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Puntel M, Muhammad AKMG, Candolfi M, Salem A, Yagiz K, Farrokhi C, Kroeger KM, Xiong W, Curtin JF, Liu C, Bondale NS, Lerner J, Pechnick RN, Palmer D, Ng P, Lowenstein PR, Castro MG. A novel bicistronic high-capacity gutless adenovirus vector that drives constitutive expression of herpes simplex virus type 1 thymidine kinase and tet-inducible expression of Flt3L for glioma therapeutics. J Virol 2010; 84:6007-17. [PMID: 20375153 PMCID: PMC2876634 DOI: 10.1128/jvi.00398-10] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 03/29/2010] [Indexed: 01/03/2023] Open
Abstract
Glioblastoma multiforme (GBM) is a deadly primary brain tumor. Conditional cytotoxic/immune-stimulatory gene therapy (Ad-TK and Ad-Flt3L) elicits tumor regression and immunological memory in rodent GBM models. Since the majority of patients enrolled in clinical trials would exhibit adenovirus immunity, which could curtail transgene expression and therapeutic efficacy, we used high-capacity adenovirus vectors (HC-Ads) as a gene delivery platform. Herein, we describe for the first time a novel bicistronic HC-Ad driving constitutive expression of herpes simplex virus type 1 thymidine kinase (HSV1-TK) and inducible Tet-mediated expression of Flt3L within a single-vector platform. We achieved anti-GBM therapeutic efficacy with no overt toxicities using this bicistronic HC-Ad even in the presence of systemic Ad immunity. The bicistronic HC-Ad-TK/TetOn-Flt3L was delivered into intracranial gliomas in rats. Survival, vector biodistribution, neuropathology, systemic toxicity, and neurobehavioral deficits were assessed for up to 1 year posttreatment. Therapeutic efficacy was also assessed in animals preimmunized against Ads. We demonstrate therapeutic efficacy, with vector genomes being restricted to the brain injection site and an absence of overt toxicities. Importantly, antiadenoviral immunity did not inhibit therapeutic efficacy. These data represent the first report of a bicistronic vector platform driving the expression of two therapeutic transgenes, i.e., constitutive HSV1-TK and inducible Flt3L genes. Further, our data demonstrate no promoter interference and optimum gene delivery and expression from within this single-vector platform. Analysis of the efficacy, safety, and toxicity of this bicistronic HC-Ad vector in an animal model of GBM strongly supports further preclinical testing and downstream process development of HC-Ad-TK/TetOn-Flt3L for a future phase I clinical trial for GBM.
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Affiliation(s)
- Mariana Puntel
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - A. K. M. G. Muhammad
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Marianela Candolfi
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Alireza Salem
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Kader Yagiz
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Catherine Farrokhi
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Kurt M. Kroeger
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Weidong Xiong
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - James F. Curtin
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Chunyan Liu
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Niyati S. Bondale
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Jonathan Lerner
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Robert N. Pechnick
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Donna Palmer
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Philip Ng
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Pedro R. Lowenstein
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Maria G. Castro
- Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Davis Bldg., Room 5090, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California 90048, Department of Psychiatry and Behavioral Neurosciences, David Geffen School of Medicine, University of California, Los Angeles, California, The Brain Research Institute, University of California, Los Angeles, California, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, Department of Medicine and Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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64
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Curtin JF, Liu N, Candolfi M, Xiong W, Assi H, Yagiz K, Edwards MR, Michelsen KS, Kroeger KM, Liu C, Muhammad AKMG, Clark MC, Arditi M, Comin-Anduix B, Ribas A, Lowenstein PR, Castro MG. HMGB1 mediates endogenous TLR2 activation and brain tumor regression. PLoS Med 2009; 6:e10. [PMID: 19143470 PMCID: PMC2621261 DOI: 10.1371/journal.pmed.1000010] [Citation(s) in RCA: 277] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 11/19/2008] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor that carries a 5-y survival rate of 5%. Attempts at eliciting a clinically relevant anti-GBM immune response in brain tumor patients have met with limited success, which is due to brain immune privilege, tumor immune evasion, and a paucity of dendritic cells (DCs) within the central nervous system. Herein we uncovered a novel pathway for the activation of an effective anti-GBM immune response mediated by high-mobility-group box 1 (HMGB1), an alarmin protein released from dying tumor cells, which acts as an endogenous ligand for Toll-like receptor 2 (TLR2) signaling on bone marrow-derived GBM-infiltrating DCs. METHODS AND FINDINGS Using a combined immunotherapy/conditional cytotoxic approach that utilizes adenoviral vectors (Ad) expressing Fms-like tyrosine kinase 3 ligand (Flt3L) and thymidine kinase (TK) delivered into the tumor mass, we demonstrated that CD4(+) and CD8(+) T cells were required for tumor regression and immunological memory. Increased numbers of bone marrow-derived, tumor-infiltrating myeloid DCs (mDCs) were observed in response to the therapy. Infiltration of mDCs into the GBM, clonal expansion of antitumor T cells, and induction of an effective anti-GBM immune response were TLR2 dependent. We then proceeded to identify the endogenous ligand responsible for TLR2 signaling on tumor-infiltrating mDCs. We demonstrated that HMGB1 was released from dying tumor cells, in response to Ad-TK (+ gancyclovir [GCV]) treatment. Increased levels of HMGB1 were also detected in the serum of tumor-bearing Ad-Flt3L/Ad-TK (+GCV)-treated mice. Specific activation of TLR2 signaling was induced by supernatants from Ad-TK (+GCV)-treated GBM cells; this activation was blocked by glycyrrhizin (a specific HMGB1 inhibitor) or with antibodies to HMGB1. HMGB1 was also released from melanoma, small cell lung carcinoma, and glioma cells treated with radiation or temozolomide. Administration of either glycyrrhizin or anti-HMGB1 immunoglobulins to tumor-bearing Ad-Flt3L and Ad-TK treated mice, abolished therapeutic efficacy, highlighting the critical role played by HMGB1-mediated TLR2 signaling to elicit tumor regression. Therapeutic efficacy of Ad-Flt3L and Ad-TK (+GCV) treatment was demonstrated in a second glioma model and in an intracranial melanoma model with concomitant increases in the levels of circulating HMGB1. CONCLUSIONS Our data provide evidence for the molecular and cellular mechanisms that support the rationale for the clinical implementation of antibrain cancer immunotherapies in combination with tumor killing approaches in order to elicit effective antitumor immune responses, and thus, will impact clinical neuro-oncology practice.
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Affiliation(s)
- James F Curtin
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Naiyou Liu
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Marianela Candolfi
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Weidong Xiong
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Hikmat Assi
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Kader Yagiz
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Matthew R Edwards
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
| | - Kathrin S Michelsen
- Inflammatory Bowel Disease Center and Immunobiology Research Institute, Cedars Sinai Medical Center, Los Angeles, California, United States of America
| | - Kurt M Kroeger
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Chunyan Liu
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - A. K. M. Ghulam Muhammad
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Mary C Clark
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
| | - Moshe Arditi
- Division of Pediatric Infectious Diseases, Cedars Sinai Medical Center, Los Angeles, California, United States of America
| | - Begonya Comin-Anduix
- Department of Surgery, University of California, Los Angeles, California, United States of America
| | - Antoni Ribas
- Department of Surgery, University of California, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
| | - Pedro R Lowenstein
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- The Brain Research Institute, University of California, Los Angeles, California, United States of America
| | - Maria G Castro
- Board of Governors' Gene Therapeutics Research Institute and Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, United States of America
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- The Brain Research Institute, University of California, Los Angeles, California, United States of America
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