Human Gene TherapyVol. 30, No. 11 AbstractsFree AccessESGCT 27th Annual Congress In collaboration with SETGyc Barcelona, Spain October 22–25, 2019 AbstractsPublished Online:7 Nov 2019https://doi.org/10.1089/hum.2019.29095.abstractsAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Selected Oral PresentationsOR01Paired-nickase S.aureus Cas9 system is an efficient and potentially safer in vivo treatment for Primary Hyperoxaluria Type 1L Torella1 I Raimondi1 A Vales1 C Olague1 A Abad1 J R Rodriguez-Madoz3 M Huarte1 E Salido2 G Gonzalez-Aseguinolaza1 N Zabaleta141: Gene Therapy and Regulation of Gene Expression Program, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain. 2: Hospital Universitario de Canarias, Universidad La Laguna, Tenerife, Spain. Centre for Biomedical Research on Rare Diseases (CIBERER). 3: Cell Therapy Program, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain. 4: Harvard Medical School, Grousbeck Gene Therapy Center, Schepens Eye Research Institute, Mass. Eye and Ear, Boston (MA)Primary hyperoxaluria type 1 (PH1) is a rare genetic metabolic disorder associated with mutations in AGXT gene, causing hepatic alanine-glyoxylate aminotransferase (AGT) deficiency. Consequently, oxalate is overproduced in the liver and accumulated in kidneys causing life-threatening renal damage. The only curative treatment is liver transplantation, thus, new therapies are required. The inhibition of glycolate oxidase (GO), the enzyme implicated in the synthesis of glyoxylate (precursor of oxalate), has been proven to be an efficient substrate reduction therapy (SRT) to treat PH1. Recently, AAV8-CRISPR/Cas9-mediated in vivo SRT was shown to greatly diminish GO expression, resulting in urine oxalate reduction and prevention of kidney damage. Nevertheless, concerns regarding CRISPR/Cas9 off-target effects should not be underestimated. Our approach to decrease off-target modifications was to use a nickase Cas9 combined with two gRNAs targeting nearby regions on the opposite strand. PH1 mice were treated with D10A-SaCas9 nickase mutants and two gRNAs previously tested efficient for the WT SaCas9. Simultaneous nicks greatly interfered with transcription and translation of Hao1, showing no significant differences with WT Cas9, while individual nicks did not interfere with the target gene expression. As expected, GO inhibition decreased urine oxalate levels and crystal accumulation in kidney parenchyma. Moreover, potential off-target sites for each gRNA were identified by CIRCLE-seq and NGS analysis is being performed in mice treated with WT or nickase SaCas9. In conclusion, dual nickase Cas9 should be preferred over nuclease strategy for more efficient and safer in vivo treatment of this monogenic disease.OR02HDR-CRISPR: a novel system to promote Cas9-mediated homology-directed DNA repairA Carusillo1 T Cathomen1 C Mussolino11: Institute for Transfusion Medicine and Gene Therapy, Medical Center - University of FreiburgPrecise genome editing requires the harnessing of homologous recombination-based homology-directed repair (HDR) pathway and a proper donor template to precisely seal a designer nuclease (DN)-induced DNA double strand break (DSB). However, competing DNA repair pathways, such as non-homologous end-joining (NHEJ), predominate in mammalian cells, often resulting in HDR frequencies far below the thresholds required for clinical translation. While chemical compounds have been used to synchronize the cells in cell cycle phases when the HDR pathway is most active or, alternatively, to inhibit NHEJ, their potential side effects limit the use of such drugs in clinical settings. To overcome this limitation, we sought to increase at the DSB the local concentration of factors critical for either engaging HDR or inhibiting NHEJ, and generated 13 different Cas9-fusion proteins (referred to as HDR-CRISPRs). We used a traffic light reporter (TLR) system to assess the frequency of DSBs that are either repaired by NHEJ or HDR, respectively, and achieved up to 3-fold increase in HDR-mediated repair events with selected HDR-CRISPRs. Importantly, the simultaneous inhibition of the NHEJ pathway further improved the HDR to NHEJ ratio, leading to an