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Partially corrected X-linked severe combined immunodeficiency: long-term problems and treatment options

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Abstract

Rapid progress has been made from the identification of the molecular defects causing X-linked severe combined immune deficiency (X-SCID) to the development of cutting-edge therapeutic approaches such as hematopoietic stem cell transplant and gene therapy for XSCID. Successful treatment of XSCID has created a new population of patients, many of whom are now adolescents and young adults and are facing a variety of chronic problems secondary to partial correction of their underlying disease. This review focuses on the clinical challenges facing these patients (and their caregivers) and provides an overview of some of the treatment options available, including gene therapy.

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References

  1. Glanzmann E, Riniker P. Essential lymphocytophthisis; new clinical aspect of infant pathology. Ann Paediatr. 1950;175(1–2):1–32.

    PubMed  CAS  Google Scholar 

  2. Buckley RH, Schiff RI, Schiff SE, Markert ML, Williams LW, Harville TO, et al. Human severe combined immunodeficiency: genetic, phenotypic, and functional diversity in one hundred eight infants. J Pediatr. 1997;130(3):378–87.

    PubMed  CAS  Google Scholar 

  3. Fischer A, Le Deist F, Hacein-Bey-Abina S, Andre-Schmutz I, Basile Gde S, de Villartay JP, et al. Severe combined immunodeficiency. A model disease for molecular immunology and therapy. Immunol Rev. 2005;203:98–109.

    PubMed  CAS  Google Scholar 

  4. Buckley RH. Molecular defects in human severe combined immunodeficiency and approaches to immune reconstitution. Annu Rev Immunol. 2004;22:625–55.

    PubMed  CAS  Google Scholar 

  5. Noguchi M, Yi H, Rosenblatt HM, Filipovich AH, Adelstein S, Modi WS, et al. Interleukin-2 receptor gamma chain mutation results in X-linked severe combined immunodeficiency in humans. Cell. 1993;73(1):147–57.

    PubMed  CAS  Google Scholar 

  6. Puck JM, Deschenes SM, Porter JC, Dutra AS, Brown CJ, Willard HF, et al. The interleukin-2 receptor gamma chain maps to Xq13.1 and is mutated in X-linked severe combined immunodeficiency, SCIDX1. Hum Mol Genet. 1993;2(8):1099–104.

    PubMed  CAS  Google Scholar 

  7. Huang LH, Shyur SD, Weng JD, Shin C, Huang FY, Tzen CY. Disseminated cutaneous bacille Calmette-Guerin infection identified by polymerase chain reaction in a patient with X-linked severe combined immunodeficiency. Pediatr Dermatol. 2006;23(6):560–3.

    PubMed  Google Scholar 

  8. Huang LH, Shyur SD, Weng JD, Shin C, Tzen CY, Huang FY. Disseminated Bacille Calmette-Guerin disease as the initial presentation of X-linked severe combined immunodeficiency—a case report. Asian Pac J Allergy Immunol. 2005;23(4):221–6.

    PubMed  Google Scholar 

  9. Denianke KS, Frieden IJ, Cowan MJ, Williams ML, McCalmont TH. Cutaneous manifestations of maternal engraftment in patients with severe combined immunodeficiency: a clinicopathologic study. Bone Marrow Transplant. 2001;28(3):227–33.

    PubMed  CAS  Google Scholar 

  10. Muller SM, Ege M, Pottharst A, Schulz AS, Schwarz K, Friedrich W. Transplacentally acquired maternal T lymphocytes in severe combined immunodeficiency: a study of 121 patients. Blood. 2001;98(6):1847–51.

    PubMed  CAS  Google Scholar 

  11. Myers LA, Patel DD, Puck JM, Buckley RH. Hematopoietic stem cell transplantation for severe combined immunodeficiency in the neonatal period leads to superior thymic output and improved survival. Blood. 2002;99(3):872–8.

