U.S. patent number 6,984,379 [Application Number 08/225,478] was granted by the patent office on 2006-01-10 for gene therapy by administration of genetically engineered cd34.sup.+ cells obtained from cord blood.
This patent grant is currently assigned to Children's Hospital of LosAngeles, N/A, The United States of America as represented by the Department of Health and Human Services, The United States of America as represented by the Department of Health and Human Services. Invention is credited to R. Michael Blaese, Donald B. Kohn, Robert C. Moen, Craig A. Mullen.
United States Patent |
6,984,379 |
Kohn , et al. |
January 10, 2006 |
Gene therapy by administration of genetically engineered CD34.sup.+
cells obtained from cord blood
Abstract
A method of providing a therapeutic effect in a human patient
which comprises administering to the patient CD34+ cells obtained
from cord blood. The CD34+ cells have been engineered with at least
one nucleic acid sequence encoding a therapeutic agent. Such CD34+
cells may be engineered by transducing the cells with a retroviral
vector including the nucleic acid sequence encoding the therapeutic
agent. This method has been applied in treating newborn infants
suffering from ADA deficiency.
Inventors: |
Kohn; Donald B. (Tarzana,
CA), Blaese; R. Michael (Rockville, MD), Mullen; Craig
A. (Sugar Land, TX), Moen; Robert C. (Mountain View,
CA) |
Assignee: |
Children's Hospital of
LosAngeles (LosAngeles, CA)
The United States of America as represented by the Department of
Health and Human Services (Washington, DC)
N/A (N/A)
|
Family
ID: |
35517771 |
Appl.
No.: |
08/225,478 |
Filed: |
April 8, 1994 |
Current U.S.
Class: |
424/93.21;
424/93.2; 435/320.1; 435/325; 514/44R; 530/350; 536/22.1; 536/23.1;
536/24.1 |
Current CPC
Class: |
A61K
38/50 (20130101); A61K 48/0008 (20130101); C12N
9/78 (20130101); C12N 2799/027 (20130101) |
Current International
Class: |
A61K
48/00 (20060101); C12N 5/00 (20060101); C12N
15/00 (20060101); C12N 15/63 (20060101); C12N
15/74 (20060101) |
Field of
Search: |
;424/93.21,93.2 ;514/44
;435/320.1,172.3,240.1,240.2,91.1,71.31 ;530/350
;536/22.1,23.1,24.1 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Mitani et al, Philos Trans R Soc Lond B. Biol Sci, Feb. 1993,
339(1288), pp. 217-224. cited by examiner .
Culver et al, (Immunology section) Pediatr. Res. 31 : 149 A 1992.
cited by examiner .
Anderson, W. F. Human Gene Therapy, Science, 256, May 8, 1992
808-813. cited by examiner .
Moritz et al, Human Cord Blood Cells as Targets for Gene Transfer,
J. Exp. Med., vol. 178, Aug., 1993, 529-536. cited by examiner
.
Kohn et al, Retroviral Vector Mediated Gene Transfer into Primitive
Human Hemetopoietic Progenitor Cells, Exp Hematol. 20 : 1065-71
(1992). cited by examiner .
Marshall, Science, 269, 1995, 1050-1055. cited by examiner .
Uhlmann et al., Chem. Rev. 90(4): 544-588, 1990. cited by examiner
.
Milligan et al., J. Med. Chem. 36(14): 1924-1937, 1992. cited by
examiner .
Oakin et al., "NIH Report and Recommendations", Dec. 7, 1995 1-40.
cited by examiner .
Kohn et al. Nat. Med. 1(10): 1017-1023, 1995. cited by examiner
.
Culver, "Gene Therapy--A Handbook for Physicians" 1994, pp. 1-117.
cited by examiner .
Orkin and Motulsky, 1995, "Report and Recommendationof the panel to
assess the NIH investment in research on Gene therapy", NIH, Dec.
7, 1995. cited by examiner .
Moore, 1993, Journal of Hematotherapy, 2(2):221-224, Aug. 1993.
cited by examiner .
Miller, et al., Biotechniques, vol. 7, No. 9, pp. 980-990 (1989).
cited by other .
Hock, et al., Blood, vol. 74, No. 2, pp. 876-881 (Aug. 1, 1989).
cited by other .
Moritz, et al., J. Exp. Med., vol. 178, pp. 529-536 (Aug., 1993).
cited by other.
|
Primary Examiner: Wehbe; Anne M.
Attorney, Agent or Firm: Olstein; Elliot M. Lillie; Raymond
J.
Claims
What is claimed is:
1. A method of expressing a therapeutic agent in a human,
comprising: administering autologous CD34+ cells obtained from cord
blood to said human, said autologous CD34+ cells having been
genetically engineered to include at least one nucleic acid
sequence encoding adenosine deaminase.
2. The method of claim 1 wherein said at least one nucleic acid
sequence is contained in a viral vector.
3. The method of claim 2 wherein said viral vector is a retroviral
vector.
4. The method of claim 1 wherein said CD34+ cells are administered
in an amount of from about 5.times.10.sup.5/kg to about
10.times.10.sup.7/kg.
5. A method of treating a human patient suffering from severe
combined immune deficiency resulting from adenosine deaminase
deficiency, comprising: administering autologous CD34+ cells
obtained from cord blood to said patient, said autologous CD34+
cells having been genetically engineered to include a nucleic acid
sequence encoding adenosine deaminase, said autologous CD34+ cells
being administered to said patient in an amount effective to treat
said severe combined immune deficiency resulting from adenosine
deaminase deficiency in said patient by providing said patient with
an effective amount of said adenosine deaminase by expression of
said nucleic acid sequence encoding adenosine deaminase in said
patient.
6. The method of claim 5 wherein said nucleic acid sequence
encoding adenosine deaminase is contained in a viral vector.
7. The method of claim 6 wherein said viral vector is a retroviral
vector.
8. The method of claim 5 wherein said CD34+ cells are administered
in an amount of from about 5.times.10.sup.5/kg to about
10.times.10.sup.7/kg.
9. The method of claim 5 wherein said patient is a newborn infant
and said CD34+ cells are obtained from the cord blood of said
newborn infant.
10. A method of treating an infant suffering from severe combined
immune deficiency resulting from adenosine deaminase deficiency,
comprising: obtaining cord blood from said infant; separating CD34+
cells from said cord blood; cultivating said CD34+ cells obtained
from said cord blood in the presence of (i) Interleukin-3; (ii)
Interleukin-6; and (iii) a c-kit ligand; transfecting said CD34+
cells with a nucleic acid sequence encoding adenosine deaminase;
and administering to said infant said transfected CD34+ cells, said
CD34+ cells being administered to said infant in an amount
effective to treat severe combined immune deficiency resulting from
adenosine deaminase deficiency in said infant by providing said
infant with an effective amount of said adenosine deaminase by
expression of said nucleic acid sequence encoding adenosine
deaminase in said infant.
