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Developing adenoviral‐mediated in vivo gene therapy for ornithine transcarbamylase deficiency
Author(s) -
Raper S. E.,
Wilson J. M.,
Yudkoff M.,
Robinson M. B.,
Ye X.,
Batshaw M. L.
Publication year - 1998
Publication title -
journal of inherited metabolic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 102
eISSN - 1573-2665
pISSN - 0141-8955
DOI - 10.1023/a:1005369926784
Subject(s) - genetic enhancement , ornithine transcarbamylase deficiency , viral vector , transduction (biophysics) , ornithine transcarbamylase , vector (molecular biology) , biology , in vivo , immune system , adenoviridae , immunology , cancer research , recombinant dna , medicine , pharmacology , gene , genetics , urea cycle , arginine , biochemistry , amino acid
There are a number of reasons for choosing ornithine transcarbamylase (OTC) deficiency as a candidate for gene therapy: the gene has been cloned; the disorder is relatively common; the current clinical outcome is poor; and there are authentic animal models. In considering the development of gene therapy for OTC deficiency, we focused on the use of in vivo gene therapy with an adenoviral vector. Using the partially OTC‐deficient sparse fur mouse we found transduction and expression could be achieved using an intravenous infusion of a recombinant adenovirus containing the OTC cDNA. The results were transient as a result of immune activation in response to the vector and vector‐transduced cells. By modifying the adenoviral construct, creating an E1 deletion–E2 temperature‐sensitive mutation, we blunted the cytotoxic T lymphocyte immune response and achieved correction of biochemical abnormalities for 2–3 months. We also found that transduction and expression following gene transfer occurred sufficiently rapidly to protect against acute hyperammonaemia within 24 h. Subsequent preclinical studies in mice and non‐human primates demonstrated that E1–E4‐deleted vectors had a substantially improved safety profile and similar efficacy. With this evidence of efficacy and safety of adenoviral vectors, we are embarking on a phase I trial of intravascular gene transfer using an E1–E4‐deleted vector in adults with partial OTC deficiency.