Expression of thymidine kinase mediated by a novel non-viral delivery system under the control of vascular endothelial growth factor receptor 2 promoter selectively kills human umbilical vein endothelial cells

Suicide gene strategies applied in ovarian cancer studies

Ovarian cancer represents the most lethal gynecological malignancy among women in developed countries. Despite the recent innovations, the improvements in the 5-year survival rate have been insufficient and the management of this disease still remains a challenge. The fact that the majority of patients experience recurrent or resistant disease have substantiated the necessity of an innovative treatment. Among various strategies investigated, the recent strides made in gene delivery techniques have made gene therapy, including suicide gene strategies, a potential alternative for treating ovarian cancer. Various suicide gene candidates, which are capable of promoting cancer cell apoptosis directly after its entry or indirectly by prodrug administration, can be separated into three systems using enzyme-coding, toxin or pro-apoptotic genes. With this review, we aim to provide an overview of different suicide genes depending on therapeutic strategies, the vectors used to deliver these transgenes specifically to malignant cells, and the combined treatments of these genes with various therapeutic regimens.

Scoping Review of Targeted Ultrasound Contrast Agents in the Detection of Angiogenesis

A systematic search was conducted to categorize targeted ultrasound contrast agents (UCAs) used in cancer-related angiogenesis detection. We identified 15 unique contrast agents from 2008 to March 2018. Most primary research articles studied UCAs targeted to vascular endothelial growth factor receptor or α_v β₃ -integrin. Breast cancer and colon cancer are the most common neoplastic processes in which these agents were studied. BR55 (Bracco Research SA, Geneva, Switzerland), a vascular endothelial growth factor receptor-targeting UCA, is the first targeted UCA that has completed phase 0 trials. Our review identifies a gap in the literature regarding the application of targeted UCAs in cancer models beyond breast and colon cancers and identifies other promising UCAs.

Promoter-Operating Targeted Expression of Gene Therapy in Cancer: Current Stage and Prospect

The technique of targeted expression of interesting genes, including distinct delivery systems and specific gene promoter-operating expression, is an important strategy for gene therapy against cancers. Up to now, extensive literature documented the efficacy of distinct delivery systems, such as the liposome system, nano-particle system, polyetherimide (PEI) system, and so on, in cancer gene therapy. However, a related document on the potential value of using a specific gene promoter, such as a tumor suppressor, in cancer gene therapy was still scary. The main obstacle might be that the selection of an ideal gene promoter to operate interesting gene expression in cancer gene therapy is still not fully understood. Therefore, many efforts need to be done in order to make it a real power tool for the human clinical treatment of cancer patients. The purpose of this review is to clarify the current state and some problematics in development of promoter-operating targeted expression of interesting genes and highlight its potential in cancer gene therapy.

Combined effect of ultrasound/SonoVue microbubble on CD4(+)CD25(+) regulatory T cells viability and optimized parameters for its transfection

The purpose of this study was to investigate the combined effect of ultrasound and SonoVue microbubble on CD4(+)CD25(+) regulatory T cells (Tregs) viability and to explore the appropriate parameters for Tregs transfection. Tregs were separated from peripheral venous blood of patients with hepatocellular carcinoma and seeded in 96-well plates. The optimal ultrasound exposure time and optimal SonoVue microbubble concentration for Tregs were measured by mechanical index (MI) of 1.2 or 1.4, exposure time of 0, 30, 60, 90, 120, 150, 180s, and 0, 10, 20, 30, 40, 50μL/100μL microbubble per well, respectively. In addition, the combined effect of ultrasound and microbubble on Tregs viability was evaluated according to the following parameters: MI 1.2/1.4+exposure time of 120, 150, 180s+0, 10, 20, 30, 40, 50μL/100μL microbubble per well. Tregs viability investigations were performed in order to explore the optimal transfection condition. The efficiency of plasmid transfer was determined by detection of luciferase activity on the microscopic examinations. The proliferation of Tregs could be promoted by ultrasound exposures, while being decreased with the increasing concentration of microbubbles. Under the current experimental conditions, the optimal ultrasound parameters were MI=1.4 and exposure time=150/180s. The optimal microbubble concentration was 10μL/100μL. Compared with treatment with ultrasound or microbubbles alone, the transfection efficiency of Tregs improved 50% by combining ultrasound and microbubble. The results indicate that both ultrasound and microbubble could affect the Tregs proliferation and the optimal Treg transfection rate was obtained by treating with 10% microbubbles and ultrasound exposure for 150/180s under ultrasound MI of 1.4.

