Hepatic gene therapy: present and future

Galactosylated poly(ethylene glycol)-chitosan-graft-polyethylenimine as a gene carrier for hepatocyte-targeting

Chitosan and chitosan derivatives have been proposed as alternative and biocompatible cationic polymers for non-viral gene delivery. However, the low transfection efficiency and low specificity of chitosan is an aspect of this approach that must be addressed prior to any clinical applications. In the present study a chitosan derivative, galactosylated poly(ethylene glycol)-chitosan-graft-polyethylenimine (Gal-PEG-CHI-g-PEI), was investigated as a potential hepatocyte-targeting gene carrier. The composition of Gal-PEG-CHI-g-PEI was characterized using (1)H nuclear magnetic resonance ((1)H NMR), and the particle size and zeta potential of Gal-PEG-CHI-g-PEI/DNA complexes were measured using dynamic light scattering (DLS). The Gal-PEG-CHI-g-PEI exhibited lower cytotoxicity compared to PEI 25K as a control. Likewise, Gal-PEG-CHI-g-PEI/DNA complexes showed good hepatocyte specificity. Furthermore, Gal-PEG-CHI-g-PEI/DNA complexes transfected liver cells more effectively than PEI 25K in vivo after intravenous (i.v.) administration. Together, these results suggest that Gal-PEG-CHI-g-PEI, which has improved transfection efficiency and hepatocyte specificity both in vitro and in vivo, may be useful for gene therapy.

A transient three-plasmid expression system for the production of hepatocytes targeting retroviral vectors

Targeting of retroviral vectors to specific cells was attempted through modifying the surface protein of the murine leukemia viruses (MLVs), but in many cases the protein function was affected, and it is difficult to achieve the targeted delivery. In this study, we have tried to engineer ecotropic Moloney murine leukemia viruses (MoMLV)-based retroviral vectors to transduce hepatocytes. A chimeric envelope (Env) expression plasmid was constructed containing the hepatitis B virus PreS2 peptide fused to aa +1 at the N-terminus of Env. Following simultaneous transfection of pgag-pol, pLEGFP and chimeric env plasmids into 293T cells, helper-free retrovirus stocks with the titer of approximately 10(4) infectious units/ml were achieved at 48 h post-transfection. These pseudotype vectors showed the normal host range of retrovirus, infecting host NIH 3T3 cells, although the efficiency was reduced compared with that of virions carrying wild-type ecotropic MoMLV envelope. In addition, the resultant pseudotype viruses could transduce human hepatoma cells mediated by polymerized human serum albumin with relatively high titers in comparison with those transductions without polymerized human serum albumin. This approach can be used to target hepatocytes selectively.

Galactosylated chitosan-graft-polyethylenimine as a gene carrier for hepatocyte targeting

Chitosans have been proposed as alternative, biocompatible cationic polymers for nonviral gene delivery. However, the low transfection efficiency and low specificity of chitosan need to be addressed before clinical application. We prepared galactosylated chitosan-graft-polyethylenimine (GC-g-PEI) copolymer by an imine reaction between periodate-oxidized GC and low-molecular-weight PEI. The molecular weight and composition were characterized using gel permeation chromatography column with multi-angle laser scattering and (1)H nuclear magnetic resonance, respectively. The copolymer was complexed with plasmid DNA in various copolymer/DNA (N/P) charge ratios, and the complexes were characterized. GC-g-PEI showed good DNA-binding ability and superior protection of DNA from nuclease attack and had low cytotoxicity compared to PEI 25K. GC-g-PEI/DNA complexes showed higher transfection efficiency than PEI 25K in both HepG2 and HeLa cell lines. Transfection efficiency into HepG2, which has asialoglycoprotein receptors, was higher than that into HeLa, which does not. GC-g-PEI/DNA complexes also transfected liver cells in vivo after intraperitoneal (i.p.) administration more effectively than PEI 25K. These results suggest that GC-g-PEI can be used in gene therapy to improve transfection efficiency and hepatocyte specificity in vitro and in vivo.