11. The method of claim 10 wherein said nucleic acid sequence
encoding adenosine deaminase is contained in a viral vector.
12. The method of claim 11 wherein said viral vector is a
retroviral vector.
13. The method of claim 10 wherein said CD34+ cells are
administered in an amount of from about 5.times.10.sup.5/kg to
about 10.times.10.sup.7/kg.
14. The method of claim 10 wherein said patient is a newborn infant
and said CD34+ cells are obtained from the cord blood of said
newborn infant.
15. The method of claim 4 wherein said CD34+ cells are administered
in an amount of from about 5.times.10.sup.5/kg to about
1.times.10.sup.7/kg.
16. The method of claim 15 wherein said CD34+ cells are
administered in an amount of from about 5.times.10.sup.5/kg to
about 5.times.10.sup.6/kg.
Description
This invention relates to gene therapy. More particularly, this
invention relates to gene therapy in a human patient by
administering to the patient CD34.sup.+ cells genetically
engineered with at least one DNA sequence encoding a therapeutic
agent.
BACKGROUND OF THE INVENTION
Human umbilical cord blood (UCB) can be a source of hematopoietic
stem cells for gene therapy, as an alternative to allogenic
bone-marrow transplantation, for the treatment of a number of
genetic diseases.
Previous work has examined conditions for optimal retroviral
mediated gene transduction of human bone marrow progenitor cells.
It has been found that pre-stimulation of marrow (either the total
mononuclear cell fraction or isolated CD34+ cells) with
combinations of hematopoietic growth factors increases the extent
of gene transfer. For example, IL-3 and IL-6 increased gene
transfer from 10% to 50%. (Nolta, et al., Human Gene Therapy, Vol.
1, pgs. 257 268 (1990)). Addition of c-kit ligand provided a
further increase in gene transfer efficiency. (Nolta, et al., Exp.
Hematol., Vol. 20, pgs. 1065 1071 (1992)). The cytokines may act,
at least in part, by inducing cell cycling which is required for
retroviral integration. (Nolta, et al., 1990.)
The above studies were performed using the method of
co-cultivation, in which the bone marrow cells are grown upon a
monolayer of vector-producing fibroblasts. Initial attempts to
obtain efficient gene transfer into human marrow progenitor cells
using cell-free retroviral supernatants consistently yielded lower
levels of gene transfer than can be achieved by using
co-cultivation. Moore, et al., Blood, Vol. 79, pgs. 1393 1399
(1992) reported that the presence of an underlayer of marrow
stromal cells facilitates efficient cell-free retroviral
transduction of human marrow progenitor cells, which eliminated the
need for co-culture on the murine vector packaging cells.
Umbilical cord and placental blood represent a uniquely rich source
of hematopoietic stem cells. (Broxmeyer, et al., Proc. Nat. Acad.
Sci., Vol. 86, pg. 3828 (1989)). Large numbers of stem cells can be
collected from normal cord and placental blood without cytokine
mobilization and without performing invasive procedures on the
patient. Based on quantitative progenitor assays it has been
estimated that there are a sufficient number of progenitors in a
single cord/placental blood collection to reconstitute an adult
after marrow ablation. (Broxmeyer, et al., Proc. Nat. Acad. Sci.,
Vol. 89, pg. 4109 (1992)). Within two days of birth, the number of
circulating hematopoietic progenitor cells drops dramatically to
the level seen in older children and adults; thus, collection of
stem cells at birth from the cord or placenta represents a unique
opportunity to obtain cells needed for gene therapy (such as, for
example, gene therapy for ADA deficiency) easily and safely.
Successful reconstitution of more than 50 children with
hemoglobinopathies and with malignancies by allogenic cord blood
has been performed. (Broxmeyer, et al., Blood Cells, Vol. 17, pg.
313 (1991); McGlave, Blood Cells, Vol. 17, pg. 330 (1991);
Gluckman, et al., N. Engl. J. Med., Vol. 321, pg. 1174 (1989);
Flomenberg, et al., Bone Marrow Transplant, Vol. 10, Suppl. 1, pg.
115 (1992)).
Some conditions which permit in vitro gene transfer into umbilical
cord blood cells recently have been described. Moritz, et al., J.
Exp. Med., Vol. 178, pgs. 529 536 (August 1993) found that
co-cultivation of the cells was most efficient, viral supernatant
transduction on a marrow stromal layer was almost as effective, and
transduction with viral supernatant alone was less effective. These
experiments also involved the use of c-kit ligand and Interleukin-6
in the culture medium.
DETAILED DESCRIPTION OF THE INVENTION
It is an object of the present invention to provide a method of
providing for optimal transduction of CD34+ cells obtained from
cord blood, and to administer such cells in a gene therapy
treatment.
In accordance with an aspect of the present invention, there is
provided a method of providing a therapeutic effect in a human
patient. The method comprises administering to the patient CD34+
cells obtained from cord blood. The CD34+ cells have been
genetically engineered to include least one nucleic acid sequence
encoding a therapeutic agent.
The term "nucleic acid sequence" as used herein, means a DNA or RNA
molecule, and includes complete and partial gene sequences, and
includes polynucleotides as well. Such term also includes a linear
series of deoxyribonucleotides or ribonucleotides connected one to
the other by phosphodiester bonds between the 3' and 5' carbons of
the adjacent pentoses.
The at least one nucleic acid sequence is contained in at least one
expression vehicle. The term "expression vehicle" as used herein
means any genetic construct including the at least one nucleic acid
sequence, and is capable of providing for expression of such
sequence.
The expression vehicle may be any expression vehicle which is
capable of transfecting cells and expressing the at least one
nucleic acid sequence in vivo. Such expression vehicles include,
but are not limited to, eukaryotic vectors, prokaryotic vectors
(such as, for example, bacterial plasmids), and viral vectors. The
expression vehicle also may be contained within a liposome.
In one embodiment, the expression vehicle is a viral vector. Viral
vectors which may be employed include, but are not limited to,
retroviral vectors, adenovirus vectors, adeno-associated virus
vectors, and Herpes Virus vectors. Preferably, the viral vector is
a retroviral vector.
In a preferred embodiment, a packaging cell line is transduced with
the viral vector, which includes the at least one nucleic acid
sequence which encodes a therapeutic agent, to form a producer cell
line including the viral vector. The producer cell line generates
viral particles capable of transducing the CD34+ cells obtained
from cord blood.
In a preferred embodiment, the viral vector is a retroviral vector.
Examples of retroviral vectors which may be employed include, but
are not limited to, Moloney Murine Leukemia Virus, spleen necrosis
virus, and vectors derived from retroviruses such as Rous Sarcoma
Virus, Harvey Sarcoma Virus, avian leukosis virus, gibbon ape
leukemia virus, human immunodeficiency virus, myeloproliferative
sarcoma virus, and mammary tumor virus. Preferably, the retroviral
vector is an infectious but non-replication competent retrovirus;
however, replication competent retroviruses may also be used.
