Abstract
Fetal gene therapy may prove useful in treating diseases that manifest in the perinatal or early postnatal period. Adenoviruses effectively transfer gene expression to a variety of tissues but also stimulate inflammatory and immune responses. The purpose of this study was to test the hypothesis that exposure of fetal sheep to a first generation adenovirus vector encoding bacterial β-galactosidase, Av1nBg, before the development of the immune system, is safe, minimizes inflammatory and immune responses and induces tolerance. A total of 22 fetal sheep was studied; of these, two were born with respiratory distress, seven were electively killed and 13 died in utero. The incidence of mortality was higher than the ⩽10% we have experienced with other fetal sheep studies and was not likely related to complications arising from surgical or anesthetic procedures. Inflammatory and fibrotic responses were observed in the lungs and may represent untoward long-term consequences of in utero adenoviral gene therapy. Tolerance to Av1nBg was not established, and repeated exposure to Av1nBg before birth was associated with significant pathology and mortality.
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References
Mastrangeli A et al. Diversity of airway epithelial cell targets for in vivo recombinant adenovirus-mediated gene transfer J Clin Invest 1993 91: 225–234
Yei SP et al. In vivo evaluation of the safety of adenovirus-mediated transfer of the human cystic fibrosis transmembrane conductance regulator cDNA to the lung Hum Gene Ther 1994 5: 731–744
Lemarchand P, Jones M, Yamada I, Crystal RG . In vivo gene transfer and expression in normal uninjured blood vessels using replication-deficient recombinant adenovirus vectors Circ Res 1993 72: 1132–1138
Vincent M et al. Adenovirus-mediated gene transfer to the respiratory tract of fetal sheep in utero Hum Gene Ther 1995 6: 1019–1028
Holzinger A et al. Intra-amniotic administration of an adenoviral vector for gene transfer to fetal sheep and mouse tissues Pediatr Res 1995 38: 1–7
McCray PB Jr et al. Adenovirus-mediated gene transfer to fetal pulmonary epithelia in vitro and in vivo J Clin Invest 1995 95: 2620–2632
Simon RH et al. Adenovirus-mediated transfer of the CFTR gene to lung of nonhuman primates: toxicity study Hum Gene Ther 1993 4: 771–780
Yang Y et al. Cellular immunity to viral antigens limits E1-deleted adenoviruses for gene therapy Proc Natl Acad Sci USA 1994 91: 4407–4411
Zsengeller ZK et al. Persistence of replication-deficient adenovirus-mediated gene transfer in lungs of immune-deficient (nu/nu) mice Hum Gene Ther 1995 6: 457–467
Zabner J et al. Safety and efficacy of repetitive adenovirus-mediated transfer of CFTR cDNA to airway epithelia of primates and cotton rats Nat Genet 1994 6: 75–83
Billingham RE, Brent L, Medawar PB . ‘Activity acquired tolerance’ of foreign cells Nature 1953 172: 603–606
Quantin B, Perricaudet LD, Tajbakhsh S, Mandel J-L . Adenovirus as an expression vector in muscle cells in vivo Proc Natl Acad Sci USA 1992 89: 2581–2584
Stratford-Perricaudet LD, Makeh I, Perricaudet M, Briand P . Widespread long-term gene transfer to mouse skeletal muscles and heart J Clin Invest 1992 90: 626–630
Dosch H-M, Hui MF, Doherty PJ . Development of normal and abnormal immune functions in humans In: Cooper EL, Nisbet-Brown E (eds) . Developmental Immunology Oxford University Press: Oxford 1993 pp 452–470
Crombleholme TM, Bianchi DW . In utero hematopoietic stem cell transplantation and gene therapy Semin Perinatol 1994 18: 376–384
Flake AW et al. Treatment of X-linked severe combined immunodeficiency by in utero transplantation of paternal bone marrow New Engl J Med 1996 335: 1806–1810
Morris B . The ontogeny and comportment of lymphoid cells in fetal and neonatal sheep Immunol Rev 1986 91: 219–233
Zepeda M, Wilson JM . Neonatal cotton rats do not exhibit destructive immune responses to adenoviral vectors Gene Therapy 1996 3: 973–979
Takahashi M et al. Long-term correction of bilirubin-UDP-glucurononsyltransferase deficiency in Gunn rats by administration of a recombinant adenovirus during the neonatal period J Biol Chem 1996 271: 26536–26542
