Imaging herpes simplex virus type 1 amplicon vector-mediated gene expression in human glioma spheroids.

Vectors derived from herpes simplex virus type 1 (HSV-1) have great potential for transducing therapeutic genes into the central nervous system; however, inefficient distribution of vector particles in vivo may limit their therapeutic potential in patients with gliomas. This study was performed to investigate the extent of HSV-1 amplicon vector-mediated gene expression in a three-dimensional glioma model of multicellular spheroids by imaging highly infectious HSV-1 virions expressing green fluorescent protein (HSV-GFP). After infection or microscopy-guided vector injection of glioma spheroids at various spheroid sizes, injection pressures and injection times, the extent of HSV-1 vector-mediated gene expression was investigated via laser scanning microscopy. Infection of spheroids with HSV-GFP demonstrated a maximal depth of vector-mediated GFP expression at 70 to 80 µm. A > 80% transduction efficiency was reached only in small spheroids with a diameter of < 150 µm. Guided vector injection into the spheroids showed transduction efficiencies ranging between < 10 and > 90%. The results demonstrated that vector-mediated gene expression in glioma spheroids was strongly dependent on the mode of vector application-injection pressure and injection time being the most important parameters. The assessment of these vector application parameters in tissue models will contribute to the development of safe and efficient gene therapy protocols for clinical application.

Acute loss of vision with hypoplasia of the contralateral carotid artery.

We report a case of a young woman with acute loss of vision of the left eye. The first diagnosis of hypoplasia of the common carotid artery, internal carotid artery, and vertebral artery on the right side was made by means of magnetic resonance angiography. The ischemic optic nerve lesion was caused by a steal phenomenon from the left internal carotid artery to the right cerebral hemisphere with consecutive hypoperfusion of the left ophthalmic artery. Anomalies of the cerebrovascular system should be included in the differential diagnosis of acute loss of vision, even in young patients without cerebrovascular risk factors.

Imaging-guided convection-enhanced delivery and gene therapy of glioblastoma.

In a prospective phase I/II clinical study, we treated eight patients suffering from recurrent glioblastoma multiform with stereotactically guided intratumoral convection-enhanced delivery of an HSV-1-tk gene-bearing liposomal vector and systemic ganciclovir. Noninvasive identification of target tissue together with assessment of vector-distribution volume and the effects of gene therapy were achieved using magnetic resonance imaging and positron emission tomography. The treatment was tolerated well without major side effects. In two of eight patients, we observed a greater than 50% reduction of tumor volume and in six of eight patients focal treatment effects. Intracerebral infusion of contrast medium before vector application displayed substantial inhomogeneity of tissue staining indicating the need of test infusions to monitor the mechanical distribution of vectors. Visualization of therapeutic effects on tumor metabolism and documentation of gene expression using positron emission tomography indicated that molecular imaging technology appears to be essential for the further development of biological treatment strategies.