Intravenous Delivery of Liposome-mediated Nonviral DNA Is Less Toxic than Intraperitoneal Delivery in Mice

Suicide gene therapy has been shown to be an effective means of destroying pancreatic cancer cells. Liposomes have been described as having better efficacy in gene delivery, and an advantage of using liposomes as gene carriers is that they can be used repeatedly in vivo. The objective of this study is to compare the effect of gene delivery routes and to determine whether systemic delivery of the rat insulin promoter (RIP)-directed suicide gene construct would permit cell-specific gene delivery in vivo. Severe combined immunodeficient (SCID) mice were injected with liposome-RIP-TK (thymidine kinase) complex by either the intraperitoneal or the intravenous route. Twenty-four hours post gene delivery, mice received ganciclovir (GCV) treatment twice daily for 14 days. Mice were sacrificed at various time points. Complete necropsy and serum chemistry analysis were performed. Islet morphology was determined using hematoxylin and eosin (H&E) staining. Serum glucose and insulin levels were also determined. To determine the toxic effect on pancreatic islet cells, immunostaining of insulin-producing and glucagon-producing cells was carried out at each time point. H&E staining indicated that both intravenous and intraperitoneal liposome-RIP-TK gene expression had no effect in normal endocrine islet cells. Both gene-delivery routes in mice resulted in normal glycemia and serum insulin levels. The endocrine islets were intact, with a normal distribution pattern of insulin-producing beta cells and glucagon-secreting alpha cells. However, serum chemistry analysis revealed significantly elevated levels of liver enzymes; suggesting that possible liver damage had occurred with the intraperitoneal gene delivery of liposome-pRIP-TK. Intravenous liposome-mediated gene delivery had no effect on liver enzyme levels. Liposome-mediated gene delivery via intravenous injection was less toxic than intraperitoneal delivery. This gene-delivery route requires fewer liposome-DNA complexes and maintains normal liver function. Thus, intravenous delivery of gene therapy would be superior to intraperitoneal administration of gene therapy in mice.

Remarkably size-regulated cell invasion by artificial viruses. Saccharide-dependent self-aggregation of glycoviruses and its consequences in glycoviral gene delivery

We here report a novel example of artificial glycoviral vectors constructed via number- and size-controlled gene (pCMVluc, 7040 bp) coating with micellar glycocluster nanoparticles (GNPs) of calix[4]resorcarene-based macrocyclic glycocluster amphiphiles having eight or five saccharide moieties with terminal alpha-glucose (alpha-Glc), beta-glucose (beta-Glc), or beta-galactose (beta-Gal) residues. The resulting glycoviruses are compactly packed (approximately 50 nm) and well charge-shielded (zeta approximately equal 0 mV), undergo saccharide-dependent (alpha-Glc > beta-Gal >> beta-Glc) self-aggregation, and transfect cell (Hela and HepG2) cultures as triggered by the pinocytic form of endocytosis. The semilogarithmic linear size-activity correlation suggests that size-restricted pinocytosis (<100 nm) is effective only for monomeric viruses. The activities of oligomeric and otherwise poorly active beta-Gal-functionalized viruses toward hepatic HepG2 cells are approximately 10(2)-times higher than expected on the size basis, owing to the receptor-mediated specific pathway involving the asialoglycoprotein receptors on the hepatic cell surfaces. The scope and prospect of artificial glycoviruses are discussed.

A preclinical model of hepatocyte gene transfer: the in vivo, in situ perfused rat liver