Retroviral vectors are useful as agents to mediate
retroviral-mediated gene transfer into eukaryotic cells. Retroviral
vectors generally are constructed such that the majority of
sequences coding for the structural genes of the virus are deleted
and replaced by the gene(s) of interest. Most often, the structural
genes (i.e., gag, pol, and env), are removed from the retroviral
backbone using genetic engineering techniques known in the art.
This may include digestion with the appropriate restriction
endonuclease or, in some instances, with Bal 31 exonuclease to
generate fragments containing appropriate portions of the packaging
signal.
These new genes have been incorporated into the proviral backbone
in several general ways. The most straightforward constructions are
ones in which the structural genes of the retrovirus are replaced
by a single gene which then is transcribed under the control of the
viral regulatory sequences within the long terminal repeat (LTR).
Retroviral vectors have also been constructed which can introduce
more than one gene into target cells. Usually, in such vectors one
gene is under the regulatory control of the viral LTR, while the
second gene is expressed either off a spliced message or is under
the regulation of its own, internal promoter.
Efforts have been directed at minimizing the viral component of the
viral backbone, largely in an effort to reduce the chance for
recombination between the vector and the packaging-defective helper
virus within packaging cells. A packaging-defective helper virus is
necessary to provide the structural genes of a retrovirus, which
have been deleted from the vector itself.
In one embodiment, the retroviral vector may be one of a series of
vectors described in Bender, et al., J. Virol. 61:1639 1649 (1987),
based on the N2 vector (Armentano, et al., J. Virol., 61:1647 1650)
containing a series of deletions and substitutions to reduce to an
absolute minimum the homology between the vector and packaging
systems. These changes have also reduced the likelihood that viral
proteins would be expressed. In the first of these vectors,
LNL-XHC, there was altered, by site-directed mutagenesis, the
natural ATG start codon of gag to TAG, thereby eliminating
unintended protein synthesis from that point. In Moloney murine
leukemia virus (MoMuLV), 5' to the authentic gag start, an open
reading frame exists which permits expression of another
glycosylated protein (pPr80.sup.gag). Moloney murine sarcoma virus
(MoMuSV) has alterations in this 5' region, including a frameshift
and loss of glycosylation sites, which obviate potential expression
of the amino terminus of pPr80.sup.gag. Therefore, the vector LNL6
was made, which incorporated both the altered ATG of LNL-XHC and
the 5' portion of MoMuSV. The 5' structure of the LN vector series
thus eliminates the possibility of expression of retroviral reading
frames, with the subsequent production of viral antigens in
genetically transduced target cells. In a final alteration to
reduce overlap with packaging-defective helper virus, Miller has
eliminated extra env sequences immediately preceding the 3' LTR in
the LN vector (Miller, et al., Biotechniques, 7:980 990, 1989).
The paramount need that must be satisfied by any gene transfer
system for its application to gene therapy is safety. Safety is
derived from the combination of vector genome structure together
with the packaging system that is utilized for production of the
infectious vector. Miller, et al. have developed the combination of
the pPAM3 plasmid (the packaging-defective helper genome) for
expression of retroviral structural proteins together with the LN
vector series to make a vector packaging system where the
generation of recombinant wild-type retrovirus is reduced to a
minimum through the elimination of nearly all sites of
recombination between the vector genome and the packaging-defective
helper genome (i.e. LN with pPAM3).
In one embodiment, the retroviral vector may be a Moloney Murine
Leukemia Virus of the LN series of vectors, such as those
hereinabove mentioned, and described further in Bender, et al.
(1987) and Miller, et al. (1989). Such vectors have a portion of
the packaging signal derived from a mouse sarcoma virus, and a
mutated gag initiation codon. The term "mutated" as used herein
means that the gag initiation codon has been deleted or altered
such that the gag protein or fragments or truncations thereof, are
not expressed.
In another embodiment, the retroviral vector may include at least
four cloning, or restriction enzyme recognition sites, wherein at
least two of the sites have an average frequency of appearance in
eukaryotic genes of less than once in 10,000 base pairs; i.e., the
restriction product has an average DNA size of at least 10,000 base
pairs. Preferred cloning sites are selected from the group
consisting of NotI, SnaBI, Sa1I, and XhoI. In a preferred
embodiment, the retroviral vector includes each of these cloning
sites. Such vectors are further described in U.S. patent
application Ser. No. 919,062, filed Jul. 23, 1992, and incorporated
herein by reference in its entirety.
When a retroviral vector including such cloning sites is employed,
there may also be provided a shuttle cloning vector which includes
at least two cloning sites which are compatible with at least two
cloning sites selected from the group consisting of NotI, SnaBI,
Sa1I, and XhoI located on the retroviral vector. The shuttle
cloning vector also includes at least one desired gene which is
capable of being transferred from the shuttle cloning vector to the
retroviral vector.
The shuttle cloning vector may be constructed from a basic
"backbone" vector or fragment to which are ligated one or more
linkers which include cloning or restriction enzyme recognition
sites. Included in the cloning sites are the compatible, or
complementary cloning sites hereinabove described. Genes and/or
promoters having ends corresponding to the restriction sites of the
shuttle vector may be ligated into the shuttle vector through
techniques known in the art.
The shuttle cloning vector can be employed to amplify DNA sequences
in prokaryotic systems. The shuttle cloning vector may be prepared
from plasmids generally used in prokaryotic systems and in
particular in bacteria. Thus, for example, the shuttle cloning
vector may be derived from plasmids such as pBR322; pUC 18;
etc.
The vector includes one or more promoters. Suitable promoters which
may be employed include, but are not limited to, the retroviral
LTR; the SV40 promoter; and the human cytomegalovirus (CMV)
promoter described in Miller, et al., Biotechniques, Vol. 7, No. 9,
980 990 (1989), or any other promoter (e.g., cellular promoters
such as eukaryotic cellular promoters including, but not limited
to, the histone, pol III, and .beta.-actin promoters). Other viral
promoters which may be employed include, but are not limited to,
adenovirus promoters, TK promoters, and B19 parvovirus promoters.
The selection of a suitable promoter will be apparent to those
skilled in the art from the teachings contained herein.
The vector then is employed to transduce packaging cell lines to
form producer cell lines. Examples of packaging cells which may be
transfected include, but are not limited to, the PE501, PA317,
.psi.-2, .psi.-AM, PA12, T19-14X, VT-19-17-H2, .psi.CRE, .psi.CRIP,
GP+E-86, GP+envAm12, and DAN cell lines as described in Miller,
Human Gene Therapy, Vol. 1, pgs. 5 14 (1990), which is incorporated
herein by reference in its entirety. The vector may transduce the
packaging cells through any means known in the art. Such means
include, but are not limited to, electroporation, the use of
liposomes, and CaPO.sub.4 precipitation.
