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Viralvectors
ViralvectorsareusedforthedeliveryofgeneticalmaterialintocellsBecauseviruseshaveanaturalabilitytoefficientlydelivertheir genome into host cells they are an ideal tool for genetransfer and are often used by molecular biologists to delivertherapeuticgenes
TransductionAbortive(non-replicative)infectionthatintroducesfunctionalgeneticinformationexpressedfromtherecombinantvectorsintothetargetcell
bull Gene therapy (deliver a gene to patientswho lack the gene or carry defectivevertions)
bull Todeliveyantigens(viralvaccines)bull Viraloncotherapybull Researchuses
Virus vectors
Viral Vectors
bull Non-enveloped virus bull The capsid diameter is about 60-90 nm bull Icosahedral symmetry with projections in each of the of the 5 fold axis
AdenovirusAdenovirusampvectors
copyPrinciplesofVirologyASMPress
bull Linear double-stranded DNA (non-segmented) of 35-36kb bull Genes are codified in both strands with overlapping transcription units bull The genome has a) terminally redundant sequences which have inverted terminal repetitions (ITR)agrave origin of replication b) Packaging sequence (ψ)
Genome functional organization
E1A E1BE2AE2BE3E4
OnsetDNAsynthesis
Inhibits apoptosis(darrp53) Block host mRNA transport Stimulate viral mRNA transport
Transctivates all other early genes and stimulates the host cell to enter an S phase-like state
Viral DNA replication
Early Late
Involved in modulating the IR of infected cells
Structural proteins
Facilitate DNA replication enhance late gene expression and decrease host protein synthesis
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
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1
UL4
3U
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5U
L46
UL4
7
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0U
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UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
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2
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L28
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2
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8U
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3
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6
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0U
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1
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45
US2
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US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
ViralvectorsareusedforthedeliveryofgeneticalmaterialintocellsBecauseviruseshaveanaturalabilitytoefficientlydelivertheir genome into host cells they are an ideal tool for genetransfer and are often used by molecular biologists to delivertherapeuticgenes
TransductionAbortive(non-replicative)infectionthatintroducesfunctionalgeneticinformationexpressedfromtherecombinantvectorsintothetargetcell
bull Gene therapy (deliver a gene to patientswho lack the gene or carry defectivevertions)
bull Todeliveyantigens(viralvaccines)bull Viraloncotherapybull Researchuses
Virus vectors
Viral Vectors
bull Non-enveloped virus bull The capsid diameter is about 60-90 nm bull Icosahedral symmetry with projections in each of the of the 5 fold axis
AdenovirusAdenovirusampvectors
copyPrinciplesofVirologyASMPress
bull Linear double-stranded DNA (non-segmented) of 35-36kb bull Genes are codified in both strands with overlapping transcription units bull The genome has a) terminally redundant sequences which have inverted terminal repetitions (ITR)agrave origin of replication b) Packaging sequence (ψ)
Genome functional organization
E1A E1BE2AE2BE3E4
OnsetDNAsynthesis
Inhibits apoptosis(darrp53) Block host mRNA transport Stimulate viral mRNA transport
Transctivates all other early genes and stimulates the host cell to enter an S phase-like state
Viral DNA replication
Early Late
Involved in modulating the IR of infected cells
Structural proteins
Facilitate DNA replication enhance late gene expression and decrease host protein synthesis
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
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UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
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9U
L40
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1
UL4
3U
L44
UL4
5U
L46
UL4
7
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0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
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UL5
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UL7
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2
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7U
L28
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9
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2
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5U
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UL3
7U
L38
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8U
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US6
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0U
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3
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6
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0U
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3U
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9U
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1
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3U
L44
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7
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0U
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5U
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45
US2
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US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
bull Gene therapy (deliver a gene to patientswho lack the gene or carry defectivevertions)
bull Todeliveyantigens(viralvaccines)bull Viraloncotherapybull Researchuses
Virus vectors
Viral Vectors
bull Non-enveloped virus bull The capsid diameter is about 60-90 nm bull Icosahedral symmetry with projections in each of the of the 5 fold axis
AdenovirusAdenovirusampvectors
copyPrinciplesofVirologyASMPress
bull Linear double-stranded DNA (non-segmented) of 35-36kb bull Genes are codified in both strands with overlapping transcription units bull The genome has a) terminally redundant sequences which have inverted terminal repetitions (ITR)agrave origin of replication b) Packaging sequence (ψ)
Genome functional organization
E1A E1BE2AE2BE3E4
OnsetDNAsynthesis
Inhibits apoptosis(darrp53) Block host mRNA transport Stimulate viral mRNA transport
Transctivates all other early genes and stimulates the host cell to enter an S phase-like state
Viral DNA replication
Early Late
Involved in modulating the IR of infected cells
Structural proteins
Facilitate DNA replication enhance late gene expression and decrease host protein synthesis
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 649
copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
Viral Vectors
bull Non-enveloped virus bull The capsid diameter is about 60-90 nm bull Icosahedral symmetry with projections in each of the of the 5 fold axis
AdenovirusAdenovirusampvectors
copyPrinciplesofVirologyASMPress
bull Linear double-stranded DNA (non-segmented) of 35-36kb bull Genes are codified in both strands with overlapping transcription units bull The genome has a) terminally redundant sequences which have inverted terminal repetitions (ITR)agrave origin of replication b) Packaging sequence (ψ)
Genome functional organization
E1A E1BE2AE2BE3E4
OnsetDNAsynthesis
