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Efficacy to biologics in rheumatoid arthritis (RA) patients is variable and is likely influenced by each patient’s circulating drug levels. Using modelling and simulation, the aim of this study was to investigate whether adalimumab and etanercept biosimilar dosing intervals can be altered to achieve therapeutic drug levels at a faster/similar time compared to the recommended interval. RA patients starting subcutaneous Amgevita or Benepali (adalimumab and etanercept biosimilars, respectively) were recruited and underwent sparse serum sampling for drug concentrations. Drug levels were measured using commercially available kits. Pharmacokinetic data were analysed using a population approach (popPK) and potential covariates were investigated in models. Models were compared using goodness-of-fit criteria. Final models were selected and used to simulate alternative dosing intervals. Ten RA patients starting the adalimumab biosimilar and six patients starting the etanercept biosimilar were recruited. One-compartment PK models were used to describe the popPK models for both drugs; no significant covariates were found. Typical individual parameter estimates were used to simulate altered dosing intervals for both drugs. A simulation of dosing the etanercept biosimilar at a lower rate of every 10 days reached steady-state concentrations earlier than the usual dosing rate of every 7 days. Simulations of altered dosing intervals could form the basis for future personalised dosing studies, potentially saving costs whilst increasing efficacy., QC 20240627

Efficacy to biologics in rheumatoid arthritis (RA) patients is variable and is likely influenced by each patient’s circulating drug levels. Using modelling and simulation, the aim of this study was to investigate whether adalimumab and etanercept biosimilar dosing intervals can be altered to achieve therapeutic drug levels at a faster/similar time compared to the recommended interval. RA patients starting subcutaneous Amgevita or Benepali (adalimumab and etanercept biosimilars, respectively) were recruited and underwent sparse serum sampling for drug concentrations. Drug levels were measured using commercially available kits. Pharmacokinetic data were analysed using a population approach (popPK) and potential covariates were investigated in models. Models were compared using goodness-of-fit criteria. Final models were selected and used to simulate alternative dosing intervals. Ten RA patients starting the adalimumab biosimilar and six patients starting the etanercept biosimilar were recruited. One-compartment PK models were used to describe the popPK models for both drugs; no significant covariates were found. Typical individual parameter estimates were used to simulate altered dosing intervals for both drugs. A simulation of dosing the etanercept biosimilar at a lower rate of every 10 days reached steady-state concentrations earlier than the usual dosing rate of every 7 days. Simulations of altered dosing intervals could form the basis for future personalised dosing studies, potentially saving costs whilst increasing efficacy., QC 20240627

Efficacy to biologics in rheumatoid arthritis (RA) patients is variable and is likely influenced by each patient’s circulating drug levels. Using modelling and simulation, the aim of this study was to investigate whether adalimumab and etanercept biosimilar dosing intervals can be altered to achieve therapeutic drug levels at a faster/similar time compared to the recommended interval. RA patients starting subcutaneous Amgevita or Benepali (adalimumab and etanercept biosimilars, respectively) were recruited and underwent sparse serum sampling for drug concentrations. Drug levels were measured using commercially available kits. Pharmacokinetic data were analysed using a population approach (popPK) and potential covariates were investigated in models. Models were compared using goodness-of-fit criteria. Final models were selected and used to simulate alternative dosing intervals. Ten RA patients starting the adalimumab biosimilar and six patients starting the etanercept biosimilar were recruited. One-compartment PK models were used to describe the popPK models for both drugs; no significant covariates were found. Typical individual parameter estimates were used to simulate altered dosing intervals for both drugs. A simulation of dosing the etanercept biosimilar at a lower rate of every 10 days reached steady-state concentrations earlier than the usual dosing rate of every 7 days. Simulations of altered dosing intervals could form the basis for future personalised dosing studies, potentially saving costs whilst increasing efficacy., QC 20240627