The producer cell line generates infectious but non-replicating
viral vector particles which-include the at least one therapeutic
agent. Such vector particles then may be employed to transduce
CD34.sup.+ cells, which will express the nucleic acid sequence
encoding the therapeutic agent. The vector particles may transduce
the CD34.sup.+ cells at a multiplicity of infection of from 1 to 20
vectors per cell, preferably from 2 to 10 vectors per cell, and
more preferably at about 6 vectors per cell.
The CD34.sup.+ cells are obtained from cord blood by any of a
variety of accepted means known to those skilled in the art. For
example, umbilical cord blood may be obtained from a normal term
delivery by gravity drainage from the umbilical cord stump into an
anticoagulant. The mononuclear cells, in one embodiment, may be
isolated by centrifugation on a two-step Ficoll/Hypaque 72% Percoll
gradient, and by collecting and pooling the cells at both the
plasma/Ficoll and Ficoll/Percoll interfaces.
Various techniques for isolating and storing cord blood and
obtaining stem and progenitor cells from such blood are disclosed
in U.S. Pat. No. 5,192,533, issued Mar. 9, 1993, to Boyse, et
al.
In one embodiment, CD34.sup.+ cells are isolated using the Cell Pro
CEPRATE system. (Berenson, et al., Blood, Vol. 77, pg. 1717 (1991);
Berenson, et al., J. Clin. Invest., Vol. 81, pg. 951 (1988)). In
such embodiment, CD34.sup.+ cells may be isolated from cord blood
by an immunoabsorption technique that utilizes anti-CD34 antibody
12.8 and a solid phase avidin-biotin column. (Berenson, et al.,
Blood, Vol. 77, pg. 1717 (1991); Berenson, et al., J. Clin.
Invest., Vol. 81, pg. 951 (1988)). Final purities, as assessed by
FACS, may be from 50% to 90%, and 50- to 150-fold enrichment of
CD34.sup.+ cells may be obtained. (Heimfeld, et al., Blood, Vol.
78, Suppl. 1, pg. 16a (1991); Berenson, 1991; Bensinger, et al.,
Prog. Clin. Biol. Res., Vol. 337, pg. 93 (1990)).
The CD34.sup.+ cells in one embodiment may be co-cultured with the
producer cells. In another embodiment, the CD34.sup.+ cells are
cultured during transduction on a layer of bone marrow stromal
cells. In yet another embodiment, the CD34.sup.+ cells, during
transduction, are cultured in the presence of at least one
cytokine. Cytokines which may be added to the culture of CD34.sup.+
cells during the transduction of such cells include, but are not
limited to, Interleukin-1.alpha., Interleukin-3, Interleukin-6,
Interleukin-11, Interleukin-12, Flt-3 ligand, leukemia inhibitory
factor (LIF), and c-kit ligand, also known as mast cell growth
factor, or MGF, or stem cell factor. In a preferred embodiment, the
CD34.sup.+ cells are cultured in the presence of Interleukin-3,
Interleukin-6, and MGF or stem cell factor. Applicants have found
that, by culturing the CD34.sup.+ cells in the presence of
Interleukin-3, Interleukin-6, and c-kit ligand, one achieves
improved transduction of the CD34.sup.+ cells with the infectious
retroviral vector particles.
The transduced CD34.sup.+ cells then may be administered to a human
patient in an amount effective to produce a therapeutic effect in
the patient. In general, such cells are administered in an amount
of from about 5.times.10.sup.5/kg to about 10.times.10.sup.7/kg,
preferably from about 5.times.10.sup.5/kg to about
1.times.10.sup.7/kg, and more preferably from about
5.times.10.sup.5/kg. to about 5.times.10.sup.6/kg. The number of
cells administered is dependent upon a variety of factors,
including, but not limited to, the age, sex, and weight of the
patient, the disease to be treated, and the severity thereof.
The term "therapeutic" is used in a generic sense and includes
treating agents, prophylactic agents, and replacement agents.
Nucleic acid sequences encoding therapeutic agents which may be
placed into the vector include, but are not limited to, nucleic
acid sequences encoding cytokines, tumor necrosis factor (TNF)
genes, such as TNF-.alpha.; genes encoding interferons such as
Interferon-.alpha., Interferon-.beta., and Interferon-.gamma.;
genes encoding interleukins such as Il-1, IL-1.beta., and
Interleukins 2 through 14; the gamma chain of the IL-2 receptor;
genes encoding GM-CSF; genes encoding adenosine deaminase, or ADA;
genes which encode cellular growth factors, such as lymphokines,
which are growth factors for lymphocytes; genes encoding soluble
CD4; Factor VIII; Factor IX; T-cell receptors; the LDL receptor,
ApoE, ApoC, ApoAI and other genes involved in cholesterol transport
and metabolism; the alpha-1 antitrypsin (.alpha.1AT) gene, the
ornithine transcarbamylase (OTC) gene, the CFTR gene, the insulin
gene, viral thymidine kinase genes, such as the Herpes Simplex
Virus thymidine kinase gene, the cytomegalovirus virus thymidine
kinase gene, and the varicella-zoster virus thymidine kinase gene;
ZAP70 transcription factor; Fc receptors for antigen-binding
domains of antibodies, the RAG1 and RAG2 genes, which encode
enzymes that are essential for assembly of T-cell and B-cell
receptors, and antisense sequences such as those that inhibit viral
replication, such as antisense sequences which inhibit replication
of hepatitis B or hepatitis non-A non-B virus.
The promoters which control such genes may be those as hereinabove
described, or such genes may be controlled by their own native
promoters.
It is to be understood, however, that the scope of the present
invention is not to be limited to specific foreign genes or
promoters.
The method of the present invention is particularly applicable to
the treatment of newborn infants who have been determined to have
severe combined immune deficiency (SCID) caused by, for example,
adenosine deaminase (ADA) deficiency. Thus, in one embodiment,
umbilical cord blood is obtained from the umbilical cord stump of a
newborn infant determined to have severe combined immune
deficiency. The CD34.sup.+ cells then are separated from the cord
blood by methods such as those hereinabove described. The
CD34.sup.+ cells then are cultured in a medium which also includes
Interleukin-3, Interleukin-6, and stem cell factor. The cells then
are transduced with retroviral vector particles which include a
nucleic acid sequence encoding the adenosine deaminase (ADA) gene.
After the transduced cells are cultured, they are administered to
the infant intravenously in an effective therapeutic amount.
