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Blood, 15 May 2006, Vol. 107, No. 10, pp. 3859-3864.
Prepublished online as a Blood First Edition Paper on January 31, 2006; DOI 10.1182/blood-2005-12-4961.
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Submitted December 16, 2005
Accepted January 12, 2006
High-level expression of porcine factor VII from genetically-modified bone marrow-derived stem cells
Bagirath Gangadharan, Ernest T Parker, Lucienne M Ide, H. Trent Spencer, and Christopher B Doering*
Division of Hematology, Oncology, BMT, Department of Pediatrics, Emory University, Atlanta, Georgia, USA; Aflac Cancer Center and Blood Disorders Service, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
Division of Hematology, Oncology, BMT, Department of Pediatrics, Emory University, Atlanta, Georgia, USA; Program in Molecular and Systems Pharmacology, Graduate Division of Biological and Biomedical Sciences, Emory Universityrogram in Molecular and Systems Pharmacology, Atlanta, Georgia, USA
* Corresponding author; email: cdoerin{at}emory.edu.
Clinical success for gene therapy of hemophilia A will be judged by achievement of sustained, therapeutic levels of coagulation factor VIII (fVIII). Previous clinical trials have suffered from transient, sub-therapeutic expression of human fVIII transgenes. Porcine fVIII contains sequence elements that enable more efficient biosynthesis than human fVIII due to enhanced post-translational transit through the secretory pathway. In this study, we evaluated ex vivo retroviral gene transfer of a high-expression porcine fVIII transgene into bone marrow-derived stromal and hematopoetic stem/progenitor cells (MSCs and HSCs, respectively) and transplantation into genetically-immunocompetent hemophilia A mice. Both MSCs and HSCs demonstrated high-level expression of porcine fVIII in vivo. However following transplantation of gene-modified MSCs, fVIII activity levels rapidly returned to baseline due to the formation of anti-porcine fVIII neutralizing antibodies. Alternatively, transplantation of HSCs into myeloablated and non-myeloablated hemophilia A mice resulted in high-level fVIII expression despite low-level hematopoietic reconstitution by gene-modified cells. FVIII expression was sustained beyond 10 months indicating that immunological tolerance to porcine fVIII was achieved. Furthermore, transplantation of bone marrow from primary recipients into naive secondary recipients resulted in sustained, high-level fVIII expression demonstrating successful genetic modification and engraftment of HSCs.

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