Efficacy to biologics in rheumatoid arthritis (RA) patients is variable and is likely influenced by each patient’s circulating drug levels. Using modelling and simulation, the aim of this study was to investigate whether adalimumab and etanercept biosimilar dosing intervals can be altered to achieve therapeutic drug levels at a faster/similar time compared to the recommended interval. RA patients starting subcutaneous Amgevita or Benepali (adalimumab and etanercept biosimilars, respectively) were recruited and underwent sparse serum sampling for drug concentrations. Drug levels were measured using commercially available kits. Pharmacokinetic data were analysed using a population approach (popPK) and potential covariates were investigated in models. Models were compared using goodness-of-fit criteria. Final models were selected and used to simulate alternative dosing intervals. Ten RA patients starting the adalimumab biosimilar and six patients starting the etanercept biosimilar were recruited. One-compartment PK models were used to describe the popPK models for both drugs; no significant covariates were found. Typical individual parameter estimates were used to simulate altered dosing intervals for both drugs. A simulation of dosing the etanercept biosimilar at a lower rate of every 10 days reached steady-state concentrations earlier than the usual dosing rate of every 7 days. Simulations of altered dosing intervals could form the basis for future personalised dosing studies, potentially saving costs whilst increasing efficacy., QC 20240627

Efficacy to biologics in rheumatoid arthritis (RA) patients is variable and is likely influenced by each patient’s circulating drug levels. Using modelling and simulation, the aim of this study was to investigate whether adalimumab and etanercept biosimilar dosing intervals can be altered to achieve therapeutic drug levels at a faster/similar time compared to the recommended interval. RA patients starting subcutaneous Amgevita or Benepali (adalimumab and etanercept biosimilars, respectively) were recruited and underwent sparse serum sampling for drug concentrations. Drug levels were measured using commercially available kits. Pharmacokinetic data were analysed using a population approach (popPK) and potential covariates were investigated in models. Models were compared using goodness-of-fit criteria. Final models were selected and used to simulate alternative dosing intervals. Ten RA patients starting the adalimumab biosimilar and six patients starting the etanercept biosimilar were recruited. One-compartment PK models were used to describe the popPK models for both drugs; no significant covariates were found. Typical individual parameter estimates were used to simulate altered dosing intervals for both drugs. A simulation of dosing the etanercept biosimilar at a lower rate of every 10 days reached steady-state concentrations earlier than the usual dosing rate of every 7 days. Simulations of altered dosing intervals could form the basis for future personalised dosing studies, potentially saving costs whilst increasing efficacy., QC 20240627

Hepatotoxicity is a serious adverse drug reaction related to methotrexate (MTX). However, the cause of drug-induced liver injury (DILI) is still unclear and unpredictable. Genetic risk factors may predispose for MTX-DILI. Therefore, we conducted a nested case-control genome-wide association study to explore genetic risk factors associated with MTX-DILI. Seven international groups contributed blood samples and data of patients with rheumatoid arthritis who used MTX. MTX-DILI was defined as an alanine aminotransferase (ALT) level of at least three times the upper limit of normal (ULN), to increase contrast controls ALT levels did not raise above two times the ULN. Per study site, control subjects and patients with MTX-DILI (ratio 3:1) were matched for age, gender, and duration of MTX use. Patients were genotyped using Illumina GSA MD-24v1-0 and data were imputed using the 1000 Genomes reference panel. Single-nucleotide polymorphisms (SNPs) were analyzed using an additive genetic model, corrected for sex, country, and age. A P-value of ≤ 5 × 10−8 was considered significant, whereas a P-value of ≤ 5 × 10−6 was considered suggestive. A total of 108 MTX-DILI cases and 311 controls were included for association analysis. None of the SNPs were significantly associated with MTX-DILI. However, we found seven suggestive genetic variants associated with MTX-DILI (P-values 7.43 × 10−8 to 4.86 × 10−6). Of those, five SNPs were in the intronic protein-coding regions of FTCDNL1, BCOR, FGF14, RBMS3, and PFDN4/DOK5. Investigation of candidates SPATA9 (rs72783407), PLCG2 (rs60427389), RAVER2 (rs72675408), JAK1 (rs72675451), PTPN2 (rs2476601), MTHFR C677T (rs1801133), and into the HLA region did not show significant findings. No genetic variants associated with MTX-DILI were found, whereas suggestive SNPs need further investigation.