    PubMed  CAS  Google Scholar 

  12. Puck JM. Neonatal screening for severe combined immune deficiency. Curr Opin Allergy Clin Immunol. 2007;7(6):522–7.

    PubMed  Google Scholar 

  13. Gatti RA, Meuwissen HJ, Allen HD, Hong R, Good RA. Immunological reconstitution of sex-linked lymphopenic immunological deficiency. Lancet. 1968;2(7583):1366–9.

    PubMed  CAS  Google Scholar 

  14. Buckley RH, Schiff SE, Schiff RI, Markert L, Williams LW, Roberts JL, et al. Hematopoietic stem-cell transplantation for the treatment of severe combined immunodeficiency. N Engl J Med. 1999;340(7):508–16.

    PubMed  CAS  Google Scholar 

  15. Antoine C, Muller S, Cant A, Cavazzana-Calvo M, Veys P, Vossen J, et al. Long-term survival and transplantation of haemopoietic stem cells for immunodeficiencies: report of the European experience 1968–99. Lancet. 2003;361(9357):553–60.

    PubMed  Google Scholar 

  16. Somech R, Roifman CM. Mutation analysis should be performed to rule out gammac deficiency in children with functional severe combined immune deficiency despite apparently normal immunologic tests. J Pediatr. 2005;147(4):555–7.

    PubMed  CAS  Google Scholar 

  17. Sharfe N, Dadi HK, Shahar M, Roifman CM. Human immune disorder arising from mutation of the alpha chain of the interleukin-2 receptor. Proc Natl Acad Sci USA. 1997;94(7):3168–71.

    PubMed  CAS  Google Scholar 

  18. Chinen J, Davis J, De Ravin SS, Hay BN, Hsu AP, Linton GF, et al. Gene therapy improves immune function in preadolescents with X-linked severe combined immunodeficiency. Blood. 2007;110(1):67–73.

    PubMed  CAS  Google Scholar 

  19. Muller-Ruchholtz W, Wottge HU, Muller-Hermelink HK. Lymphocytes and hemopoietic bone marrow cells—antigenic relationships between these cells and lymphatic tissue repopulation from stem cells. Adv Exp Med Biol. 1976;66:147–52.

    PubMed  CAS  Google Scholar 

  20. Speckmann C, Pannicke U, Wiech E, Schwarz K, Fisch P, Friedrich W, et al. Clinical and immunological consequences of a somatic reversion in a patient with X-linked severe combined immunodeficiency. Blood. 2008; Aug 26 [Epub ahead of print].

  21. Wada T, Yasui M, Toma T, Nakayama Y, Nishida M, Shimizu M, et al. Detection of T lymphocytes with a second-site mutation in skin lesions of atypical X-linked severe combined immunodeficiency mimicking Omenn syndrome. Blood. 2008;112(5):1872–5.

    PubMed  CAS  Google Scholar 

  22. Leonard WJ, O’Shea JJ. Jaks and STATs: biological implications. Annu Rev Immunol. 1998;16:293–322.

    PubMed  CAS  Google Scholar 

  23. Leonard WJ. The molecular basis of X-linked severe combined immunodeficiency: defective cytokine receptor signaling. Annu Rev Med. 1996;47:229–39.

    PubMed  CAS  Google Scholar 

  24. Felsburg PJ, Hartnett BJ, Henthorn PS, Moore PF, Krakowka S, Ochs HD. Canine X-linked severe combined immunodeficiency. Vet Immunol Immunopathol. 1999;69(2–4):127–35.

    PubMed  CAS  Google Scholar 

  25. Felsburg PJ, Somberg RL, Perryman LE. Domestic animal models of severe combined immunodeficiency: canine X-linked severe combined immunodeficiency and severe combined immunodeficiency in horses. Immunodefic Rev. 1992;3(4):277–303.

    PubMed  CAS  Google Scholar 

  26. Cao X, Shores EW, Hu-Li J, Anver MR, Kelsall BL, Russell SM, et al. Defective lymphoid development in mice lacking expression of the common cytokine receptor gamma chain. Immunity. 1995;2(3):223–38.

    PubMed  CAS  Google Scholar 

  27. Hong R, Cooper MD, Allan MJ, Kay HE, Meuwissen H, Good RA. Immunological restitution in lymphopenic immunological deficiency syndrome. Lancet. 1968;1(7541):503–6.

