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Mani S, Jindal D, Singh M. Gene Therapy, A Potential Therapeutic Tool for Neurological and Neuropsychiatric Disorders: Applications, Challenges and Future Perspective. Curr Gene Ther 2023; 23:20-40. [PMID: 35345999 DOI: 10.2174/1566523222666220328142427] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 01/18/2022] [Accepted: 02/02/2022] [Indexed: 02/08/2023]
Abstract
Neurological and neuropsychiatric disorders are the main risks for the health care system, exhibiting a huge socioeconomic load. The available range of pharmacotherapeutics mostly provides palliative consequences and fails to treat such conditions. The molecular etiology of various neurological and neuropsychiatric disorders is mostly associated with a change in genetic background, which can be inherited/triggered by other environmental factors. To address such conditions, gene therapy is considered a potential approach claiming a permanent cure of the disease primarily by deletion, silencing, or edition of faulty genes and by insertion of healthier genes. In gene therapy, vectors (viral/nonvial) play an important role in delivering the desired gene to a specific region of the brain. Targeted gene therapy has unraveled opportunities for the treatment of many neurological and neuropsychiatric disorders. For improved gene delivery, the current techniques mainly focus on designing a precise viral vector, plasmid transfection, nanotechnology, microRNA, and in vivo clustered regulatory interspaced short palindromic repeats (CRISPR)-based therapy. These latest techniques have great benefits in treating predominant neurological and neurodevelopmental disorders, including Parkinson's disease, Alzheimer's disease, and autism spectrum disorder, as well as rarer diseases. Nevertheless, all these delivery methods have their limitations, including immunogenic reactions, off-target effects, and a deficiency of effective biomarkers to appreciate the effectiveness of therapy. In this review, we present a summary of the current methods in targeted gene delivery, followed by the limitations and future direction of gene therapy for the cure of neurological and neuropsychiatric disorders.
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Affiliation(s)
- Shalini Mani
- Department of Biotechnology, Centre for Emerging Diseases, Jaypee Institute of Information Technology, Noida, U.P., India
| | - Divya Jindal
- Department of Biotechnology, Centre for Emerging Diseases, Jaypee Institute of Information Technology, Noida, U.P., India
| | - Manisha Singh
- Department of Biotechnology, Centre for Emerging Diseases, Jaypee Institute of Information Technology, Noida, U.P., India
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Appraisal for the Potential of Viral and Nonviral Vectors in Gene Therapy: A Review. Genes (Basel) 2022; 13:genes13081370. [PMID: 36011281 PMCID: PMC9407213 DOI: 10.3390/genes13081370] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 12/16/2022] Open
Abstract
Over the past few decades, gene therapy has gained immense importance in medical research as a promising treatment strategy for diseases such as cancer, AIDS, Alzheimer’s disease, and many genetic disorders. When a gene needs to be delivered to a target cell inside the human body, it has to pass a large number of barriers through the extracellular and intracellular environment. This is why the delivery of naked genes and nucleic acids is highly unfavorable, and gene delivery requires suitable vectors that can carry the gene cargo to the target site and protect it from biological degradation. To date, medical research has come up with two types of gene delivery vectors, which are viral and nonviral vectors. The ability of viruses to protect transgenes from biological degradation and their capability to efficiently cross cellular barriers have allowed gene therapy research to develop new approaches utilizing viruses and their different genomes as vectors for gene delivery. Although viral vectors are very efficient, science has also come up with numerous nonviral systems based on cationic lipids, cationic polymers, and inorganic particles that provide sustainable gene expression without triggering unwanted inflammatory and immune reactions, and that are considered nontoxic. In this review, we discuss in detail the latest data available on all viral and nonviral vectors used in gene delivery. The mechanisms of viral and nonviral vector-based gene delivery are presented, and the advantages and disadvantages of all types of vectors are also given.
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da Silva A, Lepetre-Mouelhi S, Couvreur P. Micro- and nanocarriers for pain alleviation. Adv Drug Deliv Rev 2022; 187:114359. [PMID: 35654211 DOI: 10.1016/j.addr.2022.114359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/10/2022] [Accepted: 05/20/2022] [Indexed: 12/28/2022]
Abstract
Acute or chronic pain is a major source of impairment in quality of life and affects a substantial part of the population. To date, pain is alleviated by a limited range of treatments with significant toxicity, increased risk of misuse and inconsistent efficacy, owing, in part, to lack of specificity and/or unfavorable pharmacokinetic properties. Thanks to the unique properties of nanoscaled drug carriers, nanomedicine may enhance drug biodistribution and targeting, thus contributing to improved bioavailability and lower off-target toxicity. After a brief overview of the current situation and the main critical issues regarding pain alleviation, this review will examine the most advanced approaches using nanomedicine of each drug class, from the preclinical stage to approved nanomedicines.
