Ornithine Transcarbamylase Deficiency Clinical Trial


Ornithine Transcarbamylase Deficiency

A large number of genetic diseases have been described that cause derangements in metabolic pathways of the liver. A deficiency of the urea cycle enzyme Ornithine Transcarbamylase (OTC) is a paradigm for such metabolic diseases. Genes deficient in this enzyme are unable to break down nitrogen, which leads to an accumulation of such toxic substances as ammonia. Investigators at the IHGT were recently approved to initiate a Phase I Clinical Trial to evaluate the utility of gene therapy for treating OTC deficiency.

The general concept involves using a virus as a vehicle to deliver the normal OTC gene to the liver cells of the patients. A modified version of the human adenovirus has been created by deleting potential disease-causing genes and inserting the normal OTC gene. When infused into the blood this recombinant virus targets the liver cells very specifically and efficiently. Patients eligible for this clinical trial are adults partially deficient of OTC. This would include the affected males who live beyond adolescence and adult carrier females. A total of 18 patients will be enrolled in the trial. Participating patients are admitted to the Hospital of the University of Pennsylvania where they undergo a procedure in which a catheter is inserted into a groin artery and advanced into the vessel that perfuses the liver. The vector is injected into the catheter thereby targeting the liver. The patients remain in the hospital for several days can return home after appropriate follow-up is arranged. This is a dose escalation study in which the initial patients receive the lowest dose of vector, which is advanced in subsequent groups pending an evaluation of the safety data.