Thromb Haemost 2006; 95(02): 341-347
DOI: 10.1160/TH05-08-0559
Animal Models
Schattauer GmbH

Tolerance to factor VIII in a transgenic mouse expressing human factor VIII cDNA carrying an Arg593 to Cys substitution

Wendy S. Bril*
1   Department of Plasma Proteins, Sanquin Research at CLB and Landsteiner Laboratory, AMC, University of Amsterdam, Amsterdam, The Netherlands
,
Pauline M. W. van Helden*
1   Department of Plasma Proteins, Sanquin Research at CLB and Landsteiner Laboratory, AMC, University of Amsterdam, Amsterdam, The Netherlands
,
Christina Hausl
2   BMT-Research, Vienna, Austria
,
Marleen G. Zuurveld
1   Department of Plasma Proteins, Sanquin Research at CLB and Landsteiner Laboratory, AMC, University of Amsterdam, Amsterdam, The Netherlands
,
Rafi U. Ahmad
3   Baxter BioScience, Vienna, Austria
,
Martine J. Hollestelle
1   Department of Plasma Proteins, Sanquin Research at CLB and Landsteiner Laboratory, AMC, University of Amsterdam, Amsterdam, The Netherlands
,
Pieter H. Reitsma
4   Department of Experimental Internal Medicine, AMC, Amsterdam, The Netherlands
,
Karin Fijnvandraat
5   Department of Pediatrics, EKZ/Children’s AMC, University of Amsterdam, The Netherlands
,
Rene A. W. van Lier
6   Department of Experimental Immunology, AMC, Amsterdam
,
Hans Peter Schwarz
3   Baxter BioScience, Vienna, Austria
,
Koen Mertens
1   Department of Plasma Proteins, Sanquin Research at CLB and Landsteiner Laboratory, AMC, University of Amsterdam, Amsterdam, The Netherlands
7   Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS) Utrecht, The Netherlands
,
Birgit M. Reipert
2   BMT-Research, Vienna, Austria
3   Baxter BioScience, Vienna, Austria
,
Jan Voorberg
1   Department of Plasma Proteins, Sanquin Research at CLB and Landsteiner Laboratory, AMC, University of Amsterdam, Amsterdam, The Netherlands
› Institutsangaben
Financial support: Supported by a grant from the Netherlands Organization of Science (NWO grant 902–26–204).
Weitere Informationen

Publikationsverlauf

Received 16. August 2005

Accepted after resubmission 25. Januar 2005

Publikationsdatum:
28. November 2017 (online)

Summary

Inhibitory antibodies develop in approximately 25% of patients with severe hemophilia A following treatment with factor VIII. In E-16KO or E-17KO mice, in which the factor VIII gene has been inactivated by insertion of a neo cassette, inhibitors develop following administration of factor VIII. Here, we describe the generation of transgenic mice expressing human factor VIII-R593C (huFVIII-R593C). Human factor VIII-R593C cDNA under control of a mouse albumin enhancer/promoter was injected into fertilized oocytes. Analysis of transgenic mice revealed that human factor VIII-R593C was expressed in the liver. Transgenic mice were crossed with factor VIII-deficient mice (E-16KO mice). In plasma of E-16KO mice antibodies were detected after five serial intravenous injections of factor VIII, while plasma of huFVIII-R593C/E-16KO mice did not contain detectable levels of antibodies. No antibody secreting cells were observed in either spleen or bone marrow of huFVIII-R593C/E-16KO mice. Also, factor VIII-specific memory B cells were not observed in the spleen of huFVIII-R593C/E-16KO mice. Analysis of T cell responses revealed that splenocytes derived of E-16KO mice secreted IL-10 and IFN-γ following restimulation with factor VIII in vitro. In contrast, no factor VIII-specific T cell responses were observed in huFVIII-R593C/E-16KO mice. These results indicate that huFVIII-R593C/E-16KO mice are tolerant to intravenously administered factor VIII. It is anticipated that this model may prove useful for studying immune responses in the context of factor VIII gene therapy.

* These authors contributed equally to this manuscript.