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Bidve P, Prajapati N, Kalia K, Tekade R, Tiwari V. Emerging role of nanomedicine in the treatment of neuropathic pain. J Drug Target 2019; 28:11-22. [PMID: 30798636 DOI: 10.1080/1061186x.2019.1587444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Neuropathic pain (NeP) is a complex chronic pain condition associated with nerve injury. Approximately, 7-10% of the general population across the globe is suffering from this traumatic condition, but the existing treatment strategies are inadequate to deliver pain relief and are associated with severe adverse effects. To overcome these limitations, lot of research is focussed on developing new molecules with high potency and fewer side effects, novel cell and gene-based therapies and modification of the previously approved drugs by different formulation aspects. Nanomedicine has attracted a lot of attention in the treatment of many diverse pathological conditions because of their unique physiochemical and biological properties. In this manuscript, we highlighted the emerging role of nanomedicine in different therapies (drug, cell and gene), also we emphasised on the challenges associated with nanomedicine such as development of well-characterised nanoformulation, scaling of batches with reproducible results and toxicity along with this we discussed about the future of nanomedicine in the treatment of neuropathic pain.
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Affiliation(s)
- Pankaj Bidve
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Namrata Prajapati
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Kiran Kalia
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Rakesh Tekade
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Vinod Tiwari
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
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Ozbilgin MK, Aktas C, Temel M, Önal T, Türköz Uluer E, Vatansever HS, Kurtman C. POMC expression of the urothelium of the urinary bladder of mice submitted to pelvic radiation. EUR J INFLAMM 2016. [DOI: 10.1177/1721727x15624698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective: Patients who have had pelvic radiotherapy as part of their cancer therapy may develop subsequent urinary bladder injury. The acute changes that the urothelium undergo after radiation are known, but the healing mechanism of the urothelium of the urinary bladder after pelvic radiotherapy is not clearly understood. Proopiomelanocortin (POMC) peptides, which have immunomodulatory effects, are produced locally in sites outside of the central nervous system. This study aims to determine the role of POMC expression in the urothelium during radiation injury. Methods: Twenty-four male Swiss Albino mice were divided into four groups. A single-fractioned 10 Gy of ionizing radiation was applied to the pelvic zone of all mice with Cobalt-60 radiotherapy. The first group 1, which consisted intact animal and not irradiated was the control group, and the second, third, and fourth groups were euthanized after 24 h (Group 2), 48 h (Group 3), and 7 days (Group 4) after irradiation. All bladders were prepared for histochemical analysis using hematoxylin eosin (H&E) and immunohistochemical analysis using anti-POMC antibody. Results: No morphological differences were seen in all the group samples stained with H&E. POMC expression of the urothelium of bladder tissue samples shows different staining levels. Group 1 (96.7 ± 7.68), Group 2 (88.3 ± 8.04), and Group 3 (85.10 ± 10.9) were very weakly stained, but the POMC immunoreactivity of Group 4 (113.0 ± 12.8) was observed to be strong. Conclusion: Expression of POMC from urothelium seems to prevent bladder damage from radiation supplying differentiation and restoration of the urothelium.
