Safe and Efficient Gene Therapy for Pyruvate Kinase Deficiency

Mol Ther. 2016 Aug;24(7):1187-98. doi: 10.1038/mt.2016.87. Epub 2016 May 3.

Abstract

Pyruvate kinase deficiency (PKD) is a monogenic metabolic disease caused by mutations in the PKLR gene that leads to hemolytic anemia of variable symptomatology and that can be fatal during the neonatal period. PKD recessive inheritance trait and its curative treatment by allogeneic bone marrow transplantation provide an ideal scenario for developing gene therapy approaches. Here, we provide a preclinical gene therapy for PKD based on a lentiviral vector harboring the hPGK eukaryotic promoter that drives the expression of the PKLR cDNA. This therapeutic vector was used to transduce mouse PKD hematopoietic stem cells (HSCs) that were subsequently transplanted into myeloablated PKD mice. Ectopic RPK expression normalized the erythroid compartment correcting the hematological phenotype and reverting organ pathology. Metabolomic studies demonstrated functional correction of the glycolytic pathway in RBCs derived from genetically corrected PKD HSCs, with no metabolic disturbances in leukocytes. The analysis of the lentiviral insertion sites in the genome of transplanted hematopoietic cells demonstrated no evidence of genotoxicity in any of the transplanted animals. Overall, our results underscore the therapeutic potential of the hPGK-coRPK lentiviral vector and provide high expectations toward the gene therapy of PKD and other erythroid metabolic genetic disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Hemolytic, Congenital Nonspherocytic / genetics*
  • Anemia, Hemolytic, Congenital Nonspherocytic / metabolism
  • Anemia, Hemolytic, Congenital Nonspherocytic / therapy*
  • Animals
  • Blood Cells / metabolism
  • Cell Differentiation
  • Disease Models, Animal
  • Erythrocytes / cytology
  • Erythrocytes / metabolism
  • Erythropoiesis
  • Genetic Therapy* / adverse effects
  • Genetic Therapy* / methods
  • Genetic Vectors / genetics
  • Glycolysis
  • Hematopoietic Stem Cell Transplantation
  • Hematopoietic Stem Cells / cytology
  • Hematopoietic Stem Cells / metabolism
  • Humans
  • Lentivirus / genetics
  • Metabolic Networks and Pathways
  • Metabolome
  • Metabolomics
  • Mice
  • Mice, Transgenic
  • Mutation
  • Phenotype
  • Pyruvate Kinase / deficiency*
  • Pyruvate Kinase / genetics
  • Pyruvate Kinase / metabolism
  • Pyruvate Metabolism, Inborn Errors / genetics*
  • Pyruvate Metabolism, Inborn Errors / metabolism
  • Pyruvate Metabolism, Inborn Errors / therapy*
  • Transduction, Genetic

Substances

  • Pyruvate Kinase

Supplementary concepts

  • Pyruvate Kinase Deficiency of Red Cells