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APPLICATIONS FOR GENE
         THERAPY




Felix Kriedemann
Gonzalo Briones
11ºA                      1
Gene Therapy


Objectives:
1. Recognize significance and uses of gene
   therapy.
2. Define background theory and methodologies.
3. Address potential clinical applications,
   limitations, and future directions.



                                                 2
Objectives of gene therapy:
  1. Management and correction of human diseases
     a. Inherited and acquired disorders
     b. Cancer
     c. AIDS/HIV

Good news: Promising advances during the last two
decades in making DNA technology.


Bad news: Efficacy in any gene therapy protocol not
definitive.

       1. Inadequate understanding of biological
interactions of vector and host.


                                                      3
(27)
       (86)




              4
5
Some global terms/definitions:

1. Genes and nucleic acids
2. Vector, viral delivery systems
3. Gene transfer
4. Reporter gene
5. Transfer efficiency
6. Germ vs. somatic cells
7. In/ex vivo, in situ, in vitro.




                                    6
Genetic diseases:
Type 1: Single locus (gene) is defective and responsible
for the disease, 100% heritable.
       examples: Sickle cell anemia,
                    Hypercholesterolemia
                    Cystic fibrosis
Type 2: Polygenic traits, less than 100% heritable, may be
dependent on environmental factors and lifestyle.
      examples: Heart disease
                  Cancer
                  Diabetes
                  Alcoholism
                  Schizophrenia
                  Criminal behavior?
                  etc….?
                                                           7
How it works ?
Exogenous DNA
+ vector (viral)

                         Protein expression
            Cytosol

          Endosome
                            Transcription
           Lysosome          (nucleases)




Barriers that prevent transfer of exogenous DNA

                                                  8
Categories of clinical gene transfer protocols.

   1. Inherited/monogenic disorders:
      ADA deficiency
      Alpha-1 antitrypsin
      Chronic granulomatous disease
      Cystic fibrosis
      Familial hypercholesterolemia
      Fanconi Anemia
      Gaucher Disease
      Hunter syndrome
      Parkinsons


   2. Infectious Diseases:
       HIV
                                                  9
4. Cancer (by approach):
      Antisense
             Chemoprotection
             Immunotherapy: ex vivo / in vivo
             Thymidylate kinase
      Tumor suppressor genes



3. Acquired disorders:
      peripheral artery disease
      Rheumatoid arthritis


                                                10
11
‘Cancer regression in patients after transfer of genetically
                engineered lymphocytes.’




Liver




Lymph
 node




                                                                12
Case study: Jesse Gelsinger
*First documented patient to die from gene therapy
    treatment.
Disease: liver enzyme deficiency
   (ornithine transcarbamylase, OTC) –
      controls ammonia metabolism
Vector used to deliver OTC – modified adenovirus
Objective: deliver vector to liver cells and express OTC.
Problem: Very low transfer efficiency (1%), difficult to get
   enough functioning OTC expressed to do any good.
Solution: Infect with higher dose of viral particles.
             (38 trillion)

                                                               13
Outcome:
      -Vector not only delivered gene to liver but to other
      tissue.
      - Systemic inflammatory response.
      -Patient acquired fever, coma and finally death.

Why?
-Animal studies suggested that the dose was correct .
-Adenoviral vectors known to induce inflammatory
response.
-Patient already compromised:
      Patient had higher than allowed ammonia levels.



                                                          14
Bibliography
And, A. (1994). Gene Therapy: Some History, Applications, Problems, and
Prospects. [online] Retrieved from: http://tpx.sagepub.com/content/36/1/97.full
[Accessed: 2 Apr 2013].

Herkules.oulu.fi (1997). Applications of somatic gene therapy. [online]
Retrieved from: http://herkules.oulu.fi/isbn9514255429/html/x298.html
[Accessed: 2 Apr 2013].

Intechopen.com (2012). What is Gene Therapy | Applications | InTechOpen.
[online] Retrieved from: http://www.intechopen.com/books/gene-therapy-
applications [Accessed: 2 Apr 2013].

Iptv.org (2004). Gene Therapy » Medical Uses of GE » Uses » Explore More:
Genetic Engineering. [online] Retrieved from:
http://www.iptv.org/exploremore/ge/uses/use2_gene.cfm [Accessed: 2 Apr
2013].

MedicineNet (2013). Gene Therapy - The Future Is Here!. [online] Retrieved
from: http://www.medicinenet.com/script/main/art.asp?articlekey=12662
[Accessed: 2 Apr 2013].

YouTube (n.d.). Vector design for vaccine and gene therapy applications.
[online] Retrieved from: http://www.youtube.com/watch?v=zKLpRufcy0k
[Accessed: 2 Apr 2013].