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Affiliation(s)
- M Kemal Ozbilgin
- Celal Bayar University School of Medicine, Department of Histology and Embryology, Manisa, Turkey
| | - Caner Aktas
- Department of Radiation Oncology, Diskapi Training and Research Hospital, Ankara, Turkey
| | - Merve Temel
- Celal Bayar University School of Medicine, Department of Histology and Embryology, Manisa, Turkey
| | - Tuna Önal
- Celal Bayar University School of Medicine, Department of Histology and Embryology, Manisa, Turkey
| | - Elgin Türköz Uluer
- Celal Bayar University School of Medicine, Department of Histology and Embryology, Manisa, Turkey
| | - H Seda Vatansever
- Celal Bayar University School of Medicine, Department of Histology and Embryology, Manisa, Turkey
- Near East University, Experimental Health Research Center of Health Sciences, Nicosia, North Cyprus
| | - Cengiz Kurtman
- Department of Radiation Oncology, Ankara University School of Medicine, Ankara, Turkey
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Yoshimura N, Oguchi T, Yokoyama H, Funahashi Y, Yoshikawa S, Sugino Y, Kawamorita N, Kashyap MP, Chancellor MB, Tyagi P, Ogawa T. Bladder afferent hyperexcitability in bladder pain syndrome/interstitial cystitis. Int J Urol 2015; 21 Suppl 1:18-25. [PMID: 24807488 DOI: 10.1111/iju.12308] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 08/27/2013] [Indexed: 12/30/2022]
Abstract
Bladder pain syndrome/interstitial cystitis is a disease with lower urinary tract symptoms, such as bladder pain and urinary frequency, which results in seriously impaired quality of life of patients. The extreme pain and urinary frequency are often difficult to treat. Although the etiology of bladder pain syndrome/interstitial cystitis is still not known, there is increasing evidence showing that afferent hyperexcitability as a result of neurogenic bladder inflammation and urothelial dysfunction is important to the pathophysiological basis of symptom development. Further investigation of the pathophysiology will lead to the effective treatment of patients with bladder pain syndrome/interstitial cystitis.
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Affiliation(s)
- Naoki Yoshimura
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Yoshimura N, Miyazato M, Sasaki K, Yokoyama H, Oguchi T, Chancellor MB, Funahashi Y. Gene therapy for lower urinary tract dysfunction. Int J Urol 2012; 20:56-63. [DOI: 10.1111/j.1442-2042.2012.03226.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 10/05/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Naoki Yoshimura
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh; Pennsylvania; USA
| | - Minoru Miyazato
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh; Pennsylvania; USA
| | - Katsumi Sasaki
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh; Pennsylvania; USA
| | - Hitoshi Yokoyama
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh; Pennsylvania; USA
| | - Tomohiko Oguchi
- Department of Urology; University of Pittsburgh School of Medicine; Pittsburgh; Pennsylvania; USA
| | - Michael B Chancellor
- Department of Urology; Oakland University William Beaumont School of Medicine; Royal Oak; Michigan; USA
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Goins WF, Cohen JB, Glorioso JC. Gene therapy for the treatment of chronic peripheral nervous system pain. Neurobiol Dis 2012; 48:255-70. [PMID: 22668775 DOI: 10.1016/j.nbd.2012.05.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 05/11/2012] [Accepted: 05/24/2012] [Indexed: 11/30/2022] Open
Abstract
Chronic pain is a major health concern affecting 80 million Americans at some time in their lives with significant associated morbidity and effects on individual quality of life. Chronic pain can result from a variety of inflammatory and nerve damaging events that include cancer, infectious diseases, autoimmune-related syndromes and surgery. Current pharmacotherapies have not provided an effective long-term solution as they are limited by drug tolerance and potential abuse. These concerns have led to the development and testing of gene therapy approaches to treat chronic pain. The potential efficacy of gene therapy for pain has been reported in numerous pre-clinical studies that demonstrate pain control at the level of the spinal cord. This promise has been recently supported by a Phase-I human trial in which a replication-defective herpes simplex virus (HSV) vector was used to deliver the human pre-proenkephalin (hPPE) gene, encoding the natural opioid peptides met- and leu-enkephalin (ENK), to cancer patients with intractable pain resulting from bone metastases (Fink et al., 2011). The study showed that the therapy was well tolerated and that patients receiving the higher doses of therapeutic vector experienced a substantial reduction in their overall pain scores for up to a month post vector injection. These exciting early clinical results await further patient testing to demonstrate treatment efficacy and will likely pave the way for other gene therapies to treat chronic pain.
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Affiliation(s)
- William F Goins
- Dept of Microbiology & Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh PA 15219, USA.