Therapeutic properties of a vector carrying the HSV thymidine kinase and GM-CSF genes and delivered as a complex with a cationic copolymer

BACKGROUND

Gene-directed enzyme prodrug therapy (GDEPT) represents a technology to improve drug selectivity for cancer cells. It consists of delivery into tumor cells of a suicide gene responsible for in situ conversion of a prodrug into cytotoxic metabolites. Major limitations of GDEPT that hinder its clinical application include inefficient delivery into cancer cells and poor prodrug activation by suicide enzymes. We tried to overcome these constraints through a combination of suicide gene therapy with immunomodulating therapy. Viral vectors dominate in present-day GDEPT clinical trials due to efficient transfection and production of therapeutic genes. However, safety concerns associated with severe immune and inflammatory responses as well as high cost of the production of therapeutic viruses can limit therapeutic use of virus-based therapeutics. We tried to overcome this problem by using a simple nonviral delivery system.

METHODS

We studied the antitumor efficacy of a PEI (polyethylenimine)-PEG (polyethylene glycol) copolymer carrying the HSVtk gene combined in one vector with granulocyte-macrophage colony-stimulating factor (GM-CSF) cDNA. The system HSVtk-GM-CSF/PEI-PEG was tested in vitro in various mouse and human cell lines, ex vivo and in vivo using mouse models.

RESULTS

We showed that the HSVtk-GM-CSF/PEI-PEG system effectively inhibited the growth of transplanted human and mouse tumors, suppressed metastasis and increased animal lifespan.

CONCLUSIONS

We demonstrated that appreciable tumor shrinkage and metastasis inhibition could be achieved with a simple and low toxic chemical carrier - a PEI-PEG copolymer. Our data indicate that combined suicide and cytokine gene therapy may provide a powerful approach for the treatment of solid tumors and their metastases.

The increase of VEGF secretion from endothelial progenitor cells post ultrasonic VEGF gene delivery enhances the proliferation and migration of endothelial cells

We investigated the feasibility of exogenous gene expression in endothelial progenitor cells (EPCs) through the use of ultrasonic microbubble transfection (UMT). EPCs originating from porcine peripheral blood were cultured in a medium containing constructed vascular endothelial growth factor (VEGF) pDNA followed by UMT. Simultaneously, comprehensive functional evaluations were conducted to investigate the effects of UMT of the VEGF gene on the EPCs. The results showed that UMT yielded significant VEGF protein expression. VEGF-containing supernatant originating from EPCs post UMT led to significantly enhanced activities of proliferation by more than 20% and migration by approximately 30% in human aortic endothelial cells. The duration of additional secretion of VEGF protein attributable to the exogenous VEGF gene in the EPCs post UMT lasted more than 96 hours. In conclusion, UMT successfully delivers the VEGF gene into porcine EPCs, and VEGF-containing supernatant derived from EPCs post UMT enhances the proliferation and migration of human aortic endothelial cells.

Vascular gene transfer and drug delivery in vitro using low-frequency ultrasound and microbubbles

AIM

To determine the effects of ultrasound exposure in combination with a microbubble contrast agent (SonoVue) on the cellular uptake and delivery of drugs/genes into human umbilical vein endothelial cells (HUVECs) as well as their biological effects on migration.

METHODS

HUVECs in suspension were exposed to pulsed ultrasound with a 10% duty cycle in combination with various concentrations of a microbubble contrast agent (SonoVue) using a digital sonifier at a frequency of 20 kHz and an intensity of 3.77 W/cm(2) on the surface of a horn tip. Cell culture inserts were used to determine the cell migration ability.

RESULTS

Exposure to pulsed ultrasound resulted in enhanced green fluorescent protein (EGFP) gene transfection efficiencies ranging from 0.2% to 2%. The transfection efficiency of HUVECs was approximately 3-fold higher in the presence of SonoVue than in its absence at the effective exposure time of 6 s. For drug delivery to HUVECs using ultrasound, the delivery efficiencies of a low-molecular-weight model drug (TO-PRO-1, M(W) 645.38) were significantly higher when compared to drug delivery without ultrasound, with a maximum efficiency of approximately 34%. However, the delivery efficiencies of a high-molecular-weight model drug (Dextran-Rhodamine B, M(W) 70,000) were low, with a maximum delivery efficiency of nearly 0.5%, and gene transfection results were similarly poor. The migration ability of HUVECs exposed to ultrasound was also lower than that of the control (no exposure).

CONCLUSION

The use of low-frequency and low-energy ultrasound in combination with microbubbles could be a potent physical method of increasing drug/gene delivery efficiency. This technique is a promising nonviral approach that can be used in cardiovascular disease therapy.