almost even distribution of HDR to NHEJ. These results support our hypothesis that the local recruitment of factors to the DSB to either promote HDR or inhibit NHEJ can modulate the DNA repair choice without altering the physiology of the target cells. We envision that this strategy is readily translatable to clinically relevant applications.OR03Targeted gene correction of human hematopoietic stem cells for the treatment of Wiskott-Aldrich SyndromeABSTRACT WITHDRAWNOR04Adeno-associated virus in human liver: natural history and consequences in tumor developmentT La Bella1 S Imbeaud1 C Peneau1 I Mami1 S Datta1 Q Bayard1 S Caruso1 T Z Hirsch1 J Calderaro2 G Morcrette13 C Guettier3 V Paradis4 G Amaddeo2 A Laurent2 L Possenti5 L Chiche6 P Bioulac-Sage7 J F Blanc7 E Letouzé1 J C Nault18 J Zucman-Rossi191: Functional Genomics of Solid Tumors, Centre de Recherche des Cordeliers, Inserm U1138, Paris, France. 2: Groupe Hospitalier Henri Mondor, AP-HP, Inserm U955, Université Paris-Est, Créteil, France. 3: Hôpitaux Paul Brousse et Bicêtre, Inserm U1193, Le Kremlin Bicêtre, France. 4: Hôpital Beaujon, Clichy, France. 5: CHU Bordeaux, Hôpital Haut-Lévêque, Bordeaux, France. 6: CHU Bordeaux, Centre Médico Chirurgical Magellan, Haut-Lévêque Hospital, Pessac, France. 7: BaRITOn, Inserm U1053, Bordeaux, France 8: Hôpitaux Universitaires Paris–Seine Saint-Denis, Site Jean Verdier, Bondy, France. 9: European Hospital Georges Pompidou, AP-HP, Paris, France.Adeno-associated virus (AAV) is a defective mono-stranded DNA virus, endemic in human population (35–80%). Recurrent clonal AAV2 insertions are associated with the pathogenesis of rare human hepatocellular carcinoma (HCC) developed on normal liver. This study aimed to characterize the natural history of AAV infection in the liver and its consequence in tumor development. Viral DNA was quantified in tumor and non-tumor liver tissues of 1461 patients and in silico analyses using viral capture data explored viral variants and new clonal insertions. AAV DNA was detected in 21% of the patients, more frequently in the non-tumor counterpart (18%) than in tumor (8%). The full-length viral sequences were reconstructed in 57 patients leading to identify two distinct AAV subtypes: one similar to AAV2, the other hybrid between AAV2 and AAV13 sequences. Episomal viral forms were found in 4% of the non-tumor tissues, frequently associated with viral RNA expression and human herpesvirus type 6 (HHV6), the candidate natural AAV helper virus. In 30 HCC, clonal AAV insertions were recurrently identified in CCNA2, CCNE1, TERT, TNFSF10, KMT2B and GLI1/INHBE. AAV insertion triggered oncogenic overexpression through multiple mechanisms that differ according to the localization of the integration site. Clonal AAV insertions were positively selected during HCC development on non-cirrhotic liver challenging the notion of AAV as a non-pathogenic virus. In conclusion, this is the first large scale study that provides an integrated analysis of wild type AAV infection in the liver with the identification of viral genotypes, molecular forms, helper virus relationship and viral integrations.OR05Paracrine delivery of therapeutic biologics for cancerS N Smith1 R Schubert2 B Simic1 D Brücher1 M Schmid1 V Gradinaru2 A Plückthun11: University of Zurich 2: California Institute of TechnologyA fundamental goal of cancer drug delivery is to achieve sufficient levels within the tumour without leading to high systemic concentrations that might cause off-target toxicities. In situ production of protein-based therapeutics by tumour cells provides an attractive alternative to treatment with repeated high bolus injections, as secretion by the tumour itself could provide high local concentrations that act in a paracrine fashion over an extended duration. For this purpose, we have developed a non-oncolytic adenoviral delivery system that allows for targeting of Ad5 to discrete cell types by redirecting viral tropism to cell surface biomarkers through the use of interchangeable adapters. Furthermore, we recently described the engineering of a protein-based ‘shield’ that is coated on the Ad5 capsid, which, together with the retargeting adapters, allows for