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Shen PC, Shiau AL, Jou IM, Lee CH, Tai MH, Juan HY, Lin PR, Liu GS, Wu CL, Hsieh JL. Inhibition of cartilage damage by pro-opiomelanocortin prohormone overexpression in a rat model of osteoarthritis. Exp Biol Med (Maywood) 2011; 236:334-40. [DOI: 10.1258/ebm.2010.010319] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pro-opiomelanocortin (POMC) is a precursor of various neuropeptides. POMC-derived neuropeptides are potent inflammation inhibitors and immunosuppressants. Evidence that osteoarthritis (OA) is an inflammatory disease is accumulating. We assessed whether intra-articular gene delivery of POMC ameliorates experimentally induced OA in a rat model. OA was induced in Wistar rats by anterior cruciate ligament-transection (ACLT) in the knee of one hind limb. Adenoviral vector encoding human POMC (AdPOMC) was injected intra-articularly into the knee joints after ACLT. The transgene expression and the inflammatory responses were evaluated using immunoblotting, immunohistochemistry and enzyme-linked immunosorbent assay. The treated joints were assessed histologically for manifestations of the disease. Human POMC was expressed in the chondrocytes and synovial membrane after the intra-articular injection. POMC gene transfer reduced nuclear factor- κB activity and the levels of interleukin-1 β in HTB-94 chondrosarcoma cells and Raw 264.7 macrophages; it also reduced microvessel density in the synovium. Histological examination showed that symptoms of OA in AdPOMC-treated rats were less severe than in rats treated with either empty adenoviral vector (AdNull) or normal saline. Intra-articular injection of adenoviral vectors expressing POMC significantly suppressed the progression and severity of OA, and reduced inflammatory responses and angiogenesis. POMC gene delivery may offer novel therapeutic approach for treating OA.
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Affiliation(s)
- Po-Chuan Shen
- Department of Orthopedic Surgery, Tainan Hospital, Department of Health, Executive Yuan, Tainan 70043
| | | | - I-Ming Jou
- Department of Orthopedics, National Cheng Kung University Medical College, Tainan 70101
| | - Che-Hsin Lee
- Department of Microbiology, School of Medicine, China Medical University, Taichung 40402
| | - Ming-Hong Tai
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804
| | | | - Pey-Ru Lin
- Department of Microbiology and Immunology
| | - Guei-Sheung Liu
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 807
| | - Chao-Liang Wu
- Department of Biochemistry and Molecular Biology, National Cheng Kung University Medical College, 1 University Road, Tainan 70101
| | - Jeng-Long Hsieh
- Department of Nursing, Chung Hwa University of Medical Technology, 89 Wun-Hwa 1st Street, Jen-Te, Tainan Hsien 717, Taiwan
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Christ GJ. Potential applications of gene therapy/transfer to the treatment of lower urinary tract diseases/disorders. Handb Exp Pharmacol 2011:255-65. [PMID: 21290230 DOI: 10.1007/978-3-642-16499-6_12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Identification of molecular targets for novel therapeutics is a natural consequence of the age of molecular and personalized medicine. How this information is leveraged and applied to the treatment of functional diseases/disorders of the lower urinary tract will determine if this field of medicine can keep pace with technological developments and patient expectations for improved therapies. In this regard, therapeutic improvements for the treatment of lower urinary tract diseases and disorders have been largely incremental over the past 30 years. The goal of this report is to review the evidence pointing toward the enormous potential of gene therapy/transfer to provide a paradigm shift from palliative to curative therapeutic solutions for lower urinary tract diseases/disorders. In fact, it seems clear that gene therapy represents a biotechnology approach particularly suitable to applications in the lower urinary tract. Although much more research is required, ample preclinical evidence already indicates that, for example, gene therapy can favorably impact/alter virtually every aspect of bladder physiology/function. In short, further investigations and continued applications of gene therapy to the treatment of lower urinary tract diseases/disorders seems a prudent step toward potentially marked and more durable therapeutic improvements.
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Affiliation(s)
- George J Christ
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine Baptist Medical Center, Winston-Salem, NC, USA.
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Abstract
Chronic pathological pain is characterized by extensive plasticity of the systems involved in pain signal transmission and modulation and tissue remodeling in several CNS structures. These long-lasting alterations are mediated by, or associated with, changes in the production of key molecules of nociceptive processing. Gene-based approaches offer the unique possibility of using local or even cell-type specific interventions to correct the abnormal production of some of these proteins, modulate the activity of signal transduction pathways, or overproduce various therapeutic secreted proteins. We showed that certain viral-derived vectors are particularly suitable for mediating gene transfer highly preferential for instance into the primary sensory neurons or into the spinal cord glial cells that represent particularly pertinent targets in the search for new therapeutic strategies of pathological pain.
