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Journal of Virology, May 2000, p. 4816-4823, Vol. 74, No. 10
IRBM P. Angeletti, Rome, Italy
Received 22 September 1999/Accepted 4 February 2000
The current therapy for hepatitis B and C is based on systemic
administration of recombinant human alpha interferon (r-hIFN- Interferon (IFN) was
discovered by Isaac and Lindenmann in 1957 (18), and
recently the U.S. Food and Drug Administration has approved recombinant
human IFN- The currently available treatment for HCV with r-hIFN- It is not clear why r-hIFN- These clinical limitations in addition to the high cost of the
treatment have prompted research for new delivery systems, either by
modifying the recombinant protein (13) or through a gene
therapy approach. To this end, the antiviral properties of different
IFN- IFN- Cell lines.
293 and 293Cre4 cells (23) were grown
in minimal essential medium (MEM) supplemented with 10%
heat-inactivated fetal calf serum (FCS). 911 (human embryonic
retinoblasts), L-929 (mouse fibroblasts), and HuH-7 (human hepatoma)
cells were grown in Dulbecco's modified Eagle's medium (DMEM)
supplemented with 10% FCS. DBT cells (mouse fibroblasts) were grown in
DMEM supplemented with 10% tryptose phosphate broth and 5% fetal calf serum.
Mouse strains.
The mice used in this study were
immunocompetent, 6- to 8-week-old (at the time of injection), C57/B6
females purchased from Charles River. Groups of four to five mice
received injections in the tail vein of Ad vectors diluted in
physiologic solution in volumes of 200 µl. Blood was obtained by
retroorbital bleeding, and serum was stored at Construction of mIFN-
0022-538X/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Liver-Specific Alpha 2 Interferon Gene Expression
Results in Protection from Induced Hepatitis
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ABSTRACT
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
). However, systemic delivery of r-hIFN-
is associated with severe side
effects, but more importantly, it is effective in only a small
percentage of patients. In an effort to maximize IFN-
antiviral efficacy, we have explored the therapeutic potential of murine IFN-
2
(mIFN
2) selectively expressed in the liver. To this end, we have
developed a helper-dependent adenovirus vector (HD) containing the
mIFN-
2 gene under the control of the liver-specific transthyretin promoter (HD-IFN). Comparison with a first-generation adenovirus carrying the same mIFN-
2 expression cassette indicates that at certain HD-IFN doses, induction of antiviral genes can be achieved in
the absence of detectable circulating mIFN-
2. Challenge of injected
mice with mouse hepatitis virus type 3 showed that HD-IFN provides high
liver protection. Moreover, liver protection was also observed in acute
nonviral liver inflammation hepatitis induced by concanavalin A at 1 month postinfection. These results hold promise for the development of
a gene therapy treatment for chronic viral hepatitis based on
liver-restricted expression of IFN-
2.
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INTRODUCTION
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
(r-hIFN-
) for the treatment of hepatitis B virus (HBV)
and hepatitis C virus (HCV) infections. IFN-
acts on target cells to
confer a state of resistance to viral infectivity at one or more stages
of virus entry or replication. These biological effects require binding
to the type I IFN receptor complex, which is composed of two subunits,
and
(12). Both subunits undergo rapid
ligand-dependent tyrosine phosphorylation, and the
subunit itself
acts as a species-specific transducer for type I IFN action
(7). At least 30 genes are known to be transcriptionally
induced by type I IFNs, including 2',5'-oligoadenylate synthetase
(2'5'OAS), the double-stranded RNA-activated protein kinase, and the
IFN-I response factor I (8, 10). 2'5'OAS is important for
antiviral response, and its activity is required by cells to activate
the endonuclease RNase L, which degrades RNA (31).
results in
clearance of the virus in only 20% of patients. However, recent
clinical trials have shown that a combination of r-hIFN-
and the
antiviral drug ribavirin can increase the percentage of recovery up to
40% (9, 30). Although these results appear to be very
promising, systemic injection of r-hIFN-
is associated with
severe side effects, which worsen in combination with ribavirin, causing the withdrawal of 20% of patients from therapy.
treatment is effective in only a
minority of patients. One possible explanation has been postulated on
the basis of association of specific HCV genotype and lack of sustained
response. HCV proteins may block IFN-
-induced antiviral polypeptides, thus allowing virus replication to take place (26, 35, 36). However, the induction of a stronger antiviral
response may overcome this blockage, suggesting that treatment
of these species may require a higher amount of IFN-
.
types have been explored in mice using naked DNA injection into
muscle. A prophylactic injection of plasmid DNA expressing different
murine IFN-
(mIFN-
) types succeeded in reducing cytomegalovirus
replication in the injected mice to a limited extent (42).