Inhibits apoptosis(darrp53) Block host mRNA transport Stimulate viral mRNA transport
Transctivates all other early genes and stimulates the host cell to enter an S phase-like state
Viral DNA replication
Early Late
Involved in modulating the IR of infected cells
Structural proteins
Facilitate DNA replication enhance late gene expression and decrease host protein synthesis
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
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UL2
2
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L28
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9
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2
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L26
UL2
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L28
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9U
L30
UL3
1U
L32
UL3
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L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
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6
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0U
L21
UL2
3U
L24
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L40
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1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
bull Non-enveloped virus bull The capsid diameter is about 60-90 nm bull Icosahedral symmetry with projections in each of the of the 5 fold axis
AdenovirusAdenovirusampvectors
copyPrinciplesofVirologyASMPress
bull Linear double-stranded DNA (non-segmented) of 35-36kb bull Genes are codified in both strands with overlapping transcription units bull The genome has a) terminally redundant sequences which have inverted terminal repetitions (ITR)agrave origin of replication b) Packaging sequence (ψ)
Genome functional organization
E1A E1BE2AE2BE3E4
OnsetDNAsynthesis
Inhibits apoptosis(darrp53) Block host mRNA transport Stimulate viral mRNA transport
Transctivates all other early genes and stimulates the host cell to enter an S phase-like state
Viral DNA replication
Early Late
Involved in modulating the IR of infected cells
Structural proteins
Facilitate DNA replication enhance late gene expression and decrease host protein synthesis
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
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5U
L46
UL4
7
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0U
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UL5
5U
L56
ICP3
45
US2
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US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
bull Linear double-stranded DNA (non-segmented) of 35-36kb bull Genes are codified in both strands with overlapping transcription units bull The genome has a) terminally redundant sequences which have inverted terminal repetitions (ITR)agrave origin of replication b) Packaging sequence (ψ)
Genome functional organization
E1A E1BE2AE2BE3E4
OnsetDNAsynthesis
Inhibits apoptosis(darrp53) Block host mRNA transport Stimulate viral mRNA transport
Transctivates all other early genes and stimulates the host cell to enter an S phase-like state
Viral DNA replication
Early Late
Involved in modulating the IR of infected cells
Structural proteins
Facilitate DNA replication enhance late gene expression and decrease host protein synthesis
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Genome functional organization
E1A E1BE2AE2BE3E4
OnsetDNAsynthesis
Inhibits apoptosis(darrp53) Block host mRNA transport Stimulate viral mRNA transport
Transctivates all other early genes and stimulates the host cell to enter an S phase-like state
Viral DNA replication
Early Late
Involved in modulating the IR of infected cells
Structural proteins
Facilitate DNA replication enhance late gene expression and decrease host protein synthesis
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
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9
UL2
2
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5U
L26
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L28
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9U
L30
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1U
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L34
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5U
L36
UL3
7U
L38
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UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
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UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
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9U
L40
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1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
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5U
L56
ICP3
45
US2
US3
US4
US6
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US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
Adenovirusampvectors
bull EfficientlyinfectpostmitoMccells
bull Fast(48h)onsetofgeneexpression
bull EpisomalminimalriskofinserMonmutagenesis
bull Upto37kbcapacity
bull PureconcentratedprepsrouMne
bull gt50humanserotypesanimalserotypes
bull Drawbackimmunity
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
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0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
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UL2
2
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7U
L28
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9
UL2
2
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9U
L30
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1U
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5U
L36
UL3
7U
L38
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8U
L49
UL5
3U
L52
US6
UL1
0U
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UL1
3
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6
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0U
L21
UL2
3U
L24
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9U
L40
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1
UL4
3U
L44
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7
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0U
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5U
L56
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45
US2
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US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
gt Presence of E1-like factors in many cellscan allow for expression of viral proteinswhich normally initiate a strong immuneresponse dampening the efficacy of a firstgenerationgtSpace
gtReducedyieldsgtAlthoughattenuatedtoxicity towards thevectorscan be seen stable transgene expression isgenerallynotseen
Adenoviralvectors
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
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UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
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1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
These vectors whenused in vivo result inlong term high-leveltransgene expressionc o m b i n e d w i t hnegligibletoxicity
The main disadvantage for these vectors is the complexproductionduetotheneednotonlyforasuitableproducercell line but also a complementing Ad vector (helper Advector _ HAd) which provides the necessary packagingproteinsoftheviralparticle
The requirement of the HAd brings about the problem ofcontaminationfromtheHAdwhenusingE1complementingproducercells
Adenovirus vectors
insert
bull Third generation vectors all genes deleted contain only two ITRs and psi
bull Require helper virus which is E1-deleted
copyPrinciples of Virology ASM Press
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
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UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