Bakgrund: I Sverige drabbas cirka 370 barn av någon form av cancer varje år. Av dessa överlever idag ungefär 85% men för vissa barn övergår den kurativa vården till palliativ vård. Syfte: Syftet med studien är att undersöka föräldrarnas upplevelse av att ha ett barn med cancer och som vårdas palliativt. Metod: Studien är en icke-systematisk litteraturundersökning där 12 artiklar har inkluderats. De valda artiklarna har analyserats genom integrerad innehållsanalys. Vid analysen så växte två huvudteman fram delaktighet och kluvna känslor. Inom dessa huvudteman fann författarna fyra subteman, vårdrelationen, beslutstagande, hopp och förlust. Resultat: Studiens resultat belyser vikten av god vårdrelation, god kommunikation och information. Studiens resultat uppmärksammar även de svårigheter föräldrarna upplevde vid beslutstagandet. Föräldrarna användande sig av copingstrategier omedvetet för hantering av förlust, sorg och lidande. Slutsats: Föräldrarnas upplevelser vid den pediatriska palliativa vården påverkades positivt av en god vårdrelation, att de hade tillgång information och kommunikation.

At the end of December 2019, in Wuhan, China, a rapidly spreading unknown virus was reported to have caused coronavirus disease of 2019 (COVID-19). Origin linked to Wuhan’s wholesale food market where live animals are sold. This disease is caused by SARS Coronavirus-2 (SARS-CoV-2), which is closely related to the Severe Acute Respiratory Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). This virus shares a high sequence identity with bat-derived SARS-like Coronavirus, which indicating its zoonotic origin. The virus spread globally, provoking widespread attention and panic. This Coronavirus is highly pathogenic and causes mild to severe respiratory disorders. Later, it was declared a global pandemic by the World Health Organization (WHO) due to its highly infectious nature and worldwide mortality rate. This virus is a single-stranded, positive-sense RNA genome, and its genome length about 26 to 32 kb that infects a broad range of vertebrates. The researchers worldwide focus on establishing treatment strategies on drug and vaccine development to prevent this COVID-19 pandemic. A drug repurposing approach has been used to identify a rapid treatment for the people affected by COVID-19, which could be cost-effective and bypass some Food and Drug Association (FDA) regulations to move quickly in phase-3 trials. However, there is no promising therapeutic option available yet. This book chapter addresses current information about the COVID-19 disease, including its origins, impacts, and the novel potential drug candidates that can help treat the COVID-19.

Contains fulltext : 207863.pdf (publisher's version ) (Open Access)

Contains fulltext : 207863.pdf (publisher's version ) (Open Access)

Contains fulltext : 207863.pdf (publisher's version ) (Open Access)

Due to rise in drug resistance among pathogens, there is always an urge to look for new drug alternatives. So in this study we aimed to identify the unexplored rhizosphere microflora of alfalfa plant for new antimicrobials. With initial screening for isolates from rhizosphere region for antibacterial activity against selected bacterial pathogens, the isolate AL10 had better activity selected for this study. The isolate mass was cultured and secondary metabolites were extracted using ethyl acetate and subjected to FTIR and GC-MS analysis. Based on functional diversity analysis, the isolate subjected to anti-bacterial activity revealed significant activity against Streptococcus pneumonia, Klebsiella, S. aureus with zone of inhibition in the range of18-20 mm. Based on GC-MS analysis report ten compounds were identified and 1-Octadecane and 1-nonadecanol were found to be responsible for bio-activity. FT-IR results showed that N-H stretching functional group was dominantly present in the extract. Molecular identification of the isolate by 16S rRNA sequencing showed the isolate as Pantoea agglomerans. The results showed that the isolate P.agglomerans, gram negative bacteria had wide antibacterial activity due to 1-Octadecane and 1-nonadecanol. Though Alfalfa plant has been described for various biological activities, this is a first report on rhizosphere region of plant reporting for antibacterial potential microbes.

