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Project
4: A Novel Suicide Gene for Therapy of Graft Versus Host Disease.
The use of small molecules to control the expression and/or activity
of transgene products is an attractive strategy for initiating
signaling pathways that regulate cellular functions including
cell death. A novel inducible suicide gene based on the induction
of apoptosis through oligimerization of the human Fas protein
by a bivalent synthetic drug ligand has been developed and could
potentially overcome the problem of immune responses to protein
products encoded by suicide genes derived from pathogens. The
Fas suicide construct, termed NGFR-2FKBP-Fas is made up of three
human proteins expressed as a chimeric molecule. The molecule
consists of the extracellular and transmembrane domains of the
low affinity nerve growth factor receptor, two copies of the FK506-binding
protein, and the cytoplasmic domain of Fas. A bivalent drug AP1903
that will bind to FKBP can be administered to induce oligimerization
of the linked Fas receptor and signal apoptosis in the target
cell. In the proposed study the strategy of using a synthetic
drug to regulate the survival of gene-modified cells in vivo will
be evaluated in allogeneic hematopoietic stem cell transplant
recipients who receive donor T lymphocytes modified to express
NGFR-2FKBP-Fas as adoptive immunotherapy for relapsed chronic
myeloid leukemia. In this setting, the transferred T cells may
eradicate the leukemia but also cause persistent graft versus
host disease. The introduction of NGFR-2FKBP-Fas will bring these
cells under pharmacologic control and permit their ablation in
vivo in patients with GVHD. These studies will provide insight
into the clinical use of chemical dimerizing agents to regulate
transgene function and may identify a suicide gene which is not
immunogenic in humans and could be broadly applied to control
graft versus host disease. The specific aims are: 1.) To determine
the safety, in vivo persistence, and biologic activity of adoptive
immunotherapy with donor T lymphocytes modified by retrovirus
mediated gene transfer to express LNGFR-2FKBP-Fas for patients
with relapse of CML after allogeneic HCT. 2.) To determine if
LNGFR-2FKBP-Fas transduced T lymphocytes can be ablated in patients
who develop graft versus host disease by the administration of
the synthetic FKBP binding drug AP1903. 3.) To determine if a
host immune response is elicited to the LNGFR-2FKBP-Fas transgene
product.
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