The Lentivirus System – Introduction

45 min Read
Summary Video

For the past 25 years, tremendous efforts have been put into understanding the structure and biology of the HIV virus in the hopes of curing AIDS. In the pursuit of a cure, potent HIV-based transgene delivery vectors were developed (1). Although lentiviral vectors can also be derived from other primate lentiviruses (HIV-2 and SIV) and non-primate lentiviruses (MVV, FIV, EIAV, CAEV and BIV), HIV-based vectors make up the majority of lentiviral vectors used in research today. Due to its unique advantages and the remarkable improvements made upon the recombinant lentivirus system, lentiviral vectors are now widely used in basic biology and translational studies for stable transgene overexpression, persistent gene silencing, immunization, transgenic animals, stem cell modifications, and much more (2).

In addition to Lentiviral vectors, abm also offers adenoviral and adeno-associated viral (AAV) vectors. Read more about each virus in our knowledge base.

Viral Vector Selector Tool
The Lentivirus Genome Map and Structure

The lentivirus belongs to the retroviridae family of viruses. The retroviridae genome consists of a single stranded positive sense RNA that is converted into double stranded DNA during the replication process. In most other types of viruses, viral DNA is transcribed into RNA which is then translated into protein. In contrast, retrovirus RNA is first reverse-transcribed into DNA and then integrated into the host cell genome. After integration, the host cell will transcribe the viral genes along with its own genes, thereby producing stable transgene expression. In addition, lentiviruses are unique members of the retroviridae family as most retroviruses cannot productively infect non-dividing cells (3) whereas lentiviruses can infect cells regardless of their proliferation status (4), making them particularly attractive for human gene therapy. Hepatocytes, neurons, hematopoietic stem cells, monocytes, and macrophages are some examples of potential targets for lentiviral vector based gene therapy (5).

The lentivirus is the most common gene delivery vehicle used to establish stable cell lines. Read more about our custom stable cell line generation service here.
The HIV-1 lentivirus genome map and structure

Figure 1 – The HIV-1 lentivirus genome map and structure.

HIV-1 is the most well-studied and used lentivirus in research (5). HIV has a single stranded RNA genome of around 9 kb in length that includes three major structural genes: gag, pol, and env. (Figure 1)

Gag is first transcribed into unspliced mRNA and then cleaved into transcripts encoding the three viral core proteins:.

  • matrix (MA) proteins, which are necessary for virion assembly and infection of non-dividing cells;
  • capsid (CA) proteins, which form the hydrophobic core of virion
  • nucleocapsid (NC) proteins, which protect the viral genome by coating and associating tightly with viral RNA in virions

The pol gene encodes for the viral protease (PRO), reverse transcriptase (RT) and integrase (IN), enzymes essential for viral replication.

The env gene encodes the viral surface glycoprotein gp160, which is cleaved into the surface protein gp120 (SU) and transmembrane protein gp41 (TM) during the process of viral maturation. These surface proteins are essential for virus entry into the host cell as they enable binding to cellular receptors and fusion with cellular membranes (5).

In addition to these major genes, the viral genome also contains regulatory genes (tat and rev) as well as 4 accessory genes (vif, vpr, vpu, and nef). Tat encodes the transactivators critical for activating viral transcription while rev encodes a protein that regulates the splicing and export of viral transcripts. Tat and rev are the first proteins to be synthesized following integration and are required to accelerate the production of viral mRNAs. On the other hand, the proteins encoded by accessory genes are not essential for virus replication in host cells (5). Among them, vpr is a virion-associated protein present only in primate lentiviruses. Vpr can act as a weak transcriptional transactivator of the long terminal repeats (LTR) present in the viral genome (6) and participates in enabling infection of non-diving cells (7).

As mentioned, two LTRs flank the viral genome and are required for viral transcription, reverse transcription, and integration of the viral genome. Located between the 5’-LTR and the gag gene is another critical component, ψ, which is a signal for genome dimerization and packaging (Figure 1).

