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Blood, 1 January 2006, Vol. 107, No. 1, pp. 63-72. Prepublished online as a Blood First Edition Paper on September 20, 2005; DOI 10.1182/blood-2005-05-2032.
Submitted May 20, 2005
Universite Paris-Descartes, Faculte de medecine, Inserm Unit 429, site Necker-Enfants Malades, Paris, France * Corresponding author; email: lagresle{at}necker.fr.
Severe combined immunodeficiency (SCID) caused by mutations in RAG-1 or RAG-2 genes is characterized by a complete block in T and B cell development. The only curative treatment is allogenic hematopoietic stem cell transplantation which gives a high survival rate (90%) when an HLA-genoidentical donor exist but unsatisfactory results when only partially compatible donors are available. We have thus been interested in the development of a potential alternative treatment by using retroviral gene transfer of a normal copy of RAG-1 cDNA. We show here that this approach applied to RAG-1 deficient mice restores normal B and T cell function even in the presence of a reduced number of mature B cells. The reconstitution is stable over time attesting for a selective advantage of transduced progenitors. Noteworthy, a high transgene copy number was detected in all lymphoid organs and this was associated with a risk of lymphoproliferation as observed in one mouse. Altogether, these results demonstrate that correction of RAG-1 deficiency can be achieved by gene therapy in immunodeficient mice but that human application would require the use of self-inactivated vector in order to decrease the risk of lymphoproliferative diseases.
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