improved tumour specificity and prevention of viral clearance. To test this delivery strategy in vivo, SCID-beige mice bearing orthotopic BT474 xenografts were treated with three doses of either a cancer-specific, non-replicative Ad5 that encodes a secreted anti-HER2 antibody, trastuzumab, in its genome, or with the protein therapeutic itself (Herceptin®). We have employed state-of-the-art whole tumour clearing and imaging with confocal microscopy at high spatial resolution in 3D to assess biodistribution, and large volumetric imaging has revealed that the secreted therapeutic diffuses significantly throughout the tumour leading to a therapeutic effect and delayed tumour outgrowth. Moreover, the systemic concentration of antibody is significantly reduced with viral delivery, suggesting that paracrine delivery may be a promising strategy for delivery of biologics with narrow therapeutic indices.OR06Base editor-mediated CD33 engineering to improve safety and efficacy of CD33-targeted cancer therapyO Humbert1 S Cook1 M Llevellyn1 G Laszlo1 J K Joung23 B Kleinstiver23 R B Walter14 H P Kiem141: Fred Hutchinson Cancer Research Center 2: Massachusetts General Hospital 3: Harvard Medical School 4: University of WashingtonAntigen-specific immunotherapies for myeloid malignancies, including acute myeloid leukemia (AML), have largely focused on CD33, a myeloid differentiation antigen displayed on AML blasts and possibly on leukemia stem cells. Improved survival with the CD33 antibody-drug conjugate gemtuzumab ozogamicin (GO) in AML patients has validated CD33 as immunotherapeutic target. An important limitation of this approach is however the significant on-target/off-leukemia effects attributed to the expression of CD33 on normal myeloid cells, causing severe cytopenia in treated patients. Recent studies, including by our group, have demonstrated that CRISPR/Cas9 nuclease-based editing of CD34+ hematopoietic stem and progenitor cells (HSPCs) conferred protection from CD33-directed drugs. While promising, this CRISPR-based strategy suffers from off-target activity due to cleavage of a nearby CD33 homolog pseudogene and from activation of endogenous TP53-mediated DNA damage responses. To address these limitations, we have explored the use of cytosine base editors (CBE) that introduce precise nucleotide substitutions and circumvent the need for DNA double strand breaks. We investigated 2 different strategies for introducing non-sense and splicing mutations in CD33. CBE-treatment of human CD34+ HSPCs did not impair engraftment and differentiation in a mouse model, while reducing CD33 expression and protecting cells from in vivo GO administration. Next-generation sequencing analysis of blood nucleated cells confirmed the persistence and specificity of CBE-induced mutations in vivo. Together, these results validate the use of CBE for the generation of CD33 engineered hematopoiesis to improve safety and efficacy of CD33-targeted therapies.OR07De novo generation of functional human thymus organoids from induced pluripotent stem cellsA Chhatta1 M Cordes1 S Vloemans1 M Hanegraaf1 T Cupedo2 F Carlotti1 J Cornelissen2 D Salvatori1 R Hoeben1 M Mikkers1 W E Fibbe1F JT Staal11: Leiden University Medical Center 2: Erasmus Medical CenterA proper functional thymus is required for generation of T cell mediated immunity. This is dramatically illustrated by patients lacking a thymus, such as children with complete diGeorge Syndrome which is fatal if left untreated. Therapeutic options for such patients are limited and confined to transplantation of small fragments from allogeneic neonatal thymi. Following the concept that an autologous medical product would be advantageous for any condition in which thymic function is impaired, we set out to develop a preclinical strategy to generate functional human thymi from induced pluripotent stem cells (iPSC), as potential autologous stem cell source. Here we describe that human iPSC can be differentiated into induced thymic epithelial cells (iTEPC) following developmental stages that mimic normal development. This protocol is most robust when combined with directed differentiation enforced by lentiviral expression of FoxN1, the