Hemophilia BVancouver, is a moderately severe hereditary disorder in which the factor IX antigen is present in relatively normal amounts but the biological activity of factor IX is markedly reduced. Previous studies have demonstrated that although the patient has 62% of the normal factor IX antigen level in his plasma, he shows only 2.6% of normal factor IX procoagulant activity. In addition, radioimmunoassays have shown that epitopes on both the heavy and light chains of activated factor IX are present. These two results were taken as an indication that the molecular defect causing the hemophilia may be a point mutation involving an amino acid change in the protein. In order to identify the mutation involved, DNA was isolated from lymphocytes in a blood sample from the patient. This DNA was used to construct a genomic library in the λ vector EMBL3. One million of the resultant clones were screened with a labelled factor IX cDNA probe to identify those clones containing portions of the factor IX gene. DNA inserts from three λ clones, which together span the entire gene, were subcloned to facilitate sequence analysis of the exons and intron / exon junctions of the factor IX gene. The nucleotide sequences of the coding regions were found to match the published sequence of the normal gene, except for one nucleotide. A single mutation was found at nucleotide 31,311 of the factor IX gene (Yoshitake et al.,1985), corresponding to amino acid 397 of the mature protein. This alteration, which changes an isoleucine codon, ATA, to a threonine codon, ACA, is novel among the mutations which have been reported to cause hemophilia B. A three dimensional model of the protease domain of factor IXа, which was prepared on the basis of its homology to the pancreatic serine proteases, was examined in the vicinity of residue 397. The position of threonine 397 in this model suggests that this mutation could alter the hydrogen bonding between factor IXа and its substrate, factor X. Taken together, these data suggest that this mutation is the cause of the hemophilia in this patient. / Medicine, Faculty of / Medical Genetics, Department of / Graduate

Orientador: Joyce Maria Annichino-Bizzacchi / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T01:02:06Z (GMT). No. of bitstreams: 1 DePaula_LaisIvinaSilva_M.pdf: 1198632 bytes, checksum: 0ba443fa4dbfb9c64ad09eacb865b1bb (MD5) Previous issue date: 2015 / Resumo: Problemas associados à aterosclerose são a causa mais comum de morte na população ocidental. A aterosclerose é uma doença inflamatória, e existe uma associação da coagulação com processos inflamatórios e complicações da doença arterial. Estudos populacionais inicialmente demonstraram uma diminuição do risco de infarto agudo do miocárdio em homens hemofílicos, quando comparados com controles pareados por idade e sexo. Contudo estudos subsequentes não confirmaram esses achados, havendo inclusive um estudo que mostrou aumento do risco de doença aterosclerótica e infarto em pacientes hemofílicos. Um dos fatores que deve ter tido importante papel nessa mudança foi o aumento da sobrevida dos pacientes a partir de 1999, com o advento de terapêuticas mais eficazes. Este estudo teve como objetivo investigar o papel da deficiência grave de fator IX (FIX), no desenvolvimento da doença aterosclerótica, em um modelo de dislipidemia, utilizando animais da linhagem C57Bl/6 deficientes de apolipoproteína E (APOE -/-). Comparamos grupos de animais com deficiência de apoE com ou sem deficiência de FIX (hemofílicos B - HB), através da avaliação quantitativa das lesões, na raiz e em toda sua extensão aórtica; e caracterização histológica das lesões na raiz aórtica por imunofluorecência. Nossos resultados mostraram que os animais com hemofilia B e deficiência de apoE apresentaram o mesmo grau de formação de placa aterosclerótica quando comparados com o grupo controle (APOE -/-), com 8 e 22 semanas de dieta. Portanto, a deficiência do fator IX não protegeu contra a formação de lesões ateroscleróticas na raiz e em toda extensão aórtica. O mesmo ocorreu na avaliação qualitativa, quando comparamos a porcentagem total de macrófagos e de células musculares lisas. Independente dos seus elevados níveis de colesterol e triglicerídeos. Contudo, foi evidente a diminuição na quantidade de macrófagos M1, através da produção de IL - 