Sung-Yun Pai, M.D.

Sung-Yun Pai, M.D.
Senior Investigator

The goal of our research program is to develop tailored cellular therapies for children, adolescents and young adults with genetic diseases of the blood and immune system. To do so, we seek to reveal the cellular, biological and genetic underpinnings of these disorders and study the factors that lead to optimal and sustained immune function.

Areas of Expertise

1) pediatric hematopoietic stem cell transplantation, 2) gene therapy, 3) inborn errors of immunity, 4) severe combined immunodeficiency (SCID), 5) Wiskott-Aldrich syndrome (WAS), 6) DOCK8 deficiency

Contact Info

Sung-Yun Pai, M.D.
Center for Cancer Research
National Cancer Institute
Building 10, Room 1-5240
Bethesda, MD 20892
Ph: 240-858-7284

Inborn errors of immunity are genetic disorders that can cause a wide range of problems with the immune system, including immunodeficiency and immune dysregulation that can lead to cancers of the immune system. Hematopoietic stem cell (HSC) transplant and gene therapy approaches can be effective treatments for these disorders but several significant challenges remain, including toxicity from myeloablation agents required for successful HSC transplant, graft rejection, graft vs. host disease, and the variable efficacy of viral vectors used in gene therapy. Cellular therapy for these disorders ideally would be effective in every patient, using tailored conditioning regimens, with the least toxicity possible. To achieve this goal, our team is focused on cellular therapy for several disorders, including severe combined immunodeficiency (SCID), Wiskott-Aldrich syndrome (WAS) and DOCK8 deficiency, and developing new gene therapy approaches for these disorders.

Severe combined immunodeficiency (SCID)

Our goal is to understand how the genetic cause of severe combined immunodeficiency (SCID) impacts T cell, B cell, and natural killer (NK) cell growth and function, and thereby tailor cellular therapy approaches to achieve optimal results with minimum toxicity.

SCID is a group of genetically heterogeneous diseases that share a common feature, the profound absence of T cell development, which in turn, results in lack of humoral immunity. The lack of functioning T cells in patients with SCID gives them the ability to undergo HSC transplant without myeloablation. However, without such agents, successful growth and development of infused HSC is minimal, and therefore B cells, NK cells, and myeloid cells remain uncorrected. The results of such transplants vary according to whether the genetic defect affects non-T cell lineage development or function.

Dr. Pai is leading two multi-institutional trials of cellular therapy for SCID, and her group is performing mechanistic studies to determine the impact and extent of conditioning on HSC engraftment, and correction of B cell development and function. The Conditioning SCID Infants Diagnosed Early (CSIDE) trial is a randomized trial comparing a low dose versus moderate dose busulfan-based conditioning regimen prior to allogeneic transplant in SCID patients with defects in IL2RG, JAK3, RAG1 and RAG2 (NCT03619551). The group is also analyzing results of a multi-institutional trial of gene therapy for patients with X-linked SCID, caused by defects in the IL2RG gene (NCT03311503).

Wiskott-Aldrich syndrome and DOCK8 deficiency

Cytoskeletal rearrangement in response to cell signaling is critical for proper growth and function of multiple immune cells, including T cells, B cells, NK cells, dendritic cells, and other myeloid cells. The protein complex of DOCK8 and Wiskott-Aldrich syndrome (WAS) protein connects T cell receptor and B cell receptor signaling to the actin cytoskeleton, allowing for regulation of the cell’s cytoskeleton. DOCK8 and WAS proteins are also crucial for T cell and B cell activation, memory cell development, and immune synapse formation. Mutations in either DOCK8 or WAS genes result in immune deficiency syndromes that have similar and distinct features. While both disorders can be treated by HSC transplant and gene therapy approaches, significant challenges remain. Gene therapy using lentiviral vectors avoids complications of allogeneic transplantation; however, current trials for WAS fail to treat the effects of WAS consistently, and gene therapy for DOCK8 deficiency has not yet been developed. Our laboratory aims to understand the underlying function of WAS and DOCK8 proteins by analyzing the outcomes of cellular therapy for these disorders. We also are developing new gene therapy approaches to both of these disorders, taking advantage of their shared expression pattern to achieve regulated expression closer to what is normally found in healthy immune cells.