Kass-Eisler A et al. Circumventing the immune response to adenovirus-mediated gene therapy Gene Therapy 1996 3: 154–162
Acsadi G et al. A differential efficiency of adenovirus-mediated in vivo gene transfer into skeletal muscle cells of different maturity Hum Mol Gen 1994 3: 579–584
Tripathy SK et al. Stable delivery of physiologic levels of recombinant erythropoietin to the systemic circulation by intramuscular injection of replication-defective adenovirus Proc Natl Acad Sci USA 1994 91: 11557–11561
Walter J et al. Successful expression of human factor IX following repeat administration of an adenoviral vector in mice Proc Natl Acad Sci USA 1996 93: 3056–3061
Haynes BF, Denning SM . Lymphopoiesis In: Stamatoyannopoulos G, Nienhuis AW, Majerus PW, Varmus H (eds) . The Molecular Basis of Blood Diseases, 2nd edn WB Saunders: Philadelphia 1994 pp 425–462
Mackay CR, Maddox JF, Brandon MR . Thymocyte subpopulations during early fetal development in sheep J Immunol 1986 136: 1592–1599
Haynes BF, Heinly CS . Early human T cell development: analysis of the human thymus at the time of initial entry of hematopoietic stem cells into the fetal thymic microenvironment J Exp Med 1995 181: 1445–1458
Silverstein AM, Prendergast RA, Kraner KL . Fetal response to antigenic stimulus IV. Rejection of skin homografts by the fetal lamb J Exp Med 1964 119: 955–964
Zanjani ED et al. Engraftment and long-term expression of human fetal hemapoietic stem cells in sheep following transplantation in utero J Clin Invest 1992 89: 1178–1188
Neiderhuber JE, Shermeta D, Turcotte JG, Gikas PW . Kidney transplantation in the foetal lamb Transplantation 1971 12: 161–166
Osburn BI, Hoskins RK . Antibody responses to Brucella ovis in maternal and foetal sheep J Infect Dis 1969 119: 267–272
Silverstein AM, Uhr JW, Kraner KL . Fetal response to antigenic stimulus. II. Antibody production by the fetal lamb J Exp Med 1963 117: 799–812
Sekhon HS, Larson JE . In utero gene transfer into the pulmonary epithelium Nature Med 1995 1: 1201–1203
Olver RE, Schneeburger EE, Walters DV . Epithelial solute permeability, ion transport and tight junction morphology in the developing lung of the fetal lamb J Physiol 1981 315: 395–412
Teramoto S et al. Effect of adenoviral vector infection on cell proliferation in cultured primary human airway epithelial cells Hum Gene Ther 1995 6: 1045–1053
Adesanya MR, Redman RS, Baum BJ, O’Connell BC . Immediate inflammatory responses to adenovirus-mediated gene transfer in rat salivary glands Hum Gene Ther 1996 7: 1085–1093
Blaiset MA, Couto CG, Evans KL, Smeak DD . Complications of indwelling, silastic central venous access catheters in dogs and cats J Am Animal Hosp Assoc 1995 31: 379–384
Miyasaka M, Morris B . The ontogeny of the lymphoid system and immune responsiveness in sheep Prog Vet Microbiol Immunol 1988 4: 21–55
Todd L, Mullen M, Olley PM, Rabinovitch M . Pulmonary toxicity of monocrotaline differs at critical periods of lung development Pediatr Res 1985 19: 731–737
Massaro D et al. Postnatal development of alveoli. Regulation and evidence for a critical period in rats J Clin Invest 1985 76: 1297–1305
Northway WH et al. Late pulmonary sequelae of bronchopulmonary dysplasia New Engl J Med 1990 323: 1793–1799
Trapnell BC et al. Expression of the cystic fibrosis transmembrane conductance regulator gene in the respiratory tract of normal individuals and individuals with cystic fibrosis Proc Natl Acad Sci USA 1991 88: 6565–6569
Hierholzer J, Bingham P . Vero microcultures for adenovirus neutralization tests J Clin Micro 1978 7: 499–506
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Iwamoto, H., Trapnell, B., McConnell, C. et al. Pulmonary inflammation associated with repeated, prenatal exposure to an E1, E3-deleted adenoviral vector in sheep. Gene Ther 6, 98–106 (1999). https://doi.org/10.1038/sj.gt.3300804
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DOI: https://doi.org/10.1038/sj.gt.3300804
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