{"id":206389,"date":"2017-12-07T01:02:16","date_gmt":"2017-12-07T01:02:16","guid":{"rendered":"http:\/\/healthmedicinet.com\/i2\/routing-gene-therapy-directly-into-the-brain\/"},"modified":"2017-12-07T01:02:16","modified_gmt":"2017-12-07T01:02:16","slug":"routing-gene-therapy-directly-into-the-brain","status":"publish","type":"post","link":"http:\/\/healthmedicinet.com\/i2\/routing-gene-therapy-directly-into-the-brain\/","title":{"rendered":"Routing gene therapy directly into the brain"},"content":{"rendered":"<p>A therapeutic technique to transplant blood-forming (hematopoietic) stem cells directly into the brain could herald a revolution in our approach to treating central nervous system diseases and neurodegenerative disorders.<\/p>\n<p>The technique, which could be used to transplant donor-matched hematopoietic stem cells (HSCs) or a patient&#8217;s own genetically-engineered HSCs into the brain, was reported in <em>Science Advances<\/em> today by researchers from the Dana-Farber\/Boston Children&#8217;s Cancer and Blood Disorders Center and the San Raffaele Telethon Institute for Gene Therapy.<\/p>\n<p>In their study, the team tested the technique in a mouse model to treat lysosomal storage disorders, a group of severe metabolic disorders that affect the central nervous system.<\/p>\n<p>The team&#8217;s findings are groundbreaking because, until now, it was thought that HSCs &#8212; from a healthy, matched donor or a patient&#8217;s own genetically-corrected cells &#8212; needed to be transplanted indirectly, through an intravenous line to the bloodstream.<\/p>\n<p>Therapeutic success has then depended on those cells engrafting in a patient&#8217;s bone marrow, maturing and naturally circulating into the brain, at a very slow and inefficient rate.<\/p>\n<p><strong>A race against time<\/strong><\/p>\n<p>But in children with lysosomal storage disorders, caused by enzyme imbalances that result in a dangerous build-up of lipids, carbohydrates or other materials in the body&#8217;s cells, time is of the essence to stop the disease&#8217;s progression.<\/p>\n<p>&#8220;The main issue with the conventional HSC transplant strategy has been the length of time needed for the therapy to take effect in the brain,&#8221; says Alessandra Biffi, MD, director of the gene therapy program at Dana-Farber\/Boston Children&#8217;s and the senior author of the new study.<\/p>\n<p>&#8220;It can take up to a year for the genetically-engineered cell lineage to proliferate, spread and produce therapeutic effects in the brain &#8212; oftentimes, patients don&#8217;t have the luxury of time to wait,&#8221; Biffi adds.<\/p>\n<p>Biffi and her team wanted to find a faster &#8212; and more direct &#8212; way to transplant therapeutic HSCs into the brain.<\/p>\n<p>In a mouse model of lysosomal storage disorders, Biffi&#8217;s team transplanted HSCs &#8212; which they had genetically engineered to correct the enzyme imbalance &#8212; directly into the brain. They found the direct approach jumpstarted the therapeutic benefits much faster than intravenous infusion alone. They call their method, which infuses the cells into fluid-filled cavities in the brain called ventricles, &#8220;intracerebroventricular&#8221; delivery.<\/p>\n<p><strong>Creating a chimera<\/strong><\/p>\n<p>Once the genetically-engineered HSCs are transplanted into the brain&#8217;s ventricles, the crucial enzyme they contain helps to metabolize the materials that were previously building up and causing tissue damage.<\/p>\n<p>A new lineage of cells descended from the transplanted HSCs &#8212; a type of cell called a myeloid &#8212; begin to scavenge and consume the excess material that is responsible for neurodegeneration.<\/p>\n<p>&#8220;There&#8217;s a positive impact from the presence of the new, metabolically-functional myeloid cells because they release signaling cytokines that counteract neuroinflammation, which if unchecked can trigger neuronal damage,&#8221; Biffi says.<\/p>\n<p>Importantly, the transplanted HSCs engraft in the mouse brains without migrating to other areas of the central nervous system. This essentially could create a chimera &#8212; a separate genetic profile within an organism &#8212; within the brain.<\/p>\n<p>The ability to engineer a chimeric population of brain cells could open powerful new avenues to preventing or reversing neurodegenerative diseases like Parkinson&#8217;s, Alzheimer&#8217;s, ALS and more.<\/p>\n<p><strong>From the lab to the human brain<\/strong><\/p>\n<p>Although transplanting HSCs directly into the human brain sounds invasive at first, Biffi explains that the procedure would not be overly complex in actuality.<\/p>\n<p>&#8220;I envision this could be a one-time treatment accomplished via a catheter temporarily placed into the brain&#8217;s ventricles, under standard anesthesia,&#8221; Biffi says. &#8220;This would be in line with currently-used clinical procedures that enable access to the brain for treatment.&#8221;<\/p>\n<p>Based on the promising results of their mouse studies, Biffi and her colleagues are moving forward with plans to develop the procedure for the clinic.<\/p>\n<p>She says there is great potential for intracerebroventricular delivery of genetically-modified HSCs, alone or in combination with intravenous gene therapies. This approach would be a new tool for clinicians to treat a range of conditions that affect the brain or the entire nervous system.<\/p>\n<p align=\"center\">###<\/p>\n<p>In addition to Biffi, other authors on the study were: Alessia Capotondo, Rita Milazzo, Jose M. Garcia-Manteiga, Eleonora Cavalca, Annita Montepeloso, Brian S. Garrison, Marco Peviani and Derrick J. Rossi.<\/p>\n<p>This study was funded by the European Community (Consolidator European Research Council 617162), the Italian Ministry of Health (GR-2011-02347261), Telethon Foundation (TGT_B01) and Boston Children&#8217;s Hospital.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A therapeutic technique to transplant blood-forming (hematopoietic) stem cells directly into the brain could herald a revolution in our approach to treating central nervous system diseases and neurodegenerative disorders. The technique, which could be used to transplant donor-matched hematopoietic stem cells (HSCs) or a patient&#8217;s own genetically-engineered HSCs into the brain, was reported in Science [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[310],"tags":[543],"class_list":["post-206389","post","type-post","status-publish","format-standard","hentry","category-health","tag-health"],"_links":{"self":[{"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/posts\/206389","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/comments?post=206389"}],"version-history":[{"count":0,"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/posts\/206389\/revisions"}],"wp:attachment":[{"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/media?parent=206389"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/categories?post=206389"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/healthmedicinet.com\/i2\/wp-json\/wp\/v2\/tags?post=206389"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}