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Prepublished online as a Blood First Edition Paper on November 14, 2002; DOI 10.1182/blood-2002-07-2195.
GENE THERAPY
From the Molecular Medicine Program, Mayo Foundation,
Rochester; and Division of Hematology and Internal Medicine, Mayo
Clinic, Rochester, MN.
Live attenuated measles virus (MV-Edm) has potent oncolytic
activity against myeloma xenografts in mice. Therapy of multiple myeloma, a disseminated plasma cell malignancy, would require systemic
administration of the virus. Thus, the virus should ideally be targeted
to infect only myeloma cells to minimize collateral damage to normal
tissues: viral binding to its natural receptors must be ablated and a
new specificity domain that targets entry into myeloma cells be added.
This study covers 2 critical steps toward generating such a retargeted
virus: (1) a new specificity domain against the plasma cell marker CD38
was constructed in the form of a single-chain antibody (scFv)
and (2) display of that scFv on the measles viral envelope glycoprotein
successfully redirected virus entry through CD38 expressed on target
cells devoid of the natural MV receptors. The anti-CD38 scFv was
tethered to the C-terminus of the hemagglutinin (H) glycoprotein of
MV-Edm through a Factor Xa protease cleavable linker. Immunoblot
analysis demonstrated that the scFv was efficiently incorporated into
recombinant viral particles. Replication of MV- Multiple myeloma, which is responsible for the
deaths of 10 000 Americans annually, is a disseminated plasma cell
malignancy, not curable with current therapy.1 Median
survival is approximately 4 years, and new approaches to therapy are
required. The disease responds initially to alkylating agents and
corticosteroids but eventually becomes refractory. High-dose melphalan
therapy followed by autologous stem cell transplantation leads to
better remissions but does not greatly prolong
survival.2-4
Viruses that replicate selectively in neoplastic cells hold
considerable promise as novel therapeutic agents for the treatment of
malignancy and several are being tested in clinical
trials.5 We recently reported that the live attenuated
Edmonston B vaccine strain of measles virus (MV-Edm) has potent and
selective oncolytic activity against CD138 sorted plasma cells from
patients with multiple myeloma and against myeloma
xenografts.6 MV-Edm caused extensive cytopathic damage
through cell-cell fusion and the formation of multinucleated giant
cells (syncytia) in myeloma cells but not in phytohemagglutinin
(PHA)-stimulated peripheral blood lymphocytes from healthy
volunteers.6 Single or multiple doses of virus injected
intratumorally or intravenously caused growth inhibition or total
regression of subcutaneous human myeloma xenografts grown in
immunocompromised mice.6 We have also generated trackable viruses that encode an inert soluble marker peptide in the viral genome
such that viral gene expression can easily be monitored by following
peptide levels in the cell culture media or body fluids.7
The engineered virus enhanced the survival of mice bearing
intraperitoneal ovarian cancer tumors by more than 250%.8 Encouraged by these promising results, we are in the process of obtaining approval to proceed with a phase 1 dose escalation clinical trial for patients with advanced or recurrent ovarian cancer.
Application of MV-Edm for virotherapy of multiple myeloma would require
systemic administration of the virus because of the disseminated nature
of the disease. Thus, to prevent collateral damage to normal tissues,
the oncolytic activity of the virus should be targeted exclusively to
myeloma cells. We reported that MV-Edm was intrinsically oncolytic for
tumor cells and caused minimal cytopathic damage on normal
nontransformed cells.6,8 To further enhance specificity,
virus entry and receptor dependent cell-cell fusion can potentially be
targeted specifically to myeloma cells.9,10 The need for
targeting entry and infection is readily apparent in biodistribution
studies after administration of MV-Edm in MV-susceptible mice. We found
that MV-Edm efficiently infects macrophages in the spleen, lymph nodes,
and peritoneal cavity11 (K.-W.P. et al, unpublished
observations, 2002). Thus, for systemic therapy of myeloma, we
need to generate a retargeted virus, devoid of binding to its natural
receptors, that will infect and fuse myeloma cells exclusively through
a novel receptor. There are 4 steps to the development of such a
retargeted virus: (1) identification of a receptor that is
overexpressed in the myeloma cells to allow targeted binding of the
virus to this receptor, (2) construction of the ligand (eg,
single-chain antibody [scFv]) that will bind to the chosen receptor,
(3) display of the ligand as a functional entity on the virus to
redirect virus entry through the targeted receptor, and (4) ablation of
the original tropism of the virus for its natural receptors. Measles
virus entry into target cells is dependent on attachment of the
envelope hemagglutinin (H) glycoprotein to cellular receptors and
subsequent fusion of viral-cell membranes via the envelope fusion (F)
glycoprotein.12 Two cellular receptors for MV entry have
been identified, CD46, a ubiquitous cellular receptor found on all
nucleated cells, and CDw150 or SLAM (signaling lymphocyte activation
molecule), which is present on activated B cells, T cells, and
monocytes.13-17 Mutations in the H glycoprotein that
inhibit fusion through the CD46 receptor have been reported, and
mutagenesis studies are currently in progress in our laboratories to
identify mutations in H that ablate SLAM binding.