In the case of HBV, transgenic mice have been developed as a model for
viral replication and gene expression. Injection of a first-generation
adenovirus (Ad) vector expressing the
-galactosidase gene
(Ad-
gal) led to a transient inhibition of HBV virus replication in
association with the advent of inflammatory cytokines induced by
adenovirus injection (5).
exhibits a short half-life in the blood after parenteral
protein administration (15, 40), suggesting that the limited performance of IFNs in hepatitis treatment may be caused, at least in
part, by insufficient or lack of sustained delivery of the protein to
the liver. Because liver-specific gene delivery could overcome these
limitations, we have explored the effects of mIFN-
2 gene delivery
mediated by Ad vectors that have been shown to transduce mainly in the
liver when injected intravenously (17). To further limit
mIFN-
2 expression to the target tissue, the mIFN-
2 gene was
cloned under the control of the liver-specific transthyretin promoter (TTR) (27). The mIFN-
2 expression cassette
was rescued in a first-generation Ad vector, Ad-IFN, and in a
helper-dependent (HD) vector, HD-IFN. The HD vectors do not express any
viral proteins and result in prolonged transgene expression in
immunocompetent mice upon systemic delivery (4, 20, 24, 33).
In this study, we show that the combination of an HD vector and
liver-specific promoter resulted in intrahepatic IFN-
expression,
which protected the liver in acute hepatitis models.
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MATERIALS AND METHODS
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
80°C. At the
indicated time, mice were sacrificed, and organs were rapidly frozen in
liquid nitrogen and stored at
80°C.
2 expression cassette.
A synthetic
mIFN-
2 gene was assembled by PCR with 28 oligonucleotides, 40 nucleotides in length, which collectively encoded both strands of the
gene, as previously described (34). The PCR product was then
cloned in pBluescript II (pBS-mIFN) and sequenced. The bovine growth
hormone poly(A) site was amplified by PCR from plasmid pcDNA
(Invitrogen), adding an XbaI site at the 5' end and a
NotI site at the 3' end. This fragment was cloned downstream of the mIFN-
2 cDNA in pBS-mIFN, generating pBS-mIFN-bGH. The liver-specific TTR gene minimal enhancer and promoter (27)
was excised as a HindIII fragment from pTTR-CAT (kindly
provided by R. H. Costa) and inserted upstream of the mIFN cDNA in
pBS-mIFN-bGH, generating pTTR-mIFN-bGH. To improve the level of
expression, an artificial intron was amplified by PCR from pCAT3basic
(Invitrogen) and subcloned into the HindIII and
EcoRI sites between the TTR promoter and enhancer and the
mIFN cDNA, generating pTTR-intr-mIFN-bGH (Fig.
1).

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FIG. 1.
Structure of HD-IFN and Ad-IFN and expression of
mIFN-
2 in vitro. (A and B) mIFN-
2 expression cassette used in
this study. The mIFN-
2 gene was cloned downstream of the TTR
promoter (prom.) and enhancer (enh.) followed by the polyadenylation
signal of bovine growth hormone (GH pA). Int., intron. (A) To generate
the HD-IFN vector, the expression cassette was cloned in the
SmiI site of the STK120 backbone vector, which contains the
following sequence: the left-terminus Ad5 internal terminal repeats
(ITR) and packaging signal (
); a fragment of the human hypoxanthine
guanine phosphoribosyltransferase (HPRT); a human fragment of the C346
cosmid; and the right-terminus Ad5 ITR sequence. (B) To derive the
Ad-IFN vector, the expression cassette was recombined in the E1 region
of pHVAd1 vector as described in Materials and Methods. (C) The human
cell lines Huh-7 and HeLa were transduced with either HD-IFN (open
bars) or Ad-IFN (solid bars) at a multiplicity of infection of 10. Secretion of mIFN-
2 into the cell culture medium was measured by the
VSV cythopathic inhibition assay as described in Materials and
Methods.
Ad vectors.
