WASHINGTON (AP) —
French scientists mixed gene therapy and bone marrow transplants in two
boys to seemingly halt a brain disease that can kill by adolescence.
The
surprise ingredient: They disabled the HIV virus so it couldn't cause
AIDS, and then used it to carry in the healthy new gene.
The
experiment marks the first time researchers have tried that
long-contemplated step in people — and the first effective gene therapy
against a severe brain disease, said lead researcher Dr. Patrick
Aubourg of the University Paris-Descartes.
Although it's a small,
first-step study, it has "exciting implications" for other blood and
immune disorders that had been feared beyond gene therapy's reach, said
Dr. Kenneth Cornetta, president of the American Society of Gene and
Cell Therapy.
"This study shows the power of combining gene
therapy and cell therapy," added Cornetta, whose own lab at Indiana
University has long researched how to safely develop gene delivery
using lentiviruses, HIV's family.
The research was published in Friday's edition of the journal Science.
In
20 years of gene therapy research, there have been few home runs and
some headline-making setbacks — including a risk of leukemia caused by
otherwise successful gene therapy for another rare disorder, "bubble
boy disease." That's a risk that specialists hope a lentivirus-based
gene therapy will eliminate.
Best known from the movie "Lorenzo's
Oil", adrenoleukodystrophy, or ALD, is a rare genetic disease that, in
its most devastating form, destroys the coating of nerve fibers in
boys' brains. Without that coating, called myelin, the neurological
system breaks down. The disease typically strikes between the ages of
four and 10, leading to blindness, deafness, dementia and loss of
muscle control, and killing them within a few years.
Bone marrow
transplants can halt ALD by letting new myelin-forming stem cells take
root. But it's difficult to find a matching marrow donor, and the
transplant itself is very risky.
So what if stem cells from the
boys' own bone marrow could be genetically corrected, eliminating the
ALD mutation? To do that, Aubourg's team had to overcome a technical
hurdle: Gene therapy works when scientists harness deliver a healthy
new gene by attaching to a virus that can harmlessly infect cells. But
none of today's so-called gene therapy "vectors" could penetrate enough
of the stem cells needed for an ALD treatment to work.
Unlike
most viruses, HIV can penetrate stem cells, and it sticks permanently.
So Aubourg's team removed the genetic parts of HIV that make it
dangerous, leaving basically a scaffolding to carry the new therapeutic
gene.
Then they culled stem cells from two 7-year-old boys in the
early stages of ALD, and mixed in the healthy gene. The boys underwent
bone marrow-destroying chemotherapy and then had their genetically
corrected stem cells reinserted.
Two years later, the boys have
shown no sign of worsening brain damage and are functioning well with
15 percent of their blood cells producing the healthy protein, said
Aubourg, who plans to test the experimental procedure in more patients.
An advocacy group, the Stop ALD Foundation, is working to raise money
for a similar U.S. study.
On the Net:
Science Web site: http://www.sciencemag.org