In the current study, we have taken major strides toward generating a
fully retargeted measles virus for myeloma therapy. We first generated
a scFv against CD38, a plasma cell marker densely expressed on myeloma
cells, and then demonstrated that the anti-CD38 scFv could be tethered
to the C-terminus of the measles virus H envelope glycoprotein. The
scFv was incorporated into functional recombinant MV-Edm virions, and
display of the anti-CD38 scFv mediated virus entry into CD38
receptor-positive rodent cells that otherwise are not permissive to
infection by the unmodified virus. The targeted virus was oncolytic
only for CD38 receptor-positive cells and caused extensive cell-to-cell
fusion and cytopathic effects in these cells. In vivo experiments
demonstrated that infection of 1% of the CD38+ cells by
the recombinant virus was sufficient to significantly inhibit the
growth of the xenografts and enhance the survival of mice.
Cell culture
Generation of scFv against CD38
Generation of scFv displaying recombinant MV-Edm The pCGH plasmid19 encodes MV-H glycoprotein and was modified to include an IEGR Factor Xa protease cleavage site (single amino acid code), followed by SfiI and NotI cloning sites. The scFv cDNA was PCR amplified as SfiI/NotI fragments and inserted as in-frame fusions linked to the C-terminal codon of the H glycoprotein to generate pCGHX -CD38. The genes for the recombinant H glycoproteins were then cloned as PacI/SpeI fragments into the
full-length infectious clone p(+) MVNSe plasmid.20
Recombinant viruses were rescued using the standard MV rescue
system21 and were characterized by immunoblotting and
infection assays.
Characterization of recombinant MV-Edm Immunoblotting.
To facilitate detection of virions in immunoblots, a Flag tag
(DYKDDDDK) was inserted after the start codon of the H glycoprotein of
MV-Edm and MV- Virus titrations and infection assays.
To compare the growth characteristics of the recombinant virus with
MV-Edm, Vero cells were infected with the respective virus at a
multiplicity of infection (MOI) of 3.0 for 2 hours. The
inoculum was then removed, standard media replaced, and the cells were maintained at 32°C for virus propagation. At 24, 36, 48, and 72 hours
after infection, conditioned media were harvested and cleared of cell debris by centrifugation. Cells were scraped into 1 mL Opti-MEM
(Gibco BRL, Rockville, MD), and the cell-associated viruses were
released by 2 freeze-thaw cycles. Viral titers were determined by 50%
end point dilution assays (median tissue-culture infectious dose [TCID50]) on Vero cells.6 For
the specificity assays, CHO and CHO-CD38 cells were plated overnight in
6-well plates (2 × 105 cells/well), washed with
phosphate-buffered saline (PBS) the next day, and infected with the
viruses at various MOI (10 In vivo experiments All animal experiments were reviewed and approved by the Institutional Animal Care and Use Committee. CHO-CD38 cells (5 × 106 cell/100 µL per site) were mixed with MV-Edm or MV- CD38 at 4°C and implanted immediately subcutaneously into
the right flank of 5-week-old female CB.17 severe combined
immunodeficient (SCID) mice (Harlan Sprague Dawley, Indianapolis, IN).
