Immune dysregulation, Polyendocrinopathy, Enteropathy, X-linked (IPEX) syndrome is a rare autoimmune
disease due to mutations in the gene encoding for Forkhead box P3 (FOXP3), a transcription factor fundamental for the
function of thymus-derived (t) regulatory T (Treg) cells. The dysfunction of Treg cells results in the development of devastating
autoimmune manifestations affecting multiple organs, eventually leading to premature death in infants, if not
promptly treated by hematopoietic stem cell transplantation (HSCT). Novel gene therapy strategies can be developed for
IPEX syndrome as more definitive cure than allogeneic HSCT. Here we describe the therapeutic approaches, alternative to
HSCT, currently under development. We described that effector T cells can be converted in regulatory T cells by LVmediated
FOXP3-gene transfer in differentiated T lymphocytes. Despite FOXP3 mutations mainly affect a highly specific
T cell subset, manipulation of stem cells could be required for long-term remission of the disease. Therefore, we believe
that a more comprehensive strategy should aim at correcting FOXP3-mutated stem cells. Potentials and hurdles of both
strategies will be highlighted here.
Keywords: Autoimmunity, cell therapy, Forkhead box P3, gene correction, Immune dysregulation Polyendocrinopathy
Enteropathy X-linked syndrome, lentiviral vector, regulatory T cells.
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