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L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
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1
UL4
3U
L44
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7
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0U
L51
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5U
L56
ICP3
45
US2
US3
US4
US6
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US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 649
copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
11
FirstgenerationAdvectorsproduction
AdEasy Adenoviral Vector System 5
FIGURE 1 Production of recombinant adenovirus
gene of interest
Ori
Ori
Kan
Pac I
Pac I
Pac I
RecombinantAd
Plasmid
Transfect AD-293 (or HEK293) cells
Digest with IPac
LITR
Encapsidation signal
RITR
LITREncapsidation
signal
Promotergene of interest
poly AAdenoviral DNA
Pac IPac I
cotransformB 5183 cells select for Kan
JR
linearize with IPme
MCSShuttle Vector
R ight A
rm
Ori
Kan
gene of interest
Pac I
Pac I
LITREncapsidation
signal
RIT
R
poly APme ILeft ArmCloning Geneof Interest
HomologousRecombination
in Bacteriain vivo
Virus Productionin AD-293 Cells
Regions ofHomologous
Recombination
Left Arm
pAdEasy-1Vector
Ori Right Arm
Pac I
Amp
RITR
RIT
R
RIT
R
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
HighcapacityAdvectorsproduction
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
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UL2
2
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L28
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9
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2
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L26
UL2
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L28
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9U
L30
UL3
1U
L32
UL3
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L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
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6
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0U
L21
UL2
3U
L24
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L40
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1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
13
bull It is a site-specific recombination strategy that can be used for inversion deletion translocation and insertion of DNA sequence
bull Cre-Lox recombination system consists of Cre recombinase enzyme Sequence called Lox P site or simply Lox sequence (on which Cre recombinase acts) Natural Function of Cre-Lox System The system was initially discovered in a temperate bacteriophage P1 Functions of Cre-Lox system in P1 bacteriophage are bull To circularise viral DNA once it is injected into host cell Hence P1 DNA exists as plasmid inside the host
instead of integrating into host genome to form prophage bull During division to separate interlinked circularised viral DNAs so that they are passed equally to daughter
cells bull Copy number maintenance
Lox P Site Lox P site is a 34 bp sequence which consists of 8 bp asymmetric core sequence (it determines the directionality of the Lox P site) 13 bp flanking inverted repeats Lox P sequence representing the asymmetric core and the flanking inverted repeat Cre Recombinase Cre recombinase is the product of Cyclization recombination gene (38 Kda) One Cre recombinase binds to single inverted repeat (ie on a single Lox sequence two Cre molecule binds)
bull Cre recombinase and Lox sequence are not native to plants and animals
Cre-Lox P system
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
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UL2
2
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L28
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9
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2
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L26
UL2
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L28
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9U
L30
UL3
1U
L32
UL3
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L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
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6
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0U
L21
UL2
3U
L24
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L40
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1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
VectorProduction
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
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L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
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Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
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ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
FirstgenerationvectorproductionHEK293 agrave Is the major host cell line for Ad vector development including development of master cell banks and development and optimization of Ad-manufacturing processes agrave Is problematic for large-scale viral production andclinicalapplications(1RCAin3x1010viralparticles)
PerC6agraveBest design and master cell banks for GMP Adproductionagravehas strict licensing costsuses preventing manylaboratoriesfromworkingwiththiscelllineagrave is considered less robust thanHEK293 cell lineasitislessadaptabletoserumfreecultureforlargescaleproductionAdvectors
VLI-293InsertionofspacerDNA(8kb)(followingnt3510)agrave this does not prevent homologous recombinationduetoretentionofhomologybetweenthegenomeandAdvectorbutpackagingoftheAdvectorwillbesuppressedduetotheincreasedsize
HeLaisnotallowedforcommercialusebecauseofitshightumorigenicity
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
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L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
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Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
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ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 645
copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Secondgenerationvectorproduction
One of the main differences from E1 complementing cell lines where E1A and E1B are expressed constitutively is that several of these cell lines rely on the use of conditionally active transcription units or gene products to control the expression of these proteins as the viral products from E2A and E4 regions are toxic to the cells
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
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L34
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L36
UL3
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L38
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8U
L49
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L52
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3
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45
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0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
It should be noted that evenwith thistype of system contamination is notfully eliminated (01 to 1 is usuallyseen) but physical separation of theHC -Ad and HAd t h rough C sC lultracentrifugation can address thisissueFor small preparations this is generally acceptable however forindustrial-scaleclinicalgradevectorproductionfurthermeasureshave to be taken especially as some of this contamination cancontainpackagingcompetentHAd
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
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L34
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L36
UL3
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L38