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Peripheral non-viral MIDGE vector-driven delivery of beta-endorphin in inflammatory pain. Mol Pain 2009; 5:72. [PMID: 20003437 PMCID: PMC2797781 DOI: 10.1186/1744-8069-5-72] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 12/14/2009] [Indexed: 01/13/2023] Open
Abstract
Background Leukocytes infiltrating inflamed tissue produce and release opioid peptides such as β-endorphin, which activate opioid receptors on peripheral terminals of sensory nerves resulting in analgesia. Gene therapy is an attractive strategy to enhance continuous production of endogenous opioids. However, classical viral and plasmid vectors for gene delivery are hampered by immunogenicity, recombination, oncogene activation, anti-bacterial antibody production or changes in physiological gene expression. Non-viral, non-plasmid minimalistic, immunologically defined gene expression (MIDGE) vectors may overcome these problems as they carry only elements needed for gene transfer. Here, we investigated the effects of a nuclear localization sequence (NLS)-coupled MIDGE encoding the β-endorphin precursor proopiomelanocortin (POMC) on complete Freund's adjuvant-induced inflammatory pain in rats. Results POMC-MIDGE-NLS injected into inflamed paws appeared to be taken up by leukocytes resulting in higher concentrations of β-endorphin in these cells. POMC-MIDGE-NLS treatment reversed enhanced mechanical sensitivity compared with control MIDGE-NLS. However, both effects were moderate, not always statistically significant or directly correlated with each other. Also, the anti-hyperalgesic actions could not be increased by enhancing β-endorphin secretion or by modifying POMC-MIDGE-NLS to code for multiple copies of β-endorphin. Conclusion Although MIDGE vectors circumvent side-effects associated with classical viral and plasmid vectors, the current POMC-MIDGE-NLS did not result in reliable analgesic effectiveness in our pain model. This was possibly associated with insufficient and variable efficacy in transfection and/or β-endorphin production. Our data point at the importance of the reproducibility of gene therapy strategies for the control of chronic pain.
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Goins WF, Goss JR, Chancellor MB, de Groat WC, Glorioso JC, Yoshimura N. Herpes simplex virus vector-mediated gene delivery for the treatment of lower urinary tract pain. Gene Ther 2009; 16:558-69. [PMID: 19242523 DOI: 10.1038/gt.2009.19] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Interstitial cystitis (IC)/painful bladder syndrome (PBS) is a painful debilitating chronic visceral pain disorder of unknown etiology that affects an estimated 1 million people in the United States alone. It is characterized by inflammation of the bladder that results in chronic pelvic pain associated with bladder symptoms of urinary frequency and urgency. Regardless of the etiology, IC/PBS involves either increased and/or abnormal activity in afferent nociceptive sensory neurons. Pain-related symptoms in patients with IC/PBS are often very difficult to treat. Both medical and surgical therapies have had limited clinical utility in this debilitating disease and numerous drug treatments, such as heparin, dimethylsulfoxide and amitriptyline, have proven to be palliative at best, and in some IC/PBS patients provide no relief whatsoever. Although opiate narcotics have been employed to help alleviate IC/PBS pain, this strategy is fraught with problems as systemic narcotic administration causes multiple unwanted side effects including mental status change and constipation. Moreover, chronic systemic narcotic use leads to dependency and need for dose escalation due to tolerance; therefore, new therapies are desperately needed to treat refractory IC/PBS. This has led our group to develop a gene therapy strategy that could potentially alleviate chronic pelvic pain using the herpes simplex virus-directed delivery of analgesic proteins to the bladder.
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Affiliation(s)
- W F Goins
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
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14
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Christ G, Andersson KE, Atala A. The future of bladder research: Molecular profiling, new drug targets, gene therapy, and tissue engineering. Curr Urol Rep 2008; 8:95-9. [PMID: 17303012 DOI: 10.1007/s11934-007-0056-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- George Christ
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, BRF1 Building, Room 442, Medical Center Blvd., Winston Salem, NC, 27157, USA.