It is estimated that approximately 1% of the CHO-CD38 cells will be
infected by the MV- CD38 virus but not by MV-Edm. The mice were
observed twice a week for tumor growth, and, when tumors were palpable,
tumor sizes were measured using calipers in 2 dimensions. Tumor volumes were calculated as a2 × b × 0.5, where a is the
shorter diameter and b is the longer diameter. Animals were killed if
tumor volumes reached 10% of body weight, if the tumors ulcerated, if
there was more than 10% of weight loss, if the animals were unable to obtain food and water, or if they were in distress.
Statistical analysis The cumulative survival between the treatment and control groups were compared using repeated analysis of measurements on the SAS program.
Generation of recombinant MV- CD38 virions. As shown in
Figure 1B, the H glycoprotein of recombinant MV- CD38 had a higher
apparent molecular weight than that of MV-Edm. After treatment with
FXa, the anti-CD38 scFv was cleaved off from the hybrid protein,
yielding an H glycoprotein with the same molecular weight as that of
unmodified MV-Edm. Treatment of MV-Edm virions with FXa had no effect
on the size of the unmodified H glycoprotein.
Efficient replication of the recombinant virus with a displayed scFv The growth kinetics of the recombinant virus was compared with that of unmodified MV-Edm by performing a one-step growth curve in which Vero cells were infected with either virus at a high multiplicity of infection (MOI = 3.0). At 24, 36, 48, and 72 hours after infection, virus yield was determined by TCID50 titrations on Vero cells. The growth kinetics of MV-Edm and MV- CD38 were similar (Figure 2). Display of the scFv
did not severely hinder replication of MV- CD38, although the maximal
titers reached by MV- CD38 are slightly (2- to 3-fold) less than that
of MV-Edm (Figure 2).
MV- CD38 viruses were
titrated on CHO-CD38 and CHO cells by counting the number of infectious
centers, defined as multinucleated syncytia containing more than 20 nuclei at 36 hours after infection. MV- CD38 readily infected the
CD38-expressing CHO cells while remaining noninfectious on the parental
CHO cells (Figure 4). The unmodified
MV-Edm did not form syncytia on the CHO cells, irrespective of CD38
status (Figure 4).
To further verify that infection of the CD38-expressing CHO cells by
MV-
Display of scFv did not alter virus infection in CD38+ CD46+ human cells Human fibrosarcoma HT1080 cells were transfected with a CD38 expression plasmid, and clones expressing CD38 were selected. The cells were infected with MV- CD38 or MV-Edm, and the number of
syncytia-forming units per milliliter of virus was determined. Infection of CD38+ HT1080 cells and parental HT1080 cells
by the recombinant MV- CD38 virus were comparable, indicating that
display of the scFv did not enhance or inhibit viral entry and
infection in cells displaying the targeted receptor (Figure
6). Additional studies of infectivity on
a panel of myeloma cell lines expressing different levels of CD38
indicated that MV-Edm and MV- CD38 infected these cells equally well (Table 1). In addition, the
recombinant virus, like the unmodified MV-Edm, was potently cytotoxic
for transformed myeloma cells and caused minimal cell death in
nontransformed PHA-stimulated PBLs (Table 1).
In vivo antitumorigenic activity of the recombinant virus To determine if the recombinant virus could mediate CD38-targeted oncolysis in a model system, we premixed CHO-CD38 cells with MV- CD38
or MV-Edm at 4°C and immediately implanted the cells subcutaneously
into the flanks of SCID mice. In these experiments, about 1% of the
cells would be infected by the recombinant MV- CD38 virus but not by
MV-Edm. As shown in Figure 7, the
cumulative survival of mice in the test group was significantly longer
(P < .001) than that of mice in the control
group.