 
  • References

  • 1 Hoyer LW. Hemophilia A. N Engl J Med 1994; 330: 38-47.
  • 2 Mannucci PM, Tuddenham EG. The hemophilias--from royal genes to gene therapy. N Engl J Med 2001; 344: 1773-9.
  • 3 Lollar P. Pathogenic antibodies to coagulation factors. Part one: factor VIII and factor IX. J Thromb Haemost 2004; 02: 1082-95.
  • 4 Bi L, Lawler AM, Antonarakis SE. et al. Targeted disruption of the mouse factor VIII gene produces a model of hemophilia A. Nat Genet 1995; 10: 119-21.
  • 5 Bi L, Sarkar R, Naas T. et al. Further characterization of factor VIII-deficient mice created by gene targeting: RNA and protein studies. Blood 1996; 88: 3446-50.
  • 6 Muchitsch EM, Turecek PL, Zimmermann K. et al. Phenotypic expression of murine hemophilia. Thromb Haemost 1999; 82: 1371-3.
  • 7 Qian J, Borovok M, Bi L. et al. Inhibitor antibody development and T cell response to human factor VIII in murine hemophilia A. Thromb Haemost 1999; 81: 240-4.
  • 8 Reipert BM, Ahmad RU, Turecek PL. et al. Characterization of antibodies induced by human factor VIII in a murine knockout model of hemophilia A. Thromb Haemost 2000; 84: 826-32.
  • 9 Sasgary M, Ahmad RU, Schwarz HP. et al. Single cell analysis of factor VIII-specific T cells in hemophilic mice after treatment with human factor VIII. Thromb Haemost 2002; 87: 266-72.
  • 10 Hausl C, Maier E, Schwarz HP. et al. Long-term persistence of anti-factor VIII antibody-secreting cells in hemophilic mice after treatment with human factor VIII. Thromb Haemost 2002; 87: 840-5.
  • 11 Hausl C, Ahmad RU, Schwarz HP. et al. Preventing restimulation of memory B cells in hemophilia A: a potential new strategy for the treatment of antibody-dependent immune disorders. Blood 2004; 104: 115-22.
  • 12 Qian J, Collins M, Sharpe AH. et al. Prevention and treatment of factor VIII inhibitors in murine hemophilia A. Blood 2000; 95: 1324-9.
  • 13 Rossi G, Sarkar J, Scandella D. Long-term induction of immune tolerance after blockade of CD40-CD40L interaction in a mouse model of hemophilia A. Blood 2001; 97: 2750-7.
  • 14 Reipert BM, Sasgary M, Ahmad RU. et al. Blockade of CD40/CD40 ligand interactions prevents induction of factor VIII inhibitors in hemophilic mice but does not induce long lasting immune tolerance. Thromb Haemost 2001; 86: 1345-52.
  • 15 Qian J, Burkly LC, Smith EP. et al. Role of CD154 in the secondary immune response: the reduction of pre-existing splenic germinal centers and anti-factor VIII inhibitor titre. Eur J Immunol 2000; 30: 2548-54.
  • 16 Lei TC, Scott DW. Induction of tolerance to factor VIII inhibitors by gene therapy with immunodominant A2 and C2 domains presented by B cells as Ig fusion proteins. Blood 2005; 105: 4865-70.
  • 17 Bril WS, MacLean PE, Kaijen PH. et al. HLA class II genotype and factor VIII inhibitors in mild hemophilia A patients with an Arg593 to Cys mutation. Hemophilia 2004; 10: 509-14.
  • 18 Fijnvandraat K, Turenhout EAM, Van den Brink EN. et al. The missense mutation Arg593→Cys is related to antibody formation in a patient with mild hemophilia A. Blood 1997; 89: 4371-7.
  • 19 Thompson AR, Murphy MEP, Liu M-L. et al. Loss of tolerance to endogenous factor VIII in a mild hemophilia A patient with an Arg593→Cys mutation. Blood 1997; 90: 1902-10.
  • 20 Roelse JC, de Laaf RT, Timmermans SM. et al. Intracellular accumulation of factor VIII induced by missense mutations Arg593→Cys and Asn618→Ser explains cross-reacting material-reduced hemophilia A. Br J Haematol 2000; 108: 241-6.
