Beard Brian C, Keyser Kirsten A, Trobridge Grant D, Peterson Laura J, Miller Daniel G, Jacobs Michael, Kaul Rajinder, Kiem Hans-Peter
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Hum Gene Ther. 2007 May;18(5):423-34. doi: 10.1089/hum.2007.011.
Recent advances have allowed for improved retrovirus-mediated gene transfer, and therapeutic benefits have been described in patients. These successes have shown the potential of hematopoietic stem cell (HSC) gene therapy, but treatment-related leukemia and benign expansion of gene-modified clones have shifted the attention toward safety. The delayed onset of adverse events in gene therapy clinical trials emphasizes the importance of long-term integration site studies in large animal models. We have addressed safety by characterizing the genomic location of 555 integration sites of the three most commonly used integrating retroviral vectors, that is, gammaretrovirus, lentivirus, and foamy virus, in long-term repopulating cells from dogs. Gammaretroviral integrants showed the most significant frequency of occurrence very close (<2.5 kb) to transcription start sites, but a substantial portion of all three retroviral integrants were within 50 kb. Importantly, gammaretroviral integrants were found more frequently in and near proto-oncogenes, suggesting this retroviral system may be the most prone to adverse gene activation. These data suggest that gammaretroviral vectors may have the highest intrinsic risk, but also emphasize that no vector system can be defined as "safe" based solely on integration profile.
近年来的进展使得逆转录病毒介导的基因转移得到了改进,并且在患者中已描述了治疗益处。这些成功展示了造血干细胞(HSC)基因治疗的潜力,但与治疗相关的白血病以及基因修饰克隆的良性扩增已将注意力转向安全性。基因治疗临床试验中不良事件的延迟发生强调了在大型动物模型中进行长期整合位点研究的重要性。我们通过对来自犬类的长期重建造血细胞中三种最常用的整合型逆转录病毒载体(即γ逆转录病毒、慢病毒和泡沫病毒)的555个整合位点的基因组位置进行表征来解决安全性问题。γ逆转录病毒整合体在非常靠近(<2.5 kb)转录起始位点处显示出最高的出现频率,但所有三种逆转录病毒整合体中有很大一部分位于50 kb范围内。重要的是,γ逆转录病毒整合体在原癌基因及其附近更频繁地被发现,这表明该逆转录病毒系统可能最容易发生不良基因激活。这些数据表明γ逆转录病毒载体可能具有最高的内在风险,但也强调了没有任何载体系统可以仅基于整合图谱就被定义为“安全”。