1?, em comparação aos camundongos controles, deficientes apenas de apoE. Um dado intrigante é que apesar de termos observado uma diminuição de macrófagos M1 nos animais hemofílicos, isso não foi acompanhado por uma diminuição nas lesões ateroscleróticas. Portanto, apesar da hipocoagulabilidade e do perfil de resposta dos macrófagos, nossos resultados sugerem que outros fatores foram mais importantes no desenvolvimento da aterosclerose. Nossos resultados corroboram os achados mais recentes de que pacientes hemofílicos também são susceptíveis ao desenvolvimento de doença aterosclerótica, incluindo doença coronariana / Abstract: Problems associated with atherosclerosis are the most common cause of death in the western population. Atherosclerosis is an inflammatory disease, and there is a coagulation associated with inflammatory processes and complications of arterial disease. Population studies initially demonstrated a decreased risk of acute myocardial infarction in men hemophiliacs compared with controls matched for age and sex. But subsequent studies have not confirmed these findings, including having a study that showed increased risk of atherosclerotic disease and stroke in hemophilia patients. One of the factors that must have played an important role in this change was the increased survival of patients since 1999, with the advent of more effective therapies. This study aimed to investigate the role of severe deficiency of factor IX (FIX), in the development of atherosclerosis, dyslipidemia in a model using animals C57BL strain / 6 deficient apolipoprotein E (APOE - / -). Groups of animals compared with apoE-deficient or without FIX deficiency (hemophilia B - HB) by quantitative evaluation of lesions in the root and aortic its entire extension; and histological characterization of the lesions in the aortic root by immunofluorescence. Our results showed that animals with hemophilia B and apoE deficiency showed the same degree of atherosclerotic plaque formation when compared with the control group (APOE - / -), with 8 and 22 weeks of diet. Therefore, factor IX deficiency does not protect against the formation of atherosclerotic lesions in the aortic root and throughout extension. The same occurred in the qualitative evaluation, when comparing the total percentage of macrophages and smooth muscle cells. Whatever your high cholesterol and triglycerides. However, it was apparent decrease in the amount of M1 macrophages by IL - 1? compared to control mice, apoE deficient only. A given intriguing is that although we observed a decrease of M1 macrophages in hemophiliacs animals, this was not accompanied by a decrease in atherosclerotic lesions. Therefore, despite the hypocoagulability and macrophage response profile, our results suggest that other factors are more important in the development of atherosclerosis. Our results support the latest findings that hemophilia patients are also susceptible to developing atherosclerosis, including coronary heart disease / Mestrado / Fisiopatologia Médica / Mestra em Ciências

Permanent repair of the F9 gene is a significant goal to cure Hemophilia B disease. Advanced gene therapy using CRISPR/Cas9 system can increase circulation level of Factor IX proteins to a significant level without the need of demanding infusions of FIX concentrates. Induced pluripotent stem cells represent an ideal cell for gene therapy because patient-derived cells could be reprogrammed into iPSCs, genetically modified, selected, expanded and then induced to differentiate into fully functional hepatocytes in vitro. This study covered a portion of a 5-year project which ultimately aims at establishing therapeutic results in transgenic Hemophilia B mice by injecting genetically corrected iPSC-derived hepatocytes into the liver. The purpose of this thesis is to summarize what has been completed up to now: generation of the proper model of Hemophilia B human iPSCs using CRISPR/Cas9-mediated genome editing and differentiation of healthy and disease specific iPSCs into hepatocytes which will allow disease modelling to look for cell function, viability, homogeneity and drug screening. Further research will be done to effectively knock-in the F9 allele into liver safe harbor site of disease specific iPSCs, which will express FIX at a significant level to show therapeutic effects.