  • 21 Needham M, Gooding C, Hudson K. et al. LCR/ MEL: a versatile system for high-level expression of heterologous proteins in erythroid cells. Nucleic Acids Res 1992; 20: 997-1003.
  • 22 Pinkert CA, Ornitz DM, Brinster RL. et al. An albumin enhancer located 10 kb upstream functions along with its promoter to direct efficient, liver-specific expression in transgenic mice. Genes Dev 1987; 01: 268-76.
  • 23 Wagenaar GT, van Vuuren AJ, Girma M. et al. Characterization of transgenic mice that secrete functional human proteinC inhibitor into the circulation. Thromb Haemost 2000; 83: 93-101.
  • 24 Hollestelle MJ, Thinnes T, Crain K. et al. Tissue distribution of factor VIII gene expression in vivo--a closer look. Thromb Haemost 2001; 86: 855-61.
  • 25 Leyte A, Mertens K, Distel B. et al. Inhibition of human coagulation factor VIII by monoclonal antibodies. Mapping of functional epitopes with the use of recombinant factor VIII fragments. Biochem J 1989; 263: 187-94.
  • 26 Lenting PJ, Donath MJ, van Mourik JA. et al. Identification of a binding site for blood coagulation factor IXa on the light chain of human factor VIII. J Biol Chem 1994; 269: 7150-5.
  • 27 Kasper CK, Aledort LM, Counts RB. et al. A more uniform measurement of factor VIII inhibitors. Thromb Diath Haemorrh 1975; 34: 869-72.
  • 28 Billiau A, Matthys P. Modes of action of Freund’s adjuvants in experimental models of autoimmune diseases. J Leukoc Biol 2001; 70: 849-60.
  • 29 Evans GL, Morgan RA. Genetic induction of immune tolerance to human clotting factor VIII in a mouse model for hemophilia A. Proc Natl Acad Sci U S A 1998; 95: 5734-9.
  • 30 Vigouroux S, Yvon E, Biagi E. et al. Antigen-induced regulatoryT cells. Blood 2004; 104: 26-33.
  • 31 Jin DY, Zhang TP, Gui T. et al. Creation ofa mouse expressing defective human factor IX. Blood 2004; 104: 1733-9.
  • 32 Sabatino DE, Armstrong E, Edmonson S. et al. Novel hemophilia B mouse models exhibiting a range of mutations in the Factor IX gene. Blood 2004; 104: 2767-2774.
  • 33 Van den Brink EN, Timmermans SMH, Turenhout EAM. et al. Longitudinal analysis of factor VIII inhibitors in a previously untreated mild hemophilia A patient with an Arg593→Cys substitution. Thromb Haemost 1999; 81: 723-6.
  • 34 Rawle FE, Shi CX, Brown B. et al. Heterogeneity of the immune response to adenovirus-mediated factor VIII gene therapy in different inbred hemophilic mouse strains. J Gene Med 2004; 06: 1358-68.
  • 35 Hay CR, Ollier W, Pepper L. et al. HLA class II profile:a weak determinant of factor VIII inhibitor development in severe haemophilia A. UKHCDO Inhibitor Working Party. Thromb Haemost 1997; 77: 234-7.
  • 36 Oldenburg J, Picard JK, Schwaab R. et al. HLA genotype of patients with severe haemophilia A due to intron 22 inversion with and without inhibitors of factor VIII. Thromb Haemost 1997; 77: 238-42.
  • 37 Jacquemin M, Vantomme V, Buhot C. et al. CD4+ T-cell clones specific for wild-type factor VIII: a molecular mechanism responsible for a higher incidence of inhibitor formation in mild/moderate hemophilia A. Blood 2003; 101: 1351-8.
  • 38 Cook DN, Pisetsky DS, Schwartz DA. Toll-like receptors in the pathogenesis of human disease. Nat Immunol 2004; 05: 975-9.
  • 39 Pipe SW, Saint-Remy JM, Walsh CE. New high technology products for the treatment of hemophilia. Hemophilia 2004; 10: 55-63.
  • 40 Hough C, Lillicrap D. Gene therapy for hemophilia: an imperative to succeed. J Thromb Haemost 2005; 03: 1195-205.