BRIEF DESCRIPTION OF THE DRAWINGS
The invention will now be described with respect to the drawings,
wherein:
FIG. 1 is a schematic of the construction of plasmid pG1;
FIG. 2 is the sequence of the multiple cloning site in plasmid pG1
(SEQ ID NO:1);
FIG. 3 is a map of plasmid pG1;
FIG. 4 is a map of plasmid pN2;
FIG. 5 is a map of plasmid pG1Na;
FIG. 6 is a map of plasmid pG1NaSvADA;
FIG. 7 is a map of the LN vector;
FIG. 8 is a map of the LXSN vector; and
FIG. 9 is a map of the LASN vector.
EXAMPLES
The invention will now be described with respect to the following
examples; however, the scope of the present invention is not
intended to be limited thereby.
Example 1
A. Construction of pG1NaSvAd
Plasmid pG1NaSvAd was constructed from the backbone of plasmid pG1.
Plasmid pG1 was constructed from PLNSX (Palmer et al., Blood,
73:438 445; 1989). The construction strategy for plasmid pG1 is
shown in FIG. 1. The 1.6 kb EcoRI fragment, containing the 5'
Moloney Sarcoma Virus (MoMuSV) LTR, and the 3.0 kb EcoRI/ClaI
fragment, containing the 3' LTR, the bacterial origin of
replication and the ampicillin resistance gene, were isolated
separately. A linker containing seven unique cloning sites was then
used to close the EcoRI/ClaI fragment on itself, thus generating
the plasmid pGO. The plasmid pGO was used to generate the vector
plasmid pG1 by the insertion of the 1.6 kb EcoRI fragment
containing the 5' LTR into the unique EcoRI site of pGO. Thus,
pG1(FIG. 3) consists of a retroviral vector backbone composed of a
5' portion derived from MoMuSV, a short portion of gag in which the
authentic ATG start codon has been mutated to TAG (Bender et al.
1987), a 54 base pair multiple cloning site (MCS) containing from
5' to 3' the sites EcoRI, NotI, SnaBI, Sa1I, BamHI, XhoI, HindIII,
ApaI, and ClaI, and a 3' portion of MoMuLV from base pairs 7764 to
7813 numbered as described in (Van Beveren et al., Cold Spring
Harbor, Vol. 2, pg. 567, 1985). (FIG. 2). The MCS was designed to
generate a maximum number of unique insertion sites, based on a
screen of non-cutting restriction enzymes of the pG1 plasmid, the
neo.sup.R gene, the .beta.-galactosidase gene, the hygromycin.sup.R
gene, and the SV40 promoter.
The "backbone" vector pG1Na was constructed from pG1 and pN2
(Armentano, et-al., J. Virology, Vol. 61, pgs. 1647 1650 (1987)).
pG1Na was constructed by cutting pN2 (FIG. 4) with EcoRI and AsuII,
filling in the ends of the EcoRI/AsuII fragment containing the
neo.sup.R gene, and ligating the fragment into SnaBI digested pG1
to form pG1Na (FIG. 5).
pG1Na was cut with Hind III and Sa1I, and the ends were filled in
with Klenow. A fragment containing human ADA cDNA (ATCC Accession
Nos. 57226, 77670 and 78563) under the control of an SV40 promoter
is ligated to the end-filled HindIII/Sa1I digested pG1Na to form
pG1NaSvAd. (FIG. 6).
B. Generation of Producer Cell Line
A producer cell line was made from vector plasmid and packaging
cells. The PA317/G1NaSvAd producer cell was made by the same
general techniques used to make previous clinically relevant
retroviral vector producer cell lines. The vector plasmid pG1NaSvAd
DNA was transfected into a ecotropic packaging cell line, PE501.
Supernatant from the PE501 transfected cells was then used to
transinfect the amphotropic, hTK containing, packaging cell line
(PA317). Clones of transinfected producer cells were then grown in
G418 containing medium to select clones that contain the Neo.sup.R
gene. The clones were then titered for retroviral vector
production. Several clones were then selected for further testing
and finally a clone was selected for clinical use.
5.times.10.sup.5 PE501 cells (Miller, et al., Biotechniques, Vol.
7, pgs. 980 990 (1989), incorporated herein by reference) were
plated in 100 mm dishes with 10 ml high glucose Dulbecco's Modified
Essential Medium (DMEM) growth medium supplemented with 10% fetal
bovine serum (HGD10) per dish (3 100 mm dishes are required per
transfection). The cells were incubated at 37.degree. C., in a 5%
CO.sub.2 atmosphere overnight.
The plasmid pG1NaSvAd then was transfected into PE501 cells by
CaPO.sub.4 precipitation using 50 .mu.g of DNA by the following
procedure.
50 .mu.g of DNA, 50 .mu.l 10.times.CaCl.sub.2, and 450 .mu.l of
sterile H.sub.2O was mixed in a 15 ml polypropylene tube to yield a
0.25M CaCl.sub.2 solution containing 50 .mu.g DNA, 0.5 ml 2.times.
BBS (containing 50 mM
N-N-bis-(2-hydroxyethyl)-2-aminoethane-sulfonic acid, 280 mM Na Cl,
1.5 mMNa.sub.2 HPO.sub.4, and 50 mM Hepes, pH6.95), then was added
to the tube and the contents of the tube were mixed by pipetting.
The DNA solution then was left at room temperature for about 20
minutes to 1 hour. 1 ml of DNA solution then was added to each
culture dish, and each dish was swirled to ensure even distribution
of the DNA. The dishes then were incubated at 35.degree. C. in a 3%
CO.sub.2 atmosphere overnight.
A culture dish(es) with optimum precipitate following the overnight
incubation then was selected. The medium/DNA precipitate was
aspirated from the dish(es), and 5 mL PBS was added to each dish.
The dish(es) was allowed to sit for 2 to 3 minutes to allow salts
to dissolve.
The dish(es) then was washed again with PBS to remove the salt and
the salt solution. 10 ml of HGD10 medium then was added to the
dish(es), and the dish(es) incubated at 37.degree. C. in a 5%
CO.sub.2 atmosphere for about 48 hrs.
A 48 hour transient supernatant then was collected from the
transfected cells by removing the supernatant from the cells and
placing it in a 15 ml polypropylene tube. The dish(es) then was
rinsed with 5 ml PBS. The PBS then was removed, and 1 ml
trypsin-EDTA was added to each dish. Three 15 ml polypropylene
tubes then were labeled undiluted, 1:10, and 1:100, respectively. 9
ml of HGD10 plus 0.8 mg/ml of G418 were added to the 1:10 and the
1:100 tubes.
When the cells were no longer adherent to the dish, 9 ml of HGD10
and 0.8 mg/ml of G418 were added to the undiluted tube, and the
cells transferred to the undiluted tube.
Serial dilutions of the cells then were made by adding 1 ml of
undiluted cells to the 1:10 tube, and then by adding 1 ml of the
1:10 cells to the 1:100 tube. The cells then were mixed.
