[HTML][HTML] Development of a forward-oriented therapeutic lentiviral vector for hemoglobin disorders

N Uchida, MM Hsieh, L Raines, JJ Haro-Mora… - Nature …, 2019 - nature.com
N Uchida, MM Hsieh, L Raines, JJ Haro-Mora, S Demirci, AC Bonifacino, AE Krouse…
Nature Communications, 2019nature.com
Hematopoietic stem cell (HSC) gene therapy is being evaluated for hemoglobin disorders
including sickle cell disease (SCD). Therapeutic globin vectors have demanding
requirements including high-efficiency transduction at the HSC level and high-level,
erythroid-specific expression with long-term persistence. The requirement of intron 2 for high-
level β-globin expression dictates a reverse-oriented globin-expression cassette to prevent
its loss from RNA splicing. Current reverse-oriented globin vectors can drive phenotypic …
Abstract
Hematopoietic stem cell (HSC) gene therapy is being evaluated for hemoglobin disorders including sickle cell disease (SCD). Therapeutic globin vectors have demanding requirements including high-efficiency transduction at the HSC level and high-level, erythroid-specific expression with long-term persistence. The requirement of intron 2 for high-level β-globin expression dictates a reverse-oriented globin-expression cassette to prevent its loss from RNA splicing. Current reverse-oriented globin vectors can drive phenotypic correction, but they are limited by low vector titers and low transduction efficiencies. Here we report a clinically relevant forward-oriented β-globin-expressing vector, which has sixfold higher vector titers and four to tenfold higher transduction efficiency for long-term hematopoietic repopulating cells in humanized mice and rhesus macaques. Insertion of Rev response element (RRE) allows intron 2 to be retained, and β-globin production is observed in transplanted macaques and human SCD CD34+ cells. These findings bring us closer to a widely applicable gene therapy for hemoglobin disorders.
nature.com