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8U
L49
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L52
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3
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45
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0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 645
copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
T h i s i s a m a j o rconcernwhen vectorsare use in humantrials
Pre-existing immunity
Marked liver tropism
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 645
copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
19
SetbackampJesseampGelsinger
bull Firstpersontodieinagenetherapyclinicaltrial
bull Ornithinetranscarbamylasedeficiency
bull GivenAdvectorwithnormalOTCgeneatUPenn
bull Died4dayslatermassiveimmuneresponsemulMpleorganfailure
bull Severalrulesofconductbroken
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 645
copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
ImmuneresponsetoAdvectors80 of the human populationhas been exposed to at leastone human Ad serotype andhas developed a serotype-specificIR
PreexistingimmunityagainstaparticularAdserotypesignificantlyreducesthevector uptake shortens the duration of transgene expression and increasetoxicity
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 649
copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
Serotype switching to overcome neutralizing humoral immune response
Helper-Dependent Adenovirus Vectors Elicit IntactInnate but Attenuated Adaptive Host ImmuneResponsesInVivoagrave Improved safety and longer transgene expressionThe ability of preexisting antibodies to recognize epitopes on the capsid resulting in the vector clearance still remains a concern
Heterologous or chimeric viral surface proteinsEj HAd5 vector carrying a chimeric human-bovine fibers had a minimal hepatotoxicity and weaker inflammatory response upon iv injection in mice and also partially evaded the preexisting humoral immunityC o m b i n a t i o n o f f i b e r a n d h e x o n pseudotyping
PEGylation Decreased activation of the innate immune response (shild)
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
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UL2
2
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UL2
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L28
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9
UL2
2
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UL2
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L28
UL2
9U
L30
UL3
1U
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UL3
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L34
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5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
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UL1
3
UL1
6
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0U
L21
UL2
3U
L24
UL3
9U
L40
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1
UL4
3U
L44
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7
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0U
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45
US2
US3
US4
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US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 649
copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
22
Human Herpes virus type 1
514
Herpesviruses
Family HerpesviridaeSubfamilies and Selected Genera
Examples
Alphaherpesviruses Simplexvirus Human herpes simplex virus type 1 and 2 Varicellovirus Varicella-zoster virusBetaherpesviruses Cytomegalovirus Human cytomegalovirus Roseolovirus Human herpesvirus 6 and 7Gammaherpesviruses Lymphocryptovirus Epstein-Barr virus Rhadinovirus Human herpesvirus 8
the family Malacoherpesviridae comprises viruses of oysters The family Herpesviridae listed here includes the well-known human pathogens that belong to all three subfamilies While some herpesviruses have broad host ranges most are restrict-ed to infection of a single species and spread in the population by direct contact or aerosols The hallmark of herpesvirus infections is the establishment of a lifelong latent or quiescent infection that can reactivate to spread to other hosts and often may cause one or more rounds of disease Many herpesvirus infections are not apparent but if the hostrsquos immune defenses are compromised infections can be devastating Some her-pesviruses are pathogens of economically important animals The study of herpesviruses has provided fundamental infor-mation about the assembly of complex virions the regulation of gene expression and mechanisms of immune system mod-ulation and insight into the biology of terminally differentiat-ed cells such as neurons
A
B
Long region(126 kb)
Short region(26 kb)
Lipid envelope
Envelope proteins(gBndashgN)(~12 proteins)
Nucleocapsid
dsDNAgenome
Tegument(gt20 proteins)
TRL UL
OriL OriS
IRL IRS TRSUS
OriS
Figure 13 Structure and genome organization of alphaherpesviruses (A) Virion structure Cryo-elec-tron tomograph of a slice through a single herpes simplex virus type 1 particle (Adapted from E Grunwald et al Science 3021396ndash1398 with permission) (B) Genome organization The herpes simplex virus type 1 genome can ldquoisomerizerdquo or recombine via the large inverted repeat sequences (TRL and IRL or IRS and TRS) such that all pop-ulations consist of four equimolar isomers in which unique long and short sequences (UL and US) are inverted with respect to each other There are at least 84 open reading frames in this 152-kbp genome as well as three origins of replication (Ori)
The order Herpesvirales currently consists of 3 families 3 subfamilies 17 genera and 90 species The family Alloher-pesviridae comprises fish and amphibian herpesviruses and
ASM_POV4e_Vol1_APPENDIXindd 514ASM_POV4e_Vol1_APPENDIXindd 514 72215 1224 PM72215 1224 PM
bull Large completely sequenced easy to manipulate genome
bull Half of the viral genome is composed of non- essential genes which can be replaced with heterologous genes
bull Efficiently infects a wide variety of mitotic and post- mitotic cells
bull The ability to do not integrate in the host genome
Why HSV-1 can be engineered for gene transfer
bull Enveloped virus bull Spherical to pleomorphic bull 150-200 nm in diameter
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
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5U
L36
UL3
7U
L38
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UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
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0U
L21
UL2
3U
L24
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9U
L40
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1
UL4
3U
L44
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5U
L46
UL4
7
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0U
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5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
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2
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L28
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2
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L38
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8U
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US6
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3
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6
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1
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7
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45
US2
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US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
23
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