10 ml of HGD10 and 0.8 mg/ml G418 were added to each of six 100 mm
dishes. To one dish was added 0.5 ml of undiluted cells to make a
1:20 dilution of cells; to one dish was added 0.25 ml of undiluted
cells to make a 1:40 dilution of cells; to one dish was added 1.0
ml of the 1:10 dilution to make a 1:100 dilution of cells; to one
dish was added 0.2 ml of the 1:10 dilution to make a 1:500 dilution
of cells; to one dish was added 1.0 ml of the 1:100 dilution to
make a 1:1,000 dilution of cells; and to another dish was added 0.5
ml of the 1:100 dilution to make a 1:2,000 dilution of cells.
The six plates of cells were examined daily. The medium was changed
if there was a great amount of cell death. Such medium changes were
repeated until few dead cells were observed. At this point, live
cells or colonies were allowed to grow to a size such that the
colonies are large enough to clone out (i.e., the colonies are
visible to the naked eye when looking up through the bottom of the
plate). Viral supernatants from such colonies of PE501 cells were
collected in amounts of from about 5 ml to about 10 ml, placed in
cryotubes, and frozen in liquid nitrogen at about -70.degree.
C.
PA317 cells (Miller et al., Mol. Cell. Biol., 6:2895 2902 (1986)
and incorporated herein by reference) then were plated at a density
of 5.times.10.sup.4 cells per 100 mm plate on Dulbecco's Modified
Essential Medium (DMEM) including 4.5 g/l glucose, glutamine
supplement, and 10% fetal bovine serum (FBS).
The viral supernatant then was thawed, and 8 .mu.g/ml of polybrene
was added to viral supernatant from PE 501 cells, and the
supernatant and polybrene were mixed and loaded into a syringe with
a 0.22 .mu.m filter unit. The DMEM was suctioned off the plate of
cells, and 7 to 8 ml of viral supernatant was added for overnight
infection.
The viral supernatant then was removed and replaced with fresh 10%
FBS. One day later, the medium was changed to 10% FBS and G418 (800
.mu.g/ml). The plate then was monitored, and the medium was changed
to fresh 10% FBS and G418 to eliminate dying or dead cells whenever
necessary. The plate also was monitored for at least 10 to 14 days
for the appearance of G418 resistant colonies by scanning the
bottom of the dish without a microscope. When colonies are large
enough to see, they then were selected as clones.
The medium then was aspirated from the dish and replaced with 5 ml
PBS. The cells then were rinsed and most of the PBS was aspirated.
About 0.5 to 1.0 ml of the PBS was left on the plate to keep it
moist. Cloning rings then are placed on all selected colonies. Two
drops of trypsin-EDTA then were placed on each cloning ring. The
dish then was placed in an incubator, and tapped periodically until
the cells are released from the dish. 5 ml of HGD10 plus 1.times.
hypoxanthine aminopterin thymidine (HAT) was added to as many wells
as needed in six well dishes.
When the cells from each colony were released from the dish, 2
drops of HGD10 are added to each cloning ring. A pipette then was
set to 200 .mu.l, and inserted into a cloning ring in order to
remove all the cells. The cells then were transferred to one of the
wells in the 6-well dishes. Such procedure was repeated until all
desired clones were picked. The 6-well dishes were incubated at
37.degree. C. in a 5% CO.sub.2 atmosphere.
The clones then were observed for confluent growth. When a clone
was confluent or almost confluent, the clone was trypsinized and
expanded in a 100 ml dish.
When the expanded clone was about 90% confluent, the old medium was
removed and replaced with 10 ml of fresh HGD10 medium. The dish was
returned to the incubator for 20 to 24 hours.
After the incubation, the supernatant was removed from the dish,
and placed in a 15 ml polypropylene tube. The tube was centrifuged
at 1,200 to 1,500 rpm for 5 minutes to pellet out any cells which
may have been in the supernatant.
The supernatant then was aliquoted into six cryovials (1 ml/vial).
The aliquots were stored in liquid nitrogen. 5 ml of PBS were added
to the dish and the cells were rinsed.
When the cells were released from the dish, 9 ml of HGD10 was added
to the cells, and the cells were transferred to a 15 ml
polypropylene tube. The cells were pelleted by centrifuging at
1,200 1,500 rpm for 5 minutes.
The medium was aspirated off the cell pellet. The pellet then was
resuspended in 1 ml HGD 10 and 1 ml of 2.times.DMSO freezing
medium, and 1 ml of cells was aliquoted into each of two cryovials.
The cryovials were placed on dry ice, and, when frozen, were
transferred to liquid nitrogen.
Through the above procedures, the producer cell line
PA317/G1NaSvAd, was obtained. This cell line produces the viral
vector G1NaSvAd at a titer of 2-5.times.10.sup.5 cfu/ml.
C. Generation of Producer Cell Line From LN Vector
The LN vector (FIG. 7) (Miller, et al., Biotechniques, Vol. 7, No.
9, pgs. 980 990 (1989)), which includes a 5' LTR, a neo.sup.R gene,
and a 3' LTR including a polyadenylation signal, was transduced
into PA317 packaging cells according to the procedure of Miller, et
al., 1989. PA317 packaging cells were plated at 5.times.10.sup.5
cells per 60 mm dish on day 1. On day 2, the culture medium was
replaced with 4 ml fresh medium, and viral plasmid DNA from the LN
vector was transfected onto the cells using the calcium phosphate
precipitation procedure. (Corsaro, et al., Somat. Cell Genet., Vol.
7, pgs. 603 616 (1981); Miller, et al., Somatic Cell Mol. Genet.,
Vol. 12, pgs. 175 183 (1986)). For each plasmid sample, a
DNA-CaCl.sub.2 solution was made by mixing 25 .mu.l of 2.0
MCaCl.sub.2, 10 .mu.g plasmid DNA (in 10 mM Tris-Cl, pH 7.5), and
water to make 200 .mu.l total. Precipitation buffer was prepared by
mixing 100 .mu.l 500 mM HEPES-NaOH (pH 7.1), 125 .mu.l 2.0 M NaCl,
10 .mu.l 150 mM Na.sub.2 HPO.sub.4--NaH.sub.2PO.sub.4 (pH 7.0), and
water to make 1 ml total. DNA-CaCl.sub.2 solution (200 .mu.l) was
added dropwise with constant agitation to 200 .mu.l precipitation
buffer. After 30 minutes at room temperature, the resultant fine
precipitate was added to a dish of cells. The cells were exposed to
the DNA precipitate until day 3 when the medium was aspirated and
fresh medium was added. On day 4, the virus-containing medium was
removed, centrifuged at 3,000.times.g for 5 minutes to remove cells
and debris, and such recovered viruses may be used to infect cells.
Through the above procedure, a viral titer of LN virus vector of
0.5-5.times.10.sup.6 cfu/ml is obtained.
D. Construction of LASN and Generation of Producer Cell Line
Therefrom.
