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Last week the FDA halted a gene therapy clinical trial for arthritis 
due to the death of one of the participants. News report below from 
the Seattle Times. This treatment utilized an AAV virus - the same 
type used in 3 current Parkinson's trials. However, it is not known 
yet what caused the patient's death - if it was the gene itself, the 
virus or if it was unrelated to the gene therapy.

We should closely watch the developments with the halted gene therapy 
trial for arthritis as it may impact the Parkinson's trials too. The 
FDA said they would be reviewing all current gene therapy trials that 
utilize AAV for gene transfer. 

The 3 Parkinson's  clinical trials all have reported promising early 
results. They are:  

Genzyme's IAAV-hAADC-2 (Intrastriatal Infusion of Adeno-Associated 
Virus Encoding Human Aromatic L-Amino Acid Decarboxylase (AAV-hAADC-
2) in Subjects with Mid- to Late- Stage Parkinson’s Disease) - in 
phase I.

Genzyme is also partnering with Ceregene's CERE-120 trials in which 
the AAV delivers the gene for neurturin - a growth factor related to 
GDNF. Phase II is underway .

Neurologix's Glutamic Acid Decarboxylase (GAD) Gene Therapy - GAD 
treatment involves injecting a small amount of a gene-carrying virus 
(AAV) into the STN region of the brain to calm it down by turning the 
excitatory chemical glutamate into the inhibitory brain chemical 
GABA. The promising results of the phase 1 trial were recently 
reported and the company is planning to begin phase II by the end of 
the year.

More information on the Parkinson's clinical trials can be found in 
the www.pdpipeline.org database; on the  PDtrials.org website
and www.clinicaltrials.gov
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Seattle Times, July 28, 2007
Death clouds a gene-therapy's future 
By Ángel González

The death of a patient in a clinical trial run by Seattle-based 
Targeted Genetics is raising questions about a promising gene-therapy 
method until now thought to be safe.
The "adeno-associated virus" (AAV) used to deliver the company's drug 
for severe inflammatory arthritis has not previously caused any 
serious problems, so "no one knows why it happened," said Dr. David 
Russell, a professor of medicine at the University of Washington who 
specializes in gene therapy.
"We're all just waiting to see if it had anything to do with AAV," he 
said.
The tragedy is also a financial blow for Targeted, whose shares 
plummeted for a second day Friday and lost nearly 40 percent this 
past week.
The company reported Tuesday that a patient enrolled in experiments 
for its leading drug candidate had become seriously ill, and said the 
trial was being suspended as a precautionary measure. Two days later, 
the company and the U.S. Food and Drug Administration said the 
unidentified patient was dead.
Nothing else has been said of the patient's last moments, whereabouts 
or even cause of death. Both the company and the authorities say that 
the cause of death hasn't been established yet, and it's unclear 
whether the serious adverse effects reported earlier are related to 
the therapy at all.

But because the illness closely followed the patient's second 
injection with the drug, the agency is taking a closer look at all 
trials using the same type of gene therapy.
No other cases of serious adverse effects — which include life-
threatening conditions, disabilities or admission into a hospital — 
have been reported in any of the 29 AAV-related clinical trials 
currently supervised by the FDA, the agency says. About 600 patients 
have been treated with those therapies.

The death is the second in the history of gene-therapy trials, 
experts said. In 1999, 18-year old Jesse Gelsinger, part of a 
University of Pennsylvania study on an inherited liver disease, died 
of a massive immune reaction to a gene-therapy treatment.
There's a business link to Targeted Genetics from that case: The 
UPenn experiment was led by Dr. James Wilson, whose company, Genovo, 
licensed the technology used in the trial. Targeted Genetics acquired 
Genovo in 2000 for $66 million in stock.
The company, however, says that there's no Genovo technology in its 
inflammatory-arthritis drug.
And the drug tested in the UPenn trial was based on a different type 
of virus, said Russell.
Targeted Genetics shares fell again Friday, following news of the 
patient's death. Shares traded at $1.65, down 42 cents or 20.3 
percent.

Researchers like to use adeno-associated viruses because they 
typically produce a very mild reaction in the body's immune system, 
making them less problematic to administer. When the viruses infect a 
cell, they burrow into a specific part of its genome, making it easy 
for scientists to use them as vessels to replace faulty genes. Adeno-
associated viruses are "very efficient at delivering genes to a lot 
of different organs in the body," says Russell.
If the virus vehicle that carries Targeted Genetics' therapy turns 
out to have played a role in the patient's death, "it would be an 
important finding" for the entire field, said Russell. "It would 
indicate that we need to take that into account when we design our 
trials."Ample data in clinical and preclinical trials have indicated 
that adeno-associated viruses are safe to administer, but some 
toxicity has been demonstrated in animals, Russell said.

In an article published Friday in the academic journal Science, 
Russell and other University of Washington researchers described how 
mice injected with a type of adeno-associated virus developed cancer. 
However, the event is presumably a phenomenon unrelated to the 
Targeted Genetics case and it has only been shown to occur in mice, 
Russell said.
The Targeted Genetics trial was the only one that involved 
administering more than one dose of the drug, FDA spokeswoman Karen 
Riley said.
Some 127 patients have received an initial dose of the active drug or 
placebo, including 74 that received a second dose of the drug, 
Targeted Genetics said. All patients are currently being monitored, 
the company said.
The study was being conducted in 22 centers across the country, 
including Seattle.

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