master regulator for thymic epithelial cells. When aggregated in organoids and transplanted in nude mice (that lack a thymus), these organoids supported the development of functional T cells with a broad TCR repertoire capable of cytokine production when stimulated via the T cell receptor. Thus, we provide proof-of-principle evidence that a combination of stem cell technology nad gene therapy can restore thymic function.OR08Self-assembly of human stem/progenitor cells creates neo-vascularized skin and skin organoidsP Peking1 A Hochreiter1 M Wolf1 C Scharler1 B Vári1 E Russe2 L Krisch3 K Schallmoser13 D Strunk11: Cell Therapy Institute, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University, Salzburg, Austria. 2: Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital Barmherzige Brueder, Salzburg, Austria 3: Department of Transfusion Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University, Salzburg, AustriaStem/progenitor cells bear the potential to self-organize, creating organoids that resemble the organ functions in vitro. Here we established a humanized skin regeneration mouse model, based on self-assembly of adult as compared to iPSC-derived skin cell lineages forming neo-vascularized human skin. Adult endothelial cells (EC), skin fibroblasts (FB) and epidermal keratinocytes (KC) were propagated in 2D under xeno-free conditions. In addition, umbilical cord blood-derived iPSC were differentiated into iPS-EC,-FB, and–KC. Cell identity and purity were confirmed by flow cytometry and clonogenicity indicating their stem/progenitor potential. Skin organoid formation was performed to investigate cell self-organisation supported by human platelet-derived growth factors. Via life cell tracking sequential organoid assembly starting from stromal-vascular aggregation and followed by superficial anchorage of KC was revealed. Xeno-free human cell grafts, containing a mixture of KC, FB and EC in human platelet lysate (HPL) were transplanted onto full-thickness wounds of NSG mice using a transplant chamber to circumvent murine skin contraction. Two weeks after transplantation, histological analysis demonstrated appropriate cell organization into layered skin and a regular distribution of collagen fibers and ground substance. Immunohistochemistry confirmed the human origin of the grafts and a combination of murine and human neo-vasculature. Quantification showed significantly increased vessel numbers upon co-transplantation of EC compared to limited murine in-sprouting angiogenesis after transplantation of KC+FB only. The data show that self-assembly of human KC+FB combined with co-transplanted EC and HPL can create complex organoids in vitro and human neo-vascularized skin in vivo, building the basis for novel skin regeneration strategies.OR09Cell- and vector-engineering approaches for manufacturing high-titer GaLV pseudotyped lentiviral vectors from stable and constitutive producer cell linesA F Rodrigues12 R Nogueira1 T A Vaz1 M JT Carrondo1 A S Coroadinha1231: iBET – Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal 2: Instituto de Tecnologia Química e Biológica António Xavier, NOVA University Lisbon, Oeiras, Portugal 3: The Discoveries Centre for Regenerative and Precision Medicine, NOVA University Lisbon, Lisboa, PortugalLentiviral vectors (LV) are currently the first choice for cell and gene therapy applications when long-term expression is required and have consolidated as a preferential vector in the context of hematopoietic cells transduction. To cope with current and future demand of LV manufacturing, we have developed LentiPro26, stable and constitutive cell lines to support continuous production of LVs. LentiPro26 cells deliver competitive titers for amphotropic-pseudotyped vectors, but for Gibbon Ape Leukemia Virus (GaLV) envelope, preferable for hematopoietic cells transduction, obtaining higher titers is more challenging. Herein, we present two approaches to enable the manufacturing of high-titer LV GaLV-pseudotypes from stable and continuous producer cells lines. On the vector side, we created a panel of chimeric envelopes based on genetic modification of the cytoplasmic tail. The best envelope from our panel delivers