                                                                                  15

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Gene therapy lecture_spring_2007

  • 1. APPLICATIONS FOR GENE THERAPY Felix Kriedemann Gonzalo Briones 11ºA 1
  • 2. Gene Therapy Objectives: 1. Recognize significance and uses of gene therapy. 2. Define background theory and methodologies. 3. Address potential clinical applications, limitations, and future directions. 2
  • 3. Objectives of gene therapy: 1. Management and correction of human diseases a. Inherited and acquired disorders b. Cancer c. AIDS/HIV Good news: Promising advances during the last two decades in making DNA technology. Bad news: Efficacy in any gene therapy protocol not definitive. 1. Inadequate understanding of biological interactions of vector and host. 3
  • 4. (27) (86) 4
  • 5. 5
  • 6. Some global terms/definitions: 1. Genes and nucleic acids 2. Vector, viral delivery systems 3. Gene transfer 4. Reporter gene 5. Transfer efficiency 6. Germ vs. somatic cells 7. In/ex vivo, in situ, in vitro. 6
  • 7. Genetic diseases: Type 1: Single locus (gene) is defective and responsible for the disease, 100% heritable. examples: Sickle cell anemia, Hypercholesterolemia Cystic fibrosis Type 2: Polygenic traits, less than 100% heritable, may be dependent on environmental factors and lifestyle. examples: Heart disease Cancer Diabetes Alcoholism Schizophrenia Criminal behavior? etc….? 7
  • 8. How it works ? Exogenous DNA + vector (viral) Protein expression Cytosol Endosome Transcription Lysosome (nucleases) Barriers that prevent transfer of exogenous DNA 8
  • 9. Categories of clinical gene transfer protocols. 1. Inherited/monogenic disorders: ADA deficiency Alpha-1 antitrypsin Chronic granulomatous disease Cystic fibrosis Familial hypercholesterolemia Fanconi Anemia Gaucher Disease Hunter syndrome Parkinsons 2. Infectious Diseases: HIV 9
  • 10. 4. Cancer (by approach): Antisense Chemoprotection Immunotherapy: ex vivo / in vivo Thymidylate kinase Tumor suppressor genes 3. Acquired disorders: peripheral artery disease Rheumatoid arthritis 10
  • 11. 11
  • 12. ‘Cancer regression in patients after transfer of genetically engineered lymphocytes.’ Liver Lymph node 12
  • 13. Case study: Jesse Gelsinger *First documented patient to die from gene therapy treatment. Disease: liver enzyme deficiency (ornithine transcarbamylase, OTC) – controls ammonia metabolism Vector used to deliver OTC – modified adenovirus Objective: deliver vector to liver cells and express OTC. Problem: Very low transfer efficiency (1%), difficult to get enough functioning OTC expressed to do any good. Solution: Infect with higher dose of viral particles. (38 trillion) 13
  • 14. Outcome: -Vector not only delivered gene to liver but to other tissue. - Systemic inflammatory response. -Patient acquired fever, coma and finally death. Why? -Animal studies suggested that the dose was correct . -Adenoviral vectors known to induce inflammatory response. -Patient already compromised: Patient had higher than allowed ammonia levels. 14
  • 15. Bibliography And, A. (1994). Gene Therapy: Some History, Applications, Problems, and Prospects. [online] Retrieved from: http://tpx.sagepub.com/content/36/1/97.full [Accessed: 2 Apr 2013]. Herkules.oulu.fi (1997). Applications of somatic gene therapy. [online] Retrieved from: http://herkules.oulu.fi/isbn9514255429/html/x298.html [Accessed: 2 Apr 2013]. Intechopen.com (2012). What is Gene Therapy | Applications | InTechOpen. [online] Retrieved from: http://www.intechopen.com/books/gene-therapy- applications [Accessed: 2 Apr 2013]. Iptv.org (2004). Gene Therapy » Medical Uses of GE » Uses » Explore More: Genetic Engineering. [online] Retrieved from: http://www.iptv.org/exploremore/ge/uses/use2_gene.cfm [Accessed: 2 Apr 2013]. MedicineNet (2013). Gene Therapy - The Future Is Here!. [online] Retrieved from: http://www.medicinenet.com/script/main/art.asp?articlekey=12662 [Accessed: 2 Apr 2013]. YouTube (n.d.). Vector design for vaccine and gene therapy applications. [online] Retrieved from: http://www.youtube.com/watch?v=zKLpRufcy0k [Accessed: 2 Apr 2013]. 15

Editor's Notes

  1. SCID = severe combined immunodeficiency.