Unique risk factors for insertional mutagenesis in a mouse model of XSCID gene therapy

Yan Shou1, Zhijun Ma, Taihe Lu

  • 1Division of Experimental Hematology, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.

Insights

Gene therapy for severe combined immunodeficiency (SCID) can cause T cell malignancies. A new X-linked SCID (XSCID) mouse model shows gene therapy can lead to tumors by targeting protooncogenes, aiding vector safety testing.

Area of Science:

  • Immunology
  • Oncology
  • Gene Therapy

Background:

  • Gene therapy offers cures for SCID but carries risks of T cell malignancies due to insertional mutagenesis.
  • Unanswered questions remain regarding specific risk factors, contributing genetic lesions, and vector safety assessment for X-linked SCID (XSCID) gene therapy.

Purpose of the Study:

  • To develop and utilize an XSCID mouse model to investigate insertional mutagenesis and T cell transformation in gene therapy.
  • To identify unique risk factors and genetic lesions contributing to gene therapy-induced malignancies.
  • To establish a system for evaluating the relative safety of different gene therapy vectors.

Main Methods:

  • Development of an XSCID mouse model with ablated Arf tumor-suppressor and gammac genes.
  • Administration of gene therapy to the animal model to recapitulate clinical observations.
  • Ligation-mediated PCR analysis to identify gene integration sites and assess their proximity to protooncogenes.

Main Results:

  • The XSCID mouse model demonstrated a high incidence of integration-dependent T cell tumors, mirroring clinical trial outcomes.
  • Gene integration sites were frequently found near or within protooncogenes (e.g., Chd9, Slamf6, Tde1, Camk2b, Ly6e), indicating oncogene targeting.
  • The X-SCID background was crucial for high transformation rates, linked to the expansion of primitive hematopoietic cells acting as tumor precursors. No integrations within the Lmo2 locus were detected.

Conclusions:

  • The developed XSCID mouse model accurately reflects gene therapy-induced T cell malignancies.
  • Insertional mutagenesis targeting protooncogenes, particularly within an X-SCID background, is a key mechanism for T cell transformation.
  • This model serves as a valuable platform for testing the safety of modified vectors and understanding insertional mutagenesis risks in gene therapy.