, UK
| | - Lauren Howe
- Cellular and Molecular Therapies, NHSBT Barnsley, Barnsley, UK
| | - Francisco José Roman-Rodriguez
- UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Jose Bonafont
- UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Laura Booth
- Stem Cell & Neurotherapies Group, University of Manchester, Manchester, UK
| | - Rebecca Holley
- Stem Cell & Neurotherapies Group, University of Manchester, Manchester, UK
| | - Jon Smythe
- Cellular and Molecular Therapies, NHSBT Barnsley, Barnsley, UK
| | - Simon Jones
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Adrian Thrasher
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Claire Booth
- UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Brian W. Bigger
- Stem Cell & Neurotherapies Group, University of Manchester, Manchester, UK
- Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, UK
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Wiercinska E, Seifried E, Bonig H. CD3/CD19 Depletion for T-cell Reduction of Allogeneic Transplants: Mostly Efficient, but not Robust. Clin Hematol Int 2021; 3:103-107. [PMID: 34820615 PMCID: PMC8486974 DOI: 10.2991/chi.k.210725.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022] Open
Abstract
Aggressive T-cell depletion, in vitro or in vivo, is a prerequisite for survival of haplo-identical stem cell transplantation. The classical T-cell-depleted transplant, immunomagnetically enriched CD34+ cells, is very safe with respect to graft-versus-host reactivity, but associated with very high transplant-related and relapse mortality with an overall probability of survival of only 20%. Protocols for T- and B-cell depletion were therefore developed, reasoning that transplantation of the majority of Natural Killer (NK) cells and the substantial dose of residual T-cells might improve survival, which was, in principle, confirmed. Anecdotal reports of frequent failure to achieve adequate T-cell depletion prompted review of the aggregate data for transplant quality at our center. The first observation is the relative paucity of combined CD3/CD19 depletion processes as PTCy protocols have made inroads, 13 depletions in 8 years. Median T- and B-cell log-depletion were -3.89 and -1.92, respectively; instead of, CD34+ cell recovery was generally high (median 92%), as was NK-cell recovery (median 52%). However, the process failed to yield satisfactory T- and B-cell depletion in two out of 13 preparations, of which one product could be rescued by a second round of depletion, at the expense of CD34+ cell recovery. In our hands, the process is thus insufficiently robust for routine clinical use. Assuming similar observations in other centers, this may explain implementation of alternative protocols, such as TCRαβ/CD19 depletion or transplantation of unmanipulated grafts with subsequent in vivo depletion.
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Affiliation(s)
- Eliza Wiercinska
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt, Frankfurt a.M., Germany
| | - Erhard Seifried
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt, Frankfurt a.M., Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt a.M., Germany
| | - Halvard Bonig
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt, Frankfurt a.M., Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt a.M., Germany.,Department of Medicine/Division of Hematology, University of Washington, Seattle, WA, USA
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