    PubMed  CAS  Google Scholar 

  28. Simonsen M. Graft versus host reactions. Their natural history, and applicability as tools of research. Prog Allergy. 1962;6:349–467.

    Article  PubMed  CAS  Google Scholar 

  29. Bortin MM, Rimm AA. Severe combined immunodeficiency disease: characterization of the disease and results of transplantation. Transplant Proc. 1977;9(1):169–70.

    PubMed  CAS  Google Scholar 

  30. Rimm AA, Bortin MM. HLA antigens and severe combined immunodeficiency disease. Lancet. 1977;1(8026):1361–2.

    PubMed  CAS  Google Scholar 

  31. Moen RC, Horowitz SD, Sondel PM, Borcherding WR, Trigg ME, Billing R, et al. Immunologic reconstitution after haploidentical bone marrow transplantation for immune deficiency disorders: treatment of bone marrow cells with monoclonal antibody CT-2 and complement. Blood. 1987;70(3):664–9.

    PubMed  CAS  Google Scholar 

  32. Giri N, Vowels M, Ziegler JB, Ford D, Lam-Po-Tang R. HLA non-identical T-cell-depleted bone marrow transplantation for primary immunodeficiency diseases. Aust N Z J Med. 1994;24(1):26–30.

    PubMed  CAS  Google Scholar 

  33. Reisner Y. Differential agglutination by soybean agglutinin of human leukemia and neuroblastoma cell lines: potential application to autologous bone marrow transplantation. Proc Natl Acad Sci USA. 1983;80(21):6657–61.

    PubMed  CAS  Google Scholar 

  34. Friedrich W, Goldmann SF, Ebell W, Blutters-Sawatzki R, Gaedicke G, Raghavachar A, et al. Severe combined immunodeficiency: treatment by bone marrow transplantation in 15 infants using HLA-haploidentical donors. Eur J Pediatr. 1985;144(2):125–30.

    PubMed  CAS  Google Scholar 

  35. Buckley RH, Schiff SE, Sampson HA, Schiff RI, Markert ML, Knutsen AP, et al. Development of immunity in human severe primary T cell deficiency following haploidentical bone marrow stem cell transplantation. J Immunol. 1986;136(7):2398–407.

    PubMed  CAS  Google Scholar 

  36. Reisner Y, Kapoor N, Kirkpatrick D, Pollack MS, Cunningham-Rundles S, Dupont B, et al. Transplantation for severe combined immunodeficiency with HLA-A, B, D, DR incompatible parental marrow cells fractionated by soybean agglutinin and sheep red blood cells. Blood. 1983;61(2):341–8.

    PubMed  CAS  Google Scholar 

  37. Roifman CM, Grunebaum E, Dalal I, Notarangelo L. Matched unrelated bone marrow transplant for severe combined immunodeficiency. Immunol Res. 2007;38(1–3):191–200.

    PubMed  Google Scholar 

  38. Dvorak CC, Cowan MJ. Hematopoietic stem cell transplantation for primary immunodeficiency disease. Bone Marrow Transplant. 2008;41(2):119–26.

    PubMed  CAS  Google Scholar 

  39. Haddad E, Landais P, Friedrich W, Gerritsen B, Cavazzana-Calvo M, Morgan G, et al. Long-term immune reconstitution and outcome after HLA-nonidentical T-cell-depleted bone marrow transplantation for severe combined immunodeficiency: a European retrospective study of 116 patients. Blood. 1998;91(10):3646–53.

    PubMed  CAS  Google Scholar 

  40. Haddad E, Le Deist F, Aucouturier P, Cavazzana-Calvo M, Blanche S, De Saint Basile G, et al. Long-term chimerism and B-cell function after bone marrow transplantation in patients with severe combined immunodeficiency with B cells: a single-center study of 22 patients. Blood. 1999;94(8):2923–30.

    PubMed  CAS  Google Scholar 

  41. Buckley RH. Advances in the understanding and treatment of human severe combined immunodeficiency. Immunol Res. 2000;22(2–3):237–51.

