Curative ex vivo liver-directed gene therapy in a pig model of hereditary tyrosinemia type 1

Raymond D. Hickey, Shennen A. Mao, Jaime Glorioso, Faysal Elgilani, Bruce Amiot, Harvey Chen, Piero Rinaldo, Ronald Marler, Huailei Jiang, Timothy R. DeGrado, Lukkana Suksanpaisan, Michael K. O'Connor, Brittany L. Freeman, Samar H. Ibrahim, Kah Whye Peng, Cary O. Harding, Chak Sum Ho, Markus Grompe, Yasuhiro Ikeda, Joseph B. LillegardStephen J. Russell, Scott L. Nyberg

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


We tested the hypothesis that ex vivo hepatocyte gene therapy can correct the metabolic disorder in fumarylacetoacetate hydrolase-deficient (Fah-/-) pigs, a large animalmodel of hereditary tyrosinemia type 1 (HT1). Recipient Fah-/- pigs underwent partial liver resection and hepatocyte isolation by collagenase digestion. Hepatocytes were transduced with one or both of the lentiviral vectors expressing the therapeutic Fah and the reporter sodium-iodide symporter (Nis) genes under control of the thyroxine-binding globulin promoter. Pigs received autologous transplants of hepatocytes by portal vein infusion. After transplantation, the protective drug 2-(2-nitro-4-trifluoromethylbenzyol)- 1,3 cyclohexanedione (NTBC) was withheld from recipient pigs to provide a selective advantage for expansion of corrected FAH+ cells. Proliferation of transplanted cells, assessed by both immunohistochemistry and noninvasive positron emission tomography imaging of NIS-labeled cells, demonstrated near-complete liver repopulation by gene-corrected cells. Tyrosine and succinylacetone levels improved to within normal range, demonstrating complete correction of tyrosine metabolism. In addition, repopulation of the Fah-/- liver with transplanted cells inhibited the onset of severe fibrosis, a characteristic of nontransplanted Fah-/- pigs. This study demonstrates correction of disease in a pig model of metabolic liver disease by ex vivo gene therapy. To date, ex vivo gene therapy has only been successful in small animal models. We conclude that further exploration of ex vivo hepatocyte genetic correction is warranted for clinical use.

Original languageEnglish (US)
Article number349ra99
JournalScience translational medicine
Issue number349
StatePublished - Jul 27 2016

ASJC Scopus subject areas

  • General Medicine


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