Our lentiviral vectors are entirely customizable, enabling you to choose from various promoters (cumate, CMV, EF1a, UbC and PGK), reporters (GFP, RFP, Luciferase) and tags (no tag, HA).
The Lifecycle of the Lentivirus

The Lentivirus lifecycle can be summarized by six major steps:

  • Binding and Entry
  • Uncoating
  • Reverse Transcription
  • Proviral Integration
  • Viral Protein Synthesis and Assembly
  • Budding

Schematic representation of the lentivirus life cycle

Figure 2 – Schematic representation of the lentivirus life cycle.

In the first stage, the lentivirus binds to its target cell via interactions between its viral envelope glycoprotein and a specific cell surface receptor which determines the cellular target for the virus (viral tropism). The natural HIV infection cycle is initiated by the attachment of glycoprotein (SU) to its primary receptor CD4 as well as its co-receptor CXCR4 (expressed on T-lymphocytes) or CCR5 (expressed on monocytes). Upon receptor recognition, viral transmembrane proteins (TM) change conformation to facilitate membrane fusion of HIV with the host cell, leading to viral entry.

After entering the cell, the virion-bound matrix and capsid proteins disassemble, releasing the viral genome as well as viral proteins such as matrix (MA), reverse transcriptase (RT), integrase (IN), and Vpr proteins into the cytoplasm. Using the viral RNA as a template and host nucleotides, the reverse transcriptase synthesizes viral DNA, henceforth referred to as pro-viral DNA. The pro-viral DNA is then imported into the nucleus and integrated into the host genome via the action of viral integrase (8).

Following the integration of the pro-viral DNA, the LTR at the 5’-end of the viral genome acts as a combined enhancer and promoter, enabling the host cell’s RNA polymerase II to begin transcription of the viral genome. The LTR at the 3’-end of the genome stabilizes newly synthesized transcripts by regulating their polyadenylation. Initially, the basal promoter activity of the 5’-LTR is minimal and the initial transcription is inefficient. These first viral mRNAs are multiply spliced into short transcripts encoding the non-structural proteins Tat, Rev, and Nef, proteins that facilitate the production of other viral transcripts necessary for progression through the viral lifecycle. Newly synthesized Tat transactivates and amplifies the transcription of other structural proteins (9) while Rev bind to RRE ( Rev-responsive element) on the viral transcripts to facilitate nuclear export of singly spliced or non-spliced viral mRNAs (10). Singly spliced transcripts encode Env as well as accessory proteins, whereas non-spliced viral RNAs are translated into Gag and Pol or act as genomic RNAs for progeny viruses.

In the final stage, the exported viral genome and proteins are assembled at the plasma membrane and released from the host cell (11) (Figure 2).

293T cells are the most commonly used lentivirus packaging cell line. Read more about our ProAdhere 293T cells to find out how these cells are suitable for large scale lentivirus production. A step-by-step protocol for lentivirus packaging can be found here.
The Recombinant Lentivirus System

Replication, integration, and packaging of lentiviruses are mediated partially by cis-acting RNA or DNA sequences which do not encode proteins. Cis-acting elements such as the LTRs and ψ signals are essential in the design of recombinant lentiviral vectors and are generally included in the transfer plasmid (the part of a lentiviral vector which will integrate into the host cell genome and encode targeted genes).

The trans-acting viral elements encode structural, regulatory, and accessory proteins. Recombinant lentiviral vectors are deprived of their replication abilities for safety reasons. In the recombinant lentiviral vector, only the genomic components necessary for the early steps of the lentivirus life cycle are included (binding and entry, uncoating, reverse transcription, and pro-viral integration). Genomic components that facilitate viral protein synthesis can be excluded from the recombinant lentiviral vector. Only essential trans-acting genes such as gag and pol (necessary for viral reverse transcription and integration) as well as env (necessary for binding to host cells) are preserved.

Generally, the transfer plasmid contains the gene of interest along with the essential cis-acting elements, while essential trans-acting genes are provided separately (in trans) by the packaging plasmids (Table 1).

