NEW YORK(AP)
Scientists for the first time have used gene therapy to
dramatically improve sight in people with a rare form of blindness,
a development experts called a major advance for the experimental
technique.
Some vision was restored in four of the six young people who got
the treatment, teams of researchers in the United States and
Britain reported Sunday. Two of the volunteers who could only see
hand motions were able to read a few lines of an eye chart within
weeks.
"It's a phenomenal breakthrough," said Stephen
Rose, chief research officer of the Foundation Fighting Blindness,
which helped pay for one study done at Children's Hospital of
Philadelphia.
If successful in larger numbers, experts said, the technique has
the potential to reverse blindness from other kinds of inherited
eye diseases.
"I think this is incredibly exciting," said Dr. Jean
Bennett, a professor of ophthalmology at the University of
Pennsylvania and a leader of the Philadelphia study. "It's
the beginning of a whole new phase of studies."
The research was published online Sunday by the New England
Journal of Medicine in conjunction with presentations at a medical
meeting in Florida.
The two teams of scientists, working separately, each tested
gene replacement therapy in three patients with a form of a rare
hereditary eye disease called Leber's congenital amaurosis.
There's no treatment for the disease, which appears early in
infancy and causes severe vision loss, especially at night.
An estimated 2,000 Americans have the form of the disease they
targeted, Bennett said.
Gene therapy _ replacing faulty genes with a normal version _
has been studied in humans for over 15 years with limited success.
The field suffered a setback with the 1999 death of Jesse
Gelsinger, 18, in an experiment for a liver disorder at Penn. And
some children treated for an immune disorder called the
"bubble boy disease" later developed leukemia.
The early results of the eye experiments should give the field a
boost, some experts said.
"I think it's really a big shot in the arm for gene
therapy and for medicine in general," said Dr. Ronald Crystal,
head of genetic medicine at Weill Cornell Medical College in New
York.
Each of the study participants had mutations in a gene that
makes a protein needed by the retina, which senses light and sends
images to the brain. Those without the gene gradually lose sight
until they are blind in early adulthood.
The retina itself stays in relatively good shape for a while,
making it a good candidate for gene therapy, said Robin Ali, a
professor at University College London, who led the British team.
He likened the defective gene to a missing spark plug in a car
engine.
"The whole engine can be absolutely fine, but if it
doesn't have a spark plug, the car's not going to
work," said Ali.
For the experiment, the scientists injected millions of copies
of a working gene beneath the retina in the back of the eye. Only
one eye was treated _ the worst one _ in case anything went wrong;
the untreated eye was used for comparison. After the treatment,
their eyesight and light sensitivity were measured periodically;
mobility was tested in a maze or an obstacle course.
All three of those treated in Philadelphia showed significant
improvement in their vision, the researchers said. The volunteers _
two women, 19 and 26, and a man, 26 _ were from Italy, where they
had been screened by researchers there. The longest follow-up was
six months.
Besides reading lines on an eye chart, they could see better in
dim lit, Bennett said.
"We were not expecting to restore their vision to
20/20," she said.
In the British group, the treatment only worked in 18-year-old
Steven Howarth, whose disease was less advanced than the other two
_ a girl, 17; and a man, 23, who was followed for a year.
Howarth said he used to rush home from school because he was
worried about getting around in the dark, according to remarks
issued by the university.
"Now, my sight when it's getting dark or it's badly
lit is definitely better. It's a small change _ but it makes a
big difference to me," said Howarth, who lives in Bolton, near
Manchester.
After the injection last July, Howarth said his eye felt like
sandpaper. It was better after a week, and his eyesight gradually
improved. He was able to negotiate a dimly lit maze in 14 seconds
without bumping into any obstacles; before it took him 77 seconds
with eight errors.
There were no serious side effects reported in either group. One
of the patients in Philadelphia developed a hole in his retina
which didn't affect his eyesight. The researchers think the
hole was related to the surgery and not the injected gene.
The researchers said there was no evidence that the altered
virus used to ferry the gene into the retina's cells had
traveled outside the eye to other areas of the body.
The groups have each treated a fourth patient, including a
preteen in England. The researchers hope to see better results with
higher doses and in younger patients with less eye damage.
The National Eye Institute is funding a third similar study at
the University of Florida.
The research in Philadelphia and London was paid for by a
variety of government agencies and private foundations. An employee
of Targeted Genetics Corp., which made the altered virus used in
London, is a co-author of their report. Four of the Philadelphia
researchers, including Bennett, have either applied for or have
patents related to gene therapy. Ali and another British researcher
have also applied for a patent for the procedure.
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AP Science Writer Malcolm Ritter contributed to this report.
___
On the Net:
New England Journal of Medicine:
http://www.nejm.org
National Eye Institute:
http://www.nei.nih.gov
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