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GENE THERAPY
From the Department of Pediatrics, University of
Washington School of Medicine, Seattle, WA.
A lentivirus pseudotyped with vesicular stomatitis virus G
protein (VSV-G) encoding rat erythropoietin (EPO) complementary DNA was
administered to rat skeletal muscle and red blood cell production was
serially monitored. After a single intramuscular injection hematocrit
values increased and reached a plateau at about 35 days and were
sustained for at least 14 months. Virus doses of 6 × 107
infectious units and 6 × 106 infectious units produced
significantly increased mean hematocrit values of 68.5% ± 2.1%
(P < .001, n = 4) and 52.7% ± 1.3%
(P < .001, n = 3), respectively, over values of
control animals receiving normal saline (46.2% ± 1.5%, n = 2). A
polymerase chain reaction (PCR) assay for vector sequences in genomic
DNA showed muscle tissue at the site of injection was positive and
undetectable in liver, spleen, kidney, and lung. The intramuscular
administration of lentivirus provided a dose-responsive, highly
efficient and sustained EPO gene delivery, suggesting these
vectors may be applied generally to the systemic delivery of proteins
such as hormones and clotting factors.
(Blood. 2001;98:594-596) The recently described lentiviral vectors have the
advantage over murine leukemia retroviral vectors of enabling provirus integration into nondividing cells.1-7 These vectors are
constructed by incorporating elements from human immunodeficiency virus
1 (HIV-1) that interact with the nuclear import system and mediate transport via the nucleopore into the cell's nucleus.1-3
Significantly, this vector system has achieved transduction of
terminally differentiated brain tissue,1,8 liver,
muscle,3 and a variety of human cells.5,7,9-11 In most reports lentiviral vectors were
pseudotyped with envelope glycoproteins from amphotropic
murine leukemia virus (MLV) or vesicular stomatitis virus G
protein (VSV-G).1-3,8,12-14 Two major benefits conferred
by VSV-G pseudotyping are a more robust virus that can be easily
concentrated by centrifugation and a broad tropism.
Erythropoietin (EPO) is a 30-kd glycoprotein hormone that is the
regulator of red blood cell production and maintenance in mammals.15,16 The administration of recombinant EPO (rEPO) is now widely used for long-term treatment of anemia associated with
chronic renal failure, cancer chemotherapy, and HIV
infections.16 Delivery of this hormone by gene therapy
rather than by repeated injections may provide clinical and economic
benefits and would serve as a model for the expression of other
therapeutic proteins. We investigated whether a self-inactivating
lentiviral vector encoding rat EPO was able to mediate long-term gene
expression after a single administration to rat muscle.
Vector construction and production
Virus titer
Lentiviral infection and analysis of EPO production in vitro HeLa cells were plated at a density of 105/6-cm diameter dish and infected the next day for 4 hours in the presence of 10 µg/µL DEAE-D and after 48 hours conditioned supernatants assayed for EPO by ELISA (R&D Systems, Minneapolis, MN) according to the manufacturer's instructions.Animal experiments Virus was injected into 4 to 6 sites in the hind legs of anesthetized male Fisher 344 rats weighing 100 to 150 g, each rat receiving a total volume of 0.5 to 0.7 mL, to deliver a virus dose of 6 × 106 to 6 × 107 IU. DEAE-D was added to viral preparations at a final concentration of 20 µg/mL. Serial blood analyses were performed on EDTA-anticoagulated blood samples (300 µL) obtained from tail vein.17 Hematocrit (%), hemoglobin, platelet, and white blood cell (WBC) numbers were measured using a Coulter counter.17Genomic DNA isolation and polymerase chain reaction analysis of vector tissue distribution Genomic DNA was isolated from fresh or frozen tissue samples using a Nucleospin Tissue Kit (Clontech, Palo Alto, CA) following the manufacturer's instructions. Muscle from the injection site and liver, spleen, kidney, and lung tissues were harvested from treated and control animals. Polymerase chain reaction (PCR) was carried out using Taq DNA polymerase under the following cycling conditions: 94°C for 4 minutes followed by 40 cycles of 94°C for 30 seconds, 54°C for 30 seconds, 72°C for 30 seconds followed by 72°C for 5 minutes. Genomic DNA (50 ng) was used as template per each 25-µL PCR reaction. PCR primers to rEPO were as follows: sense 5'-AGGCGCGGAGATGGGGGTGC-3', antisense 5'-GCCTCCTTGGCCTCCAAGA-3'. Because the genomic sequence of rat EPO is not available, we based the primers on the human genomic structure. The rEPO sense primer was located at the end of the first exon and the rEPO antisense primer was located at the end of the fifth exon. We estimated the amount of vector DNA present in the genomic DNA samples by adding increasing molar ratios of 0.1% to 1000% of vector DNA to genomic DNA to perform a competitive titration. PCR products were isolated on a 2% agarose gel and stained with ethidium bromide; stain intensity assessed using Gel Doc software (Biorad, Hercules, CA).