Table 1 – Important Cis-acting and Trans-acting elements of HIV-1-based lentiviral vectors.

Molecular Function Necessity
1. Cis-acting
LTRs Contain sequences required for viral gene expression, reverse transcription, and integration Essential
Ψ Required for packaging of the genomic transfer RNA Essential
RRE Rev response element. Required for processing and transport of viral RNAs Beneficial
2. Trans-acting
gag/pol Encodes structural proteins and enzymes required for viral reproduction Essential
env Encodes envelope glycoprotein Essential
vif Assists assembly of the virions and infectivity Optional
vpu Assists release of virions Optional
vpr Assists infection of non-dividing cells Optional
tat Necessary for high level expression of viral LTR Optional
rev Necessary for expression of unspliced and singly-spliced mRNAs in vivo Beneficial
nef Required for high viral burden Optional

abm provides high titer lentivirus production and purification services up to 1010 IU/ml.

Lentivirus Pseudotyping

One property common to most retroviruses is the ability to form pseudotypes or retroviral particles that have incorporated a heterologous envelope glycoprotein (12). The envelope glycoprotein G of the vesicular stomatitis virus (VSV-G) is widely used to create pseudotyped retroviral vectors as they offer unique advantages over unmodified vectors. Firstly, VSV-G is much more stable than the natural retroviral or lentiviral envelopes, making it easier to achieve higher viral concentrations by ultracentrifugation (13). More importantly, VSV-G binds the ubiquitous membrane component phosphatidylserine, which enables the VSV-G pseudotyped virus to attach and transduce a much wider range of cells (14). Given the benefits, Akkina et al. (15) replaced the HIV-1 Env glycoprotein with VSV-G and has successfully demonstrated that the VSV-G pseudotyped HIV vector has high efficiency gene transfer into hematopoietic stem cells. Currently, most lentiviral vectors are pseudotyped with VSV-G to enable robust transduction into many cell types.

All abm’s lentiviruses are VSV-G pseudotyped for maximum transduction range.
First generation lentivirus system

Figure 3A – First generation HIV-1-based recombinant lentiviral vectors.
Second generation lentivirus system

Figure 3B – Second generation recombinant lentiviral vectors.
Third generation lentivirus system
Figure 3C – Third generation recombinant lentiviral vectors.

First generation HIV-1-based recombinant lentiviral vectors (Figure 3A)

Since lentiviral vectors are derived from the HIV-1 pathogen, biosafety issues are an important concern. During the process of using replication-defective viruses, there is a possibility of accidentally generating RCLs (replication-competent lentiviruses) via recombinations between the delivered as well as endogenous viral elements in producer cells.

In an attempt to generate a safe system for laboratory use, the first generation recombinant lentiviral system splits the viral genome into three separate plasmids: (a) a packaging plasmid; (b) an Env plasmid encoding the viral glycoprotein; and (c) a transfer vector genome construct. The packaging plasmid expresses HIV Gag, Pol and regulatory/accessory proteins under the control of a CMV promoter, all of which are required for vector packaging. The Env plasmid expresses a viral glycoprotein such as VSV-G to provide the vector particles with a receptor binding protein. In order to avoid their transmission into vector particles and to reduce the production of RCLs in vector preparations, the packaging signal ψ or the LTRs are not included in the packaging and Env plasmids. Instead, LTRs, ψ, as well as RRE are included in the transfer vector plasmid. Therefore, the transfer plasmid encodes for proteins necessary for packaging, reverse transcription and integration, but not for the expression of HIV proteins. In this way, the genomic components responsible for packaging the viral DNA are separated from the genomic components that activate them. Thus, the packaging sequences will not be incorporated into the viral genome and the virus will not reproduce after it has infected the host cell (16, 17).