    PubMed  CAS  Google Scholar 

  42. Fischer A, Landais P, Friedrich W, Morgan G, Gerritsen B, Fasth A, et al. European experience of bone-marrow transplantation for severe combined immunodeficiency. Lancet. 1990;336(8719):850–4.

    PubMed  CAS  Google Scholar 

  43. Friedrich W, Honig M, Muller SM. Long-term follow-up in patients with severe combined immunodeficiency treated by bone marrow transplantation. Immunol Res. 2007;38(1–3):165–73.

    PubMed  Google Scholar 

  44. Patel DD, Gooding ME, Parrott RE, Curtis KM, Haynes BF, Buckley RH. Thymic function after hematopoietic stem-cell transplantation for the treatment of severe combined immunodeficiency. N Engl J Med. 2000;342(18):1325–32.

    PubMed  CAS  Google Scholar 

  45. Slatter MA, Bhattacharya A, Abinun M, Flood TJ, Cant AJ, Gennery AR. Outcome of boost haemopoietic stem cell transplant for decreased donor chimerism or graft dysfunction in primary immunodeficiency. Bone Marrow Transplant. 2005;35(7):683–9.

    PubMed  CAS  Google Scholar 

  46. Slatter MA, Gennery AR. Umbilical cord stem cell transplantation for primary immunodeficiencies. Expert Opin Biol Ther. 2006;6(6):555–65.

    PubMed  CAS  Google Scholar 

  47. Moss PA, Moots RJ, Rosenberg WM, Rowland-Jones SJ, Bodmer HC, McMichael AJ, et al. Extensive conservation of alpha and beta chains of the human T-cell antigen receptor recognizing HLA-A2 and influenza A matrix peptide. Proc Natl Acad Sci USA. 1991;88(20):8987–90.

    PubMed  CAS  Google Scholar 

  48. Sarzotti M, Patel DD, Li X, Ozaki DA, Cao S, Langdon S, et al. T cell repertoire development in humans with SCID after nonablative allogeneic marrow transplantation. J Immunol. 2003;170(5):2711–8.

    PubMed  CAS  Google Scholar 

  49. Cavazzana-Calvo M, Carlier F, Le Deist F, Morillon E, Taupin P, Gautier D, et al. Long-term T-cell reconstitution after hematopoietic stem-cell transplantation in primary T-cell-immunodeficient patients is associated with myeloid chimerism and possibly the primary disease phenotype. Blood. 2007;109(10):4575–81.

    PubMed  CAS  Google Scholar 

  50. Thrasher AJ, Hacein-Bey-Abina S, Gaspar HB, Blanche S, Davies EG, Parsley K, et al. Failure of SCID-X1 gene therapy in older patients. Blood. 2005;105(11):4255–7.

    PubMed  CAS  Google Scholar 

  51. Prockop SE, Petrie HT. Regulation of thymus size by competition for stromal niches among early T cell progenitors. J Immunol. 2004;173(3):1604–11.

    PubMed  CAS  Google Scholar 

  52. Daniels JA, Lederman HM, Maitra A, Montgomery EA. Gastrointestinal tract pathology in patients with common variable immunodeficiency (CVID): a clinicopathologic study and review. Am J Surg Pathol. 2007;31(12):1800–12.

    PubMed  Google Scholar 

  53. Hussain N, Quezado M, Huizing M, Geho D, White JG, Gahl W, et al. Intestinal disease in Hermansky-Pudlak syndrome: occurrence of colitis and relation to genotype. Clin Gastroenterol Hepatol. 2006;4(1):73–80.

    PubMed  Google Scholar 

  54. Kouklakis G, Efremidou EI, Papageorgiou MS, Pavlidou E, Manolas KJ, Liratzopoulos N. Complicated Crohn’s-like colitis, associated with Hermansky-Pudlak syndrome, treated with Infliximab: a case report and brief review of the literature. J Med Case Reports. 2007;1:176 [PubMed-in process].