Delivering retroviruses targeted to hepatocytes in vivo involves the injection of retroviruses directly into the portal vein. The aim of this work was to establish a clinically relevant system for retrovirus-mediated gene transfer in a new model of in vivo, in situ perfused rat liver and to study the transgene expression. At 24 h after partial hepatectomy, the liver was completely excluded from the splanchnic circulation using an extracorporeal shunt. Two independent normothermal, oxygenated perfusion systems were used. First, liver perfusion was carried out with a recirculating system (1 h). Culture supernatant containing retroviruses (1.5 x 10(8) ffu/ml, beta-galactosidase gene) was used as perfusate. Then the liver perfusion was maintained for more 30 min in a single liver passage system using culture medium without retroviruses as perfusate. High hepatocyte transduction rates (up to 34.4%) were obtained. PCR analysis showed no provirus in extrahepatic organs. Viral titrations performed simultaneously (inflow and outflow liver lines) showed that after 1 h of perfusion (up to 30 successive liver passages) retroviruses were still detected in the liver outflow perfusate (up to 2.0 x 10(7) ffu/ml). Washing the liver for 30 min dramatically decreased the leakage of retroviruses in the outflow. In order to be of clinical use, the injection of retroviruses targeted to hepatocytes in vivo should be done while the liver is completely excluded from the splanchnic circulation to avoid any extrahepatic retrovirus diffusion.

A multi-laboratory evaluation of cryopreserved monkey hepatocyte functions for use in pharmaco-toxicology

Ethical, economic and technical reasons hinder regular supply of freshly isolated hepatocytes from higher mammals such as monkey for preclinical evaluation of drugs. Hence, we aimed at developing optimal and reproducible protocols to cryopreserve and thaw parenchymal liver cells from this major toxicological species. Before the routine use of these protocols, we validated them through a multi-laboratory study. Dissociation of the whole animal liver resulted in obtaining 1-5 billion parenchymal cells with a viability of about 86%. An appropriate fraction (around 20%) of the freshly isolated cells was immediately set in primary culture and various hepato-specific tests were performed to examine their metabolic, biochemical and toxicological functions as well as their ultrastructural characteristics. The major part of the hepatocytes was frozen and their functionality checked using the same parameters after thawing. The characterization of fresh and thawed monkey hepatocytes demonstrated the maintenance of various hepato-specific functions. Indeed, cryopreserved hepatocytes were able to survive and to function in culture as well as their fresh counterparts. The ability for synthesis (proteins, ATP, GSH) and conjugation and secretion of biliary acids was preserved after deep freeze storage. A better stability of drug metabolizing activities than in rodent hepatocytes was observed in monkey. After thawing, Phase I and Phase II activities (cytochrome P450, ethoxycoumarin-O-deethylase, aldrin epoxidase, epoxide hydrolase, glutathione transferase, glutathione reductase and glutathione peroxidase) were well preserved. The metabolic patterns of several drugs were qualitatively and quantitatively similar before and after cryopreservation. Lastly, cytotoxicity tests suggested that the freezing/thawing steps did not change cell sensitivity to toxic compounds.

Embolization of portal vein branches induces hepatocyte replication in swine: a potential step in hepatic gene therapy

PURPOSE

To determine whether embolization of portal vein branches would stimulate hepatocyte replication in pigs.

MATERIALS AND METHODS

The portal vein branches supplying 50%-70% of the liver were embolized in eight pigs by using a combination of coils and polyvinyl alcohol particles. The extent of embolization was assessed at portography in all animals and at computed tomography in one animal. Hepatocyte replication was determined by calculating the percentage of cells that incorporated bromodeoxyuridine into their nuclei. Animals survived up to 35 days after the procedure.

RESULTS

Embolization of the portal vein branches supplying the left and median lobes caused transient increases of less than 70% in portal vein pressures and of less than 100% in liver enzyme levels. Indocyanine green clearance was measured in two animals and decreased less than 50%. The percentage of replicating hepatocytes in the nonembolized lobe was 0% on day 0, 7% on day 2, 14% on day 7, and 2% on day 12.

CONCLUSION

Substantial hepatocyte replication occurred 2-7 days after embolization of portal vein branches. Further research will help determine if this procedure can facilitate retroviral transduction in large animals. If successful, the low morbidity of this method may allow its use in humans for gene therapy.