<p>Electrostatic interaction is a strong force that attracts positively and negatively charged molecules to each other. Such an interaction is formed between positively charged polycationic polymers and negatively charged nucleic acids. In this dissertation, the electrostatic attraction between polycationic polymers and nucleic acids is exploited for applications in oral gene delivery and nucleic acid scavenging. An enhanced nanoparticle for oral gene delivery of a human Factor IX (hFIX) plasmid is developed using the polycationic polysaccharide, chitosan (Ch), in combination with protamine sulfate (PS) to treat hemophilia B. For nucleic acid scavenging purposes, the development of an effective nucleic acid scavenging nanofiber platform is described for dampening hyper-inflammation and reducing the formation of biofilms.</p><p>Non-viral gene therapy may be an attractive alternative to chronic protein replacement therapy. Orally administered non-viral gene vectors have been investigated for more than one decade with little progress made beyond the initial studies. Oral administration has many benefits over intravenous injection including patient compliance and overall cost; however, effective oral gene delivery systems remain elusive. To date, only chitosan carriers have demonstrated successful oral gene delivery due to chitosan’s stability via the oral route. In this study, we increase the transfection efficiency of the chitosan gene carrier by adding protamine sulfate to the nanoparticle formulation. The addition of protamine sulfate to the chitosan nanoparticles results in up to 42x higher in vitro transfection efficiency than chitosan nanoparticles without protamine sulfate. Therapeutic levels of hFIX protein are detected after oral delivery of Ch/PS/phFIX nanoparticles in 5/12 mice in vivo, ranging from 3 -132 ng/mL, as compared to levels below 4 ng/mL in 1/12 mice given Ch/phFIX nanoparticles. These results indicate the protamine sulfate enhances the transfection efficiency of chitosan and should be considered as an effective ternary component for applications in oral gene delivery.</p><p>Dying cells release nucleic acids (NA) and NA-complexes that activate the inflammatory pathways of immune cells. Sustained activation of these pathways contributes to chronic inflammation related to autoimmune diseases including systemic lupus erythematosus, rheumatoid arthritis, and inflammatory bowel disease. Studies have shown that certain soluble, cationic polymers can scavenge extracellular nucleic acids and inhibit RNA-and DNA-mediated activation of Toll-like receptors (TLRs) and inflammation. In this study, the cationic polymers are incorporated onto insoluble nanofibers, enabling local scavenging of negatively charged pro-inflammatory species such as damage-associated molecular pattern (DAMP) molecules in the extracellular space, reducing cytotoxicity related to unwanted internalization of soluble cationic polymers. In vitro data show that electrospun nanofibers grafted with cationic polymers, termed nucleic acid scavenging nanofibers (NASFs), can scavenge nucleic acid-based agonists of TLR 3 and TLR 9 directly from serum and prevent the production of NF-ĸB, an immune system activating transcription factor while also demonstrating low cytotoxicity. NASFs formed from poly (styrene-alt-maleic anhydride) conjugated with 1.8 kDa branched polyethylenimine (bPEI) resulted in randomly aligned fibers with diameters of 486±9 nm. NASFs effectively eliminate the immune stimulating response of NA based agonists CpG (TLR 9) and poly (I:C) (TLR 3) while not affecting the activation caused by the non-nucleic acid TLR agonist pam3CSK4. Results in a more biologically relevant context of doxorubicin-induced cell death in RAW cells demonstrates that NASFs block ~25-40% of NF-ĸβ response in Ramos-Blue cells treated with RAW extracellular debris, ie DAMPs, following doxorubicin treatment. Together, these data demonstrate that the formation of cationic NASFs by a simple, replicable, modular technique is effective and that such NASFs are capable of modulating localized inflammatory responses. </p><p>An understandable way to clinically apply the NASF is as a wound bandage. Chronic wounds are a serious clinical problem that is attributed to an extended period of inflammation as well as the presence of biofilms. An NASF bandage can potentially have two benefits in the treatment of chronic wounds by reducing the inflammation and preventing biofilm formation. NASF can prevent biofilm formation by reducing the NA present in the wound bed, therefore removing large components of what the bacteria use to develop their biofilm matrix, the extracellular polymeric substance, without which the biofilm cannot develop. The NASF described above is used to show the effect of the nucleic acid scavenging technology on in vitro and in vivo biofilm formation of P. aeruginosa, S. aureus, and S. epidermidis biofilms. The in vitro studies demonstrated that the NASFs were able to significantly reduce the biofilm formation in all three bacterial strains. In vivo studies of the NASF on mouse wounds infected with biofilm show that the NASF retain their functionality and are able to scavenge DNA, RNA, and protein from the wound bed. The NASF remove DNA that are maintaining the inflammatory state of the open wound and contributing to the extracellular polymeric substance (EPS), such as mtDNA, and also removing proteins that are required for bacteria/biofilm formation and maintenance such as chaperonin, ribosomal proteins, succinyl CoA-ligase, and polymerases. However, the NASF are not successful at decreasing the wound healing time because their repeated application and removal disrupts the wound bed and removes proteins required for wound healing such as fibronectin, vibronectin, keratin, and plasminogen. Further optimization of NASF treatment duration and potential combination treatments should be tested to reduce the unwanted side effects of increased wound healing time.</p> / Dissertation

Thesis (Doctoral)--Department of Pediatrics, University Hospital of Malmö, University of Lund. / Added t.p. with thesis statement inserted. Summary in Swedish. Includes bibliographical references.

