Hematopoietic Stem Cell Gene Therapy for Angelman Syndrome: Progress and Process
Hematopoietic stem cell gene therapy for Angelman Syndrome is being developed as a potential treatment approach. The therapy involves inserting a functional copy of the UBE3A gene into a patient’s cells using a lentiviral vector. The modified cells are then transplanted back into the patient, where they can deliver the functional UBE3A gene to affected cells throughout the body, including the central nervous system. Preclinical studies in mice have shown promising results, with improvements in behavior and neurological function. The therapy is currently in the pre-IND stage, with plans for both adult and pediatric clinical trials. The conditioning regimen for the transplant is less intense than those used for cancer patients, and patients can be entertained and engaged during their hospital stay. The therapy has the potential to be a lifelong treatment, and there is the possibility of future advancements and improvements in the technology.
In this talk, we will discuss the progress and process of hematopoietic stem cell gene therapy for Angelman syndrome. This therapeutic approach involves the insertion of a functional copy of the UBE3A gene into a patient’s cells using a lentiviral vector. The goal is to deliver this functional copy of UBE3A to all affected cells in the body, including the central nervous system. We will also address the future clinical work and the potential benefits of this therapy.
Replacement Gene Therapy Approach
The hematopoietic stem cell gene therapy for Angelman syndrome involves the insertion of a functional copy of the UBE3A gene into a patient’s cells. This is achieved using a lentiviral vector, which permanently integrates into cells. By targeting the hematopoietic system, which includes blood and immune cells, this therapy has the potential to deliver the functional UBE3A gene to all affected cells in the body.
To evaluate the efficacy of this therapy, preclinical studies were conducted using a mouse model of Angelman syndrome. Human stem cells were genetically modified and transplanted into newborn and adult mice. The mice were then assessed using various behavioral assays to measure the effects of the therapy. The results showed that the UBE3A vector-transduced cell transplanted mice exhibited similar behavior to wild-type mice, indicating the potential of this therapy to correct phenotypes associated with Angelman syndrome.
Future Clinical Trials
Based on the promising results of the preclinical studies, the researchers have submitted a pre-IND package to the FDA. They are currently working on additional efficacy trials for proof of benefit, both for adult and pediatric clinical trials. The clinical trials will involve mobilizing stem cells from the patient’s bone marrow, genetically modifying them, and then transplanting them back into the patient. The patients will undergo a conditioning regimen before the gene-modified cells are transplanted intravenously. The researchers are currently in the IND-enabling stage and are hopeful that the clinical trials will begin soon.
Safety and Efficacy
The safety of this therapy has been a major concern, but extensive preclinical studies have shown no toxicity or adverse effects. The conditioning regimen used in this therapy is less intense than that used for cancer patients, making it more tolerable. Additionally, the researchers plan to store backup products of the patient’s stem cells to ensure that any potential issues can be addressed in the future. The efficacy of this therapy has been demonstrated in various preclinical studies, showing the potential to correct phenotypes associated with Angelman syndrome.
Patient Experience and Entertainment
During the hospitalization period for the stem cell transplant, it is important to ensure that pediatric patients, who may be active and require entertainment and engagement, are well taken care of. The clinical sites will need to create an environment that is safe and engaging for the patients. This may include activity centers, sensory environments, and access to entertainment devices such as iPads. Parental involvement and input will be crucial in creating a supportive and entertaining environment for the patients.
Hematopoietic stem cell gene therapy shows promise as a potential treatment for Angelman syndrome. The preclinical studies have demonstrated the safety and efficacy of this therapy, leading to the submission of a pre-IND package to the FDA. The researchers are hopeful that the clinical trials will begin soon, offering a potential one-time treatment for patients with Angelman syndrome.
- Title: Hematopoietic Stem Cell Gene Therapy for Angelman Syndrome: Progress and Process
- Author(s): Joseph Anderson, Mehrdad Abedi
- Author(s)’ affiliation: University of California, Davis
- Publication date: 2022-01-04
- Collection: 2021 FAST Science Summit