596
Figure 1 Schematic representation of the HSV-1 virion its genomic organization and the basic design of the HSV-1 derived amplicon plasmid (A) The mature wild-type HSV-1 virion is composed of 4 sub-compartments envelope tegument capsid and the 150-kb linear double-stranded DNA genome The envelope contains glycoprotein molecules involved in the cellular binding and viral entry processes of HSV-1 infection (B) The linear double-stranded DNA genome of wild-type HSV-1 encodes approximately 80-85 viral genes which are located in unique long (UL) and unique short (US) regions within the genome Inverted repeat elements (ab brsquoarsquo arsquocrsquo and ca) flank the unique regions and contain packaging signals required for cleavage and packaging of the replicated viral genome into virions and isomerization of the UL and US genomic segments Three viral origins of replication are located within the genome with 2 in the US region (oriS) and 1 in the UL region (oriL) Several viral genes whose functions are discussed are demarcated (C) The HSV-1 derived amplicon plasmid contains a single oriS or oriL and an ldquoardquo site and is devoid of all viral genes A bacterial origin of replication (ColE1) and an antibiotic resistant gene (Ampr) is included for bacterial propagation of the plasmid A transgene unit-of-interest can be cloned into the HSV-1 amplicon using standard molecular cloning techniques and packaged into HSV-1 amplicon viral particles using helper virus-based or helper virus-free packaging methodologies (Panel B was adapted from [17])
HSV-1 replicating vector recombinant vector with deletion of non-essential genes does not require specialized cell lines
Amplicon based HSV-1 vector is an amplicon-plasmid DNA containing the therapeutic gene The plasmid must contains an H S V - 1 o r i g i n o f r e p l i c a t i o n a n d t h e packaging signal (lsquoarsquo sequence)
H S V- 1 r e p l i c a t i o n defective vector contains deletions of essential f u n c t i o n s a n d c a n r e p l i c a t e s o n l y i n complementing cell lines
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
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1
UL4
3U
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5U
L46
UL4
7
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0U
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UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
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2
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L28
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2
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8U
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3
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6
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0U
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1
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45
US2
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US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
24
HSV-1-derived amplicon vectors bull Alberto Luis Epstein400
for the transduced organisms Furthermore the absence of virus genes in the amplicon genome strongly reduces the risk of reactivation complementation or recombina-tion with latent or resident HSV-1 genomes
Amplicons are quite versatile tools due to the fact that during their production the amplicon genome will replicate like HSV-1 via a mono-directional rolling circle-like mechanism generating long concatemers composed of tandem repeats of the amplicon plasmid (Boehmer amp Lehman 1997) (Fig 2B) Since infectious HSV-1 particles will always package approximately 150 Kbp DNA (the size of the virus genome) the number of repeats that a particular amplicon vector will carry and deliver will depend on the size of the original amplicon plasmid (Kwong amp Frenkel 1984) Therefore an ampli-con plasmid of around 5 Kbp will be repeated approx-imately 30 times in the amplicon vector while a very large amplicon plasmid carrying a 150 Kbp genomic locus will originate amplicon vectors carrying a single repeat of this sequence Actually a second major benefit that arises from the lack of virus genes in the amplicon plasmid is that most of the 150 Kbp capacity of the HSV-1 particle can be used to accommodate very large pieces of foreign DNA This is undoubtedly the most outstanding property of amplicons as there is no other available viral vector system displaying the capacity to deliver such a large amount of foreign DNA to the nuclear environment of mammalian cells apart from amplicons derived from other herpesviruses such as Epstein-Barr virus (EBV) or human cytomegalovirus (HCMV)
In this review we will describe the current state of the art of amplicon vector technology discuss the present limitations of these vectors and illustrate possible ways currently being investigated to improve the potential of these very interesting gene transfer tools
Production of amplicon vectors
Production of amplicon vectors involves the coordi-nated action of more than 50 viral proteins required to allow replication and packaging of the amplicon plasmid into fully infectious virus particles The viral genes en-coding these proteins could be supplied in principle by a helper virus by a viral genome or by a packaging cell line Although it is theoretically possible to construct a packaging cell line able to express the required pro-teins using a strict inducible system no such cells are yet available Hence the trans-complementing systems currently in use are based either on cloned viral DNA or on helper HSV-1 A major limitation long associated with the use of amplicons is the difficulty in producing large high-titre stocks of vector particles free of helper virus contamination and the improvement of methods to produce such stocks has been the concern of many studies over the past decade
The two major methods currently used for producing amplicons one based on infection with a HSV-1 helper virus and the other based on transfection of HSV-1 genes are described in Figs 3 and 4 respectively According to the first method which has long been the only method available cells were transfected with the amplicon plas-
Fig 1 the three types of HSV-1-based vectors Recombinant vec-tors are HSV-1 particles carrying an engineered HSV-1 genome Recombinant vectors can be attenuated (1) in which case they carry a mutation in a gene affecting virulence (white circle) and generally a reporter gene (in this case luciferase yellow arrow) to facilitate following the spread of the virus or defective (2) in which case they carry a deletion in at least one gene encoding an essential function (grey circle) Defective vectors generally carry a transgene of interest (red arrow) and a reporter gene (in this case GFP green arrow) to identify the infected cells Am-plicon vectors (3) are HSV-1 particles carrying a head-to-tail concatemer of a DNA derived from the amplicon plasmid in-stead of the virus genome These plasmids also generally carry a reporter gene and a transgene of interest In addition they carry one HSV-1 origin of DNA replication (oriS) and one packaging signal (pac) to allow amplification and packaging of the plasmid into HSV-1 particles
Fig 2 amplicon plasmid and amplicon vectors A an amplicon plas-mid is a standard Escherichia coli plasmid carrying one Herpes sim-plex virus type 1 (HSV-1) origin of DNA replication (oriS) one HSV-1 packaging signal (pac) and the transgenic and reporter sequences of interest (here represented as coloured arrows) B an amplicon vector is an HSV-1 particle carrying around 150 kbp of a head-to-tail con-catemer of DNA derived from the amplicon plasmid
Viruses 2009 1
