Li Binbin, Wu Zhihan, Xu Wenjue, Han Wenwen, Liu Jiayu, Wang Dawei, Zhang Guowei
Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Department of Basic Medical Sciences, Hangzhou Normal University School of Medicine, Hangzhou, China.
National Research Center for Translational Medicine, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Hum Gene Ther. 2021 May;32(9-10):506-516. doi: 10.1089/hum.2020.309. Epub 2021 Apr 26.
Targeting the coagulation factor IX (FIX) expression in platelets has been shown to be effective in ameliorating bleeding in hemophilia B (HB) mice. To improve the therapeutic effects and evaluate the safety of this gene therapy strategy, we generated a transgenic mouse model on an HB background with FIX Padua target expressed in platelets. The transgenic mice exhibited stable expression and storage of FIX Padua in platelets. The platelet-stored FIX Padua could be released with the activation of platelets, and the proportion of platelet-stored FIX Padua in whole blood was the same as that of platelet-stored wild-type human FIX. The platelet-derived FIX Padua showed substantially increased specific activity compared with wild-type FIX. Reduced bleeding volume in the FIX Padua transgenic mice demonstrated that bleeding in the mice was improved. Levels of thrombin-antithrombin complex, fibrinogen, D-Dimer, and blood cell counts were normal in the transgenic mice, suggesting that thrombotic risk was not increased in this mouse model. However, the leakage and failure to overcome the presence of inhibitor to wild-type FIX is also observed with FIX Padua, as expected. Taken together, our results support the conclusion that targeting FIX Padua expression in platelets may be an effective and safe gene therapy strategy for HB, and could provide an ideal model to evaluate the safety of platelet-targeted gene therapy for treating hemophilia.
靶向血小板中的凝血因子IX(FIX)表达已被证明可有效改善B型血友病(HB)小鼠的出血症状。为了提高治疗效果并评估这种基因治疗策略的安全性,我们构建了一种在HB背景下的转基因小鼠模型,该模型中血小板表达FIX Padua。转基因小鼠的血小板中FIX Padua表达和储存稳定。血小板储存的FIX Padua可随血小板激活而释放,且其在全血中所占比例与血小板储存的野生型人FIX相同。与野生型FIX相比,血小板来源的FIX Padua的比活性显著增加。FIX Padua转基因小鼠的出血体积减少,表明小鼠的出血症状得到改善。转基因小鼠的凝血酶 - 抗凝血酶复合物、纤维蛋白原、D - 二聚体水平及血细胞计数均正常,这表明该小鼠模型中血栓形成风险未增加。然而,正如预期的那样,FIX Padua也存在渗漏现象,且无法克服野生型FIX抑制剂的存在。综上所述,我们的结果支持以下结论:靶向血小板中的FIX Padua表达可能是一种治疗HB的有效且安全的基因治疗策略,并且可以为评估血小板靶向基因治疗血友病的安全性提供理想模型。