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Current
Gene Therapy
ISSN: 1566-5232

Current Gene Therapy
Volume 6, Number 6, December 2006
Contents

Cell and Gene Therapies in Cardiovascular Disease
with Special Focus on the No Option Patient
Pp. 609-623
Dawid L. Staudacher and Moshe Y. Flugelman
[Abstract]
Ex Vivo Modification of Cells to Induce
a Muscle-Based Expression Pp. 625-632
Simon P. Quenneville and Jacques P. Tremblay
[Abstract]
The C31
Integrase System for Gene Therapy Pp. 633-645
Michele P. Calos
[Abstract]
Viral Vectors for Gene-Directed Enzyme Prodrug Therapy
Pp. 647-670
Silke Schepelmann and Caroline J. Springer
[Abstract]
Intracellular Trafficking of Plasmids for Gene Therapy:
Mechanisms of Cytoplasmic Movement and Nuclear Import
Pp. 671-681
Erin E. Vaughan, James V. DeGiulio and David A. Dean
[Abstract]
Adeno-Associated Virus-Mediated Gene Transfer in Hematopoietic
Stem/Progenitor Cells as a Therapeutic Tool Pp. 683-698
Li Zhong, Weihong Zhao, Jianqing Wu, Njeri Maina, Zongchao
Han and Arun Srivastava
[Abstract]
Reviewers
List Pp. 699
Abstracts