Ultrasonic microbubble-mediated gene delivery causes phenotypic changes of human aortic endothelial cells

Ultrasound, in combination with microbubbles, serves as a feasible nonviral method in vascular gene delivery. However, the effects of ultrasonic microbubble transfection (UMT) on vascular endothelial cells remained unclear. We therefore investigated whether UMT itself causes phenotypic changes of the human aortic endothelial cells (HAEC) in vitro. HAEC were cultured with solution containing luciferase reporter gene and microbubbles followed by exposure to ultrasound of selected parameters. Thereafter, the proliferation and migration activities of HAEC were investigated. Real-time RT-PCR and/or western blotting were performed to assess expression profile of HAEC, including growth-related factors (vascular endothelial growth factor, fins-like tyrosine kinase-1 [Flt-1] and kinase insert domain-containing receptor [KDR]), coagulatory factor (von Willebrand factor), vasodilatory enzyme (endothelial nitric oxide synthase), gap junctional protein connexin43 and adhesion molecules (P-selectin, intercellular adhesion molecule 1 and vascular cell adhesion molecule 1). The results showed that in conditions where UMT lead to expression of luciferase, proliferation capacity is enhanced (p<0.001), partly attributable to the effect of ultrasound (p<0.05), after excluding the effect of contact inhibition. In addition, the expression of KDR and Flt-1 were found increased at either the mRNA level, protein level, or both (p<0.05). Other markers did not have significant changes (all p>0.2). Similarly, the migration capacity was minimally changed (p>0.3). In conclusion, UMT causes phenotypic changes of HAEC by enhancing proliferation and upregulating KDR and Flt-1, while possesses no obvious adverse effect on viable transfected cells. Further investigation is required to clarify the impact of these changes by UMT in vivo.

Contrast-enhanced ultrasound: The evolving applications

Contrast-enhanced ultrasound (CEUS) is a major breakthrough for ultrasound imaging in recent years. By using a microbubble contrast agent and contrast-specific imaging software, CEUS is able to depict the micro- and macro-circulation of the targeted organ, which in turn leads to improved performance in diagnosis. Due to the special dual blood supply system in the liver, CEUS is particularly suitable for liver imaging. It is evident that CEUS facilitates improvement for characterization of focal liver lesions (FLLs), detection of liver malignancy, guidance for interventional procedures, and evaluation of treatment response after local therapies. CEUS has been demonstrated to be equal to contrast-enhanced computed tomography or magnetic resonance imaging for the characterization of FLLs. In addition, the applicability of CEUS has expanded to non-liver structures such as gallbladder, bile duct, pancreas, kidney, spleen, breast, thyroid, and prostate. The usefulness of CEUS in these applications is confirmed by extensive literature production. Novel applications include detecting bleeding sites and hematomas in patients with abdominal trauma, guiding percutaneous injection therapy and therefore achieving the goal of using interventional ultrasonography in managing splenic trauma, assessing the activity of Crohn’s disease, and detecting suspected endoleaks after endovascular abdominal aneurysm repair. Contrast-enhanced intraoperative ultrasound (US) and intracavitary use of CEUS have been developed and clinically studied. The potential use of CEUS involves sentinel lymph node detection, drug or gene delivery, and molecular imaging. In conclusion, the advent of CEUS has greatly enhanced the usefulness of US and even changed the status of US in clinical practice. The application of CEUS in the clinic is continuously evolving and it is expected that its use will be expanded further in the future.

Effects of HSV-TK+GFP/GCV suicide gene therapy system on mouse pancreatic cancer cells

AIM: To study in vitro therapeutic effect on mouse pancreatic cancer, as well as the bystander effect with HSV-TK suicide gene in combination with prodrug GCV.

METHODS: HSV-TK and GFP were inserted into pcDNA3.1 (+) to construct pcDNA3.1+/HSV-TK+GFP, and pcDNA3.1+/HSV-TK+GFP was transferred into mouse pancreatic cancer cell MPC by Lipofectin. We then added GCV to these gene-modified cells and studied the sensitivity of the cells to GCV as well as the bystander effect.

RESULTS: The gene modified pancreatic cancer cells MPC/HSV-TK+GFP were successfully developed. In vitro experiments showed that when the MPC/HSV-TK+GFP cells accounted for 10% of hybrid cells, the low concentration (20 mg/L) of GCV was about 50% of tumor cell killing. In vivo results showed that the low concentration of GCV killed the cells. And tumor growth of the mouse model was inhibited.

CONCLUSION: Our data demonstrate MPC/HSV-TK+GFP cells are sensitive to the treatment of GCV compared with unmodified tumor cells, and remarkable bystander effect is seen.