Clinical applications of gene therapy for primary immunodeficiencies

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Primary immunodeficiencies (PIDs) have represented a paradigmatic model for successes and pitfalls of hematopoietic stem cells gene therapy. First clinical trials performed with gamma retroviral vectors (γ-RV) for adenosine deaminase severe combined immunodeficiency (ADA-SCID), X-linked SCID (SCID-X1), and Wiskott-Aldrich syndrome (WAS) showed that gene therapy is a valid therapeutic option in patients lacking an HLA-identical donor. No insertional mutagenesis events have been observed in more than 40 ADA-SCID patients treated so far in the context of different clinical trials worldwide, suggesting a favorable risk-benefit ratio for this disease. On the other hand, the occurrence of insertional oncogenesis in SCID-X1, WAS, and chronic granulomatous disease (CGD) RV clinical trials prompted the development of safer vector construct based on self-inactivating (SIN) retroviral or lentiviral vectors (LVs). Here we present the recent results of LV-mediated gene therapy for WAS showing stable multilineage engraftment leading to hematological and immunological improvement, and discuss the differences with respect to the WAS RV trial. We also describe recent clinical results of SCID-X1 gene therapy with SIN γ-RV and the perspectives of targeted genome editing techniques, following early preclinical studies showing promising results in terms of specificity of gene correction. Finally, we provide an overview of the gene therapy approaches for other PIDs and discuss its prospects in relation to the evolving arena of allogeneic transplant.

Original languageEnglish
Pages (from-to)210-219
Number of pages10
JournalHuman Gene Therapy
Volume26
Issue number4
DOIs
Publication statusPublished - Apr 1 2015

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Wiskott-Aldrich Syndrome
Genetic Therapy
Severe Combined Immunodeficiency
Adenosine Deaminase
Clinical Trials
X-Linked Combined Immunodeficiency Diseases
Chronic Granulomatous Disease
Insertional Mutagenesis
Cell- and Tissue-Based Therapy
Hematopoietic Stem Cells
Carcinogenesis
Odds Ratio
Tissue Donors
Transplants
Genes

ASJC Scopus subject areas

  • Molecular Medicine
  • Molecular Biology
  • Genetics

Cite this

Clinical applications of gene therapy for primary immunodeficiencies. / Cicalese, Maria Pia; Aiuti, Alessandro.

In: Human Gene Therapy, Vol. 26, No. 4, 01.04.2015, p. 210-219.

Research output: Contribution to journalArticle

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