Second generation recombinant lentiviral vectors (Figure 3B)

Despite the precautions, the first generation recombinant lentiviral vectors are no longer commonly in use due to biosafety risks. This prompted the development of a safer, second generation recombinant system. In this system, the genomic components encoding viral accessory proteins (Vif, Vpu, Vpr or Nef) are removed. These accessory proteins are important for HIV propagation in primary cells or in vivo (18), but not essential for lentiviral vector functions. The second generation recombinant system therefore includes only four of the nine HIV genes: gag, pol, tat, and rev (19).

abm provides both the second and third generation packaging systems for lentivirus production.

Third generation recombinant lentiviral vectors (Figure 3C)

Traditional lentiviral vectors integrate transgene cassettes flanked by the two LTRs into the host genome. However, the existence of intact LTRs in the host genome gives rise to potential safety risks. Firstly, if replication-competent recombinant lentiviruses are produced accidently, they can replicate as the wild-type viruses. In addition, the vector-transduced cells may be infected by a wild type lentivirus which can potentially act as a helper virus to rescue the integrated vector into new viral particles for replication. Finally, because LTRs have an enhancer (a binding site for host transcription factors) as well as promoter region, integration of LTRs into the genome can activate adjacent cellular genes that may be proto-oncogenes. Given these concerns, SIN (self-inactivating) lentivectors were developed.

In the third generation self-inactivating recombinant system, the U3 region of the 3’-LTR is deleted. Originally, each LTR contains three regions: U3, R, and U5, with the U3 the component acting as the enhancer/promoter. If U3 in the 3’-LTR is deleted, the same deletion would be copied and transferred into the 5’-LTR promoter/enhancer region of the integrated genome during reverse transcription. This deletion will result in transcriptional inactivation of potentially packageable viral genome in the transduced cell (20).

Tat and Rev are absolutely essential for HIV-1 replication because they regulate viral transcription and nuclear export of transcripts (21, 22). Thus to significantly increase safety, Tat is deleted from the packaging plasmid of the third generation recombinant system. Tat’s function is instead realized by replacing the U3 promoter region of the 5’-LTR in the transfer plasmid with other strong viral promoters such as CMV or RSV (23). Furthermore, Rev is provided from yet another separate plasmid for added safety.

In a nutshell, the third generation recombinant lentiviral vector system has four plasmids:

  • a packaging construct containing only gag and pol genes;
  • a plasmid expressing Rev;
  • an Env (i.e. VSV-G) plasmid;
  • a transgene plasmid driven by a heterologous strong promoter.

Because the vector system is split into four plasmids, at least three recombination events are required to generate a replication-competent HIV-1-like virus. Even if such events occurred, the resulting viruses only have Gag, Pol, Rev and VSV-G proteins, with no active LTRs, Tat or accessory proteins, markedly increasing the safety of the vectors. However, when compared to a three plasmid system (i.e. second generation), the virus yield from a third-generation vector is typically lower.

All abm’s lentiviral constructs are 3rd generation with a chimeric of RSV promoter upstream of 5’-LTR.
Advantages and disadvantages of using recombinant lentiviral vectors

Lentiviral vectors are regarded as attractive gene-delivery vehicles for several reasons:

  • they offer long term gene expression via stable vector integration into host genome;
  • they are capable of infecting both dividing and non-dividing cells;
  • they are capable of infecting a broad range of cells including important target cell types for gene and cell therapies;
  • they lack immunogenic viral proteins after vector transduction;
  • they can deliver complex genetic elements such as intron-containing sequences;
  • they are a relatively easy system for vector manipulation and production.

Due to these unique advantages, lentiviral vectors are now widely applied in basic and translational science as well as clinical trials. There are many commercially available premade lentiviral vectors, which are engineered to express or silence genome-wide genes (2).

As a leader in lentiviral technology, abm has developed a comprehensive library of human, mouse, and rat genes cloned into lentiviral vectors or ready-to-use lentiviruses. You can browse all our lentiviral products here.

