Lindsay J O, Ciesielski C J, Scheinin T, Brennan F M, Hodgson H J
Kennedy Institute of Rheumatology Division, Imperial College School of Medicine, 1 Aspenlea Road, London W6 8LH, UK.
Gut. 2003 Jul;52(7):981-7. doi: 10.1136/gut.52.7.981.
Interleukin 10 knockout (IL-10-/-) mice spontaneously develop a Th1 T cell mediated colitis with many similarities to Crohn's disease. Daily injections of IL-10 are unable to induce remission in mice with established disease. In contrast, we have shown previously that intravenous administration of adenoviral vectors encoding IL-10 (AdvmuIL-10) induces hepatic IL-10 release and leads to long term disease suppression with profound systemic immunoregulatory changes.
To determine whether rectal delivery of AdvmuIL-10 induces localised colonic IL-10 expression without systemic immune suppression, and assess its therapeutic efficacy in IL-10-/- mice with established colitis.
A single rectal infusion of 5 x 10(8) PFU AdvmuIL-10 to 10 week IL- 10-/- mice resulted in a median level of 27.3 pg/mg IL-10 in colonic homogenates harvested one week later. IL-10-/- mice with established colitis treated with an enema of 5 x 10(8) PFU AdvmuIL-10 entered clinical and histological remission whereas empty cassette adenovirus (Adv0) or phosphate buffered saline (PBS) treated mice developed progressive disease. After four weeks, the histological score of AdvmuIL-10 treated mice (4.4 (1.5)) was significantly lower than that of Adv0 (11.1 (1.1); p<0.001) and PBS (10.9 (1.0); p<0.01) treated controls. In addition, the stool concentration of IL-1beta over the four week experiment was significantly higher in mice treated with saline or Adv0 than in those treated with AdvmuIL-10 (p<0.01).
Local AdvmuIL-10 therapy reverses colitis in IL-10-/- mice without the systemic effects seen after intravenous administration. Gene therapy strategies using adenoviral vectors encoding immunoregulatory cytokines may prove to be a potent approach to the treatment of chronic inflammatory diseases such as Crohn's disease.
白细胞介素10基因敲除(IL-10-/-)小鼠会自发发展出一种由Th1 T细胞介导的结肠炎,与克罗恩病有许多相似之处。对患有已确诊疾病的小鼠每日注射白细胞介素10无法诱导病情缓解。相比之下,我们之前已表明,静脉注射编码白细胞介素10的腺病毒载体(AdvmuIL-10)可诱导肝脏释放白细胞介素10,并导致疾病长期得到抑制,同时伴有深刻的全身免疫调节变化。
确定直肠递送AdvmuIL-10是否能在不产生全身免疫抑制的情况下诱导局部结肠白细胞介素10表达,并评估其对患有已确诊结肠炎的IL-10-/-小鼠的治疗效果。
对10周龄的IL-10-/-小鼠单次直肠输注5×10⁸ PFU的AdvmuIL-10,一周后采集的结肠匀浆中白细胞介素10的中位水平为27.3 pg/mg。用5×10⁸ PFU AdvmuIL-10灌肠治疗患有已确诊结肠炎的IL-10-/-小鼠进入临床和组织学缓解期,而用空载体腺病毒(Adv0)或磷酸盐缓冲盐水(PBS)治疗的小鼠病情则逐渐加重。四周后,AdvmuIL-10治疗小鼠的组织学评分(4.4(1.5))显著低于Adv0(11.1(1.1);p<0.001)和PBS(10.9(1.0);p<0.01)治疗的对照组。此外,在为期四周的实验中,用盐水或Adv0治疗的小鼠粪便中白细胞介素1β的浓度显著高于用AdvmuIL-10治疗的小鼠(p<0.01)。
局部AdvmuIL-10治疗可逆转IL-10-/-小鼠的结肠炎,且不会产生静脉注射后出现的全身效应。使用编码免疫调节细胞因子的腺病毒载体的基因治疗策略可能被证明是治疗克罗恩病等慢性炎症性疾病的有效方法。