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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.

© 2003 by The American Society of Hematology.
 

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