Human hematopoietic stem/progenitor cells modified by zinc-finger nucleases targeted to CCR5 control HIV-1 in vivo

CCR5 is the major HIV-1 co-receptor, and individuals homozygous for a 32-bp deletion in CCR5 are resistant to infection by CCR5-tropic HIV-1. Using engineered zinc-finger nucleases (ZFNs), we disrupted CCR5 in human CD34+ hematopoietic stem/progenitor cells (HSPCs) at a mean frequency of 17% of the total alleles in a population. This procedure produces both mono- and bi-allelically disrupted cells. ZFN-treated HSPCs retained the ability to engraft NOD/SCID/IL2rγnull mice and gave rise to polyclonal multi-lineage progeny in which CCR5 was permanently disrupted. Control mice receiving untreated HSPCs and challenged with CCR5-tropic HIV-1 showed profound CD4+ T-cell loss. In contrast, mice transplanted with ZFN-modified HSPCs underwent rapid selection for CCR5−/− cells, had significantly lower HIV-1 levels and preserved human cells throughout their tissues. The demonstration that a minority of CCR5−/− HSPCs can populate an infected animal with HIV-1-resistant, CCR5−/− progeny supports the use of ZFN-modified autologous hematopoietic stem cells as a clinical approach to treating HIV-1.

[1]  F. Candotti,et al.  Revertant somatic mosaicism in the Wiskott–Aldrich syndrome , 2009, Immunologic research.

[2]  C. Barbas,et al.  T-cell protection and enrichment through lentiviral CCR5 intrabody gene delivery , 2007, Gene Therapy.

[3]  Xavier Anglaret,et al.  Transfer and Evaluation of an Automated, Low-Cost Real-Time Reverse Transcription-PCR Test for Diagnosis and Monitoring of Human Immunodeficiency Virus Type 1 Infection in a West African Resource-Limited Setting , 2005, Journal of Clinical Microbiology.

[4]  T. Klimkait,et al.  HIV-1 coreceptor usage and CXCR4-specific viral load predict clinical disease progression during combination antiretroviral therapy , 2008, AIDS.

[5]  Joseph Sodroski,et al.  CD4-induced interaction of primary HIV-1 gp120 glycoproteins with the chemokine receptor CCR-5 , 1996, Nature.

[6]  E. Thiel,et al.  Transplantation of selected or transgenic blood stem cells – a future treatment for HIV/AIDS? , 2009, Journal of the International AIDS Society.

[7]  Mario Roederer,et al.  Massive infection and loss of memory CD4+ T cells in multiple tissues during acute SIV infection , 2005, Nature.

[8]  Manfred Schmidt,et al.  Hematopoietic Stem Cell Gene Therapy with a Lentiviral Vector in X-Linked Adrenoleukodystrophy , 2009, Science.

[9]  H. Schuitemaker,et al.  R5 Human Immunodeficiency Virus Type 1 Infection of Fetal Thymic Organ Culture Induces Cytokine and CCR5 Expression , 2005, Journal of Virology.

[10]  D. McDermott,et al.  CCR5 deficiency increases risk of symptomatic West Nile virus infection , 2006, The Journal of experimental medicine.

[11]  D. Douek,et al.  HIV disease: fallout from a mucosal catastrophe? , 2006, Nature Immunology.

[12]  Michael Dean,et al.  CCR2 chemokine receptor and AIDS progression , 1997, Nature Medicine.

[13]  B. Palmer,et al.  Safety and Efficacy of a Lentiviral Vector Containing Three Anti-HIV Genes-CCR5 Ribozyme, Tat-rev siRNA, and TAR Decoy-in SCID-hu Mouse-Derived T Cells. , 2007, Molecular therapy : the journal of the American Society of Gene Therapy.

[14]  Alessandro Aiuti,et al.  Gene therapy for immunodeficiency due to adenosine deaminase deficiency. , 2009, The New England journal of medicine.

[15]  Jeffrey C. Miller,et al.  Highly efficient endogenous human gene correction using designed zinc-finger nucleases , 2005, Nature.

[16]  M. Rossol,et al.  Negative association of the chemokine receptor CCR5 d32 polymorphism with systemic inflammatory response, extra-articular symptoms and joint erosion in rheumatoid arthritis , 2009, Arthritis research & therapy.

[17]  J. McCune,et al.  IFN-α-Induced Upregulation of CCR5 Leads to Expanded HIV Tropism In Vivo , 2010, PLoS pathogens.

[18]  B. Walker,et al.  Acute human immunodeficiency virus type 1 infection. , 1998, The New England journal of medicine.

[19]  B. Palmer,et al.  HIV-1 infection and CD4 T cell depletion in the humanized Rag2-/-γc-/- (RAG-hu) mouse model , 2006, Retrovirology.

[20]  A. Lackner,et al.  The mucosal immune system: primary target for HIV infection and AIDS. , 2001, Trends in immunology.

