Correction of X-linked chronic granulomatous disease by gene therapy, augmented by insertional activation of MDS1-EVI1, PRDM16 or SETBP1

Marion G. Ott, Manfred Schmidt, Kerstin Schwarzwaelder, Stefan Stein, Ulrich Siler, Ulrike Koehl, Hanno Glimm, Klaus Kühlcke, Andrea Schilz, Hana Kunkel, Sonja Naundorf, Andrea Brinkmann, Annette Deichmann, Marlene Fischer, Claudia Ball, Ingo Pilz, Cynthia Dunbar, Yang Du, Nancy A. Jenkins, Neal G. CopelandUrsula Lüthi, Moustapha Hassan, Adrian J. Thrasher, Dieter Hoelzer, Christof Von Kalle, Reinhard Seger, Manuel Grez

Research output: Contribution to journalArticle

893 Scopus citations

Abstract

Gene transfer into hematopoietic stem cells has been used successfully for correcting lymphoid but not myeloid immunodeficiencies. Here we report on two adults who received gene therapy after nonmyeloablative bone marrow conditioning for the treatment of X-linked chronic granulomatous disease (X-CGD), a primary immunodeficiency caused by a defect in the oxidative antimicrobial activity of phagocytes resulting from mutations in gp91phox. We detected substantial gene transfer in both individuals' neutrophils that lead to a large number of functionally corrected phagocytes and notable clinical improvement. Large-scale retroviral integration site-distribution analysis showed activating insertions in MDS1-EVI1, PRDM16 or SETBP1 that had influenced regulation of long-term hematopoiesis by expanding gene-corrected myelopoiesis three- to four-fold in both individuals. Although insertional influences have probably reinforced the therapeutic efficacy in this trial, our results suggest that gene therapy in combination with bone marrow conditioning can be successfully used to treat inherited diseases affecting the myeloid compartment such as CGD.

Original languageEnglish (US)
Pages (from-to)401-409
Number of pages9
JournalNature Medicine
Volume12
Issue number4
DOIs
StatePublished - Apr 2006

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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