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Prepublished online as a Blood First Edition Paper on September 22, 2003; DOI 10.1182/blood-2003-02-0660.

Submitted March 3, 2003
Accepted December 31, 1969
Protection from endotoxemia by adenoviral-mediated gene transfer of human bactericidal/permeability-increasing protein
Scott Alexander, Jonathan Bramson, Ronan Foley, and Zhou Xing*
Department of Pathology and Molecular Medicine, and Infectious Diseases Division, Centre for Gene Therapeutics, McMaster University, Hamilton, ON, Canada
* Corresponding author; email: xingz{at}mcmaster.ca.
Sepsis represents a growing concern in high-risk patients and there has been a lack of effective preventives and therapies. Bacterial/Permeability Increasing protein (BPI) is a human neutrophil granule-associated defense molecule specific for Gram negative bacteria and their products. To develop a BPI-transgene-based prophylactic or therapeutic modality, we have developed a recombinant, replication-deficient adenoviral vector expressing full-length human BPI protein (AdhBPI). The expression of BPI is under control of a murine CMV promoter. Using in vitro and in vivo systems, AdhBPI-mediated gene transfer led to extracellular secretion of BPI protein, which effectively neutralized endotoxin (LPS) and markedly reduced the production of proinflammatory cytokines TNF- and MIP-2 by freshly isolated murine alveolar macrophages. By using a mouse model of non-lethal sepsis elicited with LPS, we demonstrated that in vivo gene transfer of BPI was able to markedly inhibit the effect of a large dose of LPS on cytokine responses when injected intra-peritoneally. Furthermore, such in vivo BPI gene transfer also improved the survival of mice suffering from lethal septic shock elicited by intra-peritoneal injection of D-galactosamine and LPS. Thus, our results suggest that human BPI gene transfer vector has the potential to be used as a therapeutic agent for septic conditions.

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