Wang Li, Feng Yan, Fu Xiao-long, Cai Xu-wei
Department of Radiotherapy, Tumour Hospital Affiliated to Fudan University, Shanghai 200032, China.
Zhonghua Yi Xue Za Zhi. 2006 Oct 31;86(40):2847-52.
To investigate the effects of gene therapy with replication-defective adenovirus enclosing Egr-1 promoter and Smad7 cDNA on irradiation-induced pulmonary fibrosis.
The recombinant replication-defective adenovirus AD. Egr-Smad7 enclosing Egr-1 promoter and Smad7 cDNA was constructed. 288 C57BL mice were randomly divided into 6 groups: AD. Egr-Smad7 group (Group RA, receiving intratracheal instillation of AD. Egr-Smad7 of the dose of 10(9) pfu/0.1 ml), AD. Egr-Smad7 + radiation group (Group RAR, receiving intratracheal instillation of AD. Egr-Smad7 of the dose of 10(9) pfu/0.1 ml and then radiation to the chest 14 h later), replication-defective adenovirus group (Group AV, receiving intratracheal instillation of replication-defective adenovirus of the dose of 10(9) pfu/0.1 ml), replication-defective adenovirus + irradiation group (Group AVR, receiving intratracheal instillation of replication-defective adenovirus of the dose of 10(9) pfu/0.1 ml and then radiation to the chest 14 h later), blank control group (Group C), and pure irradiation group (Group R), each group was re-divided into 6 subgroups of 8 mice to be observed 0, 1, 2, 4, 8, and 12 weeks after the treatment. The mice were killed at different time points and their lungs were taken out. The levels of type I collagen, type III collagen, connective tissue growth factor (CTGF), and transforming growth factor-beta1 (TGF-beta1) were detected by ELISA. The level of hydroxyproline was examined by alkaline hydrolysis method. The lung tissues were stained with HE to undergo pathological examination.
The TGF-beta1 levels of the irradiation groups all increased, peaking in the second week (all P < 0.05), all significantly higher than those of Group C. However, the TGF-beta1 levels at different time points of Group RAR were all significantly lower then those of the other irradiation groups. The CTGF levels of different groups at different time points were all significantly higher than those of Group C (P < 0.05 or P < 0.01), and the CTGF levels of Groups RA and AV were decreased to almost normal 12 weeks after the irradiation. The levels of type I collagen and type III collagen of the 1 and 2-week subgroups of Group RAR were significantly lower than those of Group C (all P < 0.01), then gradually increased, and were slightly higher than those Group C 12 weeks later. The levels of type I collagen and type III collagen at different time points of the other groups were all significantly higher than those of Group C (P < 0.05 or P < 0.01). However, The levels of type I collagen at different time points of Group RAR were all lower than those of the other groups except Group C, and the levels of type III collagen in the first to eighth weeks after irradiation of Group RAR were all lower than those of the other groups except Group C. The hydroxyproline level of the 1 and 2 week subgroups of Group RAR were significantly lower than those of Group C (all P < 0.01), and then gradually increased. The hydroxyproline levels of the other irradiation groups all gradually increased significantly, peaking at the 12 th week (all P < 0.01). 1 approximately 2 weeks after irradiation Groups RAR, RA, and AV showed remarkable pulmonary congestion changes, even more remarkable then those in Group R, 8 approximately 12 week later, fibrosis changes were found in Group R and AVR, and 12 weeks later the histological structure of lung of Group AV, RAR, and RA returned almost normal.
Radioactive rays induce Egr-1 promoter to regulated the expression of exogenous Smad7 gene that blocks the signal transduction of TGF-beta. Thus use of AD. Egr-Smad7 may become a novel strategy of gene therapy in prevention and treatment of pulmonary fibrosis.
探讨携带Egr-1启动子和Smad7 cDNA的复制缺陷型腺病毒基因治疗对放射性肺纤维化的影响。
构建携带Egr-1启动子和Smad7 cDNA的重组复制缺陷型腺病毒AD.Egr-Smad7。将288只C57BL小鼠随机分为6组:AD.Egr-Smad7组(RA组,气管内滴注剂量为10(9) pfu/0.1 ml的AD.Egr-Smad7),AD.Egr-Smad7 + 辐射组(RAR组,气管内滴注剂量为10(9) pfu/0.1 ml的AD.Egr-Smad7,14小时后胸部接受辐射),复制缺陷型腺病毒组(AV组,气管内滴注剂量为10(9) pfu/0.1 ml的复制缺陷型腺病毒),复制缺陷型腺病毒 + 照射组(AVR组,气管内滴注剂量为10(9) pfu/0.1 ml的复制缺陷型腺病毒,14小时后胸部接受辐射),空白对照组(C组),单纯照射组(R组),每组再分为6个亚组,每组8只小鼠,于治疗后0、1、2、4、8和12周进行观察。在不同时间点处死小鼠,取出肺组织。采用ELISA法检测Ⅰ型胶原、Ⅲ型胶原及结缔组织生长因子(CTGF)、转化生长因子-β1(TGF-β1)水平。采用碱水解法检测羟脯氨酸水平。肺组织行HE染色进行病理检查。
各照射组TGF-β1水平均升高,于第2周达峰值(均P < 0.05),均显著高于C组。但RAR组不同时间点的TGF-β1水平均显著低于其他照射组。不同组不同时间点的CTGF水平均显著高于C组(P < 0.05或P < 0.01),RA组和AV组照射后12周CTGF水平降至接近正常。RAR组1、2周亚组的Ⅰ型胶原和Ⅲ型胶原水平显著低于C组(均P < 0.01),随后逐渐升高,12周后略高于C组。其他组不同时间点的Ⅰ型胶原和Ⅲ型胶原水平均显著高于C组(P < 0.05或P < 0.01)。但RAR组不同时间点的Ⅰ型胶原水平均低于除C组外的其他组,RAR组照射后第1至8周的Ⅲ型胶原水平均低于除C组外的其他组。RAR组1、2周亚组的羟脯氨酸水平显著低于C组(均P < 0.01),随后逐渐升高。其他照射组的羟脯氨酸水平均显著逐渐升高,于第12周达峰值(均P < 0.01)。照射后1至2周,RAR组、RA组和AV组出现明显的肺充血改变,比R组更明显;8至12周后,R组和AVR组出现纤维化改变;12周后,AV组、RAR组和RA组肺组织学结构基本恢复正常。
放射线诱导Egr-1启动子调控外源性Smad7基因表达,阻断TGF-β信号转导。因此,应用AD.Egr-Smad7可能成为防治肺纤维化的一种新的基因治疗策略。