Crystal's "Administration of an adenovirus containing the human CFTR cDNA to the respiratory tract of individuals with cystic fibrosis" 1994

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===Abstract===
===Abstract===
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* They administered a recombinant adenovirus vector (AdCFTR) containing the normal human CFTR cDNA into the nasal and bronchial epithelium of 4 individuals with CF.
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*They administered a recombinant adenovirus vector (AdCFTR) containing the normal human CFTR cDNA into the nasal and bronchial epithelium of 4 individuals with CF.
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* They found the vector expresses the CFTR cDNA in the respiratory epithelium in vivo.
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*They found the vector expresses the CFTR cDNA in the respiratory epithelium in vivo.
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* At 2x109 pfu there was no recombination, complementation, shedding of the vector, or rise in antibody titres. Although, there was a transient and systemic pulmonary syndrome observed (possibly mediated by IL-6)
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*At 2x10<sup>9</sup> pfu there was no recombination, complementation, shedding of the vector, or rise in antibody titres. Although, there was a transient and systemic pulmonary syndrome observed (possibly mediated by IL-6)
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* They saw no long term effects
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*They saw no long term effects
===Introduction===
===Introduction===

Revision as of 19:23, 7 March 2010

Contents

Abstract

  • They administered a recombinant adenovirus vector (AdCFTR) containing the normal human CFTR cDNA into the nasal and bronchial epithelium of 4 individuals with CF.
  • They found the vector expresses the CFTR cDNA in the respiratory epithelium in vivo.
  • At 2x109 pfu there was no recombination, complementation, shedding of the vector, or rise in antibody titres. Although, there was a transient and systemic pulmonary syndrome observed (possibly mediated by IL-6)
  • They saw no long term effects

Introduction

  • CF is a common lethal hereditary disorder caused by a mutation on CFTR on chromosome 7
  • The disorder is characterized by airway and gastrointestinal disease, the lung manifestations dominate
  • The pathogenesis is clearly linked to the lack of CFTR in the respiratory epithelia
  • Symptoms in first decade:
    • Thick mucus, colonization with infectious bacteria, and chronic airway inflammation
  • One approach to prevent respiratory manifestations of CFTR is gene therapy (talked about in abstract)
  • Gene therapy must be carried out in vivo, cannot be done ex vitro

I also decided to add in the notes I took in class just for completeness

  • One of the four human gene therapy trials approved and initiated at the same time
  • Based on the results of this trial, the others were halted
  • Used CF patients who were in remarkably good health
  • Did multiple dosing to find effecting concentration

Results in the human study:

  • Treatment evoked an immune response
  • Inflammation accompanied the immune response
  • Results are short lived- at most 6 weeks
  • Because of the immune response, will not be able to do multiple dosing
  • Very inefficient transfer of gene of interest- will do nothing to correct the defect
  • "Correction of the CF phenotype of the airway epithelium might be achieved with this strategy"
  • "To maintain chronic expression, adenovirus vectors will probably have to be administered repeatedly"
    • This is not possible with an immune response
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