    Google Scholar 

  55. Adriani M, Garbi C, Amodio G, Russo I, Giovannini M, Amorosi S, et al. Functional interaction of common gamma-chain and growth hormone receptor signaling apparatus. J Immunol. 2006;177(10):6889–95.

    PubMed  CAS  Google Scholar 

  56. Buckway CK, Guevara-Aguirre J, Pratt KL, Burren CP, Rosenfeld RG. The IGF-I generation test revisited: a marker of GH sensitivity. J Clin Endocrinol Metab. 2001;86(11):5176–83.

    PubMed  CAS  Google Scholar 

  57. De Ravin SS. Short stature in partially corrected X-linked severe combined immunodeficiency-suboptimal response to growth hormone. J Pediatr Endocrinol Metab. 2008 (in press).

  58. Salerno M, Busiello R, Esposito V, Cosentini E, Adriani M, Selleri C, et al. Allogeneic bone marrow transplantation restores IGF-I production and linear growth in a gamma-SCID patient with abnormal growth hormone receptor signaling. Bone Marrow Transplant. 2004;33(7):773–5.

    PubMed  CAS  Google Scholar 

  59. Nichols WG, Guthrie KA, Corey L, Boeckh M. Influenza infections after hematopoietic stem cell transplantation: risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis. 2004;39(9):1300–6.

    PubMed  Google Scholar 

  60. Boivin G, Goyette N, Bernatchez H. Prolonged excretion of amantadine-resistant influenza a virus quasi species after cessation of antiviral therapy in an immunocompromised patient. Clin Infect Dis. 2002;34(5):E23–5.

    PubMed  Google Scholar 

  61. Weinstock DM, Gubareva LV, Zuccotti G. Prolonged shedding of multidrug-resistant influenza A virus in an immunocompromised patient. N Engl J Med. 2003;348(9):867–8.

    PubMed  Google Scholar 

  62. Ison MG, Gubareva LV, Atmar RL, Treanor J, Hayden FG. Recovery of drug-resistant influenza virus from immunocompromised patients: a case series. J Infect Dis. 2006;193(6):760–4.

    PubMed  CAS  Google Scholar 

  63. Laffort C, Le Deist F, Favre M, Caillat-Zucman S, Radford-Weiss I, Debre M, et al. Severe cutaneous papillomavirus disease after haemopoietic stem-cell transplantation in patients with severe combined immune deficiency caused by common gammac cytokine receptor subunit or JAK-3 deficiency. Lancet. 2004;363(9426):2051–4.

    PubMed  CAS  Google Scholar 

  64. Henthorn PS, Somberg RL, Fimiani VM, Puck JM, Patterson DF, Felsburg PJ. IL-2R gamma gene microdeletion demonstrates that canine X-linked severe combined immunodeficiency is a homologue of the human disease. Genomics. 1994;23(1):69–74.

    PubMed  CAS  Google Scholar 

  65. Goldschmidt MH, Kennedy JS, Kennedy DR, Yuan H, Holt DE, Casal ML, et al. Severe papillomavirus infection progressing to metastatic squamous cell carcinoma in bone marrow-transplanted X-linked SCID dogs. J Virol. 2006;80(13):6621–8.

    PubMed  CAS  Google Scholar 

  66. Nishio H, Matsui K, Tsuji H, Tamura A, Suzuki K. Immunolocalisation of the janus kinases (JAK)—signal transducers and activators of transcription (STAT) pathway in human epidermis. J Anat. 2001;198(Pt 5):581–9.

    PubMed  CAS  Google Scholar 

  67. Ratjen F, Rjabko O, Kremens B. High-dose corticosteroid therapy for bronchiolitis obliterans after bone marrow transplantation in children. Bone Marrow Transplant. 2005;36(2):135–8.

    PubMed  CAS  Google Scholar 

  68. Fischer A, Hacein-Bey-Abina S, Lagresle C, Garrigue A, Cavazana-Calvo M. Gene therapy of severe combined immunodeficiency disease: proof of principle of efficiency and safety issues. Gene therapy, primary immunodeficiencies, retrovirus, lentivirus, genome. Bull Acad Natl Med. 2005;189(5):779–85. Discussion 786–8.

