Hemophilia A （HA） is an inherited X-linked recessive bleeding disorder caused by coagulant factor VIII （FVIII） deficiency. Previous studies showed that introduction of mesenchymal stem cells （MSCs） modified by F...Hemophilia A （HA） is an inherited X-linked recessive bleeding disorder caused by coagulant factor VIII （FVIII） deficiency. Previous studies showed that introduction of mesenchymal stem cells （MSCs） modified by FVIll-expressing retrovims may result in phenotypic correction of HA animals. This study aimed at the investigation of an alternative gene therapy strategy that may lead to sustained FVIII transgene expression in HA mice. B-domain-de/eted human FVIll （hFVHIBD） vector was microinjected into single-cell embryos of wild-type mice to generate a transgenic mouse line, from which hFVIIIBD-MSCs were isolated, followed by transplantation into HA mice. RT-PCR and real-time PCR analysis demonstrated the expression of hFVlllBD in multi-organs of recipient HA mice. Immunohistochemistry showed the presence of hFVIIIBD positive staining in multi-organs of recipient HA mice. ELISA indicated that plasma hFVIIIBD level in recipient mice reached its peak （77 ng/ mL） at the 3rd week after implantation, and achieved sustained expression during the 5-week observation period. Plasma FVIII activities of recipient HA mice increased from 0% to 32% after hFVIIIBD-MSCs transplantation. APTT （activated partial thromboplastin time） value decreased in hFVIIIBD-MSCs transplanted HA mice compared with untreated HA mice （45.5 s vs. 91.3 s）. Our study demonstrated an effective phenotypic correction in HA mice using genetically modified MSCs from hFVIIIBD transgenic mice.展开更多
Background: In Africa, hemophilia is underdiagnosed and carriers have long been considered free from bleeding symptoms. However, recent research has begun to reveal hemostatic abnormalities and bleeding manifestations...Background: In Africa, hemophilia is underdiagnosed and carriers have long been considered free from bleeding symptoms. However, recent research has begun to reveal hemostatic abnormalities and bleeding manifestations in carriers of hemophilia A, particularly due to excessive inactivation of normal X chromosomes. Objective: To describe the bleeding symptoms and hemostatic abnormalities in carriers of hemophilia A (HA) in Benin. Methods: This study was conducted as a prospective cross-sectional investigation between April 2021 to March 2022. The study population consisted of identified through pedigrees of persons with hemophilia A being treated in various hospitals in Benin. Data were collected through interviews conducted by trained physician and each carrier underwent a biological workup. Results: A total of 71 hemophilia A carriers were included and 38 of whom were obligatory carriers. Thirty-one carriers (43.7%) reported abnormal bleeding symptoms. Menorrhagia has (71%) being the most important manifestation, followed by bleeding during or after childbirth (45.2%). Among the 71 carriers, 45 were of reproductive age. Of whom 22 (48.8%) had a Higham score exceeding 100. Activated partial thromboplastin time was prolonged in 7 carriers (9.9%). The mean activity factor VIII:C (FVIII:C) levels were 68.8 ± 34.9 IU/dL. The average FVIII:C level in obligatory carriers was 56.9% and among potential carriers, the average FVIII:C level was higher at 80.4%. However twelve female carriers (16.9%) had FVIII:C levels < 40%. The FVIII:C/FvWAg ratio was below 0.7 in 73.2% of female drivers. Obligatory carriers (p = 0.00003) and FVIII;C/FvWAg ratio = 0.003) were statistically associated with abnormal bleeding symptoms, while blood group O (p = 0.0002) and FVIII/FvWAg ratio = 0.0016) were associated with a higher risk of menorrhagia. Conclusion: In Benin, carriers of haemophilia A present bleeding symptoms and haemostatic abnormalities. Further studies on a larger number of carriers are needed to better characterize and manage these patients.展开更多
Hemophilia A and B are diseases caused by a single gene deficiency and are thus suitable for gene therapy.In recent clinical research,adeno-associated virus(AAV)was employed by several teams in the treatment of hemoph...Hemophilia A and B are diseases caused by a single gene deficiency and are thus suitable for gene therapy.In recent clinical research,adeno-associated virus(AAV)was employed by several teams in the treatment of hemophilia A and B,and the outcomes were encouraging.In this review,we summarized the most recent research on the mechanism and application of AAV in the treatment of hemophilia,trying to analyze the advantages of AAV gene therapy and the main challenges in its clinical use.We also summarized the clinical trials involving hemophilia,especially those employing AAV gene therapy to treat hemophilia A and B,some of which have already been completed and some that are still ongoing.From the reports of the completed clinical trials,we tried to determine the correlations among AAV dose,AAV serotype,immune response,and gene expression time.Finally,taking into account the most recent studies investigating AAV capsid modification,transgene optimization,and AAV chaperones,we summarized the direction of basic research and clinical applications of AAV in the future.展开更多
