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Blood, 15 May 2001, Vol. 97, No. 10, pp. 3311-3312
BRIEF REPORT
Induction of tolerance to human factor VIII in mice
Hengjun Chao and
Christopher E. Walsh
From the University of North Carolina Gene Therapy
Center and the Department of Medicine, University of North Carolina at
Chapel Hill, Chapel Hill, NC.
This paper reports loss of human factor VIII (hFVIII) inhibitory
antibody in immunocompetent C57BL/6 mice. High-titer anti-hFVIII antibody developed in the mice within 7 to 14 days of intraportal administration of adeno-associated virus (AAV) carrying FVIII that
coincided with a reduction in plasma hFVIII antigen. Bethesda titers
(> 100 units) persisted relatively unchanged for 9 to 10 months.
Unexpectedly, at 10 months after injection of the virus, hFVIII protein
(up to 59 ng/mL) was detected in 3 mice at the same time as
disappearance of hFVIII inhibitor. The level of hFVIII was similar to
that found in immunodeficient mice receiving the same dose of
recombinant AAV carrying hFVIII without hFVIII inhibitor. These results
suggest that tolerance to hFVIII can be induced by sustained expression
of hFVIII in a mouse model. Further elucidation of this observation may
affect use of FVIII gene transfer in the treatment of
inhibitor-positive patients with hemophilia A.

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