Molecular therapies for viral hepatitis

Survival of liver failure pigs by transplantation of reversibly immortalized human hepatocytes with Tamoxifen-mediated self-recombination

BACKGROUND/AIMS

Hepatocyte transplantation and bioartificial liver treatment are attractive alternatives to liver transplantation. The availability of well-characterized human hepatocyte lines facilitates such cell therapies.

METHODS

Human hepatocytes were immortalized with a retroviral vector SSR#197 expressing catalytic subunit of human telomerase reverse transcriptase (hTERT) and enhanced green fluorescent protein (EGFP) cDNAs flanked by a pair of loxP recombination targets. Then, Tamoxifen-dependent Cre recombinase was expressed in SSR#197-immortalized hepatocytes. Cre/LoxP recombination was performed in the established cells by simple exposure to 500 nM Tamoxifen for a week. Then, the reverted population of the cells was recovered by EGFP-negative cell sorting and characterized in vitro and in vivo using a pig model of acute liver failure (ALF) induced by d-galactosamine (0.5 g/kg) injection.

RESULTS

A human hepatocyte cell line 16T-3 was established. Reverted 16-T3 cells showed the increased expression of hepatic markers in association with enhanced levels of transcriptional factors. Compared to normal human hepatocytes, albumin production and lidocaine-metabolizing activities of reverted 16-T3 cells were 0.32 and 0.50-fold, respectively. Transplantation of reverted 16T-3 cells significantly prolonged the survival of ALF pigs.

CONCLUSIONS

Here we demonstrate the usefulness of Cre/LoxP -mediated reversible immortalization of human hepatocytes with Tamoxifen-mediated self-recombination.

Mechanisms of co-modified liver-targeting liposomes as gene delivery carriers based on cellular uptake and antigens inhibition effect

In order to deliver antisense oligonucleotides (asODN) into hepatocytes orientedly in the treatment of hepatitis B virus (HBV) infection, the liver-targeting cationic liposomes was developed as a gene carrier, which was co-modified with the ligand of the asialoglycoprotein receptor (ASGPR), beta-sitosterol-beta-d-glucoside (sito-G) and the nonionic surfactant, Brij 35. Flow cytometry (FCM) analysis and enzyme-linked immunosorbent assay (ELISA) showed that the asODN-encapsulating cationic liposomes exhibited high transfection efficiency and strong antigens inhibition effect in primary rat hepatocytes and HepG2.2.15 cells, respectively. With the help of several inhibitors acting on different steps during the targeting lipofection, the cellular uptake mechanisms of the co-modified liver-targeting cationic liposomes were investigated through antigens inhibition effect assay and confocal laser scanning microscopy (CLSM) analysis. The cellular uptake with high transfection efficiency seemed to involve both endocytosis and membrane fusion. The ligand sito-G was confirmed to be able to enhance ASGPR-mediated endocytosis, the nonionic surfactant Brij 35 seemed to be able to facilitate membrane fusion, and the co-modification resulted in the most efficient transfection but no enhanced cytotoxicity. These results suggested that the co-modified liver-targeting cationic liposomes would be a specific and effective carrier to transfer asODN into hepatocytes infected with HBV orientedly.

Oligonucleotide-Based Therapeutic Options against Hepatitis C Virus Infection

The hepatitis C virus (HCV) is the cause of a silent pandemic that, due to the chronic nature of the disease and the absence of curative therapy, continues to claim an ever-increasing number of lives. Current antiviral regimens have proven largely unsatisfactory for patients with HCV drug-resistant genotypes. It is therefore important to explore alternative therapeutic stratagems whose mode of action allows them to bypass viral resistance. Antisense oligonucleotides, ribozymes, small interfering RNAs, aptamers and deoxyribozymes constitute classes of oligonucleotide-based compounds designed to target highly conserved or functionally crucial regions contained within the HCV genome. The therapeutic expectation for such compounds is the elimination of HCV from infected individuals. Progress in oligonucleotide-based HCV antivirals towards clinical application depends on development of nucleotide designs that bolster efficacy while minimizing toxicity, improvement in liver-targeting delivery systems, and refinement of small-animal models for preclinical testing.

A self-processing ribozyme cassette: utility against human papillomavirus 11 E6/E7 mRNA and hepatitis B virus

We have been developing a self-processing triple-ribozyme cassette, which consists of two cis-acting hammerhead ribozymes flanking an internal, trans-acting hammerhead ribozyme (ITRz). Here, the single ITRz was replaced by two contiguous ITRz (dITRz), and a short poly(A) tail was designed onto the 3' end of the liberated dITRz, to produce the "SNIP(AA)" cassette. Self-processing of the cassette appeared to proceed efficiently in cells: The only region of the cassette identified in cells was the liberated dITRz, with approximately 10-20% of the dITRz found within the nucleus. We tested this reagent against two therapeutically important targets, human papillomavirus 11 E6/E7 mRNA and hepatitis B virus (HBV). Library selection protocols were utilized to define accessible target sites, and ribozymes targeted to these sites were very active in vitro. Pairs of the selected ribozymes were then inserted into the SNIP(AA) cassette. SNIP(AA) constructs targeted to the E6/E7 mRNA were tested in cell culture using a cotransfection approach. Significant reductions were produced in E6/E7 target, with 80-90% reductions observed at 5 days following cotransfection. SNIP(AA) constructs targeted to HBV RNA were tested in vivo in a transgenic mouse model. SNIP(AA) constructs were packaged in liposomes, which were targeted to hepatocytes using asialofetuin, and administered ip. After 2 weeks, a >80% reduction in viral liver DNA was observed. Immunohistochemical staining for core antigen showed a similar decrease in the number of hepatocytes staining positively, compounded by a concomitant loss of residual staining intensity. These results demonstrate the in vivo utility of the self-processing SNIP(AA) cassette against HBV.