Thesis (Doctoral)--Department of Pediatrics, University Hospital of Malmö, University of Lund. / Added t.p. with thesis statement inserted. Summary in Swedish. Includes bibliographical references.

<p>The work presented in this thesis was focused on design and construction of novel cell-loaded microcapsules by incorporation of bioactive molecules (proteins or peptides) for potential application in hemophilia B treatment. The objective of this study was to improve the viability and functionality of the encapsulated cells by creating biomimetic microenvironments for cells that more closely mimic their physiological extracellular matrix (ECM) environment.</p> <p>Three cell-adhesive molecules were used in this work: fibrinogen and fibronectin, two abundant proteins present in ECM, and arginine-glycine-aspartic acid (RGD) tri-peptide, the minimal essential cell adhesion peptide sequence and the most widely studied peptide for cell adhesion. Alginate, the most commonly used biomaterial used for cell encapsulation, was combined with either of these molecules to create biomimetic microcapsules. Non-modified alginate (control) and modified alginate matrices were used to encapsulate the factor IX (FIX) secreting cells for protein delivery. In this work, FIX-engineered cord blood-derived human mesenchymal stem cells CB MSCs were used as a cell source for FIX delivery.</p> <p>Our data suggested that fibrinogen-alginate, fibronectin-alginate and RGD-alginate microcapsules improved the viability of encapsulated MSC and are applicable in cell therapy technologies. However, fibrinogen-alginate and fibronectin-alginate microcapsules more significantly enhanced the proliferation and protein secretion from the encapsulated cells and may have potential for FIX delivery for hemophilia B and other inherited or acquired protein deficiencies. RGD-alginate microcapsules can v potentially be used for other tissue engineering applications with the aim of enhanced viability and attachment of the enclosed cells. Differentiation studies showed the osteogenic (but not chondrogenic or adipogenic) differentiation capability of FIX-engineered CB MSCs and their efficient FIX secretion while encapsulated in fibrinogen-alginate and fibronectin-alginate microcapsules.</p> / Doctor of Philosophy (PhD)

O fator IX (FIX) da coagulação sanguínea é uma proteína dependente de vitamina K de grande valor farmacêutico no tratamento da Hemofilia B, o qual é baseado na administração do fator de coagulação derivado de plasma humano ou da proteína recombinante produzida em células murinas. A terapia baseada nestas abordagens apresenta alto custo e está associada às contaminações com vírus e príons, além do desenvolvimento de inibidores de FIX. Esses efeitos aumentam o risco de morbidade e mortalidade relacionadas às hemorragias. Neste trabalho, clonamos o cDNA do FIX em um vetor lentiviral e avaliamos a expressão da proteína recombinante em duas linhagens celulares humanas. A clonagem do cDNA do FIXh no vetor de expressão lentiviral 1054 foi confirmada através da análise com enzimas de restrição específicas obtendo-se as bandas esperadas de 1407 pb e 10054 pb visualizadas em gel de agarose. As linhagens celulares 293T e SK-Hep-1 foram transduzidas com o vetor lentiviral 1054-FIX gerado em nosso laboratório e as células que apresentaram maior expressão de EGFP foram selecionadas e separadas por citometria de fluxo. A quantificação da expressão de FIXrh foi realizada por ensaios de ELISA e cromogênico. A quantificação de FIXrh total foi de 500 ng/106 células para a linhagem 293T e 803 ng/106 células para a linhagem SK-Hep-1. A atividade biológica específica de FIXh nas células 293T e SK-Hep-1 foi 0,047 UI/106 células e 0,186 UI/106 células, respectivamente. Com o intuito de avaliar o perfil de produção de FIXrh ativo ao longo do tempo, foi realizado um acompanhamento de 180 dias, no qual foi observado que a linhagem SK-Hep-1 cessou a expressão de FIX, enquanto as células 293T mantiveram a expressão durante o período. O FIXrh foi caracterizado por western blot confirmando a presença de uma banda imunoreativa esperada de 57 kDa. As linhagens 293T e SK-Hep-1 apresentaram 7,67 e 17 cópias do vetor inserido/célula, respectivamente. Considerando a importância do processo de ?