Lethal toxicity caused by expression of shRNA in the mouse striatum: implications for therapeutic design.

Therapeutic RNA interference (RNAi) has emerged as a promising approach for the treatment of many incurable diseases, including cancer, infectious disease or neurodegenerative disorders. Demonstration of efficacy and safety in animal models is necessary before planning human application. Our group and others have previously shown the potential of this approach for the dominantly inherited neurological disease DYT1 dystonia by achieving potent short-hairpin RNA (shRNA)-mediated silencing of the disease protein, torsinA, in cultured cells. To establish the feasibility of this approach in vivo, we pursued viral delivery of shRNA in two different mouse models. Surprisingly, intrastriatal injections of adeno-associated virus serotype 2/1 (AAV2/1) vectors expressing different shRNAs, whether targeting torsinA expression or mismatched controls, resulted in significant toxicity with progressive weight loss, motor dysfunction and animal demise. Histological analysis showed shRNA-induced neurodegeneration. Toxicity was not observed in animals that received control AAV2/1 encoding no shRNA, and was independent of genotype, occurring in both DYT1 and wild-type animals. Interestingly, the different genetic background of both mouse models influenced toxicity, being earlier and more severe in 129/SvEv than in C57BL/6 mice. In conclusion, our studies demonstrate that expression of shRNA in the mammalian brain can lead to lethal toxicity. Furthermore, the genetic background of rodents modifies their sensitivity to this form of toxicity, a factor that should be taken into consideration in the design of preclinical therapeutic RNAi trials.

Transcriptional and proteomic profiling in a cellular model of DYT1 dystonia.

DYT1, the most common inherited dystonia, is caused by a common dominant mutation in the TOR1A gene that leads to a glutamic acid deletion in the protein torsinA. Wild-type torsinA locates preferentially in the endoplasmic reticulum while the disease-linked mutant accumulates in the nuclear envelope. As a result, it has been proposed that DYT1 pathogenesis could result either from transcriptional dysregulation caused by abnormal interactions of mutant torsinA with nuclear envelope proteins, or from a loss of torsinA function in the endoplasmic reticulum that would impair specific neurobiological pathways. Aiming to determine whether one or both of these potential mechanisms are implicated in DYT1 pathogenesis, we completed unbiased transcriptional and proteomic profiling in well-characterized neural cell lines that inducibly express wild-type or mutant torsinA. These experiments demonstrated that the accumulation of mutant torsinA in the nuclear envelope is not sufficient to cause transcriptional dysregulation. However, we detected expression changes at the protein level that, together with other reports, suggest a potential implication of torsinA on energy metabolism and regulation of the redox state. Furthermore, several proteins identified in this study have been previously linked to other forms of dystonia. In conclusion, our results argue against the hypothesis of transcriptional dysregulation in DYT1 dystonia, suggesting potential alternative pathogenic pathways.

The ons and offs of inducible transgenic technology: a review.

Classical transgenic and gene-targeted mouse mutants are powerful model systems in which to study the pathogenesis of neurodegenerative diseases. However, a number of issues of fundamental importance to neurodegenerative research cannot be addressed using classical techniques. These include identification of the earliest events in disease pathogenesis and a determination of whether a particular pathogenic protein produces a inexorable or a reversible disease process. Both of these issues have profound implications for the rational development of new therapies. To address these questions, genetic techniques that allow pathogenic proteins to be expressed or knocked out with temporal and regional specificity have been developed. We have reviewed these systems, highlighting the tetracycline-regulated system because of its demonstrated utility in mice and its reversibility. These regulatable systems are a new and powerful tool for the neurobiologist and allow one to address a new set of important questions in an in vivo setting.

Current concepts on the clinical features, aetiology and management of idiopathic cervical dystonia.

Idiopathic cervical dystonia (ICD) is the most common form of adult-onset focal dystonia. Previously, disagreement existed about whether ICD was a psychiatric illness, but the disorder is now viewed as a neurological illness and large clinical series have clarified the clinical features of the disease. At the time of diagnosis, extracervical dystonia is found in approximately 20% of patients, and there may be a concomitant head or hand tremor. Importantly, adult-onset ICD does not become generalized, although there may be segmental spread and pain may increase independently of the dystonia. While 10-20% of patients may experience remission, nearly all patients relapse within 5 years and are left with persistent disease. The aetiology of ICD is unknown, but there has been much progress in clarifying the genetic abnormality in families with inherited adult-onset cervical dystonia; linkage to chromosome 18p has been demonstrated in one family, and the DYT1 locus has been excluded in two other families. Painful trauma may be involved in the pathogenesis of ICD. Painful stimuli are received and processed by the basal ganglia, and the synaptic changes provoked by pain may lead to the abnormal physiology underlying dystonia. Consistent with this idea are experiments which demonstrate that altered sensory input leads to plasticity of the motor cortex, and those that explore the 'tonic vibration reflex' in patients with dystonia. Another theory suggests that a primary vestibular abnormality is responsible for ICD. Botulinum toxin is the most effective treatment for ICD. Roughly 75% of patients improve, and a response is generally seen within the first week. However, many questions remain regarding the optimal technique of administration. The development of neutralizing antibodies occurs in at least 5-10% of patients, and appears to be related both to dosage and to the interval between treatments. Side-effects are generally mild and result from the action of the toxin in the periphery. If the response to botulinum toxin is not adequate, anticholinergics, benzodiazepines, baclofen and other medications are used as adjunctive therapy. Surgical therapies are available for the treatment of ICD but are reserved for patients refractory to conservative measures.

