Pancreatic cancer escape variants that evade immunogene therapy through loss of sensitivity to IFNgamma-induced apoptosis.

Combined injections into experimental tumor nodules of adenovirus encoding IL-12 and certain chemokines are capable to induce immune-mediated complete regressions. In this study, we found that the combination of two adenoviruses, one encoding IL-12 and other MIP3alpha (AdCMVIL-12+AdCMVMIP3alpha) was very successful in treating CT-26-derived colon carcinomas. However, in experimental tumors generated from the pancreatic carcinoma cell line Panc02 such combined treatment induces 50% of macroscopic complete regressions, although local relapses within 1 week are almost constant. We derived cell lines from such relapsing tumors and found that experimental malignancies derived from their inoculum were not amenable to treatment in any case with AdCMVIL-12+AdCMVMIP-3alpha. Importantly, relapsing cell lines were insensitive to in vitro induction of apoptosis by IFNgamma, in clear contrast with the original Panc02 cells. Comparative analyses by cDNA arrays of relapsing cell lines versus wild-type Panc02 were performed revealing an important number of genes (383) whose expression levels were modified more than two-fold. These changes grouped in certain gene ontology categories should harbor the mechanistic explanations of the acquired selective resistance to IFNgamma.

Vectores adenovirales de primera generación, el vector por excelencia en inmunoterapia génica del cáncer / First generation adenoviral vectors, the vector par excellence for immuno-gene therapy of cancer

La terapia génica constituye una novedosa alternativa terapéutica para muchas enfermedades cuando las terapias habituales no tienen efecto. Básicamente la terapia génica consiste en la introducción de material genético en el interior de una célula diana con el objeto de producir en ella un cambio funcional que se traduzca en un efecto terapéutico. El intenso desarrollo de esta área de la biomedicina ha llevado a la puesta en marcha de numerosos protocolos clínicos de terapia génica para el tratamiento experimental de enfermedades de diverso origen: tumoral, infeccioso, autoinmune, degenerativo, genético. En la mayoría de los casos, es necesario recurrir al empleo de un vehículo, denominado vector, para introducir el material genético en las células. Éstos pueden provenir de virus modificados genéticamente (vectores virales) o pueden ser formulaciones fisicoquímicas (vectores no virales). Actualmente existe un amplio abanico de vectores para transferencia génica, sin embargo no se dispone del vector ideal que pueda ser tan versátil como para adaptarse a las numerosas situaciones experimentales o clínicas. Debido a las propiedades de los vectores adenovirales, tales como su alta eficacia de transducción, amplio tropismo, fácil construcción y producción, éstos han sido ampliamente utilizados y se cuenta con una amplia experiencia en campos como la terapia génica del cáncer. En este sentido, y a pesar de la corta duración de expresión del transgén debido a su alta inmunogenicidad, los adenovirus de primera generación han demostrado su eficacia tanto en estrategias de inmunoterapia en modelos tumorales experimentales como también en ensayos clínicos de fase I. En este trabajo se revisan críticamente los distintos vectores virales empleados en terapia génica profundizando en las características biológicas de los adenovirus, los distintos tipos de vectores adenovirales, los diferentes sistemas de construcción de adenovirus de primera generación así como su empleo en distintas aproximaciones de inmunoterapia génica del cáncer (AU)

Gene therapy for liver diseases: recent strategies for treatment of viral hepatitis and liver malignancies.

Gene therapy has emerged as a powerful and very plastic tool to regulate biological functions in diseased tissues with application in virtually all medical fields. An increasing number of experimental and clinical studies underline the importance of genes as curative agents in the future. However, intense research is needed to evaluate the potential of gene therapy to improve efficacy and minimise the toxicity of the procedure.

Inducción de activación de NF-kB y maduración parcial en células dendríticas infectadas con adenovirus recombinantes / Dendritic cells infected with recombinant defective adenoviruses undergo NF-kB activation and partial maturation

