Improved gene delivery to human saphenous vein cells and tissue using a peptide-modified adenoviral vector
© Work et al; licensee BioMed Central Ltd. 2004
Received: 10 September 2004
Accepted: 08 October 2004
Published: 08 October 2004
The establishment of efficient gene delivery to target human tissue is a major obstacle for transition of gene therapy from the pre-clinical phases to the clinic. The poor long-term patency rates for coronary artery bypass grafting (CABG) is a major clinical problem that lacks an effective and proven pharmacological intervention. Late vein graft failure occurs due to neointima formation and accelerated atherosclerosis. Since CABG allows a clinical window of opportunity to genetically modify vein ex vivo prior to grafting it represents an ideal opportunity to develop gene-based therapies. Adenoviral vectors have been frequently used for gene delivery to vein ex vivo and pre-clinical studies have shown effective blockade in neointima development by overexpression of candidate therapeutic genes. However, high titers of adenovirus are required to achieve sufficient gene delivery to provide therapeutic benefit. Improvement in the uptake of adenovirus into the vessel wall would therefore be of benefit. Here we determined the ability of an adenovirus serotype 5 vector genetically-engineered with the RGD-4C integrin targeting peptide inserted into the HI loop (Ad-RGD) to improve the transduction of human saphenous vein smooth muscle cells (HSVSMC), endothelial cells (HSVEC) and intact saphenous vein compared to a non-modified virus (Ad-CTL). We exposed each cell type to virus for 10, 30 or 60 mins and measured transgene at 24 h post infection. For both HSVSMC and HSVEC Ad-RGD mediated increased transduction, with the largest increases observed in HSVSMC. When the experiments were repeated with intact human saphenous vein (the ultimate clinical target for gene therapy), again Ad-RGD mediated higher levels of transduction, at all clinically relevant exposures times (10, 30 and 60 mins tissue:virus exposure). Our study demonstrates the ability of peptide-modified Ad vectors to improve transduction to human vein graft cells and tissue and has important implications for gene therapy for CABG.
Long term patency rates for CABG using autologous saphenous vein are poor, showing 1, 5 and 10 years post-CABG rates of 93%, 74% and 41%, respectively  and therefore represent a significant clinical problem. Long-term failures are due to neointima formation and superimposed atherosclerosis [2–4], a pathology that lacks a suitably efficient pharmacological therapy. Significant contributions of vascular smooth muscle cell (SMC) proliferation and migration have been documented [2–4]. Anti-proliferative strategies are in phase III clinical trial using decoy oligonucleotides to the transcription factor E2F, a strategy that has shown considerable promise pre-clinically [5, 6] and also in early stage human trials . We, and others have adopted the alternate strategy of gene therapy to prevent CABG failure . CABG is an "ideal" clinical scenario for gene therapy since saphenous vein can be genetically modified ex vivo following leg harvesting and prior to coronary grafting. This unique "clinical window" has clear safety advantages over in vivo gene delivery since excess vector can be removed from the graft prior to coronary grafting. However, the clinical window is short (likely 10–60 minutes) and therefore necessitates the use of an efficient vector system for gene delivery. Adenoviral vectors have proven efficient for gene delivery in this context  although high titers are required to provide sufficient levels of gene delivery to achieve therapeutic gain using transgenes such as tissue inhibitor of metalloproteinases-3 , endothelial nitric oxide synthase  and p53 . The latter study defined the rationale behind use of adenoviral vectors since long-term benefit on graft remodelling was shown at 3 months, even though the virus was only present for 2–4 weeks post grafting . Any improvement in gene delivery above that mediated by adenoviral serotype 5 vectors would be very encouraging for clinical translation of pre-clinical therapies. To this end, a number of strategies have emerged including fiber switching (pseudotyping) and modification of adenovirus type 5 fibers with targeting peptides. Pseudotyping the fiber from adenovirus serotype 16, which binds CD46 , dramatically improves transduction to vascular cells including intact human saphenous vein allowing lower doses of vector to be used to achieve attractive levels of gene delivery to grafts ex vivo . Likewise, gene delivery to vascular smooth muscle cells can be enhanced by incorporation of cell targeting peptides isolated by phage display into the HI loop of the adenovirus fiber , the preferred site for peptide insertion . In the context of improved gene delivery mediated by the RGD-4C peptide, which was isolated by phage display and targets αv integrins , this has been shown for rabbit grafts  although the vast majority of data is based on gene delivery for cancer . Since SMC show poor coxsackie and adenovirus receptor (CAR) availability , it is particularly relevant that the RGD-4C peptide may circumvent CAR deficiency on target cells to improve levels of transduction. In this study, we assess the ability of RGD-4C-modified adenovirus serotype 5 vectors to enhance gene delivery to human saphenous vein SMC and EC as well as to intact human saphenous vein ex vivo, the ultimate clinical target.
