Xu Lingfei, Mei Manxue, Haskins Mark E, Nichols Timothy C, O'donnell Patricia, Cullen Karyn, Dillow Aaron, Bellinger Dwight, Ponder Katherine P
Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Thromb Res. 2007;120(2):269-80. doi: 10.1016/j.thromres.2006.09.010. Epub 2006 Nov 7.
Gene therapy could prevent bleeding in hemophilia. However, antibodies could inhibit coagulation, while cytotoxic T lymphocytes could destroy modified cells. The immaturity of the newborn immune system might prevent these immune responses from occurring after neonatal gene therapy.
Newborn dogs, cats, or mice were injected intravenously with a retroviral vector expressing human Factor IX. Plasma was evaluated for antigen and anti-human Factor IX antibodies. Cytotoxic T lymphocyte responses were evaluated indirectly by analysis of retroviral vector RNA in liver. Lymphocytes were evaluated for cytokine secretion and the ability to suppress an immune response to human Factor IX in mice.
Hemophilia B dogs that achieved 942+/-500 ng/ml (19% normal) or 5+/-0.4 ng/ml (0.1% normal) of human Factor IX in plasma only bled 0 or 1.2 times per year, respectively, and were tolerant to infusion of human Factor IX. Normal cats expressed human Factor IX at 118+/-29 ng/ml (2% normal) in plasma without antibody formation. However, plasma human Factor IX disappeared at late times in 1 of 4 cats, which was probably due to a cytotoxic T lymphocyte response that destroyed cells with high expression. C3H mice were tolerant to human Factor IX after neonatal gene therapy, which may involve clonal deletion of human Factor IX-responsive cells. These data demonstrate that neonatal gene therapy does not induce antibodies to human Factor IX in dogs, cats, or mice. The putative cytotoxic T lymphocyte response in one cat requires further study.
基因疗法可预防血友病患者出血。然而,抗体可能会抑制凝血,而细胞毒性T淋巴细胞可能会破坏经过修饰的细胞。新生儿免疫系统的不成熟可能会阻止这些免疫反应在新生儿基因治疗后发生。
给新生犬、猫或小鼠静脉注射表达人凝血因子IX的逆转录病毒载体。评估血浆中的抗原和抗人凝血因子IX抗体。通过分析肝脏中的逆转录病毒载体RNA间接评估细胞毒性T淋巴细胞反应。评估淋巴细胞的细胞因子分泌情况以及抑制小鼠对人凝血因子IX免疫反应的能力。
血浆中人凝血因子IX水平达到942±500 ng/ml(正常水平的19%)或5±0.4 ng/ml(正常水平的0.1%)的血友病B犬,每年分别仅出血0次或1.2次,并且对输注人凝血因子IX具有耐受性。正常猫血浆中人凝血因子IX的表达水平为118±29 ng/ml(正常水平的2%),且未形成抗体。然而,4只猫中有1只在后期血浆中的人凝血因子IX消失,这可能是由于细胞毒性T淋巴细胞反应破坏了高表达的细胞。新生基因治疗后,C3H小鼠对人凝血因子IX具有耐受性,这可能涉及对人凝血因子IX有反应的细胞的克隆缺失。这些数据表明,新生基因治疗不会在犬、猫或小鼠中诱导产生针对人凝血因子IX的抗体。一只猫中可能存在的细胞毒性T淋巴细胞反应需要进一步研究。