[21]  V. Appay,et al.  Immune activation and inflammation in HIV‐1 infection: causes and consequences , 2008, The Journal of pathology.

[22]  B. Weinshenker,et al.  CCR5Δ32 polymorphism effects on CCR5 expression, patterns of immunopathology and disease course in multiple sclerosis , 2005, Journal of Neuroimmunology.

[23]  Qingsheng Li,et al.  Peak SIV replication in resting memory CD4+ T cells depletes gut lamina propria CD4+ T cells , 2005, Nature.

[24]  Christof von Kalle,et al.  Phase 2 gene therapy trial of an anti-HIV ribozyme in autologous CD34+ cells. , 2009, Nature medicine.

[25]  Boris Jerchow,et al.  Molecular evolution of a novel hyperactive Sleeping Beauty transposase enables robust stable gene transfer in vertebrates , 2009, Nature Genetics.

[26]  T. Hocking,et al.  Heritable Targeted Gene Disruption in Zebrafish Using Designed Zinc Finger Nucleases , 2008, Nature Biotechnology.

[27]  E. Thiel,et al.  Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. , 2009, The New England journal of medicine.

[28]  I. Charo,et al.  A Mechanism for the Impaired IFN-γ Production in C-C Chemokine Receptor 2 (CCR2) Knockout Mice: Role of CCR2 in Linking the Innate and Adaptive Immune Responses1 , 2000, The Journal of Immunology.

[29]  T. Morio,et al.  Hematopoietic stem cell–engrafted NOD/SCID/IL2Rγnull mice develop human lymphoid systems and induce long-lasting HIV-1 infection with specific humoral immune responses , 2007 .

[30]  G. Crooks,et al.  Stable transgene expression in primitive human CD34+ hematopoietic stem/progenitor cells, using the Sleeping Beauty transposon system. , 2009, Human gene therapy.

[31]  M. Tankersley,et al.  T Cell-Specific siRNA Delivery Suppresses HIV-1 Infection in Humanized Mice , 2009, Pediatrics.

[32]  J. Flamm,et al.  Severe CD4+ T-Cell Depletion in Gut Lymphoid Tissue during Primary Human Immunodeficiency Virus Type 1 Infection and Substantial Delay in Restoration following Highly Active Antiretroviral Therapy , 2003, Journal of Virology.

[33]  B. Torbett,et al.  Can gene delivery close the door to HIV‐1 entry after escape? , 2006, Journal of medical primatology.

[34]  J. Church CD4+ T Cell Depletion During All Stages of HIV Disease Occurs Predominantly in the Gastrointestinal Tract , 2005, Pediatrics.

[35]  M. Kotb,et al.  Human Lymphoid and Myeloid Cell Development in NOD/LtSz-scid IL2Rγnull Mice Engrafted with Mobilized Human Hemopoietic Stem Cells 12 , 2004, The Journal of Immunology.

[36]  J. Mellors,et al.  Low-level viremia persists for at least 7 years in patients on suppressive antiretroviral therapy , 2008, Proceedings of the National Academy of Sciences.

[37]  K. Akashi,et al.  Development of functional human blood and immune systems in NOD/SCID/IL2 receptor γ chainnull mice , 2005 .

[38]  M. Jasin,et al.  Genetic manipulation of genomes with rare-cutting endonucleases. , 1996, Trends in genetics : TIG.

[39]  S J Gange,et al.  Treatment intensification does not reduce residual HIV-1 viremia in patients on highly active antiretroviral therapy , 2009, Proceedings of the National Academy of Sciences.

[40]  J. Howe,et al.  Mapping resistance to the CCR5 co-receptor antagonist vicriviroc using heterologous chimeric HIV-1 envelope genes reveals key determinants in the C2-V5 domain of gp120. , 2008, Virology.

[41]  Jerome H. Carter,et al.  Distribution of health care expenditures for HIV-infected patients. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[42]  J. Margolick,et al.  Impact of Inversion of the CD4/CD8 Ratio on the Natural History of HIV-1 Infection , 2006, Journal of acquired immune deficiency syndromes.

[43]  J. Puck,et al.  Spontaneous in vivo reversion to normal of an inherited mutation in a patient with adenosine deaminase deficiency , 1996, Nature Genetics.

[44]  A. Lackner,et al.  The gastrointestinal tract and AIDS pathogenesis. , 2009, Gastroenterology.

[45]  L. Picker Immunopathogenesis of acute AIDS virus infection. , 2006, Current opinion in immunology.

[46]  John J Rossi,et al.  Genetic therapies against HIV , 2007, Nature Biotechnology.

[47]  A. Nademanee,et al.  Autologous stem cell transplantation for HIV-associated lymphoma. , 2001, Blood.

[48]  M. Holodniy,et al.  Novel Targets for Antiretroviral Therapy , 2009, Drugs.