Targeted integration of adeno-associated virus-derived plasmids in transfected human cells

Adeno-associated virus (AAV) integrates its genomic DNA into a defined region of human chromosome 19 (AAVS1). The specificity of integration is dependent on the presence of the inverted terminal repeats (ITR) and on expression of the rep gene. To develop vectors capable of targeting the insertion of a selected DNA sequence into a specific location of human chromosome, we determined whether the rep gene can mediate site-specific integration when cloned outside of an ITR-flanked transgene cassette. HeLa and Huh-7 cells were transfected with a plasmid containing the rep gene, as well as the green fluorescent protein (GFP) and neomycin (neo) resistance gene inserted between the ITRs of AAV. Southern blot analysis of individual clones detected Rep-mediated site-specific integration of the ITR-flanked DNA in 25% and 12% of the HeLa and Huh-7 clones, respectively. The localization of the GFP-Neo sequence on chromosome 19 also was confirmed by fluorescent in situ hybridization analysis of the transfected HeLa clones. Sequence analysis of the ITR-AAVS1 junction of one of the transfected Huh-7 clones indicated that the insertion of the ITR DNA fragment had occurred at nucleotide 1003. These results have implications for the development of AAV-derived vectors capable of directing the site-specific integration of a gene of interest.

In vitro inhibition of the hepatitis delta virus replication mediated by interferon and trans-ribozyme or antisense probes

BACKGROUND/AIMS

In this study, the inhibition of hepatitis delta virus replication mediated by trans-ribozyme and antisense probes, alone or in combination with recombinant interferon alpha-2a, has been assayed.

METHODS

A 60-nucleotide-long designed trans-ribozyme, which contains the catalytic core of the hammerhead ribozyme, and a 163-nucleotide-long antisense probe were directed against the same region of the viral genome in in vitro and cell culture systems.

RESULTS

The ribozyme activity, assayed in a chemically isolated system, resulted in the trans-cleavage of 10-20% of the 40-nucleotide-long RNA substrate. A 5-nucleotide deletion in one of the flanking arms, obtained by random mutagenesis, resulted in enhancement of the trans-cleavage activity in as many as 40-60% of the substrate molecules. The efficiency of the optimized trans-ribozyme and antisense probes against the complete viral genome was assayed in a cell culture system. The inhibitory efficacy (25%) of the trans-ribozyme is lower than that of the antisense probe (35%) or interferon at 1000 U/ml (47%). An enhancement of the interferon efficacy was achieved when it was administered in cells having a previous basal expression of ribozyme (70%) or antisense probes (83%).

CONCLUSIONS

These results suggest that the combination of ribozyme or antisense probes with interferon could be a promising approach to the treatment of RNA virus infections.

Receptor-mediated delivery of foreign genes to hepatocytes

Naturally existing cell surface receptors provide convenient systems for transporting substances from the extracellular environment to the interior of cells. When such receptors are highly selective for certain cell types, the possibility exists for targeting biological agents of interest to specific tissues. In this review, the concepts, progress and problems in targeting genes and their subsequent expression in hepatocytes based on the asialoglycoprotein receptor in vitro and in vivo will be discussed. The use of protein carriers for hepatocyte specific delivery of double stranded DNA to introduce novel gene expression novel, as well as, delivery of single stranded DNA for inhibition of endogenous genes with examples of each are reviewed.

Portal branch occlusion safely facilitates in vivo retroviral vector transduction of rat liver

Hepatic gene therapy might correct the clinical manifestations of several genetic disorders in patients. Although retroviral vectors with a strong liver-specific promoter can result in stable and therapeutic levels of expression of genes from the liver, application of these techniques in humans is limited by the need to perform one or more invasive procedures to achieve ex vivo or in vivo transduction of hepatocytes. In vivo delivery involves injection of retrovirus into the portal vein during liver regeneration. Although transduction is efficient and specific for the liver, induction of hepatocyte replication requires a 70% partial hepatectomy or administration of a liver toxin. An alternative method for inducing hepatocyte replication is to occlude branches of the portal vein. This results in apoptosis of hepatocytes in the occluded lobes and compensatory replication of the hepatocytes in the nonoccluded lobes. We demonstrate here that portal branch occlusion is nearly as effective as partial hepatectomy at facilitating retroviral vector transduction in vivo and has a lower morbidity. Portal branch occlusion could be performed in larger animals by minimally invasive techniques and has been used safely to treat human patients with liver cancer. Portal branch occlusion might ultimately be used in humans to facilitate retroviral vector transduction in vivo for the treatment of genetic diseases.