Future trends in managing hepatitis C

Despite recent improvements in the treatment of patients who have chronic hepatitis C, a large proportion of patients do not achieve viral clearance. Treatment regimens are also costly, associated with significant morbidity, require substantial patient commitment, and are not appropriate for all patients. Therefore, it is important to maximize and enhance current therapeutic approaches and to investigate new approaches and therapies. Because the ability to maintain adherence to current treatment is associated with higher sustained virologic response rates (particularly in patients infected with genotype 1), strategies directed at patients and support staff to promote treatment adherence are important. Other strategies to enhance current therapy include alternative interferons (IFNs)/cytokines and new IFN delivery systems. Current therapy may also be enhanced by new ribavirin (RBV) analogs with an improved safety profile or by the addition of other immunomodulatory agents such as inosine 5'-monophosphate dehydrogenase inhibitors, histamine dihydrochloride, thymosin alfa 1, and amantadine. Some of these agents have demonstrated promising results, although further evaluation is required. Greater knowledge of the molecular biology of the hepatitis C virus (HCV) holds promise for the development of targeted therapies such as specific inhibitors of HCV polymerase, protease, or helicase, as well as therapeutic vaccines. Other potential molecular-based therapies include antisense oligonucleotides, ribozymes, and short interfering ribonucleic acid (RNA) molecules. Therapies aimed at reducing or preventing the development of fibrosis are also under investigation. Multiple-drug regimens will likely be required to enhance viral clearance and reduce viral resistance, while providing greater tolerability.

Therapeutic vaccines against infectious diseases

Therapeutic vaccines against chronic infectious diseases aim at eliciting broad humoral and cellular immune responses against multiple target antigens. Importantly, the development of such vaccines will help to establish surrogate markers of protection in humans and thus will augment the subsequent development of efficient prophylactic vaccines. A combination of synthetic small-molecule drugs and immunotherapeutics is likely to represent a powerful means of controlling chronic infections in the future. Challenges faced in developing therapeutic vaccines include the following: first, overcoming the potential impairment of immune responses due to established infection; second, optimizing schedules of vaccine administration in combination with standard of care chemotherapy; and third, defining what biological and immunological read-outs should be used to infer vaccine efficacy.

Lethiferous effects of a recombinant vector carrying thymidine kinase suicide gene on 2.2.15 cells via a self-modulating mechanism

AIM: To determine the lethiferous effects of a recombinant vector carrying thymidine kinase (TK) suicide gene on 2.2.15 cells and the possible self-modulating mechanism.

METHODS: A self-modulated expressive plasmid pcDNA3-SCITK was constructed by inserting the fragments carrying hepatitis B virus antisense-S (HBV-anti-S) gene, hepatitis C virus core (HCV-C) gene, internal ribosome entry site (IRES) element of HCV and TK gene into the eukaryotic vector pcDNA3, in which the expression of TK suicide gene was controlled by the HBV S gene transcription. 2.2.15 cells that carry the full HBV genome and stably express series of HBV antigen were transfected with pcDNA₃-SCITK or vector pcDNA₃-SCI which was used as the mock plasmid. The HepG2 cells transfected with pcDNA₃-SCITK were functioned as the negative control. All the transfected cells were incubated in DMEM medium supplemented with 10 μg/mL. of ganciclovir (GCV). The HBsAg levels in the supernatant of cell culture were detected by ELISA on the 1^st, 3^rd and 6^th day post-transfection. Meanwhile, the morphology of tranfected cells was recorded by the photograph and the survival cell ratio was assessed by the trypan blue exclusion test on the 6^th day post-transfection.

RESULTS: The structural accuracy of pcDNA₃-SCITK was confirmed by restriction endonuclease digestion, PCR with specific primers and DNA sequencing. The HBsAg levels in the supernatant of transfected 2.2.15 cell culture were significantly decreased on the 6^th day post-transfection as compared with that of the mock control (P < 0.05). The lethiferous effect of pcDNA₃-SCITK expression on 2.2.15 cells was initially noted on the 3^rd day after transfection and aggravated on the 6^th day post transfection, in which the majority of transfected 2.2.15 cells were observed shrunken, round in shape and even dead. With assessment by the trypan blue exclusion test, the survival cell ratio on the 6^th day post transfection was 95% in the negative control and only 11% in the experimental group.

CONCLUSION: The results indicate that suicide gene expression of pcDNA₃-SCITK can only respond to HBV-S gene transcription, which may be potentially useful in the treatment of HBV infection and its related liver malignancies.