Leukemia inhibitory factor and ciliary neurotrophic factor increase activated Ras in a neuroblastoma cell line and in sympathetic neuron cultures.

The cytokines leukemia inhibitory factor (LIF) and ciliary neurotrophic factor (CNTF) have been implicated in determination of neuronal phenotype as well as promotion of neuronal survival. However, the intracellular mechanisms by which their signals are transduced remain poorly understood. We have previously studied the regulation of vasoactive intestinal polypeptide gene expression by LIF and CNTF in the NBFL neuroblastoma cell line. Because these cytokines induce tyrosine phosphorylation that may lead to Ras activation, we explored a possible role for Ras in LIF- and CNTF-induced signal transduction. In NBFL cells LIF increases activated Ras in a rapid, transient, and concentration-dependent manner. CNTF and a related cytokine, oncostatin M, produce similar increases. CNTF and LIF also increase activated Ras in neuron-enriched dissociated cultures of sympathetic ganglia. Moreover, these cytokines rapidly and transiently induce specific tyrosine-phosphorylated proteins, p165 and p195. The protein kinase inhibitors K252a and staurosporine block LIF-induced increases in tyrosine phosphorylation, activated Ras, and vasoactive intestinal polypeptide mRNA in NBFL cells. These data support a possible role for Ras in the cell differentiation effects of LIF and CNTF.

Coordinate regulation of choline acetyltransferase, tyrosine hydroxylase, and neuropeptide mRNAs by ciliary neurotrophic factor and leukemia inhibitory factor in cultured sympathetic neurons.

The neurotransmitter phenotype switch that occurs in cultures of rat superior cervical ganglion neurons after treatment with leukemia inhibitory factor or ciliary neurotrophic factor is a useful model permitting investigation of the mechanisms of cytokine-mediated differentiation. Recently the actions of leukemia inhibitory factor and ciliary neurotrophic factor have been linked through their interactions with related receptor complexes. Here we compare the effects of these two cytokines on gene expression in sympathetic neuronal cultures and begin to investigate their mechanisms. We report that, as has been shown for leukemia inhibitory factor, ciliary neurotrophic factor regulates peptides and classical transmitters in these cultures at the mRNA level. In addition, we find that the induction of substance P mRNA by these cytokines is rapid, dependent on protein synthesis, and occurs in 40-50% of superior cervical ganglion neurons in dissociated culture.

The effect of the stereoisomers of butaclamol on neurotensin content in discrete regions of the rat brain.

The prevailing hypothesis concerning the mechanism of antipsychotic drug action is principally based on the striking correlation between their clinical potency and their potency in blockade of D2 dopamine receptors. However, most of these compounds also have effects at serotonin, acetylcholine, histamine, and alpha-adrenergic receptors and have recently been shown to alter the concentrations of certain neuropeptides in the rat brain after chronic drug administration. One such neuropeptide that is increased in concentration in dopamine terminal regions by clinically effective neuroleptic drugs is neurotensin (NT). Neurotensin is closely associated with dopamine neurons, as demonstrated by evidence derived from anatomic, physiologic, and pharmacologic studies. In this report, we determined the effects of chronic administration of the potent D2 receptor antagonist (+)-butaclamol and its inactive (-) stereoisomer on regional brain NT content. Moreover, we sought to determine whether the effects of haloperidol on NT concentrations can be antagonized by concomitant administration of an indirect dopamine agonist, d-amphetamine. Neurotensin content in the caudate nucleus and nucleus accumbens of the rat were significantly increased by 3 weeks of daily injections of haloperidol or (+)-butaclamol, but not (-)-butaclamol. d-Amphetamine did not alter this effect of haloperidol on NT concentrations in either the nucleus accumbens or caudate nucleus. These data are concordant with the hypothesis that D2 receptor blockade is required for NT concentration increases after antipsychotic drug treatment and that the increase in synaptic cleft dopamine content produced by d-amphetamine cannot reverse this effect of dopamine receptor antagonists.

[Therapeutic results in advanced ovarian cancer]. / Therapie-Ergebnisse beim fortgeschrittenen Ovarialkarzinom.

From 1977 to 1981 39 patients with advanced ovarian carcinoma (stage III, IV, and relapses) were treated at the department of oncology. From 1977 to 1979 we followed to a great extent the ECOG protocol (EST 2875) which means combination chemotherapy by alternating cycles. Since 1980 we used for treatment the PAC I regimen. There was no obvious difference between the therapeutic results of regimen 1 (MTX/Thio followed by 5FU/CTX) and regimen 2 (MTX/Thio followed by VCR/ADM/5FU/CTX). The greatest complete remission rate (confirmed by a second-look laparotomy) was obtained by regimen 3 (PAC I). In 8 cases PAC I was used as a second line treatment. Only 3 partial remissions were seen.