-carboxilação, foi realizada uma análise da expressão gênica dos genes envolvidos neste processo, tais como o VKORC1, ?-carboxilase e o inibidor calumenina, nas linhagens celulares. Os resultados demonstraram razões elevadas entre os genes VKORC1 e calumenina e VKORC1 e ?-carboxilase nas duas linhagens. A cinética de crescimento das células foi realizada por um período de 7 dias apresentando diferenças significativas entre as células SK-Hep-1 transduzidas e não transduzidas, enquanto que as células 293T não presentaram diferenças estatísticas no crescimento celular. A suplementação do meio de cultura com íons Ca+2 e Mg+2 foi testada para avaliar sua influência na expressão de FIXrh ativo. As células 293T apresentaram melhor desempenho nas concentrações de 0,5 mmol/L de Ca+2 e 1,0 mmol/L de Mg+2 e as células SK-Hep-1 no meio de cultura não suplementado. Nossos dados indicam que a linhagem hepática SK-Hep-1 é a melhor produtora de FIXrh funcional e as comparações realizadas entre os dois tipos celulares são importantes na caracterização do comportamento de linhagens geneticamente modificadas voltadas para a expressão de proteínas recombinantes heterólogas e abre novos caminhos para futuros estudos que visam o melhoramento da produção desse tipo de proteína. / Blood coagulation factor IX is a vitamin K-dependent protein, and it has become a valuable pharmaceutical in the treatment of Hemophilia B which is based on the plasma-derived coagulation factors or recombinant protein produced in murine cells. Coagulation therapy based on these approaches has high costs and is closely associated with prion and virus contamination besides the FIX inhibitors development. These effects increase the risk for bleeding-related morbidity and mortality. The purpose of this study was to clone hFIX into a lentiviral vector and evaluate the expression of the recombinant protein in two human cell lines. The cloning of the hFIX cDNA into 1054 lentiviral expression vector was confirmed by enzymatic restriction obtaining the expected 1407 bp and 10054 bp bands in agarose gel. The 293T and SK-Hep-1 cell lines have been stable transduced with 1054-FIX lentiviral vector generated in our laboratory and the cells with higher expression of EGFP were selected and separated by flow cytometry. The quantification of the expression of rhFIX was performed by ELISA and chromogenic assays. The concentration of total rhFIX was 500 ng/106 cells in 293T cell line and 803 ng/106 cells in SK-Hep-1 cell line. The biological activity of FIX secreted by 293T and SK-Hep-1 was 0,047 UI/106 cells and 0,186 UI/106 cells, respectively. In order to evaluate the active rhFIX production profile over time, we conducted a monitoring of 180 days, which was noted that the SK-Hep-1 cell line ceased FIX expression, while 293T cells maintained the expression during this period. rhFIX was characterized by western blot analysis confirming the presence of a expected 57 kDa immunereactive band. The 293T and SK-Hep-1 cell lines showed 7.67 and 17 integrated vector copies/cell, respectively. Considering the importance of the ?-carboxylation process, we performed a gene expression analysis of genes involved in this process, such as VKORC1, ?-carboxylase and calumenin, in cell lines. The results showed high ratios among the genes VKORC1 and calumenin and among VKORC1 and ?-carboxylase in both cell lines. The cell growth kinetics was performed by a 7-day period, showed significant differences between SK-Hep-1 transduced cells and non-transduced cells, whereas 293T cells showed no difference in cell growth. Enrichment of culture medium with Ca +2 and Mg +2 ions was tested to evaluate its influence on the expression of active FIX. 293T cells showed better performance in 0.5 mmol/L Ca+2 and 1.0 mmol/L Mg +2 concentrations and SK-Hep-1 cells in culture medium control. Our data indicate that transduced SK-Hep-1 cells are the best producer of functional rhFIX, and comparisons between these two cell lines are important in characterizing the behavior of genetically modified cell lines focused on the heterologous expression of recombinant proteins and opens new avenues for future studies aimed at improving the production of this type of protein.