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Tavares I, Lima D. From neuroanatomy to gene therapy: searching for new ways to manipulate the supraspinal endogenous pain modulatory system. J Anat 2007; 211:261-8. [PMID: 17593218 PMCID: PMC2375764 DOI: 10.1111/j.1469-7580.2007.00759.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2007] [Indexed: 11/27/2022] Open
Abstract
The endogenous pain modulatory system is a complex network of brain areas that control nociceptive transmission at the spinal cord by inhibitory and facilitatory actions. The balance between these actions ensures effective modulation of acute pain, while during chronic pain the pronociceptive effects appear to prevail. The mechanisms underlying this imbalance were studied as to the role of two medullary components of the pain modulatory system: the dorsal reticular nucleus and the caudal ventrolateral medulla, which function primarily as pronociceptive and antinociceptive centres, respectively. Both areas are connected with the spinal dorsal horn by closed reciprocal loops. In the spino-dorsal reticular nucleus loop, the ascending branch is strongly inhibited by spinal GABAergic neurons, which may act as a buffering system of the dorsal reticular nucleus-centred amplifying effect. In the spino-caudal ventrolateral medulla loop, the ascending branch is under potent excitation of substance P (SP) released from primary afferents, which is likely to trigger the intense descending inhibition detected in acute pain. During chronic pain, the activity in the lateral reticular formation of the caudal ventrolateral medulla changes, so that the action of the caudal ventrolateral medulla upon SP-responsive spinal neurons shifts from inhibitory to excitatory. The mechanisms of this modulatory shift are unknown but probably relate to the decreased expression of micro-opioid, delta-opioid and GABAB receptors. Normalizing receptor expression in the caudal ventrolateral medulla or controlling noci-evoked activity at the dorsal reticular nucleus or caudal ventrolateral medulla by interfering with neurotransmitter release is now possible by the use of gene therapy, an approach that stands out as a unique tool to manipulate the supraspinal endogenous pain control system.
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Affiliation(s)
- I Tavares
- Institute of Histology and Embryology of the Faculty of Medicine of Oporto, Portugal.
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Goss JR, Goins WF, Glorioso JC. Gene therapy applications for the treatment of neuropathic pain. Expert Rev Neurother 2007; 7:487-506. [PMID: 17492900 DOI: 10.1586/14737175.7.5.487] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Neuropathic pain is notoriously difficult to treat; currently available pharmaceutical drugs result in moderate analgesia in approximately a third of patients. As our understanding of the biological processes involved in the establishment and maintenance of neuropathic pain increases, so does the development of novel treatment options. Significant advancements have been made in the past few years in gene transfer, a very powerful potential therapy that can be used to directly target affected areas of the neuraxis or body tissues involved in neuropathic pain. Candidate gene products include directly analgesic proteins as well as proteins that interfere with pain-associated biochemical changes in nerve or other tissues underlying the disease process.
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Affiliation(s)
- James R Goss
- University of Pittsburgh, Molecular Genetics & Biochemistry, Pittsburgh, PA 15219, USA.
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17
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McLenachan S, Sarsero JP, Ioannou PA. Flow-cytometric analysis of mouse embryonic stem cell lipofection using small and large DNA constructs. Genomics 2007; 89:708-20. [PMID: 17449222 DOI: 10.1016/j.ygeno.2007.02.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Revised: 02/06/2007] [Accepted: 02/06/2007] [Indexed: 11/28/2022]
Abstract
Using the lipofection reagent LipofectAMINE 2000 we have examined the delivery of plasmid DNA (5-200 kb) to mouse embryonic stem (mES) cells by flow cytometry. To follow the physical uptake of lipoplexes we labeled DNA molecules with the fluorescent dye TOTO-1. In parallel, expression of an EGFP reporter cassette in constructs of different sizes was used as a measure of nuclear delivery. The cellular uptake of DNA lipoplexes is dependent on the uptake competence of mES cells, but it is largely independent of DNA size. In contrast, nuclear delivery was reduced with increasing plasmid size. In addition, linear DNA is transfected with lower efficiency than circular DNA. Inefficient cytoplasmic trafficking appears to be the main limitation in the nonviral delivery of large DNA constructs to the nucleus of mES cells. Overcoming this limitation should greatly facilitate functional studies with large genomic fragments in embryonic stem cells.