A holistic view of the Bengal-Nicobar Fan system requires sampling the full sedimentary section of the Nicobar Fan, which was achieved for the first time by International Ocean Discovery Program (IODP) Expedition 362 west of North Sumatra. We identified a distinct rise in sediment accumulation rate (SAR) beginning similar to 9.5 Ma and reaching 250-350 m/Myr in the 9.5-2 Ma interval, which equal or far exceed rates on the Bengal Fan at similar latitudes. This marked rise in SAR and a constant Himalayan-derived provenance necessitates a major restructuring of sediment routing in the Bengal-Nicobar submarine fan. This coincides with the inversion of the Eastern Himalayan Shillong Plateau and encroachment of the west-propagating Indo-Burmese wedge, which reduced continental accommodation space and increased sediment supply directly to the fan. Our results challenge a commonly held view that changes in sediment flux seen in the Bengal-Nicobar submarine fan were caused by discrete tectonic or climatic events acting on the Himalayan-Tibetan Plateau. Instead, an interplay of tectonic and climatic processes caused the fan system to develop by punctuated changes rather than gradual progradation.

Plate-boundary fault rupture during the 2004 Sumatra-Andaman subduction earthquake extended closer to the trench than expected, increasing earthquake and tsunami size. International Ocean Discovery Program Expedition 362 sampled incoming sediments offshore northern Sumatra, revealing recent release of fresh water within the deep sediments. Thermal modeling links this freshening to amorphous silica dehydration driven by rapid burial-induced temperature increases in the past 9 million years. Complete dehydration of silicates is expected before plate subduction, contrasting with prevailing models for subduction seismogenesis calling for fluid production during subduction. Shallow slip offshore Sumatra appears driven by diagenetic strengthening of deeply buried fault-forming sediments, contrasting with weakening proposed for the shallow Tohoku-Oki 2011 rupture, but our results are applicable to other thickly sedimented subduction zones including those with limited earthquake records.

Highlights • Sediment accumulation rates in Nicobar Fan abruptly increase 9.5 Ma. • Increased sediment flux to eastern Indian Ocean and restructuring of sediment routing. • Nicobar Fan holds significant record of Indian Ocean sedimentation in late Neogene. • Shillong Plateau and Indo–Burmese wedge uplift drive sediment south in late Miocene. A holistic view of the Bengal–Nicobar Fan system requires sampling the full sedimentary section of the Nicobar Fan, which was achieved for the first time by International Ocean Discovery Program (IODP) Expedition 362 west of North Sumatra. We identified a distinct rise in sediment accumulation rate (SAR) beginning ∼9.5 Ma and reaching 250–350 m/Myr in the 9.5–2 Ma interval, which equal or far exceed rates on the Bengal Fan at similar latitudes. This marked rise in SAR and a constant Himalayan-derived provenance necessitates a major restructuring of sediment routing in the Bengal–Nicobar submarine fan. This coincides with the inversion of the Eastern Himalayan Shillong Plateau and encroachment of the west-propagating Indo–Burmese wedge, which reduced continental accommodation space and increased sediment supply directly to the fan. Our results challenge a commonly held view that changes in sediment flux seen in the Bengal–Nicobar submarine fan were caused by discrete tectonic or climatic events acting on the Himalayan–Tibetan Plateau. Instead, an interplay of tectonic and climatic processes caused the fan system to develop by punctuated changes rather than gradual progradation.

Plate-boundary fault rupture during the 2004 Sumatra-Andaman subduction earthquake extended closer to the trench than expected, increasing earthquake and tsunami size. International Ocean Discovery Program Expedition 362 sampled incoming sediments offshore northern Sumatra, revealing recent release of fresh water within the deep sediments. Thermal modeling links this freshening to amorphous silica dehydration driven by rapid burial-induced temperature increases in the past 9 million years. Complete dehydration of silicates is expected before plate subduction, contrasting with prevailing models for subduction seismogenesis calling for fluid production during subduction. Shallow slip offshore Sumatra appears driven by diagenetic strengthening of deeply buried fault-forming sediments, contrasting with weakening proposed for the shallow Tohoku-Oki 2011 rupture, but our results are applicable to other thickly sedimented subduction zones including those with limited earthquake records.

