Helper virus induced T cell lymphoma in nonhuman primates after retroviral mediated gene transfer

Suppression of human alpha-globin gene expression mediated by the recombinant adeno-associated virus 2-based antisense vectors

We sought to investigate the usefulness of the adeno-associated virus 2 (AAV)-based vectors to suppress the excess production of the human alpha-globin gene product towards developing a treatment modality for beta-thalassemia since accumulation of free alpha-globin reduces the lifespan of red blood cells in these patients. We constructed recombinant AAV virions containing the human alpha-globin gene sequences in antisense orientation driven by the herpesvirus thymidine kinase (TK) promoter, the SV40 early gene promoter, and the human alpha-globin gene promoter, respectively, as well as a bacterial gene for resistance to neomycin (neoR) as a selectable marker. These recombinant virions were used to infect a human erythroleukemia cell line (K562) that express high levels of alpha-globin mRNA. Clonal populations of neoR cells were obtained after selection with the drug G418, a neomycin analogue. Total genomic DNA samples isolated from these cells were analyzed on Southern blots to document stable integration of the transduced neo and alpha-globin genes. Total cellular RNA samples isolated from mock-infected and recombinant virus-infected cultures were also analyzed by Northern blots. Whereas the TK promoter-driven antisense alpha-globin sequences showed no inhibition of expression of the endogenous alpha-globin gene, the SV40 promoter and the alpha-globin gene promoter-driven antisense alpha-globin sequences suppressed the expression of this constitutively over-expressed gene by approximately 29 and 91%, respectively, at the transcriptional level. These studies suggest the feasibility of utilizing the AAV-based antisense gene transfer approach in the potential treatment of beta-thalassemia.

The new frontier: gene and oligonucleotide therapy

Gene and oligonucleotide therapy are emerging as clinically viable therapeutic regimens for genetic, neoplastic, and infectious diseases. Approaches include insertion of human genes in viral vectors including recombinant retrovirus, adenovirus, adeno-associated virus, and herpes simplex virus-1, or recombinant bacterial plasmids. Viral vectors transfect cells directly; plasmid DNA is delivered with the help of cationic liposomes (lipofection), polylysine conjugates, gramicidin S, artificial viral envelopes or other such intracellular carriers. Major areas of interest include replacement of the cystic fibrosis transmembrane regulator gene and the alpha 1-antitrypsin gene; arrest of human immunodeficiency virus infection; and reversal of tumorigenicity and cancer immunization, among others. Oligonucleotide therapy is principally focusing on the same areas, although the approach is to halt DNA transcription or messenger RNA translation with code-blocking triple-helix-forming or "antisense" oligomers. Contributions from the pharmaceutical sciences are expected in pharmaceutical chemistry, drug delivery systems design, analytical chemistry, and biopharmaceutics.

Replicating vectors for gene therapy of cancer: risks, limitations and prospects

There are good theoretical arguments for exploring the use of replicating gene-transfer vectors for human cancer therapy. Such vectors should be derived from weakly pathogenic human viruses with initially broad tissue tropism. Coat protein engineering and promoter engineering might be used successfully to narrow the tropism of the vector, enhancing its ability to target tumour cells. Killing of uninfected 'bystander' tumour cells could be achieved through prodrug activation by a vector-encoded enzyme. Rapid elimination of infused vector particles by circulating antiviral antibody would limit access to tumour deposits after repeated administration, but might be circumvented by the use of infectious nucleic acid which is poorly imunogenic [64]. This putative therapeutic strategy is illustrated in Figure 1.

Circumvention of chemotherapy-induced myelosuppression by transfer of the mdr1 gene

Drug-induced myelosuppression is a frequent reason for curtailing chemotherapy in cancer patients. 'Rescue' of myelosuppressed patients with autologous marrow transplants is reasonably advanced and permits an increase in the dose of anticancer drugs. Despite this improvement, patients often relapse with drug resistance disease. The human multidrug resistance (mdr1) gene might make it possible to render hemopoietic stem cells resistant to anticancer drugs after transfer of this gene. By introducing resistant stem cells into patients it might be possible to treat these patients repeatedly with otherwise ablative therapy. This review explores the feasibility of mdr1 gene therapy.

The basic science of gene therapy

The development over the past decade of methods for delivering genes to mammalian cells has stimulated great interest in the possibility of treating human disease by gene-based therapies. However, despite substantial progress, a number of key technical issues need to be resolved before gene therapy can be safely and effectively applied in the clinic. Future technological developments, particularly in the areas of gene delivery and cell transplantation, will be critical for the successful practice of gene therapy.

Granulocyte colony-stimulating factor treatment of mice modulates differently the sensitivity of blood and bone marrow hematopoietic progenitors to retroviral vector infection

The effect of recombinant human granulocyte colony-stimulating factor (G-CSF) administration to mice on the retroviral-mediated transfer of the selectable marker gene neo to hematopoietic cells was studied. After G-CSF treatment, blood mononuclear cells and bone marrow cells were infected with the retrovirus, and the efficiency of gene transfer into myeloid progenitors was increased in peripheral blood and decreased in bone marrow cells. Bone marrow four to six months after transplantation from G-CSF treated mice revealed the presence of the transferred neo gene in 4 out of 104 mice, which is an eightfold lower proportion than in the control group. These data suggest that G-CSF in vivo treatment decreases bone marrow sensitivity and increases the sensitivity of peripheral blood cells to retroviral infection.

Retroviral gene transduction of circulating progenitor cells in patients with metastatic breast cancer

The use of somatic gene therapy for the treatment of breast cancer has many potential applications. Because chemotherapeutic protocols for breast cancer are commonly limited by bone marrow toxicity, transduction of genes into pleuripotent stem cells may allow the generation and maintenance of immune responses in the presence of lymphocytotoxic agents. The practical utility of stem cell isolation and transduction would be enhanced if stem cells circulating in the peripheral blood could be isolated in patients, however this approach has been limited by the small numbers of such cells in the circulation. In these studies, recombinant granulocyte colony stimulating factor (G-CSF) was administered to patients with metastatic breast cancer to increase the number of circulating stem cells. Stem cells in the peripheral blood were then isolated and a retroviral vector (LXSN) was used to transduce the neomycin phosphotransferase gene into these cells. Gene transduction was demonstrated by resistance to the toxic effects of a neomycin analog (G418) and the detection of retroviral DNA from transduced cells. A practical method of transfer of exogenous genes into the circulating pleuripotent stem cells of patients with metastatic breast cancer is documented by these experiments. Application of these findings may allow the generation of cells resistant to anti-neoplastic agents or unique lymphoid effector cells with potent immune functions for the treatment of patients with metastatic breast cancer.

Gene transfer into human hematopoietic progenitor cells: a review of current clinical protocols

Recent reviews by Clay Smith (1992) in this journal and by W. French Anderson (1990) and A. Dusty Miller (1992) have described the technologies used for gene transfer, the potential applications of the approach, and the safety issues that require consideration. This review will have a narrower focus. It will deal specifically with current and forthcoming clinical protocols for gene transfer into hemopoietic progenitor cells, because a major goal of gene therapy for malignant and nonmalignant disease is to transfer and express genes on a long-term basis in these cells or their progeny.