To construct pHD-IFN, the mIFN-
2 expression
cassette was excised from pTTR-intr-mIFN-bGH using SalI and
NotI and subcloned in pABS4 (Microbix). Subsequently, the
mIFN-
2 cassette and kanamycin resistance gene were recovered as a
PvuII fragment and subcloned in the SmiI site of
pSTK120 (24, 29), generating pHD-IFN. Plasmid pAd1-IFN was
generated by homologous recombination in Escherichia coli as
previously described with slight modifications (6). Briefly,
the mIFN-
2 cassette was subcloned in plasmid p
E1sp1B and
recombined in vector pHVAd1 by transformation in E. coli
strain BJ 5183 (Fig. 1).
in
cell supernatants at 48 h postinfection by the vesicular
stomatitis virus (VSV) inhibition assay. Similarly, pAd-IFN was
linearized with PmeI and transfected into 293 cells.
Multiple virus passages were performed to reach a high titer. Both Ad
vectors were purified on a CsCl density gradient, and physical
particles were measured by optical density of DNA. The titer of Ad-IFN,
measured as plaque-forming units, was determined on 911 cells by
standard plaque assay. Ad-
gal is a first-generation vector that
carries the
-galactosidase gene under the transcriptional control of
a cytomegalovirus immediate-early promoter (Quantum Biotechnologies).
Cythopathic inhibition assay for IFN.
The viral cytopathic
inhibition assay with VSV has been described elsewhere (1).
mIFN-
2 activity is expressed in units per milliliter. mIFN-
2
activity was calibrated against the curve obtained with a standard
recombinant mIFN-
(Calbiochem).
Intrahepatic mIFN-
2 measurement.
Livers were weighed and
homogenized in phosphate-buffered saline with a Polytron homogenizer,
and lysates were centrifuged for 30 min at 4°C at 14,000 rpm to
eliminate cell debris. Since IFN-
is acid stable, HCl (0.5 N) was
added to achieve pH 2.0, and extracts were incubated overnight at
4°C. Neutral pH was reached by adding NaOH, and the extracts were
centrifuged for 30 min at 4°C at 14,000 rpm. Clarified extracts were
then analyzed by the VSV inhibition assay.
Northern blot analysis and RNase protection assay. Frozen tissues were mechanically pulverized, and RNA was isolated from tissues with the Ultraspec RNA reagent (Biotecx Laboratories) according to the manufacturer's instructions. Total RNA (20 µg) was used in Northern blot analysis. The intensity of bands was quantified by PhosphorImager analysis. The RNase protection assay for quantification of mRNA was performed with the RiboQuant Multi-Probe RPA assay system (PharMingen) according to the manufacturer's instructions.
Induction of acute hepatitis. Mouse hepatitis virus type 3 (MHV-3) was amplified on mouse fibroblast DBT cells, and the titer was measured in a standard plaque assay. A total of 100 PFU was injected intraperitoneally (i.p.) in 100 µl of physiologic solution. To measure MHV-3 infectious particles present in the liver, fractions were homogenized with a Polytron homogenizer, and the lysate was centrifuged for 30 min. The titer of MHV-3 in the supernatant was determined by plaque assay. Concanavalin A (ConA; Sigma) was suspended in physiologic solution and injected intravenously (i.v.).
Biochemical and histological analysis. The extent of hepatocellular injury induced by MHV-3 or ConA injection was monitored by measuring serum alanine aminotransferase (GPT) activity at the indicated time points. GPT activity was measured in a Spotchem model SP-4410 according to the manufacturer's instructions. For histological analysis, liver fractions that had been fixed by immersion in 10% Formalin in 0.1 M phosphate buffer (pH 7.4) were dehydrated in graded alcohol and xylene and embedded in paraffin. Sections were cut and stained with Harris hematoxylin and counterstained with eosin Y. Tissue sections were subsequently washed with distilled water, dehydrated in graded alcohol and xylene, and mounted with Permount. Tissue sections were assessed for the presence of necrosis and inflammatory cell infiltration.
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RESULTS |
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Construction of Ad vectors.
To obtain liver-specific
expression of mIFN-
2, we rescued an HD vector carrying the mIFN-
2
gene under the control of the TTR promoter and enhancer (28)
(Fig. 1A). To compare the transduction efficiency of HD-IFN to that of
a first-generation Ad vector, Ad-IFN was constructed. This vector is an
E1- and E3-deleted Ad in which the same expression cassette present in
HD-IFN was inserted in the E1 region (Fig. 1B). The infectious titer of
HD-IFN was established on the basis of mIFN-
2 units produced in the
supernatant of hepatoma Huh-7 cells infected with different amounts of
both virus preparations, and the HD-IFN titer was expressed as
plaque-forming unit equivalents (PFU-E).