Highlights • Sediment accumulation rates in Nicobar Fan abruptly increase 9.5 Ma. • Increased sediment flux to eastern Indian Ocean and restructuring of sediment routing. • Nicobar Fan holds significant record of Indian Ocean sedimentation in late Neogene. • Shillong Plateau and Indo–Burmese wedge uplift drive sediment south in late Miocene. A holistic view of the Bengal–Nicobar Fan system requires sampling the full sedimentary section of the Nicobar Fan, which was achieved for the first time by International Ocean Discovery Program (IODP) Expedition 362 west of North Sumatra. We identified a distinct rise in sediment accumulation rate (SAR) beginning ∼9.5 Ma and reaching 250–350 m/Myr in the 9.5–2 Ma interval, which equal or far exceed rates on the Bengal Fan at similar latitudes. This marked rise in SAR and a constant Himalayan-derived provenance necessitates a major restructuring of sediment routing in the Bengal–Nicobar submarine fan. This coincides with the inversion of the Eastern Himalayan Shillong Plateau and encroachment of the west-propagating Indo–Burmese wedge, which reduced continental accommodation space and increased sediment supply directly to the fan. Our results challenge a commonly held view that changes in sediment flux seen in the Bengal–Nicobar submarine fan were caused by discrete tectonic or climatic events acting on the Himalayan–Tibetan Plateau. Instead, an interplay of tectonic and climatic processes caused the fan system to develop by punctuated changes rather than gradual progradation.

Plate-boundary fault rupture during the 2004 Sumatra-Andaman subduction earthquake extended closer to the trench than expected, increasing earthquake and tsunami size. International Ocean Discovery Program Expedition 362 sampled incoming sediments offshore northern Sumatra, revealing recent release of fresh water within the deep sediments. Thermal modeling links this freshening to amorphous silica dehydration driven by rapid burial-induced temperature increases in the past 9 million years. Complete dehydration of silicates is expected before plate subduction, contrasting with prevailing models for subduction seismogenesis calling for fluid production during subduction. Shallow slip offshore Sumatra appears driven by diagenetic strengthening of deeply buried fault-forming sediments, contrasting with weakening proposed for the shallow Tohoku-Oki 2011 rupture, but our results are applicable to other thickly sedimented subduction zones including those with limited earthquake records.

Highlights • Sediment accumulation rates in Nicobar Fan abruptly increase 9.5 Ma. • Increased sediment flux to eastern Indian Ocean and restructuring of sediment routing. • Nicobar Fan holds significant record of Indian Ocean sedimentation in late Neogene. • Shillong Plateau and Indo–Burmese wedge uplift drive sediment south in late Miocene. A holistic view of the Bengal–Nicobar Fan system requires sampling the full sedimentary section of the Nicobar Fan, which was achieved for the first time by International Ocean Discovery Program (IODP) Expedition 362 west of North Sumatra. We identified a distinct rise in sediment accumulation rate (SAR) beginning ∼9.5 Ma and reaching 250–350 m/Myr in the 9.5–2 Ma interval, which equal or far exceed rates on the Bengal Fan at similar latitudes. This marked rise in SAR and a constant Himalayan-derived provenance necessitates a major restructuring of sediment routing in the Bengal–Nicobar submarine fan. This coincides with the inversion of the Eastern Himalayan Shillong Plateau and encroachment of the west-propagating Indo–Burmese wedge, which reduced continental accommodation space and increased sediment supply directly to the fan. Our results challenge a commonly held view that changes in sediment flux seen in the Bengal–Nicobar submarine fan were caused by discrete tectonic or climatic events acting on the Himalayan–Tibetan Plateau. Instead, an interplay of tectonic and climatic processes caused the fan system to develop by punctuated changes rather than gradual progradation.

