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thanks Meg for the info.   I've  emailed Medtronic about their making the 
gene delivery device.  They are a great company and my neuro agrees with  me 
that their being involved might negate the effects of drug companies 
squashing it, if, as Nic says,  it works too well..

-----Original Message----- 
From: Meg Duggan
Sent: Saturday, April 14, 2012 7:50 AM
To: [log in to unmask]
Subject: Things I've Learned About ProSavin

Hi Guys - I started doing some research about ProSavin yesterday.  I have a 
call into Oxford BioMedica and hope to hear from them Monday, at which point 
I will update.  For now...

Sky News reported this week on the results of ProSavin, a new gene therapy 
from Oxford BioMedica that may revolutionize PD therapy.  The results are 
extremely encouraging, though only 15 people have been treated with 
ProSavin.
ProSavin uses a virus to deliver three enzymes directly to the striatum via 
injection, and is a one-time therapy. ProSavin is the only gene therapy 
currently in trial that aims to reproduce dopamine in the brain, other 
therapies are aimed at protecting dying cells.
From the Oxford BioMedica website:
ProSavin is an innovative gene-based treatment for Parkinson’s disease, a 
progressive movement disorder.  In Parkinson’s disease, there is 
degeneration of the cells in the brain that produce dopamine.  Using Oxfort 
BioMedica’s LentiVector gene delivery technology, ProSavin delivers the 
genes for three enzymes that are required for the synthesis of dopamine 
directly to the region of the brain called the striatum, converting cells 
into a replacement dopamine factory within the brain, thus replacing the 
patient’s own lost source of the neurotransmitter.
The three enzymes delivered by ProSavin are  AADC, TH and Ch1-GTP.  AADC is 
aromatic l-amino acid decarboxylase.  AADC catalyzes L-DOPA to dopamine, and 
is inhibited by Carbidopa outside of the blood brain barrier to inhibit the 
premature conversion of L-DOPA to Dopamine.
TH is tyrosine hydroxylase.  TH also catalyzes the formation of L-DOPA.  In 
fact, in one study Haavik and Toska characterized PD as “a tyrosine 
hysdorxylase-deficiency syndrome of the striatum.
The third enzyme, CH1-GTP is a co-factor required for the biosynthesis of 
dopamine.  GTP is encoded by the gene GCH1, mutations in which are 
associated with levodopa-responsive dystonia.
These three enzymes are delivered by  Oxford BioMedica’s LentiVector 
technology.  Again from their site:
The LentiVector gene delivery technology is designed to overcome the safety 
and delivery problems associated with earlier generations of vector systems. 
The technology can stably deliver genes into cells with up to 100% 
efficiency and can integrate genes into non-dividing cells, including 
neurons in the brain and retinal cells in the eye.  In such cell types, 
studies suggest that gene expression could be maintained indefinitely.  It 
also has a larger capacity than most other vector systems and can 
accommodate multiple therapeutic genes.
Four cohorts have currently been enrolled in the ProSavin studies, each with 
escalating doses via the LentiVector technology.  Chort One received four 
needle injections per brain hemisphere, with 1X dose. Cohort Two received 
five needle injections per hemisphere, with 2x dose. Cohort Three received 
three needle injections with 2x dose, and Cohort Four 3 needle injections 
with 5x dose.
These Four Cohorts represent a Phase I/II trial, a phase designed to assess 
the safety and efficacy of the drug. Together, the Cohort studies represent 
two does levels and an enhanced administration technique.  The Fourth Cohort 
is receiving the scaled equivalent of the optimal dose.
Oxford BioMedica is reporting two-year data.  The first two dose levels were 
safe and well-tolerated in all patients, with encouraging clinical benefit. 
The Fourth Cohort is reporting at three months and showing average motor 
function improvement of 29%.  The Third Cohort is reporting at six months, 
and showing improved motor function of 61%.  Oxford BioMedica now plans 
placebo-controlled studies and a randomized Phase II trial for this year.
Patients have remained on oral L-DOPA therapy, but across the first three 
cohorts, oral medications have either been reduced or remained stable, and 
quality of life has either increased or remained stable.
ProSavin trials are currently being conducted at two locations, the Henri 
Mondor Hospital in Paris and the Adenbrookes Hospital in Cambridge, UK. 
They are currently recruiting for trials at both locations and seeking 
mid-stage disease patients who are losing ground with oral therapies. Get 
more information at [log in to unmask]



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