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Cell and Gene Therapies in Cardiovascular Disease with Special
Focus on the No Option Patient
Dawid L. Staudacher and Moshe Y. Flugelman
Morbidity and mortality attributed to diseases of the
heart and blood vessels are growing steadily around the globe,
as a result of changing lifestyles and increased longevity.
Even in affluent countries many patients with cardiovascular
syndromes do not benefit from current conventional therapies.
Failure of drugs, catheter-based, and surgical interventions
leaves millions of patients in a great need for new therapies.
Cell and gene therapy hold great promise for cardiovascular
therapies. As most cardiovascular pathologies are confined
to a specific organ and are associated with arterial occlusion
or muscle damage, both may be amenable to local cell and gene
therapies. Local delivery of genes or cells that can promote
the formation of new blood vessels (angiogenesis)
or lead to tissue regeneration should be achievable
with current knowledge and molecular technologies. So far,
however, the promise of gene and cell therapy has not fulfilled
the expectations. Nevertheless, careful review of the work
and of current thinking in the field leaves room for optimism
that gene and cell therapy may reach the clinical setting
in the near future, providing a new option for many patients.
In this paper, we review clinical studies of gene and cell
therapy and discuss their impact on future research.
[Back to top]
Ex Vivo Modification of Cells to Induce
a Muscle-Based Expression
Simon P. Quenneville and Jacques P. Tremblay
Ex vivo gene therapy is a possible treatment for
several muscular dystrophies. The best transgene to be expressed
and the appropriate cell type to be used currently remain
the subject of many investigations. The most adequate gene
modification technique also remains to be established. Different
transgenes have already been tested in animal models and transgenic
mice. Several cell types were evaluated during the last decades
and several vectors or transfection methods were analysed.
From these essays, over time, several proofs of principles
were made to demonstrate the feasibility of this type of therapy.
For DMD, it is possible to express several truncated versions
of dystrophin or exon skipping molecules. It is also possible
to express other molecules that would mitigate the phenotype.
Different cell types are also available. From the well documented
myoblasts to the AC133 positive cells, the choice of cell
types is exploding. Gene modification also evolved during
the last decade. Efficient transfection technique and viral
vectors are currently available. Given all these possibilities,
the researcher has to make several choices. This review is
trying to give clues of how to make those choices.
[Back to top]
The C31
Integrase System for Gene Therapy
Michele P. Calos
The C31
integrase system represents a novel technology that opens
up new possibilities for gene therapy. The C31
integrase can integrate introduced plasmid DNA into preferred
locations in unmodified mammalian genomes, resulting in robust,
long-term expression of the integrated transgene. This review
describes the nature of the integration reaction and the genomic
integration sites used by the enzyme in human cells. Preclinical
applications of the system to gene therapy to date are summarized,
including in vivo use in liver, muscle, eye, and
joint and ex vivo use in skin keratinocytes, muscle
precursor cells, and T cell lines. The safety of this phage
integrase system for gene therapy is evaluated, and its strengths
and limitations are compared to other gene therapy approaches.
Ongoing and planned improvements to the phage integrase system
are discussed. We conclude that gene therapy strategies using
C31 integrase
and its derivatives offer great promise for success in the
near term.
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Viral Vectors for Gene-Directed Enzyme Prodrug Therapy
Silke Schepelmann and Caroline J. Springer
Conventional cancer treatments are often hampered by a lack
of tumour selectivity, resulting in toxicity to healthy tissue.
Gene-directed enzyme prodrug therapy (GDEPT) is a suicide
gene therapy approach that aims to improve the selectivity
of chemotherapy by enabling cancer cells to convert non-cytotoxic
prodrugs to cytotoxic drugs. Many enzyme/prodrug systems have
been described, some of which have already been tested in
clinical trials. A key component of GDEPT is a foreign enzyme
that is expressed selectively at the tumour site where it
converts the prodrug into the cytotoxic agent. The gene encoding
the prodrug-activating enzyme needs to be expressed selectively
and efficiently in tumour cells in order to spare normal tissue
from damage. Substantial efforts have been made to develop
gene therapy vectors that are capable of targeting cancer
cells. A large number of gene delivery systems have been described
for GDEPT: Viral vectors are the most advanced. They include
replication-deficient and replication-selective (oncolytic)
viruses. Recent advances in engineering viruses for GDEPT
are reviewed in this article and data from both preclinical
studies and clinical trials are discussed.
[Back to top]
Intracellular Trafficking of Plasmids for Gene Therapy:
Mechanisms of Cytoplasmic Movement and Nuclear Import
Erin E. Vaughan, James V. DeGiulio and David A. Dean
Under physiologically relevant conditions, the levels of non-viral
gene transfer are low at best. The reason for this is that
many barriers exist for the efficient transfer of genes to
cells, even before any gene expression can occur. While many
transfection strategies focus on DNA condensation and overcoming
the plasma membrane, events associated with the intracellular
trafficking of the DNA complexes have not been as extensively
studied. Once internalized, plasmids must travel potentially
long distances through the cytoplasm to reach their next barrier,
the nuclear envelope. This review summarizes the current progress
on the cytoplasmic trafficking and nuclear transport of plasmids
used for gene therapy applications. Both of these processes
utilize specific and defined mechanisms to facilitate movement
of DNA complexes through the cell. The continued elucidation
and exploitation of these mechanisms will lead to improved
strategies for transfection and successful gene therapy.
[Back to top]
Adeno-Associated Virus-Mediated Gene Transfer in Hematopoietic
Stem/Progenitor Cells as a Therapeutic Tool
Li Zhong, Weihong Zhao, Jianqing Wu, Njeri Maina, Zongchao
Han and Arun Srivastava
Hematopoietic stem cells (HSCs) have unique properties of
self-renewal, differentiation and proliferation. HSCs are
easily accessible, and can be readily delivered back to patients
by autologous transplantation, which renders them as attractive
targets for ex vivo gene therapy. The adeno-associated
virus (AAV) vectors have to date not been associated with
any malignant disease, and have gained attention as a potentially
safer alternative to the more commonly used retroviral vectors
for HSC gene therapy. Although conflicting data exist with
regard to HSC transduction by AAV vectors, in this review,
we provide an overview of AAV-mediated HSC gene transfer -
obstacles as well strategies to improve the transduction efficiency
– and the potential use of AAV vectors for gene therapy
of human diseases involving HSCs.
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