Journal
SCIENCE TRANSLATIONAL MEDICINE
Volume 8, Issue 349, Pages -Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/scitranslmed.aaf3838
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Funding
- NIH [K01 DK106056, R41 DK092105]
- American Liver Foundation Postdoctoral Fellowship Award
- Mayo Clinic Center for Regenerative Medicine Career Development Award
- Wallace H. Coulter Foundation
- Marriot Foundation
- Darwin Deason Family Foundation
- Mayo Foundation
- Center for Clinical and Translational Science KL2 program [KL2TR000136-09]
- Mayo Clinic Center for Cell Signaling in Gastroenterology, Pilot and Feasibility Award [P30DK084567]
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We tested the hypothesis that ex vivo hepatocyte gene therapy can correct the metabolic disorder in fumarylacetoacetate hydrolase-deficient (Fah(-/-)) pigs, a large animalmodel of hereditary tyrosinemia type 1 (HT1). Recipient Fa(-/-) pigs underwent partial liver resection and hepatocyte isolation by collagenase digestion. Hepatocytes were transduced with one or both of the lentiviral vectors expressing the therapeutic Fah and the reporter sodium-iodide symporter (Nis) genes under control of the thyroxine-binding globulin promoter. Pigs received autologous transplants of hepatocytes by portal vein infusion. After transplantation, the protective drug 2-(2-nitro-4-trifluoromethylbenzyol)1,3 cyclohexanedione (NTBC) was withheld from recipient pigs to provide a selective advantage for expansion of corrected FAH(+) cells. Proliferation of transplanted cells, assessed by both immunohistochemistry and noninvasive positron emission tomography imaging of NIS-labeled cells, demonstrated near-complete liver repopulation by gene-corrected cells. Tyrosine and succinylacetone levels improved to within normal range, demonstrating complete correction of tyrosine metabolism. In addition, repopulation of the Fah(-/-) liver with transplanted cells inhibited the onset of severe fibrosis, a characteristic of nontransplanted Fah(-/-) pigs. This study demonstrates correction of disease in a pig model of metabolic liver disease by ex vivo gene therapy. To date, ex vivo gene therapy has only been successful in small animal models. We conclude that further exploration of ex vivo hepatocyte genetic correction is warranted for clinical use.
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