LASN may be constructed as described in Hock, et al., Blood, Vol.
74, No. 2, pgs. 876 881, (Aug. 1, 1989). Alternatively, a PvuII to
HindIII fragment from SV40 containing the SV40 early promoter
(Fiers, et al., Nature, Vol. 273, pgs. 113 120 (1978); Reddy, et
al., Science, Vol. 200, pgs. 494 502 (1978)), and a multiple
cloning site including the EcoRI, HpaI, XhoI, and BamHI sites, was
cloned into the LN vector (FIG. 7) to form the LXSN vector (FIG. 8)
(Miller, et al., 1989)). ADA cDNA then was cloned into the LXSN
vector to form the LASN vector. (FIG. 9) (Hock, et al., Blood, Vol.
74, No. 2, pgs. 876 881 (Aug. 1, 1989)). In the LASN vector, the
ADA-encoding mRNA begins in the 5' retroviral LTR, continues
through the ADA SV40, and neo.sup.R sequences, and terminates in
the 3' LTR.
The LASN vector includes 4,700 base pairs. Base pairs 1 589
comprise the Moloney Murine Sarcoma Virus 5'LTR; base pairs 590
1462 comprise the packaging signal; base pairs 1463 2681 comprise
the ADA cDNA with linkers; base pairs 1556 1558 comprise the ATG
start codon for ADA; base pairs 2645 2647 comprise the TGA stop
codon for ADA; base pairs 2682 3027 comprise the SV40 early
promoter; base pairs 3028 4051 comprise the coding region of the
neo.sup.R gene; base pairs 4052 4106 comrpise a polypurine (Poly A)
site; and base pairs 4107 4700 comprise the Moloney Murine Leukemia
Virus 3'LTR.
A producer cell line for generating LASN is generated as
hereinabove mentioned with respect to the generation of LN vector
particles. Through this procedure, a virus titer for LASN vector
particles of 2 5.times.10.sup.5/ml is obtained.
Cell-free viral supernatants of LN viral vector, LASN viral vector,
and GlNaSvAd viral vector were prepared in Dulbecco's Minimal
Essential Medium (DMEM) with 10% fetal calf serum. E. Isolation and
Culturing of Cord Blood Cells.
Umbilical cord blood samples were obtained from normal term
deliveries by gravity drainage from the umbilical cord stump into
CPD anticoagulant. Mononuclear cells were isolated by
centrifugation on a two-step Ficoll/Hypaque-72% Percoll gradient,
and by collecting and pooling the cells at both the plasma/Ficoll
and the Ficoll/Percoll interfaces. In some of the experiments which
follow, CD34+ cells were isolated using the Cell Pro CEPRATE
system.
Cells were cultured at a final density of 0.5-1.0.times.10.sup.5
cells/ml in 5% CO.sub.2 at 37.degree. C. The medium used was basal
bone marrow medium (BBMM) consisting of IMDM with 30% fetal calf
serum, 1% BSA (Sigma, St. Louis, Mo.), 10.sup.-6M hydrocortisone,
104M 2-mercaptoethanol, 2 mM L-glutamine, 50 U/ml penicillin, and
50 .mu.g/ml streptomycin. In some of the following experiments,
recombinant human growth factors were used at the following
concentrations: Interleukin-3 at 10 .mu.g/ml (Immunex Corp.,
Seattle, Wash.), Interleukin-6 at 50 U/ml (R+D Systems,
Minneapolis, Minn.), and Mast Cell Growth Factor at 50 ng/ml (MGF,
a c-kit ligand, Immunex.).
F. Transduction of Cord Blood Cells
For transductions, one volume of virus supernatant was added to one
volume of cord blood cells in BBMM containing 2.times. growth
factors, followed by addition of protamine to 5 .mu.g/ml. The cells
and virus were incubated overnight. For repeated transductions,
cells were collected and resuspended in a fresh mixture of virus
1:1 with BBM and growth factors. After gene transfer, the cells
were washed 3 times with Hank's buffered saline with FCS, counted,
and plated in quadruplicate for colony-forming progenitor assays.
G418 was added to two plates of each set at 10 mg/ml of active
compound. After 14 to 16 days, colonies were counted as described
in Nolta, et al., Human Gene Therapy, Vol. 1, pgs. 257 268
(1990).
In a first experiment, umbilical cord blood cells were exposed to
LN vector supernatant (i) once; or (ii) daily for 3 days; or (iii)
daily for three days while cultured with Interleukin-3,
Interleukin-6, and MGF. The cells were evaluated for the presence
of G418-resistant colonies. The results are shown in Table I
below.
TABLE-US-00001 TABLE I Daily vector % G418-resistant exposures
Medium colonies 1 BBMM 3.1 3 BBMM 9.8 3 IL-3, IL-6, MGF 30.4
As shown in Table I, three daily exposures to the vector
supernatant increased the gene transfer threefold, while maximal
gene transfer was obtained by using three exposures to the vector
in the presence of Interleukin-3, Interleukin-6, and MGF.
In a second experiment, umbilical cord blood cells were exposed
daily for 3 days to LN, LASN, or GlNaSvAd vector supernatant. The
cells were cultured in (i) BBMM; (ii) BBMM plus Interleukin-3;
(iii) BBMM plus Interleukin-3 and Interleukin-6; or (iv) BBMM plus
Interleukin-3, Interleukin-6, and MGF. The cells were evaluated for
G418-resistant colonies, and the results are shown in Table II
below.
TABLE-US-00002 TABLE II % G418-resistance Vector Growth Factors
LASN GlNaSvAd LN BBMM (control) 3.2 5.6 4.8 IL-3 15.2 15.7 13.6
IL-3 plus IL-6 28.5 27.9 29.8 IL-3, IL-6, and MGF 32.1 30.6
28.6
The above results indicate that Interleukin-3 alone increased gene
transfer, and the addition of Interleukin-6 to Interleukin-3
further increased gene transfer efficiency. Supplementation of
Interleukin-3 and Interleukin-6 with MGF increased the transduction
of cord blood progenitor cells slightly further.
Example 2
Umbilical cord blood, in amounts of from 60 to 200 ml, was
collected after clamping of the umbilical cords of three newborn
infants diagnosed prenatally as having ADA deficiency. 60 ml of
blood were taken from Patient 1. This sample had a total of
5.2.times.10.sup.8 cells, 0.72% of which, or 3.7.times.10.sup.6,
were CD34+ cells, as determined by FACS employing a fluorescent
labeled CD34 antibody. 200 ml of blood were taken from Patient 2.