Essentials B cells are attractive targets for gene therapy and particularly interesting for immunotherapy. A baboon envelope pseudotyped lentiviral vector (BaEV-LV) was tested for B-cell transduction. BaEV-LVs transduced mature and plasma human B cells with very high efficacy. BaEV-LVs allowed secretion of functional factor IX from B cells at therapeutic levels in vivo. Summary: Background B cells are attractive targets for gene therapy for diseases associated with B-cell dysfunction and particularly interesting for immunotherapy. Moreover, B cells are potent protein-secreting cells and can be tolerogenic antigen-presenting cells. Objective Evaluation of human B cells for secretion of clotting factors such as factor IX (FIX) as a possible treatment for hemophilia. Methods We tested here for the first time our newly developed baboon envelope (BaEV) pseudotyped lentiviral vectors (LVs) for human (h) B-cell transduction following their adaptive transfer into an NOD/SCIDγc-/- (NSG) mouse. Results Upon B-cell receptor stimulation, BaEV-LVs transduced up to 80% of hB cells, whereas vesicular stomatitis virus G protein VSV-G-LV only reached 5%. Remarkably, BaEVTR-LVs permitted efficient transduction of 20% of resting naive and 40% of resting memory B cells. Importantly, BaEV-LVs reached up to 100% transduction of human plasmocytes ex vivo. Adoptive transfer of BaEV-LV-transduced mature B cells into NOD/SCID/γc-/- (NSG) [non-obese diabetic (NOD), severe combined immuno-deficiency (SCID)] mice allowed differentiation into plasmablasts and plasma B cells, confirming a sustained high-level gene marking in vivo. As proof of principle, we assessed BaEV-LV for transfer of human factor IX (hFIX) into B cells. BaEV-LVs encoding FIX efficiently transduced hB cells and their transfer into NSG mice demonstrated for the first time secretion of functional hFIX from hB cells at therapeutic levels in vivo. Conclusions The BaEV-LVs might represent a valuable tool for therapeutic protein se, SCOPUS: ar.j, FLWNA, info:eu-repo/semantics/published

Duchenne muscular dystrophy (DMD) is a genetic neuromuscular disorder caused by the absence of dystrophin. We developed a novel gene therapy approach based on the use of the piggyBac (PB) transposon system to deliver the coding DNA sequence (CDS) of either full-length human dystrophin (DYS: 11.1 kb) or truncated microdystrophins (MD1: 3.6 kb; MD2: 4 kb). PB transposons encoding microdystrophins were transfected in C2C12 myoblasts, yielding 65±2% MD1 and 66±2% MD2 expression in differentiated multinucleated myotubes. A hyperactive PB (hyPB) transposase was then deployed to enable transposition of the large-size PB transposon (17 kb) encoding the full-length DYS and green fluorescence protein (GFP). Stable GFP expression attaining 78±3% could be achieved in the C2C12 myoblasts that had undergone transposition. Western blot analysis demonstrated expression of the full-length human DYS protein in myotubes. Subsequently, dystrophic mesoangioblasts from a Golden Retriever muscular dystrophy dog were transfected with the large-size PB transposon resulting in 50±5% GFP-expressing cells after stable transposition. This was consistent with correction of the differentiated dystrophic mesoangioblasts following expression of full-length human DYS. These results pave the way toward a novel non-viral gene therapy approach for DMD using PB transposons underscoring their potential to deliver large therapeutic genes., SCOPUS: ar.j, info:eu-repo/semantics/published

The development of the next-generation gene therapy vectors for hemophilia requires using lower and thus potentially safer vector doses and augmenting their therapeutic efficacy. We have identified hepatocyte-specific transcriptional cis-regulatory modules (CRMs) by using a computational strategy that increased factor IX (FIX) levels 11- to 15-fold. Vector efficacy could be enhanced by combining these hepatocyte-specific CRMs with a synthetic codon-optimized hyperfunctional FIX-R338L Padua transgene. This Padua mutation boosted FIX activity up to sevenfold, with no apparent increase in thrombotic risk. We then validated this combination approach using self-complementary adenoassociated virus serotype 9 (scAAV9) vectors inhemophiliaBmice. This resulted in sustained supraphysiologic FIX activity (400%), correction of the bleeding diathesis at clinically relevant, low vector doses (5×10 10 vector genomes[vg]/kg) that are considered safe in patients undergoing gene therapy. Moreover, immune tolerance could be induced that precluded induction of inhibitory antibodies to FIX upon immunization with recombinant FIX protein. © 2014 by The American Society of Hematology., SCOPUS: ar.j, info:eu-repo/semantics/published

