Barba D, Hardin J, Ray J, Gage F H
Department of Surgery, School of Medicine, University of California, San Diego.
J Neurosurg. 1993 Nov;79(5):729-35. doi: 10.3171/jns.1993.79.5.0729.
Gene therapy has many potential applications in central nervous system (CNS) disorders, including the selective killing of tumor cells in the brain. A rat brain tumor model was used to test the herpes simplex virus (HSV)-thymidine kinase (TK) gene for its ability to selectively kill C6 and 9L tumor cells in the brain following systemic administration of the nucleoside analog ganciclovir. The HSV-TK gene was introduced in vitro into tumor cells (C6-TK and 9L-TK), then these modified tumor cells were evaluated for their sensitivity to cell killing by ganciclovir. In a dose-response assay, both C6-TK and 9L-TK cells were 100 times more sensitive to killing by ganciclovir (median lethal dose: C6-TK, 0.1 microgram ganciclovir/ml; C6, 5.0 micrograms ganciclovir/ml) than unmodified wild-type tumor cells or cultured fibroblasts. In vivo studies confirmed the ability of intraperitoneal ganciclovir administration to kill established brain tumors in rats as quantified by both stereological assessment of brain tumor volumes and studies of animal survival over 90 days. Rats with brain tumors established by intracerebral injection of wild-type or HSV-TK modified tumor cells or by a combination of wild-type and HSV-TK-modified cells were studied with and without ganciclovir treatments. Stereological methods determined that ganciclovir treatment eliminated tumors composed of HSV-TK-modified cells while control tumors grew as expected (p < 0.001). In survival studies, all 10 rats with 9L-TK tumors treated with ganciclovir survived 90 days while all untreated rats died within 25 days. Curiously, tumors composed of combinations of 9L and 9L-TK cells could be eliminated by ganciclovir treatments even when only one-half of the tumor cells carried the HSV-TK gene. While not completely understood, this additional tumor cell killing appears to be both tumor selective and local in nature. It is concluded that HSV-TK gene therapy with ganciclovir treatment does selectively kill tumor cells in the brain and has many potential applications in CNS disorders, including the treatment of cancer.
基因治疗在中枢神经系统(CNS)疾病中有许多潜在应用,包括选择性杀死脑内肿瘤细胞。利用大鼠脑肿瘤模型来测试单纯疱疹病毒(HSV)-胸苷激酶(TK)基因在全身给予核苷类似物更昔洛韦后选择性杀死脑内C6和9L肿瘤细胞的能力。将HSV-TK基因体外导入肿瘤细胞(C6-TK和9L-TK),然后评估这些修饰后的肿瘤细胞对更昔洛韦杀伤作用的敏感性。在剂量反应试验中,C6-TK和9L-TK细胞对更昔洛韦杀伤作用的敏感性(半数致死剂量:C6-TK,0.1微克更昔洛韦/毫升;C6,5.0微克更昔洛韦/毫升)比未修饰的野生型肿瘤细胞或培养的成纤维细胞高100倍。体内研究证实,腹腔注射更昔洛韦能够杀死大鼠体内已形成的脑肿瘤,这通过对脑肿瘤体积的体视学评估以及对动物90天以上生存期的研究得以量化。对通过脑内注射野生型或HSV-TK修饰的肿瘤细胞或野生型和HSV-TK修饰细胞的组合而形成脑肿瘤的大鼠进行了有无更昔洛韦治疗的研究。体视学方法确定,更昔洛韦治疗消除了由HSV-TK修饰细胞组成的肿瘤,而对照肿瘤按预期生长(p<0.001)。在生存研究中,所有10只接受更昔洛韦治疗的9L-TK肿瘤大鼠存活了90天,而所有未治疗的大鼠在25天内死亡。奇怪的是,即使只有一半的肿瘤细胞携带HSV-TK基因,由9L和9L-TK细胞组合组成的肿瘤也能被更昔洛韦治疗消除。虽然尚未完全了解,但这种额外的肿瘤细胞杀伤似乎具有肿瘤选择性且本质上是局部性的。得出的结论是,用更昔洛韦治疗的HSV-TK基因疗法确实能选择性杀死脑内肿瘤细胞,并且在中枢神经系统疾病(包括癌症治疗)中有许多潜在应用。