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Affiliation(s)
- Samuel McLenachan
- Murdoch Childrens Research Institute, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Flemington Road, Parkville, VIC 3052, Australia
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18
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Christ GJ, Hodges SJ, Melman A. An update on gene therapy/transfer treatments for bladder dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2006. [DOI: 10.1007/s11884-006-0017-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chuang YC, Yang LC, Chiang PH, Kang HY, Ma WL, Wu PC, DeMiguel F, Chancellor MB, Yoshimura N. Gene gun particle encoding preproenkephalin cDNA produces analgesia against capsaicin-induced bladder pain in rats. Urology 2005; 65:804-10. [PMID: 15833551 DOI: 10.1016/j.urology.2004.10.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2004] [Revised: 10/08/2004] [Accepted: 10/28/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate the efficacy of gene therapy using a gene gun or direct injection for the transfer of human preproenkephalin (PPE) plasmid cDNA using a capsaicin-induced bladder pain model in rats. Opioid peptides play an essential role in the modulation of micturition reflex and control of inflammatory pain. PPE is one such precursor molecule. METHODS Human PPE cDNA was cloned into a modified pCMV plasmid and delivered into the bladder wall of adult female rats by direct injection or gene gun. At 4 and 7 days after gene therapy, continuous cystometrograms were performed under urethane anesthesia by filling the bladder (0.08 mL/min) with saline, followed by 15 muM capsaicin. Immunohistochemical staining was used to detect enkephalins in the bladder after PPE cDNA transfer. RESULTS The intercontraction interval was decreased after intravesical instillation of capsaicin (65.0% and 63.1% decrease) in the control group or direct PPE gene injection group, respectively. However, the gene gun-treated group showed a significantly reduced response to capsaicin instillation at day 4 and day 7 (intercontraction interval 16.2% and 42.8% decrease, respectively). This analgesic effect was reversed by intravenous naloxone, an opioid antagonist (5 mg/kg). Increased enkephalin immunoreactivity in the bladder was observed in the gene gun-treated group at day 4, which was reduced at day 7. CONCLUSIONS The PPE gene can be effectively transferred and suppress the nociceptive response in the bladder using the gene gun method. These results support potential clinical application of PPE gene gun delivery system for the treatment of bladder pain and other types of visceral pain.
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Affiliation(s)
- Yao-Chi Chuang
- Department of Urology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Liu GS, Liu LF, Lin CJ, Tseng JC, Chuang MJ, Lam HC, Lee JK, Yang LC, Chan JHY, Howng SL, Tai MH. Gene transfer of pro-opiomelanocortin prohormone suppressed the growth and metastasis of melanoma: involvement of alpha-melanocyte-stimulating hormone-mediated inhibition of the nuclear factor kappaB/cyclooxygenase-2 pathway. Mol Pharmacol 2005; 69:440-51. [PMID: 16269535 DOI: 10.1124/mol.105.015404] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Pro-opiomelanocortin (POMC) is a prohormone of various neuropeptides, including corticotropin, alpha-melanocyte-stimulating hormone (alpha-MSH), and beta-endorphin (beta-EP). POMC neuropeptides are potent inflammation inhibitors and immunosuppressants and may exert opposite influences during tumorigenesis. However, the role of POMC expression in carcinogenesis remains elusive. We evaluated the antineoplastic potential of POMC gene delivery in a syngenic B16-F10 melanoma model. Adenovirus-mediated POMC gene delivery in B16-F10 cells increased the release of POMC neuropeptides in cultured media, which differentially regulated the secretion of pro- and anti-inflammatory cytokines in lymphocytes. POMC gene transfer significantly reduced the anchorage-independent growth of melanoma cells. Moreover, pre- or post-treatment with POMC gene delivery effectively retarded the melanoma growth in mice. Intravenous injection of POMC-transduced B16-F10 cells resulted in reduced foci formation in lung by 60 to 70% of control. The reduced metastasis of POMC-transduced B16-F10 cells could be attributed to their attenuated migratory and adhesive capabilities. POMC gene delivery reduced the cyclooxygenase-2 (COX-2) expression and prostaglandin (PG) E(2) synthesis in melanoma cells and tumor tissues. In addition, application of NS-398, a selective COX-2 inhibitor, mimicked the antineoplastic functions of POMC gene transfer in melanoma. The POMC-mediated COX-2 down-regulation was correlated with its inhibition of nuclear factor kappaB (NFkappaB) activities. Exogenous supply of alpha-MSH inhibited NFkappaB activities, whereas application of the alpha-MSH antagonist growth hormone-releasing peptide-6 (GHRP-6) abolished the POMC-induced inhibition of NFkappaB activities and melanoma growth in mice. In summary, POMC gene delivery suppresses melanoma via alpha-MSH-induced inhibition of NFkappaB/COX-2 pathway, thereby constituting a novel therapy for melanoma.