Las células dendríticas se vienen usando como adyuvantes naturales para inducir respuestas inmunitarias con utilidad terapéutica. Para conseguir esto, los genes que codifican para antígenos relevantes son transfectados en células dendríticas mediante vectores virales y no virales. Los adenovirus recombinantes defectivos que codifican para antígenos o citoquinas se utilizan con gran eficiencia para transfectar ex vivo células dendríticas. Aquí hemos estudiado los efectos de infectar células dendríticas humanas y murinas con adenovirus que codifican para el gen reportero -galactosidasa (AdCMVLacZ). La infección con AdCMVLacZ induce la translocación nuclear de diferentes factores de transcripción de la familia de NF -B, a través la inducción de fosforilación de I -B según se demuestra mediante geles de retardo de movilidad e inmunoblots. La activación de NF- B se indujo también con capsides virales semipurificadas o adenovirus sin transgén, pero no mediante un adenovirus que codifica para un inhibidor dominante negativo de I -B (AdCMVI -B). A diferencia de AdCMVI B , AdCMVLacZ induce aumentos en la expresión de CD40, CD80 y CD86 con aumentos menos significativos de MHC clase II. También induce la expresión de IL-6 pero no de TNF ni IL-12. Estos cambios hacen que las células dendríticas sean más eficientes en inducir proliferación en MLR alogénicos. Nuestros resultados muestran que los adenovirus recombinantes inducen de forma independiente de transgén, cambios en el status madurativo de células dendríticas humanas y murinas que son relevantes para sus funciones. (AU)

Alpha(v)beta(3) integrin-mediated adenoviral transfer of interleukin-12 at the periphery of hepatic colon cancer metastases induces VCAM-1 expression and T-cell recruitment.

We previously reported that systemic injection of recombinant adenovirus resulted in a rim of gene transduction around experimental liver tumor nodules. This zone of higher infection is dependent on the alpha(v)beta(3) integrin, acting as an adenovirus internalization receptor, which is overexpressed in tissues surrounding liver metastases. When a recombinant adenovirus encoding interleukin-12 (AdCMVIL-12) is given into a subcutaneous tumor nodule in mice also bearing concomitant liver tumors, a fraction of AdCMVIL-12 reaches the systemic circulation and infects liver tissue, especially at the malignant/healthy tissue interface. As a result of the expression at this location of the interleukin-12 transgenes, VCAM-1 is induced on vessel cells and mediates the recruitment of adoptively transferred anti-tumor cytolytic T-lymphocytes. These studies provide mechanistic explanations for the potent therapeutic synergy observed between interleukin-12 gene transfer and adoptive T-cell therapy.

Genetic heterogeneity in the toxicity to systemic adenoviral gene transfer of interleukin-12.

Despite the efficacy of IL-12 in cancer experimental models, clinical trials with systemic recombinant IL-12 showed unacceptable toxicity related to endogenous IFNgamma production. We report that systemic administration of a recombinant adenovirus encoding IL-12 (AdCMVmIL-12) has a dramatically different survival outcome in a number of mouse pure strains over a wide range of doses. For instance at 2.5 x 10(9) p.f.u., systemic AdCMVmIL-12 killed all C57BL/6 mice but spared all BALB/c mice. Much higher IFNgamma concentrations in serum samples of C57BL/6 than in those from identically treated BALB/c were found. Causes for heterogeneous toxicity can be traced to differences among murine strains in the levels of gene transduction achieved in the liver, as assessed with adenovirus coding for reporter genes. In accordance, IL-12 serum concentrations are higher in susceptible mice. In addition, sera from C57BL/6 mice treated with AdCMVmIL-12 showed higher levels of IL-18, a well-known IFNgamma inducer. Interestingly, lethal toxicity in C57BL/6 mice was abolished by administration of blocking anti-IFNgamma mAbs and also by simultaneous depletion of T cells, NK cells, and macrophages. These observations together with the great dispersion of IFNgamma produced by human PBMCs upon in vitro stimulation with IL-12, or infection with recombinant adenovirus encoding IL-12, suggest that patients might also show heterogeneous degrees of toxicity in response to IL-12 gene transfer.

IL-12 gene therapy for cancer: in synergy with other immunotherapies.

In preclinical models of cancer, gene therapy with interleukin 12 (IL-12) has reached unprecedented levels of success when combined with immunotherapy approaches such as gene transfer of other cytokines and/or chemokines, costimulatory molecules or adoptive cell therapy. These combinations have been found to produce synergistic rather than additive effects. Meanwhile, IL-12 gene therapy is beginning clinical testing as a single agent, but combination strategies are at hand.

Gene therapy of orthotopic hepatocellular carcinoma in rats using adenovirus coding for interleukin 12.