This sample had a total of 22.times.10.sup.8 cells, 0.83% of which,
or 18.times.10.sup.6, were CD34+ cells. 70 ml of blood were taken
from Patient 3. This sample had a total of 8.6.times.10.sup.8
cells, 0.9% of which, or 7.8.times.10.sup.6, were CD34+ cells. All
three cord blood samples were profoundly lymphopenic with no
PHA-responsive T-cells, and had elevated levels of deoxyadenosine
metabolites and decreased S-adenosyl homocysteine hydrolase (SAH)
activity. Thus, there were multiple signs of ADA deficiency
manifest at birth, despite the babies' circulatory proximity to the
maternal systems which have at least heterozygote levels of ADA
activity.
Mononuclear cells from the umbilical cord blood were isolated on a
two-layer Percoll/Ficoll gradient. The cells then are incubated
with biotinylated murine anti-CD34 antibody 12.8(CellPro, Bothell,
Wash.) in PBS/1% bovine serum albumin (BSA) for 30 minutes at
4.degree. C. at a concentration of 1.times.10.sup.8 cells/ml. The
cells were washed twice and adjusted to a concentration of
1.times.10.sup.8 cells/ml in PBS/5% BSA. Antibody-treated cells
then were passed over an avidin Biogel column (CellPro). Cells
passing through the column were collected for analysis and the
column was washed with PBS. CD34+ cells adhering to the column then
were dislodged using mechanical agitation with a 10 ml pipette and
collected in PBS/BSA.
The CD34+fraction obtained from the column was washed in PBS and
counted. Aliquots were removed for FACS analysis and progenitor
assays. 2.8.times.10.sup.6 cells were obtained (post-column) from
the blood sample of Patient 1, of which 32%, or 0.9.times.10.sup.6,
were CD34+ cells. 26.0.times.10.sup.6 cells were obtained
(post-column) from the blood sample of Patient 2, of which 62%, or
16.0.times.10.sup.6, were CD34+ cells. 9.4.times.10.sup.6 cells
were obtained (post-column) from the blood sample of Patient 3, of
which 47%, or 4.4.times.10.sup.6, were CD34+ cells. The cells then
were resuspended at a concentration of approximately
1.times.10.sup.5/ml in LASN viral vector supernatant supplemented
with 4 .mu.g/ml protamine, 50 .mu.g/ml Interleukin-6 (Sandoz, East
Hanover, N.J.), 100 .mu.g/ml stem cell factor (Amgen, Thousand
Oaks, Calif.) and 20 .mu.g/ml Interleukin-3 (Sandoz). The LASN
viral supernatant was added daily for 3 days at a multiplicity of
infection of about 6 vectors per cell. The cells were cultured in
T25 tissue culture flasks (Costar) at 37.degree. C. in a humidified
incubator with 5% CO.sub.2. At 24 and 48 hours of culture, complete
media exchanges were done by collecting media and cells out of each
flask, spinning down the cells and resuspending them at the same
concentration in freshly-thawed retroviral supernatant with the
above additives before transferring them back to the flask.
After a total of 64 72 hours in culture, the transduced cells were
harvested from the flasks. Post-transduction, 3.7.times.10.sup.6
cells were obtained from the cell culture of Patient 1.
62.times.10.sup.6 cells were obtained from the cell culture of
Patient 2, of which 63%, or 39.times.10.sup.6, were CD34.sup.+
cells as determined by FACS. 17.times.10.sup.6 cells were obtained
from the cell culture of Patient 3, of which 51%, or
8.7.times.10.sup.6, were CD34.sup.+ cells.
The harvested cells were washed twice and resuspended in normal
saline. The cells then were infused into each infant intravenously
in an amount of 1-10.times.10.sup.7 cells/kg per infusion. One
infusion was given to each infant. The total volume infused each
day did not exceed 10 ml/kg body weight, and a test dose of 2 5% of
the total volume was infused via peripheral vein followed by an
observation period of 5 10 minutes. All three infants tolerated the
infusions without apparent toxicities. The infants also were given
PEG-ADA intramuscularly at a dosage of 30 units/kg twice weekly,
and maintained in protective isolation.
In order to estimate the efficiency of the transduction of the
vectors into the cells, 7.times.10.sup.3 cells were taken from each
of the cultures obtained from Patients 1, 2 and 3. The cells were
cultured for two weeks, whereby CD34.sup.+ cells differentiated
into colony-forming units of granulocyte macrophages (CFU-GM). G418
resistance for each of these cultures then was determined. For
Patient 1, 21.1% of the CFU-GM cells were G418 resistant. For
Patient 2, 12.5% of the CFU-GM cells were G418 resistant. For
Patient 3, 19.4% of the CFU-GM cells were G418 resistant.
The babies were discharged to home at approximately two months of
age and are being followed as outpatients. Peripheral blood samples
from each patient have been received on a 2 6 weekly schedule, both
to monitor the status of their immune systems as standard clinical
care, as well as to determine the efficacy of gene transfer.
Each of the babies has developed normal numbers of T lymphocytes,
normal PHA responses, normalized levels of deoxyadenosine
metabolites with normal growth and development to date. Each was
given a tetanus immunization as part of the standard evaluation of
the immune status of immune deficient infants. There are
preliminary findings suggesting that they can now each produce a T
lymphocyte blastogenic response to tetanus antigen in vitro, a sign
indicating their development of antigen-specific immune
function.
PCR analyses of peripheral blood samples shows that each child has
circulating leukocytes which contain the vector-transferred ADA
gene. Blood samples have been separated into a peripheral blood
mononuclear (PBMC) cell fraction (lymphocytes and monocytes) and
granulocyte fraction by ficoll-hypaque density centrifugation.
Multiple aliquots of each cell fraction were frozen for subsequent
DNA and RNA analyses. Initial samples obtained in the first 2 3
months did not show evidence of circulating PBMC with the gene
above the limit of sensitivity (approximately 1 cell with the new
ADA gene/100,000 cells). Granulocyte samples have been studied from
one patient and did show gene-containing cells through this early
period at about 1/10,000 cells. Subsequently, PBMC samples from all
three patients have been showing the presence of gene containing
cells, at levels ranging from 1/10,000 up to 1/1,000.
The above results indicate that there was effective gene transfer
into at least some long-lived hematopoietic progenitor cells which
are continuing to contribute to peripheral blood cell pools out to
at least eight months.
All patents, publications, and database entries referenced in this
specification are indicative of the level of skill of persons in
the art to which the invention pertains. The disclosures of all
such patents, publications (including published patent
applications), and database entries are specifically incorporated
herein by reference in their entirety to the same extent as if each
such individual patent, publication, and database entry were
specifically and individually indicated to be incorporated by
reference.
It is to be understood, however, that the scope of the present
invention is not to be limited to the specific embodiments
described above. The invention may be practiced other than as
particularly described and still be within the scope of the
accompanying claims.
SEQUENCE LISTINGS
1
151 basesnucleic aciddoublelinearplasmid DNAmultiple cloning site
1AATTCGCGGC CGCTACGTAG TCGACGGATC CCTCGAGAAG CTTGGGCCCA T 51
* * * * *