The major disadvantage of lentiviral vectors is the potential for recombination leading to replication competent lentivirus (RCL). Production of RCL in preparations of replication-defective vectors has been recorded in numerous conditions (24, 25, 26). In later generations of vectors in which viral protein coding regions were split in the packaging cells, the frequency of recombination leading to RCL was decreased but not eliminated (27). The application of the SIN property in the vectors dramatically reduces this likelihood (28). Another concern involves the activation of the cellular proto-oncogene by residual promoter activities of integrated LTRs or the transcriptional interference and suppression by LTRs (29). Again, the SIN approach not only minimizes the expression of vector RNA, but also prevents the insertional activation of cellular oncogenes or transcriptional interference by the integrated virus.

Multiplicity of Infection (MOI)

As lentiviral infection ability of different cell types varies, different cell types may require different MOIs for successful transduction and knockdown of the target gene. Theoretically, a higher MOI will generate a higher number of transductions per cell, a higher number of transgene integrations, and a higher expression. To determine the optimal amount of lentiviruses needed for efficient transduction of your cell line, it is highly recommended that a range of MOIs (e.g. from 0.1 to 20) be tested. In order to determine the MOI, you will need to know your viral titer, or the concentration of infectious particles (IU). For example, to achieve an MOI of 2, 50 microliters at 108 IU/ml will provide enough particles to transduce 5 wells of cells, with each well containing 5 x 105 cells. Refer to the equation below to help calculate the MOI:

$$MOI = {Viral\; Titer {\left(\frac{IU}{ml}\right)} \times \; Volume \;(ml) \over Total\; number\; of\; cells}$$

You can read more about this topic in our knowledge base article, Multiplicity of Infection (MOI).

A step-by-step infection protocol can be found here. We also have a list of suggested MOIs for common cancer cell lines to help you get started. If you require a reporter lentivirus for your preliminary studies, we recommend you use one of our blank viruses.To determine your viral titer, you can also use our qPCR titer kit and get your results in less than 2 hours.
Lentiviral Vectors in Clinical Use

The first clinical study using a lentiviral vector was approved in 2001 for anti-HIV therapy (30). In this clinical trial, a VSV-G-pseudotyped HIV-based vector was engineered to conditionally express an antisense RNA against HIV envelope glycoprotein in the presence of regulatory proteins provided by the wild-type HIV virus. The safety and efficacy HIV-1 envelope antisense gene delivery to CD4+ T cells was evaluated. Four out of five subjects with chronic HIV infection showed an increase of CD4+ T cells after receiving a single dose of gene-modified autologous CD4+ T cells. In addition, the viral load decreased in all five patients after 1 year. Further observations over 2 years have not detected any adverse clinical events (31).

In another instance, a Phase I/II clinical trial of β-globin gene therapy for β-thalassaemia began in 2007 (32). In this trial, a self-inactivating lentivector, LentiGlobin, which contains the β-globin gene (including its introns, promoter, and β-locus control region/β-LCR), was used to transduce CD34+ cells ex vivo. These autologous gene-modified cells were then transplanted into patients. After 3 years of treatment, patients demonstrated corrected β-globin gene and stable blood hemoglobin levels (33). No insertional mutagenesis has been reported so far.

Up until July 2015, about 114 clinical gene therapy trials using lentiviral vectors are ongoing or have been approved, including treatment for HIV infection, monogenic diseases (X linked cerebral adrenoleukodystrophy, Sickle cell anemia, Wiskott-Aldrich Syndrome, Metachromatic Leukodystrophy, X-Linked Chronic Granulomatous Disease, Inherited Skin Disease Netherton Syndrome, mucopolysaccharidosis type VII, β-thalassemia, Fanconi Anemia Complementation Group A, X-Linked Severe Combined Deficiency, Adenosine Deaminase Deficient Severe Combined Immunodeficiency, Hemophilia A), various cancers, Parkinson’s disease and many more (34).