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Affiliation(s)
- Guei-Sheung Liu
- Graduate Institute of Medicine, Kaohsiung Medical University, Taiwan
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Wells DJ. Gene therapy progress and prospects: electroporation and other physical methods. Gene Ther 2004; 11:1363-9. [PMID: 15295618 DOI: 10.1038/sj.gt.3302337] [Citation(s) in RCA: 224] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the last 5 years, physical methods of plasmid delivery have revolutionized the efficiency of nonviral gene transfer, in some cases reaching the efficiencies of viral vectors. In vivo electroporation dramatically increases transfection efficiency for a variety of tissues. Other methods with clinical precedent, pressure-perfusion and ultrasound, also improve plasmid gene transfer. Alternatives such as focused laser, magnetic fields and ballistic (gene gun) approaches can also enhance delivery. As plasmid DNA appears to be a safe gene vector system, it seems likely that plasmid with physically enhanced delivery will be used increasingly in clinical trials.
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Affiliation(s)
- D J Wells
- Gene Targeting Unit, Department of Cellular and Molecular Neuroscience, Division of Neuroscience and Psychological Medicine, Imperial College London, Charing Cross Hospital, St Dunstan's Road, London, UK
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Abstract
PURPOSE OF REVIEW During the last 2 years, two international and two European meetings have taken place and a European Society formed dealing only with interstitial cystitis. A separate committee for interstitial cystitis was formed during the last WHO International Consensus Meeting on urinary incontinence. As a consequence, new concepts and recommendations are evolving, for example the nomenclature is changing from interstitial cystitis to painful bladder syndrome/interstitial cystitis. RECENT FINDINGS At an international meeting in Kyoto, the scientific basis for diagnosis and treatment of painful bladder syndrome/interstitial cystitis was reviewed, confirming the poor evidence for many diagnostic procedures and treatments. There are two main reasons for this: an internationally accepted definition is lacking and the disease is rare, making clinical trials difficult. A meeting in Copenhagen resulted in a standardization of the procedures for evaluation and the creation of a European Society for the Study of Interstitial Cystitis. Increased concentration of nitric oxide in the urine of patients with Hunner's ulcer may help to separate ulcer from non-ulcer patients. A prospective, randomized, placebo-controlled multicenter study failed to show a statistically significant effect of the antihistamine hydroxine or pentosan polysulfate sodium compared with placebo. The study confirmed the difficulties in recruiting patients for large-scale trials, which could be one of the reasons for the negative result. The effect of the traditional treatment with amitriptyline was confirmed in a prospective, placebo-controlled study. SUMMARY Standardized evaluation of patients with painful bladder syndrome/interstitial cystitis will benefit both patients and science. An internationally accepted definition of the condition appears to be in sight, which will make epidemiological and research studies easier.
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Affiliation(s)
- Jørgen Nordling
- Department of Urology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark.
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Abstract
The postgenomic age presents many exciting challenges and opportunities for the application of molecular medicine to the treatment of lower urinary tract diseases. Chief among these are the therapeutic possibilities afforded to selectively modulate/alter gene expression in somatic cells to "normalize" aberrant cellular responses to the existing hormonal milieu. In this paper, this therapeutic strategy will be referred to as gene therapy or gene transfer. This article specifically reviews the potential use of gene therapy/transfer to the treatment of bladder and erectile dysfunction. Available treatments for both of these common urologic diseases/disorders have contraindications, untoward side effects, or limited efficacy in certain patient populations. Moreover, that genetic material can be locally administered in the bladder and penis removes a major therapeutic obstacle to the use of gene transfer. Thus far, "proof-of-concept" has been demonstrated in preclinical studies using cellular and molecular strategies on a variety of gene targets. The continuing evolution of gene transfer vectors and gene delivery technologies is expected to further enhance the selectivity, efficacy, and duration of gene therapy, making it a viable treatment option for the amelioration of lower urinary tract diseases/disorders.
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Affiliation(s)
- George J Christ
- Departments of Urology and Physiology & Biophysics, Institute for Smooth Muscle Biology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
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