This is the second competitive renewal application for a Program Project Grant (PPG) entitled Gene Therapy for Hemophilia. The PPG consists of 3 projects and 3 cores. All three projects are continued from the previous PPG. Project 1, directed by Dr. Valder Arruda, will take advantage of a novel Factor (F.) IX variant (F.IX Padua, R338L) that has 10-fold the activity of wild type F.IX. Dr. Arruda will study F.IX Padua's efficacy and potential side-effects in the canine hemophilia 8 models as well as study the molecular basis for F.IX Padua's increased specific activity. Project 2, directed by Dr. Katherine High, will examine the safety and efficacy of continuous expression of Factor VIla after intravascular delivery to skeletal muscle of an AAVFVIIa vector in hemophilic dogs;she will also develop an inducible Vila vector that can be regulated by doxycycline. Project 3, directed by Dr. l /lortimer Poncz, will continue his successful work of the previous funding period to understand the details of thrombus development by platelet-delivered F.VIII and to develop strategies to avoid observed clot instability while retaining platelet F.VIII activity in the presence of inhibitors in both hemophilia A mice and dogs. These 3 projects will be supported by three cores: Core A, the Administrative Core, will support and co-ordinate scientific interactions among the group. Core B, the Vector Core, will provide research grade AAV and lentiviral vectors for the investigators. Finally, Core C, the Large Animal Models Core at UNC-Chapel Hill, will provide access to hemophilic dogs and will provide expertise in coagulation testing and in vivo clotting models in these animals. This PPG presents three highly innovative projects to advance the care of patients with inherited bleeding disorders, including hemophilia A, hemophilia B, and patients with inhibitors to F.VIII or F.IX. The three projects investigate therapeutic strategies that utilize skeletal muscle or hematopoietic cells as targets for gene transfer, and thus are feasible for clinical translation even for those with liver disease due to viral hepatitis, which includes a large fraction of adults with severe hemophilia. The projects are highly interactive, and all three take full advantage of the proposed cores.

Public Health Relevance

Hemophilia A and B account for most of the inherited bleeding disorders in the United States of America, affecting 1 in every 5,000 males. Present treatments replacing the missing coagulation factors are effective, but with significant limitations. This Program Project will pursue animal studies of a number of complementary, innovative gene therapy approaches for the treatment of these bleeding disorders that may provide better care and that may also serve as new approaches for the care of other inherited disorders.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Program Projects (P01)
Project #
5P01HL064190-12
Application #
8313853
Study Section
Heart, Lung, and Blood Initial Review Group (HLBP)
Program Officer
Link, Rebecca P
Project Start
2000-02-22
Project End
2016-06-30
Budget Start
2012-07-01
Budget End
2013-06-30
Support Year
12
Fiscal Year
2012
Total Cost
$2,069,413
Indirect Cost
$658,161
Name
Children's Hospital of Philadelphia
Department
Type
DUNS #
073757627
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
French, Robert A; Samelson-Jones, Benjamin J; Niemeyer, Glenn P et al. (2018) Complete correction of hemophilia B phenotype by FIX-Padua skeletal muscle gene therapy in an inhibitor-prone dog model. Blood Adv 2:505-508
Gollomp, Kandace; Lambert, Michele P; Poncz, Mortimer (2017) Current status of blood 'pharming': megakaryoctye transfusions as a source of platelets. Curr Opin Hematol 24:565-571
George, Lindsey A; Sullivan, Spencer K; Giermasz, Adam et al. (2017) Hemophilia B Gene Therapy with a High-Specific-Activity Factor IX Variant. N Engl J Med 377:2215-2227
Sim, Xiuli; Poncz, Mortimer; Gadue, Paul et al. (2016) Understanding platelet generation from megakaryocytes: implications for in vitro-derived platelets. Blood 127:1227-33
Marcos-Contreras, Oscar A; Smith, Shannon M; Bellinger, Dwight A et al. (2016) Sustained correction of FVII deficiency in dogs using AAV-mediated expression of zymogen FVII. Blood 127:565-71
Arruda, V R; Samelson-Jones, B J (2016) Gene therapy for immune tolerance induction in hemophilia with inhibitors. J Thromb Haemost 14:1121-34
High, Katherine A; Anguela, Xavier M (2016) Adeno-associated viral vectors for the treatment of hemophilia. Hum Mol Genet 25:R36-41
Siner, Joshua I; Samelson-Jones, Benjamin J; Crudele, Julie M et al. (2016) Circumventing furin enhances factor VIII biological activity and ameliorates bleeding phenotypes in hemophilia models. JCI Insight 1:e89371
Zhang, Nanyan; Zhi, Huiying; Curtis, Brian R et al. (2016) CRISPR/Cas9-mediated conversion of human platelet alloantigen allotypes. Blood 127:675-80
Lyde, R; Sabatino, D; Sullivan, S K et al. (2015) Platelet-delivered therapeutics. J Thromb Haemost 13 Suppl 1:S143-50

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