Based on the above we therefore assessed transduction in intact human saphenous vein. In order to quantify transgene expression accurately in tissue extracts we used luciferase-expressing viruses. Intact human saphenous veins were cleaned of surrounding connective tissue and cut into rings 3–4 mm in length. During preparation and infection, veins were maintained in wash medium (RPMI supplemented with 100 IU/ml penicillin, 100 μg/ml streptomycin and 2 mmol/l L-glutamine). Individual vein rings were incubated with Ad vectors for 10, 30 or 60 minutes (1 × 109 pfu / ring) before being washed twice in PBS and maintained in organ culture for 5 days. Rings were maintained in wash medium supplemented with 30% (v/v) FCS. Vein rings were snap frozen in liquid nitrogen and homogenised using a mortar and pestle for determination of reporter gene expression 5 days post-infection. Ex vivo homogenates were suspended in 100 μL reporter lysis buffer (RLB) and kept on ice for 1 hour before supernatants were analysed for luciferase expression using the Luciferase Assay System (Promega). 96 well plates were prepared using 10 μL/well of homogenate suspension diluted to a total volume of 100 μL with RLB. 100 μL of Luciferase Assay Reagent was added to each well and the plate immediately read for 10 seconds per well. Detection was achieved using a Wallac 1420 (VICTOR2) Multilabel Counter with recombinant luciferase (Promega) as a standard and normalised for total protein. Ad-RGDLuc mediated a time-dependent increase in the level of transgene expression that was evident at all exposure times studied – 10, 30 and 60 minutes (Figure 1C). This demonstrates that the RGD-4C-modification of Ad vectors can increase transduction to human saphenous vein, especially at short exposure times. The kinetics of virus binding in relation to time is therefore improved through the RGD-4C peptide and has direct implications for the design of gene therapy vectors for use in human CABG gene therapy procedures in the future. Although we have previously shown that non-modified Ad vectors transduce both endothelial and smooth muscle cells during graft gene delivery , and here show increased transduction of both cell types in vitro with RGD-modification, it will be important to fully define the uptake of the RGD-modified virus in the intact vein at the cellular level by immunotechniques. In broader terms, the design and tailoring of viruses for individual cardiovascular gene therapy applications is an important aspect of translation from pre-clinical to clinical gene therapy.
- Eagle KA, Guyton RA, Davidoff R, Ewy GA, Fonger S, Gardner TJ, Gott JP, Herrmann HC, Marlow RA, Nugent WC, O'Connor GT, Orszulak TA, Rieselbach RE, Winters WL, Yusuf S, Gibbons RJ, Alpert JS, Eagle KA, Gardner TJ, Garson A, Gregoratos G, Russell RO, SC Smith, McEntee CW, Elma MA, Pigmann GC, Starke RD, Taubert KA: ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/American Heart Association task force on practice guidleines (committee to revise the 1991 guidelines on coronary artery bypass graft surgery). J Am Coll Cardiol. 1999, 34: 1262-1342. 10.1016/S0735-1097(99)00389-7.View ArticlePubMedGoogle Scholar
- Cox JL, Chiasson DA, Gotlieb AI: Stranger in a strange land: the pathogenesis of saphenous vein graft stenosis with emphasis on structural and functional differences between veins and arteries. Prog Cardiovasc Dis. 1991, 34: 45-68. 10.1016/0033-0620(91)90019-I.View ArticlePubMedGoogle Scholar
- Bryan AJ, Angelini GD: The biology of saphenous vein graft occlusion: etiology and strategies for prevention. Curr Opin Cardiol. 1994, 9: 641-649.View ArticlePubMedGoogle Scholar
- Davies MG, Hagen P-O: Pathobiology of intimal hyperplasia: a review. Eur J Vasc Surg. 1995, 9: 7-18.View ArticleGoogle Scholar
- Mann MJ, Gibbons GH, Kernoff RS, Diet FP, Tsao PS, Cooke JP, Kaneda Y, Dzau VJ: Genetic engineering of vein grafts resistant to atherosclerosis. Proc Natl Acad Sci USA. 1995, 92: 4502-4506.PubMed CentralView ArticlePubMedGoogle Scholar
