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Gene therapy of muscular distrophy by transplantation of genetically-modified bone marrow

Obiettivo



Muscular dystrophies (MD) are a heterogeneous group of severe muscle-wasting disorders caused by mutations in the genes coding for the membrane-associated protein dystrophin or for other members of the dystrophin-associated protein complex linking the muscle fiber cytoskeleton to the extracellular matrix. No therapy is available for these severe syndromes, which have a long, progressive and devastating course, and are associated to high social and health care costs. Gene therapy of MD, i.e. delivery of a functional copy of the mutated gene to a significant fraction of the skeletal and heart muscle tissue, represents a formidable scientific and medical task. This, however, would be a definitive therapy, and even if only partially successful, would result in significant medical and economic benefits. At present, clinical application of gene therapy of MD is limited by a number of technical limitations, from immunogenicity of viral vectors to low recovery, survival and differentiation capacity of transplanted myoblasts. The difficulty in establishing an efficient delivery route for either vectors or genetically-modified cells is the most significant problem facing both in-vivo and ex vivo approaches.
We have recently obtained evidence for the existence of a bone marrow (BM)-derived, circulating myogenic progenitor, which can migrate into areas of muscle degeneration, undergo myogenic differentiation, and participate to regeneration of the damaged fibers. The availability of a cell population which could be engineered, transplanted, and then systemically delivered to a large number of muscles could theoretically represent a substantial step forward in the design of a cell-mediated replacement therapy. It would now be necessary to establish whether the chronic regeneratory stimulus that characterizes both human and mouse MD is sufficient to recruit the BM-derived progenitors, and whether this cell population is quantitatively sufficient to progressively replace a significant fraction of the skeletal muscle. The aim of this demonstration project is to provide evidence that transplantation of normal, or genetically engineered, BM can revert the phenotypic consequence of MD in suitable animal models and in real-life conditions. Three mouse mutants, mdx, ADR, and dy/dy, respectively models for Duchenne, myotonic, and congenital MD, will be transplanted with genetically-marked BM from a transgenic, co-isogeneic donor, or with genetically-corrected autologous BM. Contribution of BM-derived myogenic progenitors to muscle regeneration, and the effect of this treatment in reversing the dystrophic phenotypes, will be quantitatively analyzed at morphological and functional level by a combined effort of four highly-qualified groups working in three different European countries. The rationale of this project includes the possibility of testing whether transplantation of a complete hematopoietic system is sufficient to tolerize an immunocompetent animal towards the expression of a foreign protein (i.e. the one missing in each specific mutant) expressed by the muscle tissue. At the end of this two-year demonstration project, we will be able to evaluate the therapeutic potential of a muscle cell replacement strategy based on BM transplantation, and formulate a possible strategy for further clinical application (allogeneic, or genetically-modified autologous, BM transplantation).

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Coordinatore

Fondazione Centro San Raffaele del Monte Tabor - Istituto di Ricovero e Cura a Carattere Scientifico
Contributo UE
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Indirizzo
58,Via Olgettina
20132 Milano
Italia

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