transient titers near 10^7 TU/mL but also induced a strong cytotoxic phenotype. Thus, on the producer cell side, we abolished this phenotype by CRISPR-CAS knock-out of key cellular proteins. Genome-edited cells are capable of stably expressing the highest titer GaLV envelope with no evidence of envelope-induced cytotoxity. This work enables the use of constitutive packaging cell lines of GaLV LV pseudotypes, simultaneously featuring the competitive titres of transient production with the scalability, standardization and versatility of operation modes of stable and continuous production.OR10Generation of an automated GMP-grade protocol in a closed system for the expansion of polyclonal memory γδ-T cells for a “third party” cell bankV A Polito1 R Cristantielli1 G Weber1 T Belardinilli1 L Antonucci1 C M Arnone1 A Petretto2 F Ferrandino1 A Pitisci1 B De Angelis1 C Quintarelli1 F Del Bufalo1 F Locatelli13 I Caruana11: Department of Paediatric Haematology and Oncology, Cellular and Gene Therapy, Bambino Gesù Children's Hospital, Rome - Italy 2: Core Facilities-Proteomics Laboratory, Istituto Giannina Gaslini, Genoa, Italy 3: Department of Gynaecology/Obstetrics and Paediatrics, Sapienza University of Rome, Italyγδ-T cells are cells of the immune system with properties of both innate and adaptive compartment. Their powerful cytotoxic activity against bacteria, virus, tumours, together with their ability to recognize antigens in an HLA-independent manner and their negligible alloreactivity, make them attractive for clinical translation, especially in the perspective of a “third-party” T-cell bank. Unfortunately, γδ-T cells represent only a small lymphocyte population and therefore require in vitro expansion for clinical application. In this study, we developed a protocol to manually and automatically expand large numbers of polyclonal γδ-T memory cells, with the possibility of genetic modification to improve their anti-tumour activity. Artificial antigen presenting cells (aAPC) expressing CD86/41BBL/CD40L and the cytomegalovirus-pp65 antigen were used to induce expansion of γδ-T cells. To implement safety, aAPCs have been further modified with the inducible Caspase-9 suicide gene. γδ-T cells expanded 240 ± 109 times (day +21), expressing activation and memory markers maintaining a polyclonal phenotype (predominantly Vδ1). The extensive anti-tumour activity of this population was demonstrated in vitro with different tumour cell lines and leukaemic blasts (p < 0,01) and in vivo in a xenograft leukemia mouse model when compared to polyclonal αβ-T cells. In none of the cases, alloreactivity was observed. Phosphoproteomic and gene-expression studies reveal features between expanded and activated αβ and γδ-T (ability to operate as APCs, metabolism, pathways activated upon stimulation, phenotype, migration). The automated protocol for the isolation and expansion has been optimized and validated in the Clinimacs Prodigy closed-system, which maintains all the features obtained in the manual process.OR11Modelling skeletal muscle laminopathies with human iPS cells and bio-engineered skeletal muscles: Prospects for genetic therapiesL Pinton126D Moore16 H Steele-Stallard126 S Sarcar1 T Ozdemir12 S M Maffioletti1 J M Cuisset3 G Bonne4 P S Zammit2 F S Tedesco151: Department of Cell and Developmental Biology, University College London, London, UK 2: Randall Centre for Cell and Molecular Biophysics, King's College London, London, UK 3: Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de Neuropédiatrie, Hôpital Roger Salengro, CHRU Lille, Lille, France 4: Sorbonne Université, INSERM UMRS_974, Centre de Recherche en Myologie, Institut de Myologie, G.H. Pitié-Salpêtrière, Paris, France 5: Great Ormond Street Institute of Child Health, University College London, London, UK 6: Equally ContributingLaminopathies are severe genetic diseases caused by mutations in the LMNA gene, which encodes A-type lamins. Together with B-type lamins, they assemble into a mesh-like structure located beneath the nuclear membrane, providing structural stability and regulating gene expression. Laminopathies affect various cell types in a systemic or tissue specific manner, with the latter