Clinical Trial

Disease: Beta- Thalassemia, BT, (NCT06024876)

Disease info:

Beta-thalassemia is a group of blood disorders characterised by a reduction in the production of haemoglobin. Haemoglobin is the iron-containing protein in red blood cells that carries oxygen to cells throughout the body.

Haemoglobin is encoded by genes that encode the building blocks of the haemoglobin protein. Mutations in these genes can produce abnormal haemoglobins leading to a family of conditions termed "haemoglobinopathies". Abnormal haemoglobin appears in one of three basic circumstances:

  1. Structural defects in the haemoglobin molecule. Alterations in the gene for one of the two haemoglobin subunit chains, alpha (a) or beta (b), are called mutations. Often, mutations change a single amino acid building block in the subunit. Most commonly the change is innocuous, perturbing neither the structure nor function of the haemoglobin molecule. Occasionally, alteration of a single amino acid dramatically disturbs the behaviour of the haemoglobin molecule and produces a disease state. Sickle haemoglobin exemplifies this phenomenon.
  2. Diminished production of one of the two subunits of the haemoglobin molecule. Mutations that produce this condition are termed "thalassemias." Equal numbers of haemoglobin alpha and beta chains are necessary for normal function. Haemoglobin chain imbalance damages and destroys red cells thereby producing anaemia. Although there is a dearth of the affected haemoglobin subunit, with most thalassemias the few subunits synthesised are structurally normal.
  3. Abnormal associations of otherwise normal subunits. A single subunit of the alpha chain (from the a-globin locus) and a single subunit from the b-globin locus combine to produce a normal haemoglobin dimer. With severe a-thalassemia, the b-globin subunits begin to associate into groups of four (tetramers) due to the paucity of potential a-chain partners. These tetramers of b-globin subunits are functionally inactive and do not transport oxygen. No comparable tetramers of alpha globin subunits form with severe beta-thalassemia. Alpha subunits are rapidly degraded in the absence of a partner from the beta-globin gene cluster (gamma, delta, beta globin subunits).

In individuals suffering from beta-thalassemia, low levels of haemoglobin lead to a lack of oxygen in many parts of the body. People with beta-thalassemia are at an increased risk of developing abnormal blood clots.

Beta-thalassemia is classified into two types depending on symptom severity. Transfusion-dependent thalassemia, also known as thalassemia major, is the more severe, while thalassemia intermedia is less severe.

Frequency:
Annually, approximately 1 in 100,000 cases are diagnosed worldwide. Beta-thalassaemia occurs most frequently in people from Mediterranean countries, North Africa, the Middle East, India, China and South East Asia.
Official title:
A Clinical Study Evaluating the Safety and Efficacy of In-vitro tBE Edited Autologous Hematopoietic Stem Progenitor Cells(CS-101) in Treating Subjects With β-thalassemia
Who:
Partners:

First Affiliated Hospital of Guangxi Medical University

Locations:

Nanning, China

The First Affiliated Hospital of Guangxi Medical University, Nanning, China

Study start:
Aug. 26, 2023
Enrollment:
5 participants
Gene editing method:
CRISPR-mediated base editing (transformer Base Editor, tBE)
Type of edit:
Gene disruption
Gene:
HBG promoter
Delivery method:
- Ex-vivo
Indicator
IND Enabling Pre-clinical
Phase I Safety
Phase II Safety and Dosing
Phase III Safety and Efficacy

Status: Active not recruiting

Description

The goal of this open label, single-arm clinical study is to learn about the safety and efficacy of CS-101 in treating β-thalassemia.

CS-101 is an autologous CD34+ cell suspension, edited by in vitro base editing technology, which modifies the BCL11A binding site in HBG promoter, so that it loses the ability to bind to BCL11A, which can re-induce the production of γ-globin chain and increase the concentration of fetal hemoglobin(HbF) in the blood, compensating for the function of missing adult hemoglobin HbA to achieve clinical cure. The therapy addresses two major challenges in the current treatment of the disease: lack of matching donors and graft-versus-host diseases in allogeneic hematopoietic stem cell transplantation.

Last updated: Oct. 24, 2024
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