    PubMed  CAS  Google Scholar 

  69. Hacein-Bey-Abina S, Le Deist F, Carlier F, Bouneaud C, Hue C, De Villartay JP, et al. Sustained correction of X-linked severe combined immunodeficiency by ex vivo gene therapy. N Engl J Med. 2002;346(16):1185–93.

    PubMed  CAS  Google Scholar 

  70. Baum C, Schambach A, Modlich U, Thrasher A. Gene therapy of SCID-X1. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007;50(12):1507–17.

    PubMed  CAS  Google Scholar 

  71. Cavazzana-Calvo M, Fischer A. Gene therapy for severe combined immunodeficiency: are we there yet? J Clin Invest. 2007;117(6):1456–65.

    PubMed  CAS  Google Scholar 

  72. Qasim W, Gaspar HB, Thrasher AJ. Update on clinical gene therapy in childhood. Arch Dis Child. 2007;92(11):1028–31.

    PubMed  Google Scholar 

  73. Santilli G, Thornhill SI, Kinnon C, Thrasher AJ. Gene therapy of inherited immunodeficiencies. Expert Opin Biol Ther. 2008;8(4):397–407.

    PubMed  CAS  Google Scholar 

  74. Sokolic R, Kesserwan C, Candotti F. Recent advances in gene therapy for severe congenital immunodeficiency diseases. Curr Opin Hematol. 2008;15(4):375–80.

    PubMed  CAS  Google Scholar 

  75. Gaspar HB, Howe S, Thrasher AJ. Gene therapy progress and prospects: gene therapy for severe combined immunodeficiency. Gene Ther. 2003;10(24):1999–2004.

    PubMed  CAS  Google Scholar 

  76. Aviles Mendoza GJ, Seidel NE, Otsu M, Anderson SM, Simon-Stoos K, Herrera A, et al. Comparison of five retrovirus vectors containing the human IL-2 receptor gamma chain gene for their ability to restore T and B lymphocytes in the X-linked severe combined immunodeficiency mouse model. Mol Ther. 2001;3(4):565–73.

    PubMed  CAS  Google Scholar 

  77. Hacein-Bey-Abina S, von Kalle C, Schmidt M, Le Deist F, Wulffraat N, McIntyre E, et al. A serious adverse event after successful gene therapy for X-linked severe combined immunodeficiency. N Engl J Med. 2003;348(3):255–6.

    PubMed  Google Scholar 

  78. Cavazzana-Calvo M, Lagresle C, Hacein-Bey-Abina S, Fischer A. Gene therapy for severe combined immunodeficiency. Annu Rev Med. 2005;56:585–602.

    PubMed  CAS  Google Scholar 

  79. Fischer A, Abina SH, Thrasher A, von Kalle C, Cavazzana-Calvo M. LMO2 and gene therapy for severe combined immunodeficiency. N Engl J Med. 2004;350(24):2526–7. Author reply 2526–7.

    PubMed  CAS  Google Scholar 

  80. Howe SJ, Mansour MR, Schwarzwaelder K, Bartholomae C, Hubank M, Kempski H, et al. Insertional mutagenesis combined with acquired somatic mutations causes leukemogenesis following gene therapy of SCID-X1 patients. J Clin Invest. 2008;118(9):3143–50.

    PubMed  CAS  Google Scholar 

  81. Ott MG, Schmidt M, Schwarzwaelder K, Stein S, Siler U, Koehl U, et al. Correction of X-linked chronic granulomatous disease by gene therapy, augmented by insertional activation of MDS1-EVI1, PRDM16 or SETBP1. Nat Med. 2006;12(4):401–9.

    PubMed  CAS  Google Scholar 

  82. Hacein-Bey-Abina S, Von Kalle C, Schmidt M, McCormack MP, Wulffraat N, Leboulch P, et al. LMO2-associated clonal T cell proliferation in two patients after gene therapy for SCID-X1. Science. 2003;302(5644):415–9.

    PubMed  CAS  Google Scholar 

  83. Wu X, Li Y, Crise B, Burgess SM. Transcription start regions in the human genome are favored targets for MLV integration. Science. 2003;300(5626):1749–51.

