Magari S R, Rivera V M, Iuliucci J D, Gilman M, Cerasoli F
ARIAD Gene Therapeutics, Cambridge, Massachusetts 02139, USA.
J Clin Invest. 1997 Dec 1;100(11):2865-72. doi: 10.1172/JCI119835.
Systemic delivery of specific therapeutic proteins by a parenteral route of administration is a recognized practice in the management of several gene defects and acquired diseases. As an alternative to repetitive parenteral administration, gene therapy may provide a novel means for systemic delivery of therapeutic proteins while improving patient compliance and therapeutic efficacy. However, for gene therapy to be an efficacious and safe approach to the clinical management of such diseases, gene expression must be tightly regulated. These investigations demonstrate precise in vivo control of protein expression from cells that are engineered to secrete human growth hormone (hGH) in response to stimulation by rapamycin. The cells were implanted intramuscularly into nu/nu mice and stimulated by intravenous or oral administration of rapamycin. In vivo experiments demonstrate that the activity and pharmacokinetics of rapamycin determine the level of serum hGH that result from the engineered cells. In addition, responsiveness of the cells to rapamycin, number of cells implanted, hGH expression kinetics, and the pharmacokinetics of hGH itself, also influence the circulating levels of hGH after rapamycin stimulation. Controlled manipulation of several of these parameters, either independently or in combination, allows for precise regulation of circulating hGH concentration in vivo.
通过非肠道给药途径进行特定治疗性蛋白质的全身递送是治疗多种基因缺陷和后天性疾病的一种公认方法。作为重复非肠道给药的替代方法,基因治疗可能为治疗性蛋白质的全身递送提供一种新手段,同时提高患者的依从性和治疗效果。然而,要使基因治疗成为治疗此类疾病的有效且安全的临床方法,基因表达必须受到严格调控。这些研究表明,对于经基因工程改造以响应雷帕霉素刺激而分泌人生长激素(hGH)的细胞,可在体内实现对蛋白质表达的精确控制。将这些细胞肌肉内植入无胸腺裸鼠,并通过静脉或口服给予雷帕霉素进行刺激。体内实验表明,雷帕霉素的活性和药代动力学决定了工程细胞产生的血清hGH水平。此外,细胞对雷帕霉素的反应性、植入的细胞数量、hGH表达动力学以及hGH本身的药代动力学,也会影响雷帕霉素刺激后hGH的循环水平。对这些参数中的几个进行独立或联合的可控操作,能够在体内精确调节循环hGH浓度。