- Mann MJ, Gibbons GH, Tsao PS, vonderLeyen HE, Cooke JP, Buitrago R, Kernoff R, Dzau VJ: Cell cycle inhibition preserves endothelial function in genetically engineered rabbit vein grafts. J Clin Invest. 1997, 99: 1295-1301.PubMed CentralView ArticlePubMedGoogle Scholar
- Mann MJ, Whittemore AD, Donaldson MC, Belkin M, Conte MS, Polak JF, Orav EJ, Ehsan A, Dell'Acqua G, Dzau VJ: Ex-vivo gene therapy of human vascular bypass grafts with E2F decoy: the PREVENT single-centre, randomised, controlled trial. The Lancet. 1999, 354: 1493-1498. 10.1016/S0140-6736(99)09405-2.View ArticleGoogle Scholar
- Baker AH, Mehta D, George SJ, Angelini GD: Prevention of vein graft failure: potential applications for gene therapy. Cardiovasc Res. 1997, 35: 442 -4450. 10.1016/S0008-6363(97)00116-8.View ArticlePubMedGoogle Scholar
- George SJ, Lloyd CT, Angelini GD, Newby AC, AH Baker: Inhibition of late bein graft neointima formation in human and porcine models by adenovirus-mediated overexpression of tissue inhibitor of metalloproteinase-3. Circulation. 2000, 101: 296 -2304.View ArticlePubMedGoogle Scholar
- West Nick E.J., Qian HuSheng, Guzik Tomasz J., Black Edward, Cai Shijie, George Samuel E., Channon Keith M.: Nitric oxide synthase (nNOS) gene transfer modifies venous bypass graft remodeling: effects on vascular smooth muscle cell differentiation and superoxide production. Circulation. 2001, 104: 1526-1532.View ArticlePubMedGoogle Scholar
- Wan S, George SJ, Nicklin SA, Yim APC, Baker AH: Overexpression of p53 increases lumen size and blocks neointima formation in porcine interposition vein grafts. Mol Ther. 2004, 9: 689-698. 10.1016/j.ymthe.2004.02.005.View ArticlePubMedGoogle Scholar
- Gaggar A, Shayakhmetov DM, Lieber A: CD46 is a cellular receptor for group B adenoviruses. Nat Med. 2003, 9: 1 -15. 10.1038/nm952.View ArticleGoogle Scholar
- Havenga MJE, Lemckert AAC, Grimbergen JM, Vogels R, Huisman LGM, Valerio D, Bout A, Quax PHA: Improved adenovirus vectors for infection of cardiovascular tissues. J Virol. 2001, 75: 3335-3342. 10.1128/JVI.75.7.3335-3342.2001.PubMed CentralView ArticlePubMedGoogle Scholar
- Work LM, Nicklin SA, Brain NJR, Dishart KL, Von Seggern DJ, Hallek M, Buning H, Baker AH: Development of efficient viral vectors selective for vascular smooth muscle cells. Mol Ther. 2004, 9: 198-208. 10.1016/j.ymthe.2003.11.006.View ArticlePubMedGoogle Scholar
- Dmitriev I, Krasnykh V, Miller CR, Wang MH, Kashentseva E, Mikheeva G, Belousova N, Curiel DT: An adenovirus vector with genetically modified fibers demonstrates expanded tropism via utilization of a coxsackievirus and adenovirus receptor-independent cell entry mechanism. J Virol. 1998, 72: 9706-9713.PubMed CentralPubMedGoogle Scholar
- Pasqualini R, Koivunen E, Ruoslahti E: A peptide isolated from phage display libraries is a stryctural and functional mimic of an RGD-binding site on integrins. J Cell Biol. 1995, 130: 1189-1196. 10.1083/jcb.130.5.1189.View ArticlePubMedGoogle Scholar
- Hay CM, De Leon H, Jafari JD, Jakubczak JL, Mech CA, Hallenbeck PL, Powell SK, Liau G, Stevenson SC: Enhanced gene transfer to rabbit jugular veins by an adenovirus containing a cyclic RGD motif in the HI loop of the fiber knob. Journal of Vascular Research. 2001, 38: 315-323. 10.1159/000051062.View ArticlePubMedGoogle Scholar
- Nicklin SA, Baker AH: Tropism-modified adenoviral and adeno-associated viral vectors for gene therapy. Curr gene ther. 2002, 2: 273 -2293.View ArticlePubMedGoogle Scholar
- Nicklin SA, Von Seggern DJ, Work LM, Pek DCK, Dominiczak AF, Nemerow GR, Baker AH: Ablating adenovirus type 5 fiber-CAR binding and HI loop insertion of the SIGYPLP peptide generate an endothelial cell-selective adenovirus. Mol Ther. 2001, 4: 534 -5542. 10.1006/mthe.2001.0489.View ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.