605
Figure 3 Schematic representation of the latest packaging systems utilized for amplicon vector
production (A) The HSV-1LaLumlJ helper virus-based amplicon packaging technology involves
initial transfection of the transgene-harbored amplicon plasmid into an ICP4-complementing cell
line with subsequent superinfection with the HSV-1LaLumlJ helper virus which contains a unique
lsquofloxedrsquo packaging signal designed to reduce helper virus contamination The resultant viral
stock from the ICP4-complementing cell line that contains both packaged amplicon particles and
helper virus particles (at approximately a 11 ratio) is used to infect a second cell line which
expresses ICP4 and Cre recombinase Recombination of the loxP-sites via Cre recombinase
results in the deletion of the packaging signal from the helper virus which renders its own
genome packaging-defective and thereby reduces the titers of helper virus present (05) in the
final harvested amplicon vector stock (B) The helper virus-free packaging technology involves
the co-transfection of a permissive cell line such as Vero 2-2 cells with the transgene-harbored
amplicon plasmid and a bacterial artificial chromosome (BAC) designed to harbor the HSV-1
genome deleted in the packaging signals An accessory plasmid expressing other HSV-1
proteins such as vhs can be included to enhance titers The HSV-1-BACumlpac genome has been
strategically designed to preclude its packaging into viral particles thereby eliminating the
presence of helper virus contamination in the final amplicon vector stock (Figure was adapted
from [4568])
HSV-1 Amplicon system
25
bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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bull HSV Amplicons
Advantages
bull Packaging potential is genome length
bull Multiple copies of transgene
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
Disadvantages
bull Contamination with helper virus and recombinants
bull Silencing
bull Lack scalable high titer vector manufacture
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
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UL1
UL5
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2
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9
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2
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L26
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5U
L36
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L38
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8U
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0U
L11
UL1
3
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6
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0U
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1
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3U
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7
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L56
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45
US2
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0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
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0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
26
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
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UL5
5U
L56
ICP3
45
US2
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US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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27
Essential genes are required to produce new infectious viralparticlesinpermissivecellcultureinfections
Accessory genes encode products that are not absolutelyrequiredincellculturebutareimportantforoptimumlyticreplicationoraffectthenaturallifecycleofthevirusinvivocontributingtohostrangepathogenesisorlatency
ICP27 were known to be essential for virus replication andthus deletion of either of these genes completely interruptedvirus growth at an early stage and provided the platform forthe first- and second-generation vectors (Fig 4B) Becausethese genes are essential a method for growing such viruseswas critical to vector engineering and production By themid-1990s cell lines capable of complementing both ICP4and ICP27 had been produced thus allowing production of avector backbone that only expressed the remaining IE genesICP0 ICP22 and ICP47 (Shepard and DeLuca 1991Marconi et al 1996) The deletion of both essential IEgenes prevented the occurrence of replication-competentrecombinants during complementation an important vectorsafety feature Fortunately we found that the 427 deletionvector was able to infect sensory nerves after intradermaldelivery (Goins et al 1994) The vector was transported tothe nerve cell body and the mutant virus genome becameestablished long-term but without the ability to reactivateMoreover it was possible to achieve transient gene ex-pression in neurons using strong promoters such as thehuman cytomegalovirus (HCMV) IE gene promoter Theremaining viral IE genes were rapidly silenced and theneurons appeared to be unharmed Although the HCMV
promoter was only transiently active in the ganglia the virallatency gene promoter remained active as evidenced by theexpression of LAT suggesting that these vectors achieved alatent-like state These HSV mutants represented the firstvectors useful for gene transfer to peripheral nerves openingup the door for gene therapy
A second breakthrough came from Bill Goins in ourgroup who discovered a sequence in the latency gene locusdownstream of the latency promoter that possessed inde-pendent promoter activity Bill referred to this element asthe second latency active promoter (LAP2) LAP2 wasmoveable and capable of expressing transgenes at genomiclocations outside of the latency locus and for extended times(Goins et al 1994) The discovery of LAP2 and the capa-bility of constructing ICP427 deletion vectors togetherprovided a vector system useful for long-term gene therapyof the brain and sensory nerve conditions (Glorioso et al2003)
Despite these advances our vectors were still cytotoxic tocells in culture and failed to persist in nonneuronal tissuesthereby limiting the broad utility of HSV vectors ICP0 inparticular caused cell cycle arrest and apoptosis (Samaniegoet al 1997) While removal of the remaining HSV IE genes
FIG 4 Cascade expression of HSV genes (A) The viral tegument protein VP16 (purple) activates the IE gene promoters(green) to express the IE gene products (blue) that in turn activate the promoters of the E genes (yellow) The E geneproducts replicate the viral DNA releasing expression of the L gene products (red) that package viral genomes de novo andform the virus particle structure (B) ICP4 (diploid) and ICP27 are essential IE genes Expression of E and L genes isblocked in replication-defective HSV deleted for ICP4 andor ICP27 Vector production requires the use of engineeredcomplementing cells First-generation replication-defective HSV vectors are deleted for ICP4 (orange) Second-generationvectors are deleted for both ICP4 (orange) and ICP27 (white) Third-generation vectors are functionally deleted for all ofthe IE genes ICP4 ICP27 ICP0 (diploid) (green) ICP22 (green) and ICP47 (not shown) and are noncytotoxic or interferewith cell division (C) Genomic structure of the third-generation vector deletion of the joint sequence and all remaining IEgenes blocks the expression of any viral genes requiring complementation of ICP4 ICP27 and ICP0 in engineered U2OScells
86 GLORIOSO
1erageneracioacuten(ICP4)
2dageneracioacuten(ICP4yICP27)
3erageneracioacuten
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
HSV-1 replication defective vector
28
HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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HSV-1 replication defective vector gtcan replicates only in complementing cell lines
gtcontains deletions of essential functions
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
gtfail to ex- press any viral genes are completely devoid of toxicity and can persist in any nondividing cell type both in vitro and in vivo
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
29
HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
L51
UL5
5U
L56
ICP3
45
US2
US3
US4
US6
US7
US8
US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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HSV-1 replicating vector gt recombinant vector with deletion of non-essential genes gtremoval of accessory genes that contribute to neuropathogenesis gt late gene designated ICP345
gtdoes not require specialized cell lines gtconditionally replicating HSV vectors
1987 McGeoch et al 1988 Perry and McGeoch 1988 Wuet al 1988) we were nevertheless able to take advantage ofan important aspect of HSV biology cascade gene regula-tion (Fig 4A) Together the first wave of genes (immediateearly [IE] functions) provided activities to overcome innate
immune responses hide infected cells from immune sur-veillance block cell division prevent cell suicide preventrepression of viral gene expression and activate the ex-pression of early (E) and late (L) genes during progressionof the virus replication cycle Two of the IE genes ICP4 and
FIG 2 Genome structure loca-tion of gene classes (A) Diagram ofthe linear viral genome Blue boxesinverted repeats Terminal repeat(TR) and internal repeat (IR) flank-ing the long (L) and short (S) uniquesegments (B) The viral transcriptionunits are color coded as immediateearly (IE green) early (E yellow)early-late (L1 red) late (L2brown) and latency (LAT) gene(purple) The blue boxes representthe repeat regions that can be ma-nipulated to construct replication-defective vectors The internal jointregion contains genes that are du-plicated in the terminal repeats andcan be deleted for insertion of for-eign sequences The IE genes aredeleted to create completely silentvectors The LAT region containselements that can be used for inser-tion of transgenes that remain activein the absence of the IE genes
FIG 3 HSV vector design strategies (A) Amplicon designs Amplicons are genome-length plasmid-like vectors thatcontain a viral origin (ori) and packaging (pac) sequences that allow amplification of transfected amplicon DNA andincorporation into virus particles for amplicon delivery to cells Replication-defective helper virus supplies viral functionsneeded to replicate amplicon DNA and to make helper and amplicon particles in complementing (blue) cells Cotransfectionof noncomplementing cells (green) with amplicon DNA and helper DNA lacking packaging sequences will produce helper-free amplicon particles (B) Replication-defective vector designs Replication-defective viruses are deleted for one or moreessential virus genes and must be grown on cell lines that complement these deleted functions in trans (blue) Infection ofnoncomplementing cells in culture will not produce virus (green) and infection of other tissues (eg brain) will not allowvirus replication (C) Replication-competent (attenuated) vector designs These vectors can be propagated on non-complementing cells (green) and attenuated by removal of neuropathogenic accessory genes for targeting of brain tumorswithout harming normal brain tissue
HSV GENE VECTORS 85
186 TINS Vol 23 No 5 2000
attractive candidates for cell targeting because manytypes of neurones are defined by their neurotransmittersFor example the preproenkephalin and the tyrosine-hydroxylase (TH) promoters have been used to restrictexpression to enkephalinergic and catecholaminergicneurones respectively3637
Another approach to the problem might be to ma-nipulate the virus envelope to achieve cell-specific genedelivery HSV-1 viruses engineered to replace proteinsthat mediate attachment with the erythropoietin hor-mone peptide have been demonstrated to target erythro-poietin-receptor-bearing cells preferentially38 Theo-retically this approach can be used to direct HSV vectorstowards neurones that are characterized by specificreceptor types (for example neuropeptide receptors)Expression of multiple genes
The construction of multigene vectors is also a com-plex task Strategies to express multiple transgenes fromthe same vector are either founded on the use of mul-tiple promoters (that is separate expression of eachgene)3940 or on the insertion of IRES between the trans-genes (that is transcription of multiple genes from asingle promoter)4142 Model multigene vectors havebeen constructed with four or five independent trans-genes inserted at distinct loci which produces simul-taneous expression of all transgenes for up to sevendays40 Taking advantage of all available sites it is theo-retically possible to construct replication-defective vec-tors that express as much as 50 kb of foreign DNA Thesedata demonstrate the potential to create differenttransgene combinations for studies of their biologicalinteractions within nerve cells
Molecular analysis of behavior using HSV-1 vectors
Viral vectors have already been employed to study theeffect of alterations in the expression of single genes
within small groups of neurones on animal behaviourand disease models In this section the results obtainedusing HSV vectors will be focused on but examples ofthose obtained with other viral vectors will also bedescribedDrug addiction
Chronic drug administration elicits molecular adap-tations at the level of specific neuronal populations4344For example repeated exposure to morphine sensitizesanimals to its stimulant and rewarding properties45 andincreases expression of the gene for the AMPA gluta-mate-receptor subunit GluR1 in the ventral tegmentalarea (VTA) a crucial participant in reward mechanisms46The use of viral vectors has made it possible to investi-gate whether some of these adaptations correlate withspecific behavioural manifestations of addiction Thegene for GluR1 has been transfected into VTA neuronesusing an HSV-1 amplicon47 Thereafter sensitization tothe stimulant and rewarding properties of morphine hasbeen evaluated using appropriate protocols (morphine-induced locomotor activity and conditioned placepreference) Sensitization to both the stimulant and tothe rewarding properties of morphine was increasedafter vector-mediated expression of the gene for GluR1(but not after expression of other related genes) in theVTA This amplicon was not significantly neurotoxicand its behavioural effects were transient with a time-course that paralleled that of transgene expressionThus the behavioural consequences of morphine pre-exposure are potentiated by HSV-1-vector-mediatedexpression of the gene for GluR1 in the VTA
The repeated administration of cocaine also causescomplex molecular adaptations in the reward systemsFor example it increases phosphorylation of the tran-scription factor CREB (cAMP-response-element-bindingprotein) in the nucleus accumbens shell one of the
M Simonato et al ndash Herpes simplex vectorsT E C H N I Q U E S
trends in Neurosciences
(a)
(b)
ICP0 ICP0
ICP27 ICP4 ICP4
LATICP22
LAT
ICP3
45
UL2
UL3
UL4
UL1
UL5
UL6
UL7
UL8
UL9
UL2
2
UL2
4U
L25
UL2
7U
L28
UL2
9
UL2
2
UL2
5U
L26
UL2
7U
L28
UL2
9U
L30
UL3
1U
L32
UL3
3U
L34
UL3
5U
L36
UL3
7U
L38
UL4
UL4
8U
L49
UL5
3U
L52
US6
UL1
0U
L11
UL1
3
UL1
6
UL2
0U
L21
UL2
3U
L24
UL3
9U
L40
UL4
1
UL4
3U
L44
UL4
5U
L46
UL4
7
UL5
0U
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UL5
5U
L56
ICP3
45
US2
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US9
US1
0U
S11
