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Blood, 1 September 2004, Vol. 104, No. 5, pp. 1281-1290. Prepublished online as a Blood First Edition Paper on May 13, 2004; DOI 10.1182/blood-2003-09-3044.
Submitted September 4, 2003
Molecular Biology Institute, Howard Hughes Medical Institute, University Of California, Los Angeles, CA, USA * Corresponding author; email: drawling{at}u.washington.edu.
X-linked agammaglobulinemia (XLA) is a human immunodeficiency caused by mutations in Bruton's tyrosine kinase (Btk) and characterized by an arrest in early B-cell development, near absence of serum immunoglobulin, and recurrent bacterial infections. Using Btk and Tec doubly deficient mice (Btk-/Tec-) as a model for XLA, we determined if Btk gene therapy could be used to correct this disorder. Bone marrow (BM) from 5-fluorouracil (5FU) treated Btk-/Tec- mice was transduced with a retroviral vector expressing human Btk, MSCV-huBtk-SAR (MBS), and transplanted into Btk-/Tec- recipients. Mice engrafted with transduced hematopoietic cells exhibited rescue of both primary and peripheral Btk-dependent, B-lineage development, recovery of peritoneal B1 B cells, and correction of serum IgM and IgG3 levels. Gene transfer also restored T-independent type II immune responses and proliferation in response to B-cell antigen receptor (BCR) engagement. B-cell progenitors derived from Btk-transduced stem cells exhibited a progressive selective advantage as demonstrated by Btk staining. BM derived from primary recipients of Btk-transduced stem cells also rescued Btk dependent function in secondary transplanted hosts. Together, these data demonstrate that gene transfer into hematopoietic stem cells can reconstitute Btk-dependent B-cell development and function in vivo, and strongly support the feasibility of pursuing Btk gene transfer for XLA.
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