Commercial prospects for gene therapy--a company survey

Microencapsulation--an alternative approach to gene therapy

Non-autologous somatic gene therapy' is a novel approach to gene therapy which does not depend on genetic modification of the patient's own cells. Recombinant cell lines secreting a desired therapeutic gene product can be implanted into different patients requiring the same product replacement. Graft rejection is avoided by enclosing these cells in immuno-isolation devices whose permeability excludes the host's immune mediators but permits the transit of nutrients and recombinant gene products. The feasibility of this strategy is demonstrated by expression of recombinant human enzymes, hormones and coagulation factors from fibroblasts or myoblasts enclosed within alginate-poly-L-lysine-alginate microcapsules. Its clinical efficacy is demonstrated by the correction of pathological phenotypes in murine models of human endocrine and lysosomal storage diseases. Hence, this approach may lead to a potentially cost-effective method of gene-based therapy.

Growth retardation--an unexpected outcome from growth hormone gene therapy in normal mice with microencapsulated myoblasts

Recently, we have succeeded in using nonautologous myoblasts engineered to secrete mouse growth hormone (GH) to correct partially the growth retardation of the Snell dwarf mice, which suffer from pituitary GH deficiency. The allogeneic myoblasts were protected from immune rejection by enclosure in permselective microcapsules fabricated from alginate, thus validating the clinical efficacy of using universal nonautologous cells for somatic gene therapy. Because GH therapy is considered also for treating patients with normal pituitary function, we now apply this protocol to treat normal mice to evaluate the potential consequences of using GH gene therapy in subjects with no demonstrated GH deficiency. When microencapsulated allogeneic myoblasts engineered to secrete mouse GH were implanted into normal male and female mice, contrary to expectation, the treated animals became significantly shorter and lost weight; their internal organs became smaller and their tibial growth plates were less differentiated, indicating reduced skeletal growth. Females were more severely affected than males and 2 animals died by day 13 of unknown cause. By day 70, most of the abnormalities were restored to normal except for body weights, which remained below normal. In conclusion, although somatic gene therapy for GH delivery is beneficial for pituitary dwarfism, it may have adverse metabolic consequences in those with normal hypothalamic-pituitary functions, and the female mice were more severely affected than males.

Gene therapy. Molecular medicine of the 1990s

In less than four years, the techniques of gene transfer have been taken from the laboratory and translated into numerous clinical trials. Although gene therapy was initially designed for the molecular repair of monogenic deficiency diseases, most of the current studies of gene therapy are targeting cancer.