The development of the next-generation gene therapy vectors for hemophilia requires using lower and thus potentially safer vector doses and augmenting their therapeutic efficacy. We have identified hepatocyte-specific transcriptional cis-regulatory modules (CRMs) by using a computational strategy that increased factor IX (FIX) levels 11- to 15-fold. Vector efficacy could be enhanced by combining these hepatocyte-specific CRMs with a synthetic codon-optimized hyperfunctional FIX-R338L Padua transgene. This Padua mutation boosted FIX activity up to sevenfold, with no apparent increase in thrombotic risk. We then validated this combination approach using self-complementary adenoassociated virus serotype 9 (scAAV9) vectors inhemophiliaBmice. This resulted in sustained supraphysiologic FIX activity (400%), correction of the bleeding diathesis at clinically relevant, low vector doses (5×10 10 vector genomes[vg]/kg) that are considered safe in patients undergoing gene therapy. Moreover, immune tolerance could be induced that precluded induction of inhibitory antibodies to FIX upon immunization with recombinant FIX protein. © 2014 by The American Society of Hematology., SCOPUS: ar.j, info:eu-repo/semantics/published

Hemophilia A and B are X-linked monogenic disorders caused by deficiencies in coagulation factor VIII (FVIII) and factor IX (FIX), respectively. Current treatment for hemophilia involves intravenous infusion of clotting factor concentrates. However, this does not constitute a cure, and the development of gene-based therapies for hemophilia to achieve prolonged high level expression of clotting factors to correct the bleeding diathesis are warranted. Different types of viral and nonviral gene delivery systems and a wide range of different target cells, including hepatocytes, skeletal muscle cells, hematopoietic stem cells (HSCs), and endothelial cells, have been explored for hemophilia gene therapy. Adeno-associated virus (AAV)-based and lentiviral vectors are among the most promising vectors for hemophilia gene therapy. Stable correction of the bleeding phenotypes in hemophilia A and B was achieved in murine and canine models, and these promising preclinical studies prompted clinical trials in patients suffering from severe hemophilia. These studies recently resulted in the first demonstration that long-term expression of therapeutic FIX levels could be achieved in patients undergoing gene therapy. Despite this progress, there are still a number of hurdles that need to be overcome. In particular, the FIX levels obtained were insufficient to prevent bleeding induced by trauma or injury. Moreover, the gene-modified cells in these patients can become potential targets for immune destruction by effector T cells, specific for the AAV vector antigens. Consequently, more efficacious approaches are needed to achieve full hemostatic correction and to ultimately establish a cure for hemophilia A and B. © 2012, Mary Ann Liebert, Inc., SCOPUS: ar.j, info:eu-repo/semantics/published

Hemophilia A and B are X-linked monogenic disorders caused by deficiencies in coagulation factor VIII (FVIII) and factor IX (FIX), respectively. Current treatment for hemophilia involves intravenous infusion of clotting factor concentrates. However, this does not constitute a cure, and the development of gene-based therapies for hemophilia to achieve prolonged high level expression of clotting factors to correct the bleeding diathesis are warranted. Different types of viral and nonviral gene delivery systems and a wide range of different target cells, including hepatocytes, skeletal muscle cells, hematopoietic stem cells (HSCs), and endothelial cells, have been explored for hemophilia gene therapy. Adeno-associated virus (AAV)-based and lentiviral vectors are among the most promising vectors for hemophilia gene therapy. Stable correction of the bleeding phenotypes in hemophilia A and B was achieved in murine and canine models, and these promising preclinical studies prompted clinical trials in patients suffering from severe hemophilia. These studies recently resulted in the first demonstration that long-term expression of therapeutic FIX levels could be achieved in patients undergoing gene therapy. Despite this progress, there are still a number of hurdles that need to be overcome. In particular, the FIX levels obtained were insufficient to prevent bleeding induced by trauma or injury. Moreover, the gene-modified cells in these patients can become potential targets for immune destruction by effector T cells, specific for the AAV vector antigens. Consequently, more efficacious approaches are needed to achieve full hemostatic correction and to ultimately establish a cure for hemophilia A and B. © 2012, Mary Ann Liebert, Inc., SCOPUS: ar.j, info:eu-repo/semantics/published