O Fator IX (FIX) da coagulação sanguínea é uma proteína dependente de vitamina K de grande valor farmacêutico no tratamento da hemofilia B, o qual é baseado na administração de FIX derivado de plasma humano ou FIX recombinante. A terapia baseada nestas abordagens apresenta limitações como os altos custos e a baixa disponibilidade para a população de hemofílicos. O FIX é uma proteína complexa com grande variedade de modificações pós-traducionais e, por isso, apresenta baixa atividade específica e produtividade. A produção de um FIX recombinante com aumento na sua atividade coagulante pode contribuir para terapias de reposição e gênica mais eficazes nas quais quantidades menores das moléculas cataliticamente melhoradas serão necessárias para se obter os benefícios terapêuticos do FIX. Essa infusão diminuída poderá reduzir ou eliminar a geração de inibidores de FIX, minimizando os efeitos colaterais e reduzindo os custos do tratamento, sendo um dos desafios atuais no tratamento da hemofilia B. Nesse contexto, a engenharia genética tem se tornado uma ferramenta importante na modificação de proteínas de interesse farmacêutico visando a melhora das suas propriedades bioquímicas e biofísicas. Este trabalho teve como objetivo desenvolver novas variantes de FIX recombinante humano com aumento da sua atividade biológica. Para isso, fizemos um estudo detalhado da estrutura da proteína FIX e geramos três variantes FIX-YKALW, FIX-ALL e FIX-LLW, utilizando a técnica de mutagênese sítio dirigida. Essas variantes foram expressas em células humanas SK-Hep-1 tratadas com vitamina K e as proteínas foram caracterizadas in vitro e in vivo. A quantidade de FIX total secretada no sobrenadante celular foi similar entre as variantes FIX-YKALW e FIX-LLW (3,2 ?g/mL), enquanto FIX-ALL apresentou a menor expressão (1,8 ?g/mL), quantidades 2-3 vezes menores que de FIX controle (FIX-WT). Entretanto, a atividade biológica das variantes foi, em média, 6,2 vezes maior que FIX-WT, com atividade específica 11 vezes maior para FIX-YKALW e FIX-LLW e 24 vezes maior para FIX-ALL. FIX-YKALW apresentou a melhor geração de trombina in vitro dentre as variantes e destacou-se na avaliação da eficiência hemostática em camundongos hemofílicos B, na qual uma dose 5 vezes menor que a recomendada de FIX foi suficiente para promover uma resposta pró-coagulante. Neste trabalho foram desenvolvidas 3 novas variantes de FIX recombinante humano com maior atividade específica que o fator disponível no Sistema Único de Sáude. O FIX-ALL apresentou-se como a proteína mais potente in vitro descrita até o momento e FIX-YKALW como a mais promissora, dentre as mutantes desenvolvidas, na proteção hemostática in vivo. Estudos complementares são necessários para transpor a barreira da pesquisa para a utilização desses novos fatores de coagulação no tratamento da hemofilia B. Entretanto, esse trabalho apresenta novas proteínas com potencial de serem usadas na combinação com a terapia gênica bem como na terapia de reposição / Blood coagulation factor IX is a vitamin K-dependent protein, and it has become a valuable pharmaceutical in the treatment of hemophilia B which is based on the plasma-derived coagulation factor or recombinant protein. Coagulation therapy based on these approaches has limitations as high costs and low availability to hemophilic population. FIX is a complex protein with a wide variety of post-translational modifications and, therefore, presents low specific activity and productivity. The production of recombinant FIX with enhanced coagulant activity may contribute to more effective protein replacement and gene therapies in which reduced amounts of catalytically improved molecules will be required to obtain the therapeutic benefits of FIX. This fewer infusion may reduce or eliminate the generation of FIX inhibitors, minimizing side effects and reducing treatment costs. It is one of the current challenges for hemophilia B treatment. In this context, bioengineering has become an important