Assessment of natural and interleukin-2-induced production of interferon-gamma in patients with liver diseases

AIM: To determine whether the production of lower interferon gamma (IFNl) by lymphocytes in patients with liver diseases is due to defects of the lymphocytes themselves or to other cofactors, such as interleukin-2 (IL-2).

METHODS: Peripheral blood mononuclear cells (PBMCs) from patients with various liver diseases were cultured with or without phytohemagglutinin (PHA) and IL-2. The cells were harvested and counted, and the supernatants were tested for IFNl by a sensitive and quantitative ABC-enzyme-linked immunosorbent assay (ELISA).

RESULTS: IFNl was not found in serum samples from patients or normal individuals. However, IFNl was detectable in supernatants of non-induced and induced PBMCs by ABC-ELISA. In non-induced PBMCs (group 1), the content of IFNl in supernatants from control, chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and hepatocellular carcinoma (HCC) was 8.72/L, 5.03/L, 6.02/L, and 4.91/L, respectively. The production of IFNl in liver disease was significantly decreased compared to control. In PBMCs stimulated with PHA (group 2), the content of IFNl was 22.71/L, 17.12/L, 14.54/L, and 17.63/L, respectively. In PBMCs induced by IL-2 (group 3), the amount of IFNl in supernatant from control (60.67/L) was much larger than those from CAH (21.70/L), CPH (24.00/L), and HCC (19.15/L) (p < 0.01). When comparing the amount of IFNl in group 3 with that in group 1, we found that IFNl production was enhanced by nearly 4-folds in liver diseases and by over 7-fold in control. In contrast, the number of PBMCs, whether from liver diseases or from control, was increased by only approximately 3-fold.

CONCLUSION: The decreased production of IFNl in liver diseases, including HCC, is mainly due to endogenous defects of lymphocytes but may also involve a decrease in stimulating cofactors, such as IL-2.

In vitro and in vivo hepatoma cell-specific expression of a gene transferred with an adenoviral vector

Recombinant adenoviruses are widely used for the transfer of foreign genes into various mammalian cells. However, the utilization of these vectors for cancer gene therapy requires the specific and efficient expression of the transferred gene in tumor cells. To obtain targeted expression in hepatoma cells, we constructed recombinant adenoviral vectors containing transcriptional elements from either the rat alpha-fetoprotein (AFP) or the human insulin-like growth factor II (IGFII) genes driving expression of the nuclear beta-galactosidase gene (nls lacZ). In vitro infection revealed that the AFP but not the IGFII transcriptional regulatory sequence controlled nls lacZ expression specifically in hepatoma cells. The same specificity was obtained in vivo in subcutaneous human hepatic tumors generated by engraftment of Huh7 hepatoma cells in nude mice as well as in primary liver tumors developed in rats and mice. No marker gene expression was detectable after AFP-nls lacZ gene transfer to normal rat liver parenchyma despite evidence for the presence of DNA encoding the nls lacZ gene. However, in vivo experiments with primary liver tumors in rats and mice also revealed that primary hepatoma cells were poorly infected by adenoviral vectors. Peritumoral and normal tissues were infected efficiently by adenoviral vectors. We conclude that hepatoma cell-specific expression of a transgene can be achieved with AFP regulatory sequences but that adenoviral vectors may not be the preferable vector for transferring genes in vivo in primary liver tumors.

Pediatric gastroenterology. Update on metabolic liver disease

Wilson's disease, genetic and neonatal hemochromatosis, protoporphyria, tyrosinemia, and alpha1-antitrypsin deficiency are updated. Cost effectiveness of screening is discussed. Current therapies are evaluated, including the role of transplantation. The molecular biologic technique PCR is covered. Gene therapy is introduced.

