1
|
Arumugam P, Carey BC, Wikenheiser-Brokamp KA, Krischer J, Wessendarp M, Shima K, Chalk C, Stock J, Ma Y, Black D, Imbrogno M, Collins M, Kalenda Yombo DJ, Sakthivel H, Suzuki T, Lutzko C, Cancelas JA, Adams M, Hoskins E, Lowe-Daniels D, Reeves L, Kaiser A, Trapnell BC. A toxicology study of Csf2ra complementation and pulmonary macrophage transplantation therapy of hereditary PAP in mice. Mol Ther Methods Clin Dev 2024; 32:101213. [PMID: 38596536 PMCID: PMC11001781 DOI: 10.1016/j.omtm.2024.101213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/13/2024] [Indexed: 04/11/2024]
Abstract
Pulmonary macrophage transplantation (PMT) is a gene and cell transplantation approach in development as therapy for hereditary pulmonary alveolar proteinosis (hPAP), a surfactant accumulation disorder caused by mutations in CSF2RA/B (and murine homologs). We conducted a toxicology study of PMT of Csf2ra gene-corrected macrophages (mGM-Rα+Mϕs) or saline-control intervention in Csf2raKO or wild-type (WT) mice including single ascending dose and repeat ascending dose studies evaluating safety, tolerability, pharmacokinetics, and pharmacodynamics. Lentiviral-mediated Csf2ra cDNA transfer restored GM-CSF signaling in mGM-Rα+Mϕs. Following PMT, mGM-Rα+Mϕs engrafted, remained within the lungs, and did not undergo uncontrolled proliferation or result in bronchospasm, pulmonary function abnormalities, pulmonary or systemic inflammation, anti-transgene product antibodies, or pulmonary fibrosis. Aggressive male fighting caused a similarly low rate of serious adverse events in saline- and PMT-treated mice. Transient, minor pulmonary neutrophilia and exacerbation of pre-existing hPAP-related lymphocytosis were observed 14 days after PMT of the safety margin dose but not the target dose (5,000,000 or 500,000 mGM-Rα+Mϕs, respectively) and only in Csf2raKO mice but not in WT mice. PMT reduced lung disease severity in Csf2raKO mice. Results indicate PMT of mGM-Rα+Mϕs was safe, well tolerated, and therapeutically efficacious in Csf2raKO mice, and established a no adverse effect level and 10-fold safety margin.
Collapse
Affiliation(s)
- Paritha Arumugam
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Brenna C. Carey
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Kathryn A. Wikenheiser-Brokamp
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
- Division of Pathology & Laboratory Medicine, CCHMC, Cincinnati, OH, USA
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jeffrey Krischer
- Departments of Pediatrics and Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Matthew Wessendarp
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
| | - Kenjiro Shima
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
| | - Claudia Chalk
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
| | - Jennifer Stock
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
| | - Yan Ma
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
| | - Diane Black
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
| | - Michelle Imbrogno
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, UCMC, Cincinnati, OH, USA
| | - Margaret Collins
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, UCMC, Cincinnati, OH, USA
| | - Dan Justin Kalenda Yombo
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, UCMC, Cincinnati, OH, USA
| | - Haripriya Sakthivel
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Takuji Suzuki
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
| | - Carolyn Lutzko
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Cell Manipulations Laboratory, CCHMC, Cincinnati, OH, USA
| | | | - Michelle Adams
- Office for Clinical and Translational Research, CCHMC, Cincinnati, OH, USA
| | - Elizabeth Hoskins
- Office for Clinical and Translational Research, CCHMC, Cincinnati, OH, USA
| | | | - Lilith Reeves
- Translational Core Laboratory, CCHMC, Cincinnati, OH, USA
| | - Anne Kaiser
- Office of Research Compliance & Regulatory Affairs, CCHMC, Cincinnati, OH, USA
| | - Bruce C. Trapnell
- Translational Pulmonary Science Center, Cincinnati Children’s Hospital Medical Center (CCHMC), Cincinnati, OH, USA
- Division of Pulmonary Biology, Perinatal Institute, CCHMC, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, UCMC, Cincinnati, OH, USA
- Division of Pulmonary Medicine, CCHMC, Cincinnati, OH, USA
| |
Collapse
|