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Prepublished online as a Blood First Edition Paper on October 3, 2002; DOI 10.1182/blood-2002-03-0779.
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Blood, 15 February 2003, Vol. 101, No. 4, pp. 1359-1366
HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY
In utero gene transfer of human factor IX to fetal mice can
induce postnatal tolerance of the exogenous clotting factor
Simon N. Waddington,
Suzanne M. K. Buckley,
Megha Nivsarkar,
Sarah Jezzard,
Holm Schneider,
Thomas Dahse,
Geoff Kemball-Cook,
Maznu Miah,
Nick Tucker,
Margaret J. Dallman,
Mike Themis, and
Charles Coutelle
From the Gene Therapy, Section of Cell and Molecular
Biology, and Department of Biological Sciences, Imperial College School
of Science, Technology and Medicine, London, United
Kingdom; Childrens Hospital, University of Erlangen-Nuernberg,
Erlangen, Germany; and MRC Clinical Sciences Centre,
Faculty of Medicine, Imperial College, London, United
Kingdom.
The fundamental hypotheses behind fetal gene therapy are that it
may be possible (1) to achieve immune tolerance of transgene product
and, perhaps, vector; (2) to target cells and tissues that are
inaccessible in adult life; (3) to transduce a high percentage of
rapidly proliferating cells, and in particular stem cells, with
relatively low absolute virus doses leading to clonal transgene amplification by integrating vectors; and (4) to prevent early disease
manifestation of genetic diseases. This study provides evidence
vindicating the first hypothesis; namely, that intravascular prenatal
administration of an adenoviral vector carrying the human factor IX
(hFIX) transgene can induce immune tolerance of the transgenic protein.
Following repeated hFIX protein injection into adult mice, after
prenatal vector injection, we found persistence of blood hFIX and
absence of hFIX antibodies in 5 of 9 mice. Furthermore, there was
substantial hFIX expression after each of 2 reinjections of vector
without detection of hFIX antibodies. In contrast, all adult mice that
had not been treated prenatally showed a rapid loss of the injected
hFIX and the development of high hFIX antibody levels, both clear
manifestations of a strong immune reaction.

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