2 were
produced over time by HD-IFN- and Ad-IFN-infected human hepatoma cells
(Huh-7). In contrast, mIFN-
2 was not detected upon infection of
nonhepatic cells (HeLa). This result indicates that both Ad vectors
direct hepatic expression of the mIFN-
2 gene.
Assessment of biological response.
To verify that mIFN-
2
gene delivery could elicit a biological response in vivo, C57/B6 mice
were injected with increasing doses of HD-IFN: 2 × 108, 9 × 108, and 1.8 × 109 PFU-E. For comparison, a group of mice were injected
with 1.6 × 109 PFU of Ad-IFN. Last, a group of mice
were injected with 2 × 109 PFU of the Ad-
gal
vector to evaluate induction of antiviral genes mediated by Ad
injection in the absence of mIFN-
2 transgene expression. Mice were
sacrificed at day 7 postinjection (p.i.), and serum and livers were
collected to examine mIFN-
2 content and biological effects. Total
liver RNA was prepared from a liver fraction, and mIFN-
2 expression
was measured by Northern blot analysis. As shown in Fig.
2A, mIFN-
2 mRNA was detectable only at
the highest dose of HD-IFN injected, whereas a faint hybridization signal was detected in livers from mice injected with 9 × 108 PFU-E. No mIFN-
2 transcripts were detected in mice
injected with the lowest HD dose, either with Ad-IFN or with Ad-
gal.
We next examined the presence of mIFN-
2 in the liver. For this
purpose, fractions were homogenized and incubated overnight at low pH
to eliminate the acid-labile IFN-
that could have been released by
the inflammatory response against Ad particles (5). The acid-stable mIFN-
2 was measured by the VSV inhibition assay
(1). mIFN-
2 was not detected in Ad-
gal-injected mice,
and in Ad-IFN-injected mice, an almost undetectable level was observed
only in one of two mice examined (Fig. 2B). In contrast, injection of
HD-IFN resulted in a dose-response correlation, with the dose of
1.8 × 109 PFU-E yielding almost 1,000-fold-more
hepatic mIFN-
2 than the corresponding dose of Ad-IFN. More
importantly, injection of the lowest HD-IFN dose resulted in detectable
levels of mIFN-
2 in both mice analyzed (in the range of 50 U/g). The
presence of mIFN-
2 in the serum was clearly detected only in mice
injected with HD-IFN at the dose of 1.8 × 109 PFU-E
and almost undetectable at the dose of 9 × 108 PFU-E
(Fig. 2C).
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2 were also activated upon injection of Ad vectors,
the same filters were hybridized with the 2'5'OAS probe (Fig. 2D). A
weak hybridization signal was observed in mice injected with 2 × 109 PFU of Ad-
gal. The induction of 2'5'OAS may have
been triggered by IFN-
production, as a result of an inflammatory
response directed against the first-generation Ad vector
(5). At the same dosage, Ad-IFN yielded a slightly higher
induction of 2'5'OAS than that mediated by Ad-
gal. This induction
may be explained by the low level of expression of the mIFN-
2 gene,
as indicated by the presence of mIFN-
2 protein in the liver (Fig.
2B). As observed for the intrahepatic content of mIFN-
2, the
induction of 2'5'OAS correlated with the dose of HD-IFN. The injection
of 1.8 × 109 PFU-E induced a 25-fold-greater
activation of 2'5'OAS than the corresponding dose of Ad-
gal. Also,
injection of 2 × 108 PFU-E, which resulted in a small
amount of intrahepatic mIFN-
2, induced a significant biological response.
Lastly, the presence of inflammatory cytokines was examined in an RNase
protection assay (Fig. 2E). Tumor necrosis factor alpha (TNF-
) was
induced by all vectors in a dose-dependent manner, with an almost
undetectable signal at the lowest HD-IFN dose. In order to establish a
more precise comparison between IFN response consequent to local gene
delivery and liver inflammation induced by Ad vectors, the mRNA
expression levels of 2'5'OAS and TNF-
were normalized, and their
ratio was calculated (Fig. 2G). Interestingly, the HD vectors at all
doses tested gave a higher value than the first-generation vectors, and
the best conditions (high IFN response and least inflammation) were
seen with the lowest viral load. Taken together, these results indicate
that the biological response induced by HD-IFN is not a consequence of
the inflammation induced by Ad per se but is mainly driven by mIFN-
2
transgene expression.