tool for pharmaceutical interest protein modification to improve its biochemical and biophysical properties. This study focused on development of new recombinant human FIX variants with augmented clotting activity. We performed a detailed study of FIX protein structure and generated three variants, FIX-YKALW, FIX-ALL and FIX-LLW, using site-directed mutagenesis. Such variants were expressed in SK-Hep-1 cells treated with vitamin K and they were characterized in vitro and in vivo. The amount of FIX secreted in the cell supernatant was similar between FIX-YKALW and FIX-LLW (3.2 ?g/mL), whereas FIX-ALL displayed the lowest expression (1.8 ?g/mL), 2-3 times lower than FIX-wild-type (FIX-WT). However, the clotting activities of FIX variants were 6.2 times greater than FIX-WT. FIX-YKALW e FIX-LLW showed 11-fold higher specific activity and FIX-ALL showed 24-fold higher specific activity. FIX-YKALW displayed the greatest generation of thrombin in vitro among variants and was highlighted in the evaluation of haemostatic efficiency in hemophiliac B mice, in which a dose 5 times lower than the recommended FIX replacement therapy was enough to promote a procoagulant response. We generated 3 novel recombinant human FIX variants with enhanced specific activity than FIX available on the health system. FIX-ALL with higher in-vitro potency than any other known hyperfunctional FIX variant and FIX-YKALW as the most promising variant, among the generated mutants, for in-vivo haemostatic protection. Further studies are required to overcome the barrier to research for application of new coagulation factors on hemophilia B treatment. However, we have presented new proteins with potential for therapeutic use combined with gene therapy as well as in protein replacement therapy.

O fator IX (FIX) da coagulação sanguínea é uma proteína dependente de vitamina K de grande valor farmacêutico no tratamento da Hemofilia B, o qual é baseado na administração do fator de coagulação derivado de plasma humano ou da proteína recombinante produzida em células murinas. A terapia baseada nestas abordagens apresenta alto custo e está associada às contaminações com vírus e príons, além do desenvolvimento de inibidores de FIX. Esses efeitos aumentam o risco de morbidade e mortalidade relacionadas às hemorragias. Neste trabalho, clonamos o cDNA do FIX em um vetor lentiviral e avaliamos a expressão da proteína recombinante em duas linhagens celulares humanas. A clonagem do cDNA do FIXh no vetor de expressão lentiviral 1054 foi confirmada através da análise com enzimas de restrição específicas obtendo-se as bandas esperadas de 1407 pb e 10054 pb visualizadas em gel de agarose. As linhagens celulares 293T e SK-Hep-1 foram transduzidas com o vetor lentiviral 1054-FIX gerado em nosso laboratório e as células que apresentaram maior expressão de EGFP foram selecionadas e separadas por citometria de fluxo. A quantificação da expressão de FIXrh foi realizada por ensaios de ELISA e cromogênico. A quantificação de FIXrh total foi de 500 ng/106 células para a linhagem 293T e 803 ng/106 células para a linhagem SK-Hep-1. A atividade biológica específica de FIXh nas células 293T e SK-Hep-1 foi 0,047 UI/106 células e 0,186 UI/106 células, respectivamente. Com o intuito de avaliar o perfil de produção de FIXrh ativo ao longo do tempo, foi realizado um acompanhamento de 180 dias, no qual foi observado que a linhagem SK-Hep-1 cessou a expressão de FIX, enquanto as células 293T mantiveram a expressão durante o período. O FIXrh foi caracterizado por western blot confirmando a presença de uma banda imunoreativa esperada de 57 kDa. As linhagens 293T e SK-Hep-1 apresentaram 7,67 e 17 cópias do vetor inserido/célula, respectivamente. Considerando a importância do processo de ?-carboxilação, foi realizada uma análise da expressão gênica dos genes envolvidos neste processo, tais como o VKORC1, ?-carboxilase e o inibidor calumenina, nas linhagens celulares. Os resultados demonstraram razões elevadas entre os genes VKORC1 e calumenina e VKORC1 e ?