including striated muscle laminopathies. Although different mechanisms have been proposed, the precise pathophysiology of laminopathies remains unknown; additionally, therapy development is hindered by their rarity and lack of easily accessible cell types for ex vivo studies. To overcome these hurdles, we used induced pluripotent stem (iPS) cells from patients with skeletal muscle laminopathies such as LMNA-related congenital muscular dystrophy, limb-girdle muscular dystrophy 1B and Emery-Dreifuss muscular dystrophy (type 2 and 3), to model disease-associated phenotypes in vitro. iPS cells from four patients were differentiated into skeletal myogenic cells and myotubes. Characteristic pathological hallmarks, including nuclear shape abnormalities and mislocalisation of nuclear lamina proteins, were observed in LMNA-mutant iPS cell derivatives in proliferation and in differentiation. Notably, modelling in three-dimensional (3D) artificial muscle constructs resulted in higher fidelity recapitulation of nuclear shape abnormalities than in standard monolayer cultures, and identified nuclear length as a reproducible, mutation-specific phenotypic readout. Finally, we will present and discuss current efforts and future applications of this novel iPS cell-based platform to develop genetic therapies for laminopathies and other severe muscle disorders, including viral and non-viral strategies such as LMNA exon-skipping and gene editing.OR12Decoy-based gene therapy for Myotonic DystrophyM Matloka1234 L Arandel1234 F Rau1234 J Marie1234 M Ney1234 A Klein1234 A Sureau1234 N Naouar1234 A Ferry1234 N Sergeant567 D Furling12341: Center of Research in Myology 2: Sorbonne Université 3: Inserm UMRS974 4: Institute of Myology 5: Inserm UMRS1172 6: Alzheimer et Tauopathies, Université Lille Nord de France 7: Centre Jean Pierre AubertMyotonic dystrophy (DM) is an autosomal neuromuscular disease encompassing two distinct forms, DM1 and DM2, caused by abnormal microsatellite expansions of C(C)TG repeats in the non-coding regions of DMPK and ZNF9 genes, respectively. Mutant RNAs carrying expanded repeats are retained in the nucleus that abnormally sequester MBNL RNA-binding factors hampering their normal function in the regulation of alternative splicing events. Thus, several splicing changes in DM patients have been associated with clinical symptoms such as myotonia, muscle weakness and cognitive defects. Although various therapeutic approaches for DM are under development, to date there is no effective therapy available. Herein, we report a novel gene therapy strategy with the use of an engineered MBNLΔ RNA-binding protein that acts as a CUGexp-decoy to release sequestered endogenous MBNL factors and restore their proper functions. In vitro, the decoy interferes with CUG-expanded transcripts and normalizes splicing abnormalities. An RNAseq analysis confirmed that the vast majority of missplicing events are no more significantly altered in DM1-treated cells, indicating an almost complete recovery of MBNL1 activity. Further in vivo analysis showed that a single intramuscular injection of AAV-MBNLΔ vectors in a mouse model of the disease results in a complete and durable normalization of splicing misregulation up to one year. Moreover, systemic delivery of the decoy using AAV9 vectors improves hallmarks of the disease including abolition of the myotonia and correction of splicing defects. In conclusion, our results support this innovative decoy-based gene therapy approach as an alternate or complementary therapeutic intervention for DM treatment.OR13Shortened ex vivo transduction for hematopoietic stem cell gene therapy of Hurler disease: impact on hematopoietic reconstitution potentialE Zonari1 M E Bernardo1 M M Naldini12 I Galasso12 M Volpin1 G Desantis1 E Montini1 A Aiuti12 B Gentner11: San Raffaele Telethon Insitute for Gene Therapy (HSR-TIGET) 2: Universita Vita-Salute San RaffaeleSan Raffaele Telethon Institute for Gene Therapy (SR-TIGET) has recently started a phase I/II study on transplantation of ex vivo genetically-modified autologous CD34+ hematopoietic stem and progenitor cells (HSPC) in patients with Hurler disease (NCT03488394), implementing for the