Evidence map›Paper›PMID 30862611›Full record

ArticleBlood advances2019

FVIII expression by its native promoter sustains long-term correction avoiding immune response in hemophilic mice.

Simone Merlin, Rosella Famà, Ester Borroni, Diego Zanolini, Valentina Bruscaggin, Silvia Zucchelli, Antonia Follenzi

Open access · goldAbstract read
In one paragraph

Article in Blood advances, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 35 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Dissecting endothelial cell heterogeneity with new tools.Cell regeneration (London, England) · 2025
    Review
  5. Article
  6. Article
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  8. Article
  9. LSpECifying transgene expression.Molecular therapy. Nucleic acids · 2024
    Article
  10. Article
  11. Article
  12. Article
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  15. Article
  16. Article
  17. Gene Therapy for Inherited Bleeding Disorders.Seminars in thrombosis and hemostasis · 2021
    Review
  18. Article
  19. Article
  20. Escape or Fight: Inhibitors in Hemophilia A.Frontiers in immunology · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Simone MerlinDepartment of Health Sciences, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and.
Rosella FamàDepartment of Health Sciences, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and.
Ester BorroniDepartment of Health Sciences, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and.
Diego ZanoliniDepartment of Health Sciences, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and.
Valentina BruscagginDepartment of Health Sciences, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and.
Silvia ZucchelliDepartment of Health Sciences, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and.
Antonia FollenziDepartment of Health Sciences, Università del Piemonte Orientale "Amedeo Avogadro," Novara, Italy; and.
Università degli Studi del Piemonte Orientale “Amedeo Avogadro” · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Here we describe a successful gene therapy approach for hemophilia A (HA), using the natural F8 promoter (pF8) to direct gene replacement to factor VIII (FVIII)-secreting cells. The promoter sequence and the regulatory elements involved in the modulation of F8 expression are still poorly characterized and biased by the historical assumption that FVIII expression is mainly in hepatocytes. Bioinformatic analyses have highlighted an underestimated complexity in gene expression at this locus, suggesting an activation of pF8 in more cell types than those previously expected. C57Bl/6 mice injected with a lentiviral vector expressing green fluorescent protein (GFP) under the pF8 (lentiviral vector [LV].pF8.GFP) confirm the predominant GFP expression in liver sinusoidal endothelial cells, with a few positive cells detectable also in hematopoietic organs. Therapeutic gene delivery (LV.pF8.FVIII) in hemophilic C57/Bl6 and 129-Bl6 mice successfully corrected the bleeding phenotype, rescuing up to 25% FVIII activity, using a codon-optimized FVIII, with sustained activity for the duration of the experiment (1 year) without inhibitor formation. Of note, LV.pF8.FVIII delivery in FVIII-immunized HA mice resulted in the complete reversion of the inhibitor titer with the recovery of therapeutic FVIII activity. Depletion of regulatory T cells (Tregs) in LV-treated mice allowed the formation of anti-FVIII antibodies, indicating a role for Tregs in immune tolerance induction. The significant blood loss reduction observed in all LV.pF8.FVIII-treated mice 1 year after injection confirmed the achievement of a long-term phenotypic correction. Altogether, our results highlight the potency of pF8-driven transgene expression to correct the bleeding phenotype in HA, as well as potentially in other diseases in which an endothelial-specific expression is required.

Indexed as

AnimalsDisease Models, AnimalFactor VIIIGenetic TherapyGreen Fluorescent ProteinsHemophilia AImmune ToleranceLentivirusMicePromoter Regions, GeneticT-Lymphocytes, RegulatoryFactor VIIIGreen Fluorescent Proteins

Identifiers

PMID30862611
PMCPMC6418497
OpenAlexW2921852127

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.