Our long-term goal is to develop and use live attenuated MV-Edm as a novel virotherapy agent for the treatment of multiple myeloma. The Edmonston B strain of measles virus was derived from a clinical isolate in 1954 and was subsequently passaged in a variety of cells in tissue culture, resulting in attenuation of the virus and loss of pathogenicity.22 This virus forms the basis for the vaccine strains used in vaccination programs today and has significantly reduced the incidence of measles.23 We recently demonstrated that MV-Edm was potently cytopathic for CD138-sorted primary cells from patients with myeloma and that the virus showed significant antitumor activity against subcutaneous human myeloma xenografts in immunocompromised mice.6 In the first 2 critical steps toward generating a fully retargeted measles virus for myeloma therapy, we demonstrate in this report that (1) generation of a scFv against CD38, a receptor densely expressed on myeloma cells, and (2) successful targeted entry of MV-Edm into CD38+ rodent cells through display of the anti-CD38 scFv on the C-terminus of the H glycoprotein of MV-Edm. We previously reported that MV-Edm is selectively oncolytic for transformed myeloma cells but causes minimal cytopathic damage in nontransformed PHA-stimulated PBLs. The intrinsic tumor selective cytotoxicity is an attractive feature of this agent when considering systemic virotherapy for multiple myeloma. However, we have also noted that administration of MV-Edm into MV-susceptible transgenic mice expressing the human CD46 receptor (with human-tissue specificity) resulted in infection of macrophages in the spleen, lymph nodes, and peritoneal cavity11 (K.-W.P. et al, unpublished observation, 2002). Clearly, it will be desirable to restrict the tropism of the virus. MV-Edm binds to at least 2 receptors: CD46, which is expressed on all nucleated cells, and SLAM, a receptor found on activated B cells, T cells, and monocytes.13-17 To obtain a fully targeted virus, measles binding to these cellular receptors will have to be ablated, and virus entry will have to be redirected through a myeloma cell surface marker. In the first 2 critical steps toward such a retargeted virus, we generated an anti-CD38 scFv and demonstrated that display of the scFv redirected virus binding and entry into CD38 receptor-positive cells that were devoid of natural measles receptors. We previously reported that MV-Edm displaying an anti-CEA scFv could
enter rodent cells through the tumor-associated CEA.10 The
current study provides a second example of MV-Edm targeting through
scFv display. Because our disease focus is multiple myeloma, we chose
to target virus entry via CD38, a plasma cell marker. Human CD38 is a
type II transmembrane protein (45 kDa) with multiple functions: it is a
bifunctional enzyme capable of synthesizing cyclic adenosine
diphosphate (ADP)-ribose from nicotinamide adenine dinucleotide (NAD) and hydrolyzing cADP-ribose to ADP-ribose and is
also involved in adhesion and signaling of leukocytes.24 Thus, besides growth factor receptors9 and proteins in the immunoglobulin family,10 we demonstrate in this study
successful targeting of MV-Edm to a different class of cell surface
receptor. CD38 is densely expressed on myeloma cells, and a
high-affinity anti-CD38 monoclonal antibody has been tested in clinical
trials for patients with myeloma.25 In the current study,
we generated an anti-CD38 scFv from a hybridoma (THB7, ATCC HB-136) and
displayed it as a C-terminal extension, tethered via a protease
sensitive linker, on the extracellular domain of the MV-H envelope
glycoprotein. The scFv was incorporated into recombinant virions and
conferred the recombinant virus with a new tropism for CD38
receptor-positive CHO cells. Entry of the recombinant virus via CD38
was efficient and led to viral gene expression in infected CHO-CD38
cells, followed by cell-to-cell fusion and formation of large
multinucleated syncytia. Removal of the anti-CD38 scFv by FXa treatment
ablated infectivity of the recombinant virus on these CD38+
CHO cells. A control recombinant virus displaying a scFv against CEA10 was not infectious on the CD38+ CHO
cells, confirming that infection by MV- Whereas CD38 can substitute as an entry receptor for MV-
We thank Gabriella Rosales (Mayo Clinic, Department of Biostatistics) for help with the statistical analysis of the data.
Submitted July 31, 2002; accepted November 7, 2002.
Prepublished online as Blood First Edition Paper, November 14, 2002; DOI 10.1182/blood- 2002-07-2195.
Supported by grants from the Mayo Foundation, George M. Eisenberg Foundation, and Harold W. Siebens Foundation.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
Reprints: Kah-Whye Peng, Molecular Medicine Program, Guggenheim 18, Mayo Foundation, 200 First St SW, Rochester, MN 55905; e-mail: peng.kah{at}mayo.edu.
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