first time a shortened lentiviral transduction protocol containing prostaglandin E2. Preliminary data from the first five patients treated show rapid hematologic recovery following fludarabin/busulfan-based myeloablative conditioning: the median duration of grade 4 neutropenia and thrombocytopenia was 17 and 0 days, respectively. Median duration of neutropenia (<100 cells/mcl) was 6 days. The drug product (DP) and non-cultured (NC) CD34+ cells from the first 3 patients were xenografted into mice. With the exception of the 4 week time-point where human CD45+ engraftment in peripheral blood was reduced by 50% in DP compared to NC, there were no significant differences between groups during the follow up until 24 weeks, including secondary transplantation. This data-set confirms that the shortened ex vivo transduction protocol preserves HSPC function. Vector integration site analysis on the first patient's DP graft in primary and secondary mice is ongoing and will allow to compare graft clonality with the reference database. To further characterize the impact of ex vivo culture, we performed longitudinal single cell RNA sequencing on CD34+CD90+ cell fractions. Cells were cultured for up to 1 week, showing metabolic changes and stress responses after prolonged culture, which may impact engraftment potential. These results are anticipated to help improve the ex vivo manufacturing process.OR14The SUNRISE-PD Study, a clinical trial of AXO-LENTI-PD: a CNS-directed gene therapy for the treatment of Parkinson's DiseaseG Corcoran1 P Korner1 Y Mo1 J Benoit1 K Binley2 Y Lad2 J E Miskin2 N J Tuckwell2 D Zamoryakhin2 T Foltynie3 R A Barker4 K A Mitrophanous2 S Palfi51: Axovant Sciences 2: Oxford Biomedica (UK) Ltd 3: Department of Clinical and Movement Neurosciences, UCL Institute of Neurology 4: John van Geest Centre for Brain Repair, Department of Clinical Neuroscience, Addenbrooke's Hospital Cambridge 5: AP-HP, Groupe Hospitalier Henri-Mondor, DHU PePsy, Neurochirurgie, Psychiatrie CréteilParkinson's disease (PD) is caused in part, by the progressive degeneration of dopaminergic neurons in the substantia nigra. The standard of care, L-dopa, is highly efficacious but long-term use is complicated by motor fluctuations from intermittent stimulation of dopamine receptors and off-target effects. Therefore, a therapy that provides a continuous supply of dopamine to the area of greatest loss in PD, namely the putamen, offers the potential for reduced motor fluctuations and off-target effects. AXO-Lenti-PD is a novel gene therapy that delivers three genes critical for de novo dopamine biosynthesis, to the putamen, using a high-capacity lentiviral vector. Transduced neuronal cells produce continuous dopamine from endogenous tyrosine in the striatum. The first-generation construct of this product (ProSavin®) was found to be well-tolerated with all patients displaying some improvement in the UPDRS part III OFF score, which was sustained in some patients up to six years. To further increase the potency of this construct, the second-generation product, AXO-Lenti-PD, was developed, utilizing the same genes but in a different configuration allowing for increased dopamine production per genetically modified cell. AXO-Lenti-PD is being investigated in the two-part SUNRISE-PD study, comprised of a dose-ranging phase to confirm the optimal therapeutic dose, followed by a sham-controlled trial to assess the safety and efficacy of the optimal dose from the first part of the study. Based on data from the lowest dose cohort, AXO-Lenti-PD was observed to be generally well-tolerated, and the data suggests it may have greater efficacy compared to the highest dose of ProSavin®.OR15In vivo generated human CAR T cells eradicate B cell leukemia in preclinical mouse modelsF B Thalheimer1 S Agarwal1 T Weidner1 A Frank1 C J Buchholz11: Paul-Ehrlich-InstitutChimeric antigen receptors (CAR) T cells have shown significant clinical benefits to patients with B-cell malignancies. However, production of CAR T cells requires extensive and time-consuming procedures of cell isolation, sorting, transduction and in vitro expansion of T cells. We investigate if CAR T cell production can be radical