    PubMed  CAS  Google Scholar 

  84. Hematti P, Hong BK, Ferguson C, Adler R, Hanawa H, Sellers S, et al. Distinct genomic integration of MLV and SIV vectors in primate hematopoietic stem and progenitor cells. PLoS Biol. 2004;2(12):e423.

    PubMed  Google Scholar 

  85. Modlich U, Bohne J, Schmidt M, von Kalle C, Knoss S, Schambach A, et al. Cell-culture assays reveal the importance of retroviral vector design for insertional genotoxicity. Blood. 2006;108(8):2545–53.

    PubMed  CAS  Google Scholar 

  86. Moreb JS, Schweder M. Human A1, a Bcl-2-related gene, is induced in leukemic cells by cytokines as well as differentiating factors. Leukemia. 1997;11(7):998–1004.

    PubMed  CAS  Google Scholar 

  87. Du Y, Jenkins NA, Copeland NG. Insertional mutagenesis identifies genes that promote the immortalization of primary bone marrow progenitor cells. Blood. 2005;106(12):3932–9.

    PubMed  CAS  Google Scholar 

  88. Rabbitts TH, Bucher K, Chung G, Grutz G, Warren A, Yamada Y. The effect of chromosomal translocations in acute leukemias: the LMO2 paradigm in transcription and development. Cancer Res. 1999;59(7 Suppl):1794s–8s.

    PubMed  CAS  Google Scholar 

  89. Riviere I, Brose K, Mulligan RC. Effects of retroviral vector design on expression of human adenosine deaminase in murine bone marrow transplant recipients engrafted with genetically modified cells. Proc Natl Acad Sci USA. 1995;92(15):6733–7.

    PubMed  CAS  Google Scholar 

  90. Dave UP, Jenkins NA, Copeland NG. Gene therapy insertional mutagenesis insights. Science. 2004;303(5656):333.

    PubMed  Google Scholar 

  91. Nienhuis AW, Dunbar CE, Sorrentino BP. Genotoxicity of retroviral integration in hematopoietic cells. Mol Ther. 2006;13(6):1031–49.

    PubMed  CAS  Google Scholar 

  92. Thornhill SI, Schambach A, Howe SJ, Ulaganathan M, Grassman E, Williams D, et al. Self-inactivating gammaretroviral vectors for gene therapy of X-linked severe combined immunodeficiency. Mol Ther. 2008;16(3):590–8.

    PubMed  CAS  Google Scholar 

  93. Montini E, Cesana D, Schmidt M, Sanvito F, Ponzoni M, Bartholomae C, et al. Hematopoietic stem cell gene transfer in a tumor-prone mouse model uncovers low genotoxicity of lentiviral vector integration. Nat Biotechnol. 2006;24(6):687–96.

    PubMed  CAS  Google Scholar 

  94. Felsenfeld G, Burgess-Beusse B, Farrell C, Gaszner M, Ghirlando R, Huang S, et al. Chromatin boundaries and chromatin domains. Cold Spring Harb Symp Quant Biol. 2004;69:245–50.

    PubMed  CAS  Google Scholar 

  95. Naldini L, Blomer U, Gallay P, Ory D, Mulligan R, Gage FH, et al. In vivo gene delivery and stable transduction of nondividing cells by a lentiviral vector. Science. 1996;272(5259):263–7.

    PubMed  CAS  Google Scholar 

  96. Zufferey R, Dull T, Mandel RJ, Bukovsky A, Quiroz D, Naldini L, et al. Self-inactivating lentivirus vector for safe and efficient in vivo gene delivery. J Virol. 1998;72(12):9873–80.

    PubMed  CAS  Google Scholar 

  97. Schambach A, Bohne J, Chandra S, Will E, Margison GP, Williams DA, et al. Equal potency of gammaretroviral and lentiviral SIN vectors for expression of O6-methylguanine-DNA methyltransferase in hematopoietic cells. Mol Ther. 2006;13(2):391–400.