[49]  John Novembre,et al.  The Geographic Spread of the CCR5 Δ32 HIV-Resistance Allele , 2005, PLoS biology.

[50]  D. Nickle,et al.  Persistence of HIV in gut-associated lymphoid tissue despite long-term antiretroviral therapy. , 2008, The Journal of infectious diseases.

[51]  H. Jessen,et al.  CCR5Δ32 Genotypes in a German HIV-1 Seroconverter Cohort and Report of HIV-1 Infection in a CCR5Δ32 Homozygous Individual , 2008, PloS one.

[52]  Dale L. Greiner,et al.  T Cell-Specific siRNA Delivery Suppresses HIV-1 Infection in Humanized Mice , 2008, Cell.

[53]  J. Rossi,et al.  Characterization of anti-CCR5 ribozyme-transduced CD34+ hematopoietic progenitor cells in vitro and in a SCID-hu mouse model in vivo. , 2000, Molecular therapy : the journal of the American Society of Gene Therapy.

[54]  Yang Du,et al.  Correction of X-linked chronic granulomatous disease by gene therapy, augmented by insertional activation of MDS1-EVI1, PRDM16 or SETBP1 , 2006, Nature Medicine.

[55]  H. Broxmeyer,et al.  CCR5 Ligands Modulate CXCL12-Induced Chemotaxis, Adhesion, and Akt Phosphorylation of Human Cord Blood CD34+ Cells1 , 2009, The Journal of Immunology.

[56]  U. Dirksen,et al.  Atypical X-linked severe combined immunodeficiency due to possible spontaneous reversion of the genetic defect in T cells. , 1996, The New England journal of medicine.

[57]  Shunichi Takeda,et al.  Differential usage of non-homologous end-joining and homologous recombination in double strand break repair. , 2006, DNA repair.

[58]  R P Johnson,et al.  Gastrointestinal tract as a major site of CD4+ T cell depletion and viral replication in SIV infection. , 1998, Science.

[59]  J. Orange,et al.  Establishment of HIV-1 resistance in CD4+ T cells by genome editing using zinc-finger nucleases , 2008, Nature Biotechnology.

[60]  J. Wagner,et al.  Stable gene transfer and expression in cord blood-derived CD34+ hematopoietic stem and progenitor cells by a hyperactive Sleeping Beauty transposon system. , 2009, Blood.

[61]  A. Mortellaro,et al.  Correction of ADA-SCID by Stem Cell Gene Therapy Combined with Nonmyeloablative Conditioning , 2002, Science.

[62]  A. Klug,et al.  Targeted gene knockout in mammalian cells by using engineered zinc-finger nucleases , 2008, Proceedings of the National Academy of Sciences.

[63]  Dana Carroll,et al.  Targeted chromosomal cleavage and mutagenesis in Drosophila using zinc-finger nucleases. , 2002, Genetics.

[64]  M. Zupancic,et al.  Intrarectal transmission, systemic infection, and CD4+ T cell depletion in humanized mice infected with HIV-1 , 2007, The Journal of experimental medicine.

[65]  Xiuli Wang,et al.  Stable gene transfer to human CD34(+) hematopoietic cells using the Sleeping Beauty transposon. , 2006, Experimental hematology.

[66]  R. Hirschhorn In vivo reversion to normal of inherited mutations in humans , 2003, Journal of medical genetics.

[67]  J J Goedert,et al.  Natural history of HIV-1 cell-free viremia. , 1995, JAMA.

[68]  V. Calvez,et al.  Primary genotypic resistance of HIV-1 to CCR5 antagonists in CCR5 antagonist treatment-naive patients , 2008, AIDS.

[69]  Marc Parmentier,et al.  Resistance to HIV-1 infection in Caucasian individuals bearing mutant alleles of the CCR-5 chemokine receptor gene , 1996, Nature.

[70]  Luigi Naldini,et al.  Gene editing in human stem cells using zinc finger nucleases and integrase-defective lentiviral vector delivery , 2007, Nature Biotechnology.

[71]  B. Bennetts,et al.  HIV-1 infection in an individual homozygous for the CCR5 deletion allele , 1997, Nature Medicine.

[72]  M R Loken,et al.  Establishing optimal lymphocyte gates for immunophenotyping by flow cytometry. , 1990, Cytometry.

[73]  C. Irwin,et al.  Effect of HIV‐1 Infection on Lymphocyte Proliferation in Gut‐Associated Lymphoid Tissue , 2001, Journal of acquired immune deficiency syndromes.

[74]  D. Hazuda,et al.  The Challenge of Finding a Cure for HIV Infection , 2009, Science.

[75]  H. Schuitemaker,et al.  CC chemokine receptor 5 cell-surface expression in relation to CC chemokine receptor 5 genotype and the clinical course of HIV-1 infection. , 1999, Journal of immunology.