title: Neuroprotective gene therapy for Huntington's disease using a polymer encapsulated BHK cell line engineered to secrete human CNTF.
abstract: Huntington's disease (HD) is an autosomal dominant genetic disease with devastating clinical effects on cognitive, psychological, and motor functions. These clinical symptoms primarily relate to the progressive loss of medium-spiny GABA-ergic neurons of the striatum. There is no known treatment to date. Several neurotrophic factors have, however, demonstrated the capacity to protect striatal neurons in various experimental models of HD. This includes the ciliary neurotrophic factor (CNTF), the substance examined in this protocol. An ex vivo gene therapy approach based on encapsulated genetically modified BHK cells will be used for the continuous and long-term intracerebral delivery of CNTF. A device, containing up to 106 human CNTF-producing BHK cells surrounded by a semipermeable membrane, will be implanted into the right lateral ventricle of 6 patients. Capsules releasing 0.15-0.5 microg CNTF/day will be used. In this phase I study, the principal goal will be the evaluation of the safety and tolerability of the procedure. As a secondary goal, HD symptoms will be analyzed using a large battery of neuropsychological, motor, neurological, and neurophysiological tests and the striatal pathology monitored using MRI and PET-scan imaging. It is expected that the gene therapy approach described in this protocol will mitigate the side effects associated with the peripheral administration of recombinant hCNTF and allow a well-tolerated, continuous intracerebroventricular delivery of the neuroprotective factor.
authors.affiliation: INSERM U421, Faculté de Médecine, Créteil, France.
authors.forename: A C
authors.initials: AC
authors.lastname: Bachoud-Lévi
authors.forename: N
authors.initials: N
authors.lastname: Déglon
authors.forename: J P
authors.initials: JP
authors.lastname: Nguyen
authors.forename: J
authors.initials: J
authors.lastname: Bloch
authors.forename: C
authors.initials: C
authors.lastname: Bourdet
authors.forename: L
authors.initials: L
authors.lastname: Winkel
authors.forename: P
authors.initials: P
authors.lastname: Rémy
authors.forename: M
authors.initials: M
authors.lastname: Goddard
authors.forename: J P
authors.initials: JP
authors.lastname: Lefaucheur
authors.forename: P
authors.initials: P
authors.lastname: Brugières
authors.forename: S
authors.initials: S
authors.lastname: Baudic
authors.forename: P
authors.initials: P
authors.lastname: Cesaro
authors.forename: M
authors.initials: M
authors.lastname: Peschanski
authors.forename: P
authors.initials: P
authors.lastname: Aebischer
mesh_terms: D000818:Animals; D002460:Cell Line; D002552:Cerebral Ventricles / Q000378:metabolism; D020934:Ciliary Neurotrophic Factor / Q000235:genetics* / Q000378:metabolism; D002985:Clinical Protocols; D017321:Clinical Trials, Phase I as Topic; D006224:Cricetinae; D018014:Gene Transfer Techniques; D015316:Genetic Therapy; D006801:Humans; D006816:Huntington Disease / Q000628:therapy*; D018579:Patient Selection
chemical_list: D020934:Ciliary Neurotrophic Factor