    PubMed  CAS  Google Scholar 

  98. West AG, Gaszner M, Felsenfeld G. Insulators: many functions, many mechanisms. Genes Dev. 2002;16(3):271–88.

    PubMed  Google Scholar 

  99. Trobridge GD, Miller DG, Jacobs MA, Allen JM, Kiem HP, Kaul R, et al. Foamy virus vector integration sites in normal human cells. Proc Natl Acad Sci USA. 2006;103(5):1498–503.

    PubMed  CAS  Google Scholar 

  100. De Palma M, Montini E, Santoni de Sio FR, Benedicenti F, Gentile A, Medico E. Promoter trapping reveals significant differences in integration site selection between MLV and HIV vectors in primary hematopoietic cells. Blood. 2005;105(6):2307–15.

    PubMed  Google Scholar 

  101. Dull T, Zufferey R, Kelly M, Mandel RJ, Nguyen M, Trono D, et al. A third-generation lentivirus vector with a conditional packaging system. J Virol. 1998;72(11):8463–71.

    PubMed  CAS  Google Scholar 

  102. Yu SF, von Ruden T, Kantoff PW, Garber C, Seiberg M, Ruther U, et al. Self-inactivating retroviral vectors designed for transfer of whole genes into mammalian cells. Proc Natl Acad Sci USA. 1986;83(10):3194–8.

    PubMed  CAS  Google Scholar 

  103. Modlich U, Kustikova OS, Schmidt M, Rudolph C, Meyer J, Li Z, et al. Leukemias following retroviral transfer of multidrug resistance 1 (MDR1) are driven by combinatorial insertional mutagenesis. Blood. 2005;105(11):4235–46.

    PubMed  CAS  Google Scholar 

  104. Naumann N, De Ravin SS, Choi U, Moayeri M, Whiting-Theobald N, Linton GF, et al. Simian immunodeficiency virus lentivector corrects human X-linked chronic granulomatous disease in the NOD/SCID mouse xenograft. Gene Ther. 2007;14(21):1513–24.

    PubMed  CAS  Google Scholar 

  105. Puthenveetil G, Scholes J, Carbonell D, Qureshi N, Xia P, Zeng L, et al. Successful correction of the human beta-thalassemia major phenotype using a lentiviral vector. Blood. 2004;104(12):3445–53.

    PubMed  CAS  Google Scholar 

  106. Zychlinski D, Schambach A, Modlich U, Maetzig T, Meyer J, Grassman E, et al. Physiological promoters reduce the genotoxic risk of integrating gene vectors. Mol Ther. 2008;16(4):718–25 [Epub 2008].

    Google Scholar 

  107. Naldini L, Blomer U, Gage FH, Trono D, Verma IM. Efficient transfer, integration, and sustained long-term expression of the transgene in adult rat brains injected with a lentiviral vector. Proc Natl Acad Sci USA. 1996;93(21):11382–8.

    PubMed  CAS  Google Scholar 

  108. Cartier N. Gene therapy strategies for X-linked adrenoleukodystrophy. Curr Opin Mol Ther. 2001;3(4):357–61.

    PubMed  CAS  Google Scholar 

  109. Cartier N. Preliminary data from the first hematopoietic stem cell gene therapy trial with lentiviral vector demonstrate expression of the therapeutic protein in high percentage of lymphocytes and monocytes in two patients with X-linked adrenoleukodystrophy. Hum Gene Ther. 2007;18(10):941–53.

    Google Scholar 

  110. http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/datafiles.htm.

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Acknowledgment

This project was supported by the Intramural Research Program of the NIH, National Institute of Allergy and Infectious Diseases. We thank Dr Kol Zarember for his critical review of the manuscript and apologize to the authors of many excellent publications that we were not able to present adequately in this review.

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Correspondence to Suk See De Ravin.

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De Ravin, S.S., Malech, H.L. Partially corrected X-linked severe combined immunodeficiency: long-term problems and treatment options. Immunol Res 43, 223–242 (2009). https://doi.org/10.1007/s12026-008-8073-6

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  • DOI: https://doi.org/10.1007/s12026-008-8073-6

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