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THE QUEST: SEEKING AN ULTIMATE CURE

How Penn researcher is taking on blindness

Gene therapy on mice has been promising. Human trials are next. The target: retinitis pigmentosa.

Jean Bennett knew that she had only one hour to convince the unsmiling committee of scientists that her research project was worth supporting.

A gentle wisp of a woman with long black hair tied back, Bennett thought she had found a technique that might eventually prevent the most common form of inherited blindness - retinitis pigmentosa (RP).

Speaking quickly and moving rapidly from point to point, she was seeking support from the University of Pennsylvania's Institute for Human Gene Therapy to use genetic techniques against a disease that affects more than 100,000 people in the United States alone.

Bennett, a Penn ophthalmologist, explained how she and her husband, eye surgeon Albert Maguire, had temporarily repaired the genetic defect in mice.

Normally, the animals are blind by the third week of life, said Bennett as she flashed a color slide of a sightless newborn mouse on the screen at the head of the conference table. But the animals she and Maguire treated were apparently still able to see at eight weeks.

After finishing her presentation, Bennett was bombarded with questions, mostly from institute director James M. Wilson.

Standing to leave for a meeting on another proposed gene therapy trial, Wilson said the final decision would be made the following month, after Bennett presented even more detailed information to the institute's executive committee.

Wilson and the committee were impressed with Bennett's presentation. What she had failed to make clear, however, was that few of the 100,000 RP patients had been screened to determine which genetic form of the disease they had.

In fact, only five people in the country were known to have the particular gene defect she was working on. It was questionable that the institute would embark on a human trial with so few subjects.


Bennett's head was spinning
after her presentation to the committee last summer.

Only months earlier, she thought it would take another five years of work before she could treat patients, and here she was about to draw up specific plans for human trials.

Though more than 200 human gene therapy trials against 25 diseases have been approved throughout the world, this would be the first attempt to use the potentially revolutionary treatment against an eye disease.

Bennett knew that it was essential to get the institute's support.

Not only would the institute make the drug used in the trial - a complicated and time-consuming process - but it would also provide and care for the many animals needed for preclinical tests, get the drug-safety data required by the Food and Drug Administration before human trials can start, move the project through the complicated local and federal regulatory processes, draw up a budget, and help get money for the study.

Most scientists don't have the resources to do all these things, and Bennett was well aware of promising research projects languishing in university laboratories for want of such support.

As director of the institute, Wilson is forever pressing scientists like Bennett to think of ways of using gene therapy to treat the diseases in which they specialize.

Penn oncologists have just started human trials with a drug against mesothelioma, a rare cancer of tissue lining the chest wall and lungs.

A similar drug for brain cancer, which the institute also helped develop, is about to undergo human testing. A gene drug for a rare childhood liver disease - ornithine transcarbamylase (OTC) deficiency - is going through final regulatory reviews preparatory to human trials, which should begin in a few months.

And Wilson himself is in the middle of trials of a drug for the inherited lung disease cystic fibrosis.

Walking out into the bright afternoon sunlight with her husband and the third member of their team, noted RP specialist Samuel Jacobson, Bennett talked with the others about what now must be done to get ready for the next meeting.

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