Viral Vector Selector Tool
  • Pluta K and Kacprzak MM. Use of HIV as a gene transfer vector. Acta Biochim Pol. 2009; 56(4):531-595.
  • Sakuma T, Barry MA and Ikeda Y. Lentiviral vectors: basic to translational. Biochem J. 2012; 443:603-618.
  • Coffin JM. Virology - Retrovirus restriction revealed. Nature. 1996; 382(6594):762-763.
  • Fouchier RAM, Meyer BE, Simon JHM, Fischer U and Malim MH. HIV-1 infection of non-dividing cells: evidence that the amino-terminal basic region of the viral matrix protein is important for Gag processing but not for post-entry nuclear import. Embo Journal. 1997; 16(15):4531-4539.
  • Klimatcheva E, Rosenblatt JD and Planelles V. Lentiviral vectors and gene therapy. Frontiers in bioscience : a journal and virtual library. 1999; 4:D481-496.
  • Cohen EA, Terwilliger EF, Jalinoos Y, Proulx J, Sodroski JG and Haseltine WA. Identification of Hiv-1 Vpr Product and Function. J Acq Immun Def Synd. 1990; 3(1):11-18.
  • Connor RI, Chen BK, Choe S and Landau NR. Vpr Is Required for Efficient Replication of Human-Immunodeficiency-Virus Type-1 in Mononuclear Phagocytes. Virology. 1995; 206(2):935-944.
  • Fanales-Belasio E, Raimondo M, Suligoi B and Butto S. HIV virology and pathogenetic mechanisms of infection: a brief overview. Ann I Super Sanita. 2010; 46(1):5-14.
  • Wei P, Garber ME, Fang SM, Fischer WH and Jones KA. A novel CDK9-associated C-type cyclin interacts directly with HIV-1 Tat and mediates its high-affinity, loop-specific binding to TAR RNA. Cell. 1998; 92(4):451-462.
  • Malim MH, Hauber J, Le SY, Maizel JV and Cullen BR. The HIV-1 rev trans-activator acts through a structured target sequence to activate nuclear export of unspliced viral mRNA. Nature. 1989; 338(6212):254-257.
  • Fanales-Belasio E, Raimondo M, Suligoi B and Butto S. HIV virology and pathogenetic mechanisms of infection: a brief overview. Annali dell'Istituto superiore di sanita. 2010; 46(1):5-14.
  • Kang CY and Lambright P. Pseudotypes of vesicular stomatitis virus with the mixed coat of reticuloendotheliosis virus and vesicular stomatitis virus. Journal of virology. 1977; 21(3):1252-1255.
  • Burns JC, Friedmann T, Driever W, Burrascano M and Yee JK. Vesicular stomatitis virus G glycoprotein pseudotyped retroviral vectors: concentration to very high titer and efficient gene transfer into mammalian and nonmammalian cells. Proceedings of the National Academy of Sciences of the United States of America. 1993; 90(17):8033-8037.
  • Mastromarino P, Conti C, Goldoni P, Hauttecoeur B and Orsi N. Characterization of membrane components of the erythrocyte involved in vesicular stomatitis virus attachment and fusion at acidic pH. The Journal of general virology. 1987; 68 ( Pt 9):2359-2369.
  • Akkina RK, Walton RM, Chen ML, Li QX, Planelles V and Chen IS. High-efficiency gene transfer into CD34+ cells with a human immunodeficiency virus type 1-based retroviral vector pseudotyped with vesicular stomatitis virus envelope glycoprotein G. Journal of virology. 1996; 70(4):2581-2585.
  • Kafri T, Blomer U, Peterson DA, Gage FH and Verma IM. Sustained expression of genes delivered directly into liver and muscle by lentiviral vectors. Nature genetics. 1997; 17(3):314-317.
  • Parolin C, Dorfman T, Palu G, Gottlinger H and Sodroski J. Analysis in human immunodeficiency virus type 1 vectors of cis-acting sequences that affect gene transfer into human lymphocytes. Journal of virology. 1994; 68(6):3888-3895.
  • Fouchier RA, Simon JH, Jaffe AB and Malim MH. Human immunodeficiency virus type 1 Vif does not influence expression or virion incorporation of gag-, pol-, and env-encoded proteins. Journal of virology. 1996; 70(12):8263-8269.
