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Correction of X-linked chronic granulomatous disease by gene therapy, augmented by insertional activation of MDS1-EVI1, PRDM16 or SETBP1
Abstract
Gene transfer into hematopoietic stem cells has been used successfully for correcting lymphoid but not myeloid immunodeficiencies. Here we report on two adults who received gene therapy after nonmyeloablative bone marrow conditioning for the treatment of X-linked chronic granulomatous disease (X-CGD), a primary immunodeficiency caused by a defect in the oxidative antimicrobial activity of phagocytes resulting from mutations in gp91(phox). We detected substantial gene transfer in both individuals' neutrophils that lead to a large number of functionally corrected phagocytes and notable clinical improvement. Large-scale retroviral integration site-distribution analysis showed activating insertions in MDS1-EVI1, PRDM16 or SETBP1 that had influenced regulation of long-term hematopoiesis by expanding gene-corrected myelopoiesis three- to four-fold in both individuals. Although insertional influences have probably reinforced the therapeutic efficacy in this trial, our results suggest that gene therapy in combination with bone marrow conditioning can be successfully used to treat inherited diseases affecting the myeloid compartment such as CGD.
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“Both PRDM16 and MECOM encode the family of PR-domain proteins and are involved in chromosomal translocation in MDS and AML; both genes have been implicated in MDS and AML related to vector insertion in human gene therapy studies.”
From Hematologic Cancer after Gene Therapy for Cerebral Adrenoleukodystrophy (2024) · cites this paper as [32]
In the citing paper
“A trial using a potent γ-retroviral vector (spleen focus forming virus) to drive the CYBB gene and busulfan pre-conditioning led to engraftment of 10%-20% gene-corrected cells in two young men with the X-linked form (XCGD), with clearance of infections that had been persistent and resistant to therapy.37”
From Ex vivo modification of hematopoietic stem and progenitor cells for gene therapy (2025) · cites this paper as [37]
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Metadata
- Authors
- Ott, M. G., Schmidt, M., Schwarzwaelder, K., Stein, S., Siler, U., Koehl, U., Glimm, H., Kühlcke, K., Schilz, A., Kunkel, H., Naundorf, S., Brinkmann, A., Deichmann, A., Fischer, M., Ball, C., Pilz, I., Dunbar, C., Du, Y., Jenkins, N. A., Copeland, N. G., Lüthi, U., Hassan, M., Thrasher, A. J., Hoelzer, D., von Kalle, C., Seger, R., & Grez, M.
- Venue
- Nature Medicine
- Published
- 2006-04
- Volume
- 12
- Issue
- 4
- Pages
- 401-409
- ISSN
- 1078-8956
- 1546-170X
- Cited by
- 1,051
- References
- 1
- Language
- en
- Licence
- www.springer.com/tdm (tdm)
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- Ott, M. G., Schmidt, M., Schwarzwaelder, K., Stein, S., Siler, U., Koehl, U., Glimm, H., Kühlcke, K., Schilz, A., Kunkel, H., Naundorf, S., Brinkmann, A., Deichmann, A., Fischer, M., Ball, C., Pilz, I., Dunbar, C., Du, Y., Jenkins, N. A., . . . Grez, M. (2006). Correction of X-linked chronic granulomatous disease by gene therapy, augmented by insertional activation of MDS1-EVI1, PRDM16 or SETBP1. Nature Medicine. https://doi.org/10.1038/nm1393