-carboxilase nas duas linhagens. A cinética de crescimento das células foi realizada por um período de 7 dias apresentando diferenças significativas entre as células SK-Hep-1 transduzidas e não transduzidas, enquanto que as células 293T não presentaram diferenças estatísticas no crescimento celular. A suplementação do meio de cultura com íons Ca+2 e Mg+2 foi testada para avaliar sua influência na expressão de FIXrh ativo. As células 293T apresentaram melhor desempenho nas concentrações de 0,5 mmol/L de Ca+2 e 1,0 mmol/L de Mg+2 e as células SK-Hep-1 no meio de cultura não suplementado. Nossos dados indicam que a linhagem hepática SK-Hep-1 é a melhor produtora de FIXrh funcional e as comparações realizadas entre os dois tipos celulares são importantes na caracterização do comportamento de linhagens geneticamente modificadas voltadas para a expressão de proteínas recombinantes heterólogas e abre novos caminhos para futuros estudos que visam o melhoramento da produção desse tipo de proteína. / Blood coagulation factor IX is a vitamin K-dependent protein, and it has become a valuable pharmaceutical in the treatment of Hemophilia B which is based on the plasma-derived coagulation factors or recombinant protein produced in murine cells. Coagulation therapy based on these approaches has high costs and is closely associated with prion and virus contamination besides the FIX inhibitors development. These effects increase the risk for bleeding-related morbidity and mortality. The purpose of this study was to clone hFIX into a lentiviral vector and evaluate the expression of the recombinant protein in two human cell lines. The cloning of the hFIX cDNA into 1054 lentiviral expression vector was confirmed by enzymatic restriction obtaining the expected 1407 bp and 10054 bp bands in agarose gel. The 293T and SK-Hep-1 cell lines have been stable transduced with 1054-FIX lentiviral vector generated in our laboratory and the cells with higher expression of EGFP were selected and separated by flow cytometry. The quantification of the expression of rhFIX was performed by ELISA and chromogenic assays. The concentration of total rhFIX was 500 ng/106 cells in 293T cell line and 803 ng/106 cells in SK-Hep-1 cell line. The biological activity of FIX secreted by 293T and SK-Hep-1 was 0,047 UI/106 cells and 0,186 UI/106 cells, respectively. In order to evaluate the active rhFIX production profile over time, we conducted a monitoring of 180 days, which was noted that the SK-Hep-1 cell line ceased FIX expression, while 293T cells maintained the expression during this period. rhFIX was characterized by western blot analysis confirming the presence of a expected 57 kDa immunereactive band. The 293T and SK-Hep-1 cell lines showed 7.67 and 17 integrated vector copies/cell, respectively. Considering the importance of the ?-carboxylation process, we performed a gene expression analysis of genes involved in this process, such as VKORC1, ?-carboxylase and calumenin, in cell lines. The results showed high ratios among the genes VKORC1 and calumenin and among VKORC1 and ?-carboxylase in both cell lines. The cell growth kinetics was performed by a 7-day period, showed significant differences between SK-Hep-1 transduced cells and non-transduced cells, whereas 293T cells showed no difference in cell growth. Enrichment of culture medium with Ca +2 and Mg +2 ions was tested to evaluate its influence on the expression of active FIX. 293T cells showed better performance in 0.5 mmol/L Ca+2 and 1.0 mmol/L Mg +2 concentrations and SK-Hep-1 cells in culture medium control. Our data indicate that transduced SK-Hep-1 cells are the best producer of functional rhFIX, and comparisons between these two cell lines are important in characterizing the behavior of genetically modified cell lines focused on the heterologous expression of recombinant proteins and opens new avenues for future studies aimed at improving the production of this type of protein.