Jooss K, Turka L A, Wilson J M
Institute for Human Gene Therapy, Wistar Institute, Philadelphia, PA 19104-4268, USA.
Gene Ther. 1998 Mar;5(3):309-19. doi: 10.1038/sj.gt.3300595.
Adenoviral vectors deleted of E1 are attractive vehicles for in vivo gene therapy because efficient gene transfer can be achieved. Immune responses to the vector and vector-transduced cells lead to destruction of target cells, inflammation and difficulties with vector readministration. Immune effectors have been identified as CD8+ cytotoxic T lymphocytes, which destroy vector-transduced cells, as well as B cells which secrete neutralizing antibodies and block repeated gene transfer. The central role of CD4+ T cells in the activation of both of these effector functions has focused immunosuppressive strategies towards blockade of costimulatory molecules. We describe in this study a strategy which aims to inhibit CD4+ T cell activation by transiently administering an inhibitor of the CD28/B7 pathway, ie CTLA4Lg, at the time an E1-deleted adenovirus is administered to liver or lung. In lung, CTLA4Ig treatment significantly blocked the formation of neutralizing antibodies, allowing efficient readministration of virus, whereas transgene expression was only moderately prolonged. In contrast, CTLA4Ig did not suppress neutralizing antibody formation in the context of liver gene therapy, but resulted in more stable gene expression. In vitro assays revealed suppression of T cell activation in either organ. This observation suggests that transient inhibition of the CD28/B7 pathway at the time of virus instillation can partially interfere with both arms of the immune response to adenovirus-mediated gene transfer circumventing the need for chronic immune suppression.
缺失E1区的腺病毒载体是体内基因治疗的理想载体,因为它能实现高效的基因转移。对载体及载体转导细胞的免疫反应会导致靶细胞的破坏、炎症以及载体再次给药的困难。已确定免疫效应细胞为CD8+细胞毒性T淋巴细胞,其可破坏载体转导的细胞,还有分泌中和抗体并阻断重复基因转移的B细胞。CD4+ T细胞在激活这两种效应功能中起核心作用,这使得免疫抑制策略聚焦于阻断共刺激分子。在本研究中,我们描述了一种策略,即在向肝脏或肺脏施用缺失E1的腺病毒时,通过瞬时施用CD28/B7途径的抑制剂(即CTLA4Lg)来抑制CD4+ T细胞的激活。在肺部,CTLA4Ig治疗显著阻断了中和抗体的形成,使病毒能够高效再次给药,而转基因表达仅适度延长。相比之下,在肝脏基因治疗中,CTLA4Ig并未抑制中和抗体的形成,但导致了更稳定的基因表达。体外试验显示在任一器官中T细胞激活均受到抑制。这一观察结果表明,在病毒滴注时瞬时抑制CD28/B7途径可部分干扰对腺病毒介导的基因转移的免疫反应的两个方面,从而无需进行长期免疫抑制。