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Sci Transl Med. 2016 Jul 27;8(349):349ra99. doi: 10.1126/scitranslmed.aaf3838.

Curative ex vivo liver-directed gene therapy in a pig model of hereditary tyrosinemia type 1.

Author information

1
Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA. Department of Molecular Medicine, Mayo Clinic, Rochester, MN 55905, USA. hickey.raymond@mayo.edu.
2
Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
3
Brami Biomedical Inc., Coon Rapids, MN 55433, USA.
4
Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
5
Department of Comparative Medicine, Mayo Clinic, Scottsdale, AZ 85259, USA.
6
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
7
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA. Imanis Life Sciences, Rochester, MN 55902, USA.
8
Division of Pediatric Gastroenterology, Mayo Clinic, Rochester, MN 55905, USA.
9
Department of Molecular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
10
Department of Molecular and Medical Genetics and Department of Pediatrics, Oregon Health and Science University, Portland, OR 97239, USA.
11
Histocompatibility Laboratory, Gift of Life Michigan, Ann Arbor, MI 48108, USA.
12
Papé Family Pediatric Research Institute, Oregon Health and Science University, Portland, OR 97239, USA.
13
Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA. Midwest Fetal Care Center, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA.

Abstract

We tested the hypothesis that ex vivo hepatocyte gene therapy can correct the metabolic disorder in fumarylacetoacetate hydrolase-deficient (Fah(-/-)) pigs, a large animal model of hereditary tyrosinemia type 1 (HT1). Recipient Fah(-/-) pigs underwent partial liver resection and hepatocyte isolation by collagenase digestion. Hepatocytes were transduced with one or both of the lentiviral vectors expressing the therapeutic Fah and the reporter sodium-iodide symporter (Nis) genes under control of the thyroxine-binding globulin promoter. Pigs received autologous transplants of hepatocytes by portal vein infusion. After transplantation, the protective drug 2-(2-nitro-4-trifluoromethylbenzyol)-1,3 cyclohexanedione (NTBC) was withheld from recipient pigs to provide a selective advantage for expansion of corrected FAH(+) cells. Proliferation of transplanted cells, assessed by both immunohistochemistry and noninvasive positron emission tomography imaging of NIS-labeled cells, demonstrated near-complete liver repopulation by gene-corrected cells. Tyrosine and succinylacetone levels improved to within normal range, demonstrating complete correction of tyrosine metabolism. In addition, repopulation of the Fah(-/-) liver with transplanted cells inhibited the onset of severe fibrosis, a characteristic of nontransplanted Fah(-/-) pigs. This study demonstrates correction of disease in a pig model of metabolic liver disease by ex vivo gene therapy. To date, ex vivo gene therapy has only been successful in small animal models. We conclude that further exploration of ex vivo hepatocyte genetic correction is warranted for clinical use.

PMID:
27464750
PMCID:
PMC5477771
DOI:
10.1126/scitranslmed.aaf3838
[Indexed for MEDLINE]
Free PMC Article

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