  • Zufferey R, Nagy D, Mandel RJ, Naldini L and Trono D. Multiply attenuated lentiviral vector achieves efficient gene delivery in vivo. Nature biotechnology. 1997; 15(9):871-875.
  • Yu SF, von Ruden T, Kantoff PW, Garber C, Seiberg M, Ruther U, Anderson WF, Wagner EF and Gilboa E. Self-inactivating retroviral vectors designed for transfer of whole genes into mammalian cells. Proceedings of the National Academy of Sciences of the United States of America. 1986; 83(10):3194-3198.
  • Terwilliger E, Burghoff R, Sia R, Sodroski J, Haseltine W and Rosen C. The art gene product of human immunodeficiency virus is required for replication. Journal of virology. 1988; 62(2):655-658.
  • Laspia MF, Rice AP and Mathews MB. HIV-1 Tat protein increases transcriptional initiation and stabilizes elongation. Cell. 1989; 59(2):283-292.
  • Dull T, Zufferey R, Kelly M, Mandel RJ, Nguyen M, Trono D and Naldini L. A third-generation lentivirus vector with a conditional packaging system. Journal of virology. 1998; 72(11):8463-8471.
  • Chong H and Vile RG. Replication-competent retrovirus produced by a 'split-function' third generation amphotropic packaging cell line. Gene therapy. 1996; 3(7):624-629.
  • Vanin EF, Kaloss M, Broscius C and Nienhuis AW. Characterization of replication-competent retroviruses from nonhuman primates with virus-induced T-cell lymphomas and observations regarding the mechanism of oncogenesis. Journal of virology. 1994; 68(7):4241-4250.
  • Donahue RE, Kessler SW, Bodine D, McDonagh K, Dunbar C, Goodman S, Agricola B, Byrne E, Raffeld M, Moen R and et al. Helper virus induced T cell lymphoma in nonhuman primates after retroviral mediated gene transfer. The Journal of experimental medicine. 1992; 176(4):1125-1135.
  • Otto E, Jones-Trower A, Vanin EF, Stambaugh K, Mueller SN, Anderson WF and McGarrity GJ. Characterization of a replication-competent retrovirus resulting from recombination of packaging and vector sequences. Hum Gene Ther. 1994; 5(5):567-575.
  • Miyoshi H, Blomer U, Takahashi M, Gage FH and Verma IM. Development of a self-inactivating lentivirus vector. Journal of virology. 1998; 72(10):8150-8157.
  • Coffin JM, Hughes SH and Varmus HE. (1997). The Interactions of Retroviruses and their Hosts. In: Coffin JM, Hughes SH and Varmus HE, eds. Retroviruses. (Cold Spring Harbor (NY).
  • MacGregor RR. Clinical protocol. A phase 1 open-label clinical trial of the safety and tolerability of single escalating doses of autologous CD4 T cells transduced with VRX496 in HIV-positive subjects. Hum Gene Ther. 2001; 12(16):2028-2029.
  • Levine BL, Humeau LM, Boyer J, MacGregor RR, Rebello T, Lu X, Binder GK, Slepushkin V, Lemiale F, Mascola JR, Bushman FD, Dropulic B and June CH. Gene transfer in humans using a conditionally replicating lentiviral vector. Proceedings of the National Academy of Sciences of the United States of America. 2006; 103(46):17372-17377.
  • Bank A, Dorazio R and Leboulch P. A phase I/II clinical trial of beta-globin gene therapy for beta-thalassemia. Annals of the New York Academy of Sciences. 2005; 1054:308-316.
  • Cavazzana-Calvo M, Payen E, Negre O, Wang G, Hehir K, Fusil F, Down J, Denaro M, Brady T, Westerman K, Cavallesco R, Gillet-Legrand B, Caccavelli L, Sgarra R, Maouche-Chretien L, Bernaudin F, et al. Transfusion independence and HMGA2 activation after gene therapy of human beta-thalassaemia. Nature. 2010; 467(7313):318-322.
  • The Journal of Gene Medicine: Gene therapy clinical trials worldwide (assessed July 2015). 2015.