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Blood, 1 April 2005, Vol. 105, No. 7, pp. 2691-2698.
Prepublished online as a Blood First Edition Paper on December 2, 2004; DOI 10.1182/blood-2004-09-3496.
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Submitted September 9, 2004
Accepted November 17, 2004
Phenotypic correction and long-term expression of factor VIII in hemophilic mice by immunotolerization and nonviral gene transfer using the Sleeping Beauty transposon system
John R Ohlfest, Joel L Frandsen, Sabine Fritz, Paul D Lobitz, Scott G Perkinson, Karl J Clark, Gary Nelsestuen, Nigel S Key, R S McIvor, Perry B Hackett, and David A Largaespada*
Department of Genetics, Cell Biology and Development, University of Minnesota Cancer Center, Arnold and Mabel Beckman Center for Transposon Research, University of Minnesota, Minneapolis, MN, USA
Discovery Genomics Inc., Minneapolis, MN, USA
Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, St. Paul, MN, USA
Department of Medicine, University of Minnesota, Minneapolis, MN, USA
Department of Genetics, Cell Biology and Development, University of Minnesota Cancer Center, Arnold and Mabel Beckman Center for Transposon Research, University of Minnesota, Minneapolis, MN, USA; Discovery Genomics Inc., Minneapolis, MN, USA
* Corresponding author; email: larga002{at}umn.edu.
Hemophilia A is a lead candidate for treatment by gene therapy because small increments in the missing secreted protein product, coagulation factor VIII (FVIII), would result in substantial clinical amelioration. Clinically relevant therapy might be achieved by stably delivering a human(h) FVIII cDNA to correct the bleeding disorder. We used the Sleeping Beauty (SB) transposon, delivered as naked plasmid DNA by high-pressure tail vein injection, to integrate B-domain-deleted hFVIII genes into the chromosomes of hemophilia A mice and correct the phenotype. Since hFVIII protein is a neoantigen to these mice, sustaining therapeutic plasma hFVIII levels was problematic due to inhibitory antibody production. We circumvented this problem by tolerizing 82% of neonates by a single facial vein injection of recombinant hFVIII within 24 hours of birth (the remaining 18% formed inhibitors). Achievement of high-level (10-100% of normal) hFVIII expression and phenotypic correction required co-injection of a SB transposase-expressing plasmid to facilitate transgene integration in immunotolerized animals. Linker-mediated PCR was used to clone hFVIII transposon insertion sites from liver genomic DNA, providing molecular evidence of transposition. Thus, SB provides a nonviral means for sustained hFVIII gene delivery in a mouse model of hemophilia A if the immune response is prevented.

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