Hepatic protection mediated by HD-IFN.
To investigate the
therapeutic potency of mIFN-
2 gene delivery, we assessed the
antiviral strength of HD-IFN in acute hepatitis models. For this
purpose, we examined the effects of HD-IFN on the infection of
susceptible mouse strain C57/B6 with mouse coronavirus MHV-3. Treatment
with recombinant mIFN-
type I was shown to prolong survival
following MHV-2 exposure, particularly when the treatment was initiated
prior to viral infection (19, 22).
gal) and infected
i.p. with MHV-3 (100 PFU) at 1 week p.i. At this time point,
circulating mIFN-
2 was not detected in either Ad-IFN- or
Ad-
gal-injected mice, whereas high levels of serum mIFN-
2 were
observed in mice injected with HD-IFN (Fig. 3A). To verify the impact of mIFN-
2
gene delivery on MHV-3-mediated liver damage, transaminase (GPT) levels
in the serum were measured 3 days after MHV-3 infection (Fig. 3B). A
sharp rise in GPT levels was found in all mock-injected mice and in
four of five mice treated with Ad-IFN or Ad-
gal, whereas protection
from MHV-3 challenge was observed in 80% of the mice injected with
HD-IFN. Ad injection had no effect on the lethality of MHV-3 infection
regardless of whether the mice were injected with HD or a
first-generation Ad vector (mean survival ± standard deviation:
mock, 4.3 ± 0.54 days; Ad-
gal, 4.8 ± 0.83 days; Ad-IFN,
4.8 ± 0.83 days; and HD-IFN, 5.4 ± 1.5 days).
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2, a group of mice were injected with a
10-fold-lower dose of HD-IFN (3 × 108 PFU-E). Three
days after MHV-3 (100 PFU) infection, the mice were sacrificed, and
livers and serum were collected. Although at day 7 p.i.
circulating mIFN-
2 was not detected (data not shown), three of four
mice preinjected with HD-IFN displayed normal GPT levels in the serum
(Fig. 4A). Northern blot analysis of
liver RNA with a probe specific for 2'5'OAS gene showed that expression of mIFN-
2-responsive genes had occurred upon HD-IFN injection (Fig.
4B). A stronger 2'5'OAS signal was observed in mice injected with MHV-3
alone. However, in these mice, inflammatory cytokines such as TNF-
and IFN-
were induced, as measured in an RNase protection assay
(Fig. 4E and F), which may explain the stronger 2'5'OAS induction.
MHV-3 viral transcripts were detected in mice that displayed an
increase in GPT levels, whereas they could not be detected in mice that
had been injected with HD-IFN (Fig. 4C). The inhibition of viral
replication correlated with the MHV-3 titer in the liver extracts.
MHV-3 infectious particles were detected in only one of four
HD-IFN-protected mice, whereas significant amounts of virus were found
in the livers from all untreated mice (Fig. 4D). T-cell activation,
monitored as expression of the CD3
marker, was not different between
the groups (Fig. 4G).
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gal (Fig.
5). Liver fractions obtained from
HD-IFN-treated mice showed normal architecture, whereas untreated and
Ad-
gal-injected mice showed evidence of extensive hepatocellular
necrosis. These results show that the hepatic damage consequent to
MHV-3 infection is reduced by HD-IFN.
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,
interleukin-2, and IFN-
(23). IFN-
/
was shown to
protect mice from liver damage induced by ConA challenge, as indicated
by a reduced level of serum transaminases (3).
C57/B6 mice were injected with HD-IFN (3 × 108 PFU-E
and 6 × 108 PFU-E) and Ad-IFN (2 × 109 PFU). Serum mIFN-
2 was monitored on days 8, 16, and
25, and it was not detected in mice injected with Ad-IFN or with the
lower dose of HD-IFN (data not shown). By contrast, a low level of
mIFN-
2 was detected in the serum of mice injected with 6 × 108 PFU-E of HD-IFN, which ranged between 12.5 and 5 U of
mIFN-
2 per ml. The injected mice were challenged with ConA at day
30 p.i., and GPT levels were measured 24 h after challenge.
