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Gene therapy and its uses In treating SCID-X1. Severe Combined Immunodeficiency Syndrome. Hollywood’s Take:. Severe Combined Immunodeficiency Syndrome. David Vetter (1971-1984). SCID-X1. Most Common Type of Severe Combined Immunodeficiency Syndrome
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Gene therapy and its uses In treating SCID-X1
Severe Combined Immunodeficiency Syndrome Hollywood’s Take:
Severe Combined Immunodeficiency Syndrome David Vetter (1971-1984)
SCID-X1 • Most Common Type of Severe Combined Immunodeficiency Syndrome • Between 1:50,000 and 1:100,000 children are born with a SCID • Accounts for over 50% of cases • Sex-linked – gene is carried on the X-chromosome • It is a recessive trait
SCID-X1 • Results from damage to gene coding for γ common (γc) cytokine receptor • γ c cytokine is necessary for many interleukins to function • Defective cytokine dependent survival signaling in • T and NK leukocytes • This results in complete lack of T and NK cells, leading to total breakdown of immune system.
SCID-X1 • Clinical Symptoms: • Early onset lung and digestive tract infections • Infection by parasites • Failure to thrive
Without proper treatment, children born with SCID-X1 will die before their first birthday.
Gene Therapy • Gene therapy opens up an exciting world of possibilities for patients with SCID-X1. • No waiting for a matched Hematopoietic Stem Cell (HSC) donor • Less chance of rejection
Adenoviral Vectors • Contains DNA • Chosen for non-mitotic cells • Viral DNA is inserted into nucleus, but is never incorporated into host cell’s chromosomes • Viral DNA can undergo transcription, but not replication in the cell. • Transient expression of desired protein • No risk of oncogenic side effects
Retroviral Vectors • Used on mitotically active cells (such as HSC’s) • Enter cell by same method • Contain RNA instead of DNA • Incorporate their genetic material into the host cell’s genome via reverse transcriptase and integrase • Therapeutic DNA can be replicated along with cell’s DNA • Danger of disrupting existing genes (LMO2) http://rufusrajadurai.wetpaint.com/page/AIDS-Acquired+Immuno+Deficiency+Syndrome 1:47-3:02
Clinical Studies • Marina Cavazzano-Cavalo and Alain Fischer were first to achieve successful gene therapy for SCID-X1 in 2000. • They did so using a retroviral vector • They did not use any immunosuppressive drugs in their treatment • First two study patients saw presence of lymphocytes and immunoglobulin levels approaching normal ranges for their age cohort in as little as nine months.
Clinical Studies • Between early studies in France and Britain, it was shown that out of a total of 20 cases, all but 2 individuals saw increased lymphocyte count following gene therapy, but even the two who didn’t showed clinical signs of better overall health. • A follow-up study performed in the United States showed that effectiveness of gene therapy as a viable treatment option for SCID-X1 patients decreased with patients’ age.
Conclusion Gene therapy gives us an exciting new way to look at treating many diseases, including severe combined immunodeficiencies. While the overall technology still has some kinks to work out, the benefits of gene therapy far outweigh the risks.