Relationships between in vitro and in vivo biotransformation of drugs in humans and animals: pharmaco-toxicological consequences

Given the crucial role played by hepatocytes in the detoxification/toxification processes of drugs, these cells have been increasingly used during the last decade in various pharmaco-toxicological areas. The majority of these studies have, however, dealt with animal cells, although examples of failures in the extrapolation of the data to man are frequent. This drawback, together with the ethical considerations in performing in vivo experiments, makes the application of the human hepatocyte model critical in the preclinical evaluation of new compounds. However, before making extensive use of these promising tools for prospective pharmaceutical research, one must ensure that they can generate data that correlate well with those obtained in vivo. This is only possible through extensive studies on drugs showing a variety of phase I and phase II metabolic pathways in hepatocytes from different species, including man, and comparison with in vivo data. Providing this validation step is undertaken, the use of such systems in drug research and development may greatly enhance the rational design of safe and effective drugs, allowing savings in time, cost and test materials as well as minimizing the use of animals.

Receptor-mediated transfer of pSV2CAT DNA to a human hepatoblastoma cell line HepG2 using asialofetuin-labeled cationic liposomes

Asialofetuin-labeled liposomes (AF-lps) were developed as a vector for gene transfer to hepatocytes. Plasmid pSV2CAT DNA which encodes bacterial chloramphenicol acetyltransferase (CAT) was associated with (meaning, in this report, the sum of 'to be adsorbed on the surface of' and 'to be encapsulated into the internal phase of') AF-lps (AF-lps-pSV2CAT) prepared by a tandem combination of the detergent removal and freeze-thaw methods. Ninety-six percent of input pSV2CAT was associated with AF-lps containing N-(alpha-trimethylammonioacetyl)-didodecyl-D-glutamate chloride, and approx. two-thirds of the associated DNA was encapsulated into the internal phase. The uptake of AF-lps by the cultured human hepatoblastoma cell line HepG2, having asialoglycoprotein receptors (AGPR) on their plasma membrane, was decreased by the addition of free AF and cytochalasin B. AF-lps bound to HepG2 cells through specific interaction with AGPR, and were internalized into the cells by the receptor-mediated endocytotic pathway. HepG2 cells transfected by AF-lps-pSV2CAT showed a significantly higher CAT activity than those transfected by pSV2CAT associated with non-labeled control lps (N-lps-pSV2CAT) or a mixture of pSV2CAT and empty AF-lps. Pretreatment with EDTA-encapsulated AF-lps increased the transfection efficiency of AF-lps-pSV2CAT. The CAT activity in A431 and Swiss/3T3 cells transfected with AF-lps-pSV2CAT was low and almost the same as those transfected with N-lps-pSV2CAT. Since DNA encapsulated in lps is likely to be protected against digestion by nucleases in the blood circulation, AF-lps could be used as a gene transfer vector targeting the hepatocytes in vivo.

Porphyrias: animal models and prospects for cellular and gene therapy

The rapid progress in the development of molecular technology has resulted in the identification of most of the genes of the heme biosynthesis pathway. Important problems in the pathogenesis and treatment of porphyrias now seem likely to be solved by the possibility of creating animal models and by the transfer of normal genes or cDNAs to target cells. Animal models of porphyrias naturally occur for erythropoietic protoporphyria and congenital erythropoietic porphyria, and different murine models have been or are being created for erythropoietic and hepatic porphyrias. The PBGD knock-out mouse will be useful for the understanding of nervous system dysfunction in acute porphyrias. Murine models of erythropoietic porphyrias are being used for bone-marrow transplantation experiments to study the features of erythropoietic and hepatic abnormalities. Gene transfer experiments have been started in vitro to look at the feasibility of somatic gene therapy in erythropoietic porphyrias. In particular, we have documented sufficient gene transfer rate and metabolic correction in different CEP disease cells to indicate that this porphyria is a good candidate for treatment by gene therapy in hematopoietic stem cells. With the rapid advancement of methods that may allow more precise and/or efficient gene targeting, gene therapy will become a new therapeutic option for porphyrias.