Mice injected with Ad-IFN at the high dosage (2 × 109
PFU) were only marginally protected compared with mock-treated mice
(Fig. 6). On the contrary, an eightfold
reduction in GPT levels was observed in mice injected with the more
effective HD-IFN virus at the higher dose (6 × 108
PFU-E). Consistently, injection of HD-IFN at the dose of 3 × 108 PFU-E resulted in lower but significant protection.
Taken together, these results indicate that HD-IFN exhibits a
protective effect against liver injury even at doses that do not yield
circulating mIFN-
2 levels.
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DISCUSSION |
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We have described the construction of an HD Ad expressing the
mIFN-
2 gene. Comparison with a first-generation Ad vector containing the same mIFN-
2 expression cassette indicates that these two vectors
function quite differently in vivo, with the HD vector performing more
efficiently in inducing an mIFN-
2-mediated biological response and
greater therapeutic potency.
The better performance of the HD vector over a first-generation Ad
vector carrying the same expression cassette was recently observed with
the mouse leptin gene (24). Also in those experiments at 1 week p.i., the transgene mRNA was observed only in the HD-injected mice
and not in those injected with the Ad vector. Several factors have been
shown to contribute to the weaker Ad-mediated gene expression, including "leaky" viral protein expression, which may trigger an
immune response against transduced cells (37, 41). The host
immune response may be even more relevant to IFN gene delivery because
mIFN-
2 immune modulatory activity may contribute to clearance of the
transduced cells. Although we have not examined the extent of clearance
of transduced liver cells, the different efficiency of gene expression
between the Ad and HD vectors supports the notion that the latter
viruses, which do not express Ad proteins, are safer vectors that
should guarantee efficient and prolonged expression of the transgene of
interest. In this regard, we have observed in preliminary experiments
that liver expression of mIFN-
2 mediated by HD-IFN injection is
detectable for 3 months (data not shown).
Injection of HD-IFN resulted in high levels of liver mIFN-
2 (Fig.
2). It has been reported previously that after injection of mice with
105 U, homologous IFN-
levels peaked in the liver at
1 h p.i. (104 U/g) and subsequently decreased to
baseline levels after 8 h (15). In contrast, injection
of HD-IFN (1.8 × 109 PFU-E) resulted in a
fivefold-higher mIFN-
2 concentration in the liver than in the
serum at 1 week p.i. Moreover, the biological response, measured as
2'5'OAS induction, was dose dependent and observed even at the lowest
HD-IFN dose, which did not result in circulating mIFN-
2. The lack of
circulating mIFN-
2 at the lowest HD-IFN dose may have different
explanations. One obvious possibility is the low sensitivity of the
mIFN-
2 detection assay. An alternative explanation may be that
mIFN-
2 expressed at low levels is trapped by its own receptors in
the liver tissue and released into the bloodstream only when produced
above a certain threshold, as observed with the highest HD-IFN dose.
Injection of Ad-
gal, which resulted in a detectable induction of
2'5'OAS (Fig. 2), was not associated with protection against MHV-3
challenge (Fig. 3 and 5). It is interesting that a different result was
observed in HBV transgenic mice and in lymphocytic choriomeningitis
virus-infected C57/B6 mice; injection of a similar dose of the
Ad-
gal vector led to transient inhibition of viral replication in
both systems (5, 14). In our experiments, protection against
the more aggressive MHV-3 was observed only in the presence of IFN-
expression, indicating that HD-IFN not only induced a stronger 2'5'OAS
activation, but it likely elicited a broad spectrum of antiviral
pathways which may contribute to the antiviral state observed in the
protected mice. Hepatic expression of mIFN-
2 led to liver protection
in 80% of the C57/B6 mice infected with MHV-3 (Fig. 3). The reason why
not all of the HD-IFN-injected mice were protected from MHV-3 challenge
remains elusive. The simplest explanation is that MHV-3 replication may
have occurred in tissues, including the peritoneum, where the virus was
injected, which were not protected by mIFN-
2. This may have led to
greater virus loads in the liver, and gradually the mIFN-
2-mediated
block to virus multiplication may have been overcome in an increasing number of cells. A similar mechanism may also explain the minimal increase in survival time observed in the HD-IFN-treated mice, which
may have been limited by MHV-3 replication in extrahepatic tissues
(11).