NIH Scientific Focus Areas:
Clinical Research, Genetics and Genomics, Immunology, Stem Cell Biology
  1. Pai SY, Logan BR, Griffith LM, Buckley RH, Parrott RE, Dvorak CC, Kapoor N, Hanson IC, Filipovich AH, Jyonouchi S, Sullivan KE, Small TN, Burroughs L, Skoda-Smith S, Haight AE, Grizzle A, Pulsipher MA, Chan KW, Fuleihan RL, Haddad E, Loechelt B, Aquino VM, Gillio A, Davis J, Knutsen A, Smith AR, Moore TB, Schroeder ML, Goldman FD, Connelly JA, Porteus MH, Xiang Q, Shearer WT, Fleisher TA, Kohn DB, Puck JM, Notarangelo LD, Cowan MJ, O'Reilly RJ.
    N Engl J Med. 371(5): 434-46, 2014. [ Journal Article ]
  2. Hacein-Bey-Abina S, Pai SY, Gaspar HB, Armant M, Berry CC, Blanche S, Bleesing J, Blondeau J, de Boer H, Buckland KF, Caccavelli L, Cros G, De Oliveira S, Fernández KS, Guo D, Harris CE, Hopkins G, Lehmann LE, Lim A, London WB, van der Loo JC, Malani N, Male F, Malik P, Marinovic MA, McNicol AM, Moshous D, Neven B, Oleastro M, Picard C, Ritz J, Rivat C, Schambach A, Shaw KL, Sherman EA, Silberstein LE, Six E, Touzot F, Tsytsykova A, Xu-Bayford J, Baum C, Bushman FD, Fischer A, Kohn DB, Filipovich AH, Notarangelo LD, Cavazzana M, Williams DA, Thrasher AJ.
    N Engl J Med. 371(15): 1407-17, 2014. [ Journal Article ]
  3. Al-Herz W, Chu JI, van der Spek J, Raghupathy R, Massaad MJ, Keles S, Biggs CM, Cockerton L, Chou J, Dbaibo G, Elisofon SA, Hanna-Wakim R, Kim HB, Lehmann LE, McDonald DR, Notarangelo LD, Veys P, Chatila TA, Geha RS, Gaspar HB, Pai SY.
    J Allergy Clin Immunol. 138(3): 852-859.e3, 2016. [ Journal Article ]
  4. Burroughs LM, Petrovic A, Brazauskas R, Liu X, Griffith LM, Ochs HD, Bleesing JJ, Edwards S, Dvorak CC, Chaudhury S, Prockop SE, Quinones R, Goldman FD, Quigg TC, Chandrakasan S, Smith AR, Parikh S, Dávila Saldaña BJ, Thakar MS, Phelan R, Shenoy S, Forbes LR, Martinez C, Chellapandian D, Shereck E, Miller HK, Kapoor N, Barnum JL, Chong H, Shyr DC, Chen K, Abu-Arja R, Shah AJ, Weinacht KG, Moore TB, Joshi A, DeSantes KB, Gillio AP, Cuvelier GDE, Keller MD, Rozmus J, Torgerson T, Pulsipher MA, Haddad E, Sullivan KE, Logan BR, Kohn DB, Puck JM, Notarangelo LD, Pai SY, Rawlings DJ, Cowan MJ.
    Blood. 135(23): 2094-2105, 2020. [ Journal Article ]
  5. Miggelbrink AM, Logan BR, Buckley RH, Parrott RE, Dvorak CC, Kapoor N, Abdel- Azim H, Prockop SE, Shyr D, Decaluwe H, Hanson IC, Gillio A, Dávila Saldaña BJ, Eibel H, Hopkins G, Walter JE, Whangbo JS, Kohn DB, Puck JM, Cowan MJ, Griffith LM, Haddad E, O'Reilly RJ, Notarangelo LD, Pai SY
    Blood. 131(26): 2967-2977, 2018. [ Journal Article ]

Dr. Sung-Yun Pai received her M.D. degree from Harvard Medical School where she worked in the laboratory of Dr. Barbara Bierer on the cellular biology of calcineurin and mechanism of action of cyclosporine, tacrolimus, and sirolimus. She trained in pediatrics at Boston Children’s Hospital and pediatric hematology-oncology at Boston Children’s Hospital and Dana-Farber Cancer Institute. There she performed post-doctoral work in the laboratories of Drs. Jeffrey Leiden, I-Cheng Ho, and Laurie Glimcher demonstrating the critical roles of the transcription factor GATA3 in thymocyte development, T helper 2 cell specification and function, as well as in CD8 T cells, invariant NK-T cells, and collaboratively in breast cancer and keratinocyte development. As faculty she specialized in clinical hematopoietic stem cell transplantation for children with inborn errors of immunity and led a research program focused on development, implementation, and analysis of clinical trials of transplantation and gene therapy for these disorders. She was appointed to Associate Professor at Harvard Medical School in 2016 and served as Associate Director then Co-Director of the Gene Therapy Program at Boston Children’s Hospital. In 2020, she moved to the National Cancer Institute and National Institute of Allergy and Infectious Diseases to assume the role of Chief of the Immune Deficiency Cellular Therapy Program. Key areas of focus include severe combined immunodeficiency, Wiskott-Aldrich syndrome, and DOCK8 deficiency.

Position Degree Required Contact Name E-mail Address
Post-doctoral Fellow - Immunology, Cellular Therapy Ph.D. or equivalent, M.D. or equivalent Dr. Sung-Yun Pai
Staff Scientist - pediatric hematopoietic stem cell transplantation Ph.D. or equivalent, M.D. or equivalent Dr. Sung-Yun Pai