HeLa cells infected with pHR'CMV-rEPO-SIN at a multiplicity of infection (MOI) of about 1 were cultured and conditioned medium assayed for EPO. The mean value of duplicate experiments assayed in triplicate were 16 500 ± 13.0 mU/106 cells per 24 hours. Bioactivity of secreted EPO was confirmed by showing proliferation of HCD57 cells, an EPO-responsive cell line20 (data not shown). Cells infected with pHR'CMV-rEPO-SIN in the presence of the HIV reverse transcriptase inhibitor zidovudine (AZT) secreted EPO at a level of 122.3 ± 6.1 mU/mL per 106 cells per 24 hours, indicating that cytokine expression was lentivirus mediated and not a result of pseudotransduction due to plasmid or protein transfer. Rats injected intramuscularly with the pHR'CMV-rEPO-SIN
lentivirus exhibited elevated hematocrit values for at least 14 months and showed a dose response to virus particle number (Figure
1). The highest level of virus
administration was 6 × 107 IU and induced peak sustained
hematocrit levels of 68.5% ± 2.1%, which were significantly
different from the 46.4% ± 1.6% hematocrit values of control
animals receiving pHR'CMV-rEPO-SIN virus
(P < .001, n = 4). Rats that received a 10-fold lower
dose of virus showed mean elevated hematocrit values of
52.7% ± 1.3% (n = 3), which were significantly different from
both control animals and those receiving the higher virus dose
(P < .001). When 100 µg of the pHR'CMV-rEPO-SIN
plasmid was injected into muscle of control rats, hematocrit levels of
46.3% ± 0.9% (n = 3) were observed. These levels were not
significantly different from those in control animals that received
injections of saline (46.2% ± 11.5%; P > .09).
Animals injected with pRRLCMV-eGFP-SIN, a control lentiviral vector
capable of conferring GFP expression, had hematocrit levels of
46.4% ± 1.6% (n = 2), which were not significantly different from saline control values (P > .12; Figure 1). Mean
hemoglobin levels measured in rats receiving high-dose virus were
21.6 ± 2.6 g/dL and in animals receiving low-dose virus were
18.0 ± 0.8 g/dL; these levels were significantly elevated over
values obtained from control rats (P < .005 and
P < .02, respectively; Table
1). Platelet numbers and WBC counts were
not significantly different between any of the rats
(P > .2; Table 1). These data suggest that the elevated
hematocrit values we observed were due to sustained EPO expression from
lentivirus transduction and were not caused by either viral proteins or
pseudotransduction by plasmid DNA contained in the virus preparations.
Because of the potential for virus spread beyond the muscle injection
sites, we developed a PCR assay of genomic DNA that yielded a 350-bp
product from the lentiviral integrant and a genomic product of
450 bp (Figure 2). The presence
of 1% vector per haploid genome could be detected by this method. The
predicted genomic product was 780 bp and this difference to the
observed band size may be attributable to a difference between the rat
and human genomic structure. We assayed the muscle injection sites and
tissues obtained from spleen, lung, kidney, and liver of rats treated with pHR'CMV-rEPO-SIN and control rats injected with
pRRLCMV-eGFP-SIN and pHR'CMV-rEPO-SIN expression plasmid. Four
DNA samples obtained from muscle of a rat killed 14 months after EPO
lentivirus injection were assayed and one was strongly positive for
provirus (Figure 2, lane 17). DNA samples from spleen, lung,
kidney, and liver from the same rat were all negative (Figure
2). We observed that 20% of muscle samples from injection
sites of 3 rats receiving EPO lentivirus were positive for vector DNA.
This may reflect the difficulty of locating the exact injection sites
more than 12 months after injection. All control tissues, including
plasmid DNA-injected muscle, were negative for vector PCR.
These data are encouraging and demonstrate that a single administration of a lentivirus encoding EPO will permit sustained elevations of hematocrit and suggest this approach to the delivery of clotting factors and cytokines such as granulocyte colony-stimulating factor that do not require finely regulated expression. Our data showing increases in hematocrit values related to virus dose suggest the potential to control gene expression by controlling virus administration.
We thank Dr D. C. Dale for much helpful advice and Bryan Grogan for technical assistance, Drs J.-P. R. Biossel and H. F. Bunn for kindly supplying the rat EPO cDNA, and Drs R. Zufferey and D. Trono for supplying the lentivirus backbone plasmids.
Submitted September 15, 2000; accepted March 15, 2001.
Supported by grants DK50686, DK43727, and DK47754 from the National Institutes of Health and 902-23-248 from the Nederlandse Organisatie voor Wetenschappelijk Onderzoek.
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: William R. A. Osborne, Department of Pediatrics, RR244, MS 356320, University of Washington School of Medicine, Seattle, WA 98195; e-mail: wosborne{at}u.washington.edu.
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© 2001 by The American Society of Hematology.
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