In the presence of circulating IFN-
(Fig. 3), peripheral effects
such as peritoneal macrophage activation may contribute to liver
protection. However, injection of a low HD-IFN dose which resulted in
IFN-
being present only in the liver was equally effective,
indicating that viral resistance mechanisms activated at the local
level are sufficient for liver protection (Fig. 4). In addition, mice
protected with a lower dose of HD-IFN showed induction of the 2'5'OAS
antiviral gene associated with an absence of MHV-3 transcripts and
viral particles, in line with the notion that viral clearance may occur
without destruction of potentially infected cells (14).
Furthermore, no liver histology alterations were noted in mice
pretreated with HD-IFN, indicating that injection of HD-IFN had no
negative effects on the liver tissue which could be ascribed to MHV-3
replication in association with the inflammatory response (Fig. 5). It
is known that IFN-
promotes a variety of antiviral effects, which
include induction of antiviral genes and immunomodulatory effects. The
absence of MHV-3 mRNAs in the infected liver indicates that antiviral
activities such as those induced by 2'5'OAS may be responsible for
MHV-3 clearance. However, we cannot exclude the possibility that virus
entry and/or uncoating was also affected by IFN-
expression, as
observed for simian virus 40 and retroviruses (38), or that
IFN-
may have induced a local immune response that was ultimately
responsible for MHV-3 clearance.
HD-IFN also proved efficient in protecting the liver from damage associated with ConA challenge at 30 days p.i., suggesting that transgene expression continued during this period of time (Fig. 6). The anti-inflammatory activity of type I IFNs is thought to be mediated, at least in part, by inhibiting production of inflammatory mediators (16). This protection may have important implications in cirrhosis of the liver, where parenchymal cells are progressively destroyed by activated T cells (39).
The results obtained in this study indicate that the HD-IFN vector is
quite effective in protecting the liver from the damage associated with
acute hepatitis. We therefore believe that local delivery of IFN-
to
the liver tissue with HD Ad vectors might be a promising approach for
the treatment of chronic hepatitis. In this context, a more in-depth
assessment of the minimal therapeutic dose and potential toxic effects
needs to be carried out before this vector can be considered a
candidate for the treatment of chronic hepatitis. The development of HD
vectors for IFN-
gene delivery to the liver will have to include
transcriptional regulatory elements in order to guarantee a minimal
effective therapeutic level of IFN-
expression. This additional
modification of the HD vector will further increase the safety features
of IFN-
hepatic gene delivery. To this end, regulated liver gene
expression has recently been demonstrated with an HD vector carrying an
RU486-inducible promoter driving transcription of growth hormone
(4). Finally, a regulated HD-IFN vector will have to show
therapeutic potency in a validated animal model of chronic hepatitis,
such as woodchuck hepatitis (32). Utilizing a woodchuck
IFN-
homolog to minimize immune responses against IFN-
-transduced
cells could provide information on the efficacy of IFN-
gene
delivery in a chronically damaged and probably inflamed liver.
An additional feature that renders the delivery of IFN-
to the liver
an attractive therapeutic strategy is the observation that antiviral
effects are observed with no detectable release of IFN-
into the
bloodstream. The restricted expression of IFN-
is particularly
relevant in light of the side effects associated with the current
treatment of HCV patients, who normally receive 3 × 106 U of r-hIFN-
2 three times per week. Patients
receiving higher or more frequent doses suffer from even worse side
effects, possibly induced by circulating IFN-
(2). It is
likely that selective expression of IFN-
in the liver may render it
more tolerable. A further advantage is that liver-specific expression
of IFN-
could have autocrine and paracrine effects on the target
organ, perhaps resulting in very significant bystander effects and
thereby maximizing the therapeutic potency of IFN-
.
| |
ACKNOWLEDGMENTS |
|---|
We thank M. M. C. Lai, S. Makino, S. Stohlman, and F. Taguchi for providing MHV-3 samples and advice, S. Germoni and M. Aquilina for animal care, and E. Fattori and P. Monaci for critically reading the manuscript. We also thank J. Clench for editorial assistance and M. Emili for graphics.
| |
FOOTNOTES |
|---|
* Corresponding author. Mailing address: IRBM P. Angeletti, Via Pontina Km 30,600, 00040 Pomezia (Rome), Italy. Phone: 39-06-91093-234. Fax: 39-06-91093-225. E-mail: palombo{at}irbm.it.
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