基金supported by the grants from China National Basic Research Program(Nos.2010CB945202 and 2010CB529902)Clinical Specialty Key Program of Ministry of Public HealthState and Shanghai Key Discipline(B204)
文摘Hemophilia A （HA） is an inherited X-linked recessive bleeding disorder caused by coagulant factor VIII （FVIII） deficiency. Previous studies showed that introduction of mesenchymal stem cells （MSCs） modified by FVIll-expressing retrovims may result in phenotypic correction of HA animals. This study aimed at the investigation of an alternative gene therapy strategy that may lead to sustained FVIII transgene expression in HA mice. B-domain-de/eted human FVIll （hFVHIBD） vector was microinjected into single-cell embryos of wild-type mice to generate a transgenic mouse line, from which hFVIIIBD-MSCs were isolated, followed by transplantation into HA mice. RT-PCR and real-time PCR analysis demonstrated the expression of hFVlllBD in multi-organs of recipient HA mice. Immunohistochemistry showed the presence of hFVIIIBD positive staining in multi-organs of recipient HA mice. ELISA indicated that plasma hFVIIIBD level in recipient mice reached its peak （77 ng/ mL） at the 3rd week after implantation, and achieved sustained expression during the 5-week observation period. Plasma FVIII activities of recipient HA mice increased from 0% to 32% after hFVIIIBD-MSCs transplantation. APTT （activated partial thromboplastin time） value decreased in hFVIIIBD-MSCs transplanted HA mice compared with untreated HA mice （45.5 s vs. 91.3 s）. Our study demonstrated an effective phenotypic correction in HA mice using genetically modified MSCs from hFVIIIBD transgenic mice.
文摘Background: In Africa, hemophilia is underdiagnosed and carriers have long been considered free from bleeding symptoms. However, recent research has begun to reveal hemostatic abnormalities and bleeding manifestations in carriers of hemophilia A, particularly due to excessive inactivation of normal X chromosomes. Objective: To describe the bleeding symptoms and hemostatic abnormalities in carriers of hemophilia A (HA) in Benin. Methods: This study was conducted as a prospective cross-sectional investigation between April 2021 to March 2022. The study population consisted of identified through pedigrees of persons with hemophilia A being treated in various hospitals in Benin. Data were collected through interviews conducted by trained physician and each carrier underwent a biological workup. Results: A total of 71 hemophilia A carriers were included and 38 of whom were obligatory carriers. Thirty-one carriers (43.7%) reported abnormal bleeding symptoms. Menorrhagia has (71%) being the most important manifestation, followed by bleeding during or after childbirth (45.2%). Among the 71 carriers, 45 were of reproductive age. Of whom 22 (48.8%) had a Higham score exceeding 100. Activated partial thromboplastin time was prolonged in 7 carriers (9.9%). The mean activity factor VIII:C (FVIII:C) levels were 68.8 ± 34.9 IU/dL. The average FVIII:C level in obligatory carriers was 56.9% and among potential carriers, the average FVIII:C level was higher at 80.4%. However twelve female carriers (16.9%) had FVIII:C levels < 40%. The FVIII:C/FvWAg ratio was below 0.7 in 73.2% of female drivers. Obligatory carriers (p = 0.00003) and FVIII;C/FvWAg ratio = 0.003) were statistically associated with abnormal bleeding symptoms, while blood group O (p = 0.0002) and FVIII/FvWAg ratio = 0.0016) were associated with a higher risk of menorrhagia. Conclusion: In Benin, carriers of haemophilia A present bleeding symptoms and haemostatic abnormalities. Further studies on a larger number of carriers are needed to better characterize and manage these patients.
基金supported by the Beijing-Tianjin-Hebei basic research project 18JCZDJC44600/H2018206423 Lei ZhangNon-profit Central Research Institute Fund of Chinese Academy of Medical Sciences 2017PT31047,2018PT31038/2018PT32028+1 种基金CAMS Innovation Fund for Medical Sciences(CIFMS)2016-I2M-1-018Novartis Foundation.
文摘Hemophilia A and B are diseases caused by a single gene deficiency and are thus suitable for gene therapy.In recent clinical research,adeno-associated virus(AAV)was employed by several teams in the treatment of hemophilia A and B,and the outcomes were encouraging.In this review,we summarized the most recent research on the mechanism and application of AAV in the treatment of hemophilia,trying to analyze the advantages of AAV gene therapy and the main challenges in its clinical use.We also summarized the clinical trials involving hemophilia,especially those employing AAV gene therapy to treat hemophilia A and B,some of which have already been completed and some that are still ongoing.From the reports of the completed clinical trials,we tried to determine the correlations among AAV dose,AAV serotype,immune response,and gene expression time.Finally,taking into account the most recent studies investigating AAV capsid modification,transgene optimization,and AAV chaperones,we summarized the direction of basic research and clinical applications of AAV in the future.