The use of gene therapy to enhance antitumor immunity has emerged as a promising procedure to fight cancer. In this study we have tested the ability of an adenovirus carrying interleukin 12 (IL-12) gene (AdCMVIL-12) to eliminate tumoral lesions in 3 animal models of orthotopic hepatocellular carcinoma (HCC). Intratumoral injection of AdCMVIL-12 in animals with a single big tumor nodule implanted in the liver resulted in significant inhibition of tumor growth in a dose-dependent manner. Fifty percent of animals that received a dose of 5 x 10(9) plaque-forming units, showed complete regression of the tumor 2 weeks after treatment. In animals with 2 independent tumor nodules in the left liver lobe, injection in only one of them of 5 x 10(9) pfu AdCMVIL-12 induced, 15 days after therapy, complete regression of 50% of treated tumors and also of 50% of untreated lesions, with 60% long-term survival. Rats that were tumor free after therapy with AdCMVIL-12 showed protection against tumor rechallenge. A group of rats received the carcinogen diethylnitrosamine and developed multiple hepatic dysplasic nodules of 1 to 5 mm in diameter. These animals were treated by intrahepatic artery injection of either AdCMVIL-12 (5 x 10(9) pfu) or control vector. In this model AdCMVIL-12 induced complete tumor regression in 20% of treated rats and inhibited tumor growth in 60% of cases with an increase in rat survival. Activation of natural killer (NK) cells and inhibition of angiogenesis were found to be antitumor mechanisms set in motion by AdCMVIL-12. Our data indicate that experimental HCC can be efficiently treated by intratumoral or intravascular injection of adenovirus expressing IL-12.

Intratumoral coinjection of two adenoviruses, one encoding the chemokine IFN-gamma-inducible protein-10 and another encoding IL-12, results in marked antitumoral synergy.

We have constructed a recombinant defective adenovirus that expresses functional murine IFN-gamma-inducible protein-10 (IP-10) chemokine (AdCMVIP-10). Injection of AdCMVIP-10 into s.c. tumor nodules derived from the CT26 murine colorectal adenocarcinoma cell line displayed some antitumor activity but it was not curative in most cases. Previous studies have shown that injection of similar s. c. CT26 tumor nodules with adenovirus-encoding IL-12 (AdCMVIL-12) induces tumor regression in nearly 70% of cases in association with generation of antitumor CTL activity. AdCMVIP-10 synergizes with the antitumor effect of suboptimal doses of AdCMVIL-12, reaching 100% of tumor eradication not only against injected, but also against distant noninjected tumor nodules. Colocalization of both adenoviruses at the same tumor nodule was required for the local and distant therapeutic effects. Importantly, intratumoral gene transfer with IL-12 and IP-10 generated a powerful tumor-specific CTL response in a synergistic fashion, while both CD4 and CD8 T cells appeared in the infiltrate of regressing tumors. Moreover, the antitumor activity of IP-10 plus IL-12 combined gene therapy was greatly diminished by simultaneous in vivo depletion of CD4+ and CD8+ T cells but was largely unaffected by single depletion of each T cell subset. An important role for NK cells was also suggested by asialo GM1 depletion experiments. From a clinical point of view, the effects of IP-10 permit one to lower the required gene transfer level of IL-12, thus preventing dose-dependent IL-12-mediated toxicity while improving the therapeutic efficacy of the elicited antitumor response.

Adenoviral gene transfer of interleukin 12 into tumors synergizes with adoptive T cell therapy both at the induction and effector level.

Tumors infected with a recombinant defective adenovirus expressing interleukin 12 (IL-12) undergo regression, associated with a cytotoxic T lymphocyte (CTL)-mediated antitumor immune response. In the present study we generated anti-CT26 CTLs by short-term coculture of CT26 cells and lymph node cells obtained from mice harboring subcutaneous CT26 tumors injected with an adenoviral vector expressing IL-12 (AdCMVIL-12), control adenovirus (AdCMVlacZ), or saline. Regression of small intrahepatic CT26 tumors in unrelated syngeneic animals was achieved with CTLs derived from mice whose subcutaneous tumors had been injected with AdCMVIL-12 but not with CTLs from the other two control groups. The necessary and sufficient effector cell population for adoptive transfer consisted of CD8+ T cells that showed anti-CT26 specificity partly directed against the AH1 epitope presented by H-2Ld. Interestingly, treatment of a subcutaneous tumor nodule with AdCMVIL-12, combined with intravenous adoptive T cell therapy with short-term CTL cultures, had a marked synergistic effect against large, concomitant live tumors. Expression of IL-12 in the liver in the vicinity of the hepatic tumor nodules, owing to spillover of the vector into the systemic circulation, appeared to be involved in the increased in vivo antitumor activity of injected CTLs. In addition, adoptive T cell therapy improved the outcome of tumor nodules transduced with suboptimal doses of AdCMVIL-12. Our data provide evidence of a strong synergy between gene transfer of IL-12 and adoptive T cell therapy. This synergy operates both at the induction and effector phases of the CTL response, thus providing a rationale for combined therapeutic strategies for human malignancies.