Accessory
Essential
UL USIRL IRS TRSTRL
ICP22
ICP4
ICP0
ICP27
IE
VP16
E L+
+++
+ +
+
ndash
Fig 2 HSV-1 genome organisation and gene regulation (a) The virus genome The herpes simplex virus (HSV) genome is a linear double-stranded DNA molecule 152 kbin length and encoding at least 84 genes65 It is composed of two unique sequences the unique long (UL) and unique short (US) segments each of which is flanked by invertedrepeat elements (TRL and IRL IRS and TRS) The location of the essential genes which are required for viral replication in vitro and of the non-essential (accessory) geneswhich can be deleted without affecting replication in vitro are indicated Immediatendashearly (IE) genes (those that code for ICP4 ICP27 ICP22 and ICP0) and other locitargeted for genetic manipulation are highlighted (b) Temporal cascade of HSV gene expression detailing the role of HSV-1 IE gene transactivators and of the IE promoterstimulatory molecule VP16 The IE genes are expressed immediately after infection in the absence of de novo protein synthesis The VP16 virus tegument protein interactswith the cellular factor Oct1 to regulate the expression of the IE genes positively by binding to their promoters The IE-gene products ICP4 ICP27 and ICP0 are responsiblefor activating early (E) genes After viral DNA replication the ICP4 ICP22 and ICP27 IE polypeptides regulate expression of the late (L) genes ICP4 can also inhibit theexpression of IE genes including its own expression once transcription of the E class has been initiated
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
Engineering techniquesSimple and highly efficient BAC recombineering usinggalK selectionSoslashren Warming Nina Costantino1 Donald L Court1 Nancy A Jenkins andNeal G Copeland
Mouse Cancer Genetics Program and 1Gene Regulation and Chromosome Biology LaboratoryNational Cancer Institute Frederick MD 21702-1201 USA
Received January 11 2005 Revised and Accepted February 4 2005
ABSTRACT
Recombineering allows DNA cloned in Escherichiacoli to be modified via lambda (l) Red-mediatedhomologous recombination obviating the need forrestriction enzymes and DNA ligases to modify DNAHere we describe the construction of three newrecombineering strains (SW102 SW105 and SW106)that allow bacterial artificial chromosomes (BACs) tobe modified using galK positivenegative selectionThis two-step selection procedure allows DNA to bemodifiedwithout introducing an unwanted selectablemarker at the modification site All three strains con-tain an otherwise complete galactose operon exceptfor a precise deletion of the galK gene and a defect-ive temperature-sensitive l prophage that makesrecombineering possible SW105 and SW106 cellsin addition carry L-arabinose-inducible Cre or Flpgenes respectively The galK function can be selec-ted both for and against This feature greatly reducesthe background seen in other negative-selectionschemes and galK selection is considerably moreefficient than other related selection methodspublished We also show how galK selection can beused to rapidly introduce point mutations deletionsand loxP sites into BAC DNA and thus facilitatefunctional studies of SNP andor disease-causingpointmutations the identificationof long-range regu-latory elements and the construction of conditionaltargeting vectors
INTRODUCTION
Bacterial artificial chromosomes (BACs) have become theDNA of choice for genomic sequencing due to their high
stability and large insert size (100ndash300 kb) (1) BACs arealso being used more and more for making transgenic micesince in many cases all of the important regulatory sequencesrequired for normal gene expression can be found on a singleBAC (23) Many laboratories also use BACs as the startingpoint for making gene-targeting constructs for manipulatingmouse genes using ES cell technology (knock-outs knock-insand conditional targeting using CreloxP) (45)
Recombineering (recombination-mediated genetic engi-neering) makes it possible to modify BAC DNA via homo-logous recombination [reviewed in (67)] Recombineering ismade possible through the use of three l Red-encoded genesexo bet and gam exo encodes a 50ndash30 exonuclease that pro-duces 30 overhangs from introduced double-stranded DNAtargeting cassettes (dsDNA) bet encodes a pairing proteinthat binds to the 30 overhangs and mediates its annealingand homologous recombination with complementary DNApresent on the BAC At the same time gam encodes an inhib-itor of the Escherichia coli RecBCD exonuclease and therebyprotects the linear DNA-targeting cassette from degradationby RecBCD l Red (or the corresponding RecE and RecTgenes of the prophage Rac) can be expressed from a multicopyplasmid using an inducible promoter (89) Alternatively thesegenes can be expressed from a stably integrated defectivel prophage where exo bet and gam are controlled by thestrong phage promoter pL under stringent control of thetemperature-sensitive repressor cI857 (1011) In the pro-phage system exo bet and gam are not expressed when thebacteria are kept at 32C By shifting the bacteria to 42C foras little as 15 min the genes are rapidly induced to very highlevels and homologous recombination is very efficient
Using recombineering one can easily subclone a genomicfragment from a BAC by gap repair either for use as atransgene directly or for subsequent manipulation to make agene-targeting construct The introduction of selectable mark-ers into a BAC is also very easy using recombineering How-ever a major limitation to the usefulness of BACs is the easeand efficiency with which one can make subtle and lsquoseamlessrsquo
To whom correspondence should be addressed at Mouse Cancer Genetics Program Center for Cancer Research National Cancer Institute West 7th Street at FortDetrick Bldg 539 PO Box B Frederick MD 21702-1201 USA Tel +1 301 846 1260 Fax +1 301 846 6666 Email Copelandncifcrfgov
ordf The Author 2005 Published by Oxford University Press All rights reserved
The online version of this article has been published under an open access model Users are entitled to use reproduce disseminate or display the open accessversion of this article for non-commercial purposes provided that the original authorship is properly and fully attributed the Journal and Oxford University Pressare attributed as the original place of publication with the correct citation details given if an article is subsequently reproduced or disseminated not in its entirety butonly in part or as a derivative work this must be clearly indicated For commercial re-use please contact journalspermissionsoupjournalsorg
Nucleic Acids Research 2005 Vol 33 No 4 e36doi101093nargni035
SW102 bacteria E Coli derived strain designed for BAC recombineering using galK positivenegative selection These bacteria contain a fully functional gal operon except the galK gene is missing The ability to grow on galactose minimal medium can be restored by adding galK in trans by inserting a galK expression cassette into a BAC Next the galK cassette can be replaced by any dsDNA carrying any desired mutation by selection against galK using 2-deoxy- galactose
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
galK expression cassette
Having produced a bacterial strain SW102 which is galKdefective the next step was to make a galK expression cassettethat could be used to restore the bacteriarsquos ability to grow ongalactose by providing galK in trans This was achieved byPCR amplification of the wild-type galK ORF from W3110cells We then added a minimal bacterial promoter em7 usinga two-step PCR approach (see Materials and Methods) andcloned the expression cassette into pBluescript SK We callthis plasmid pgalK (Table 1) The constitutively active galKexpression cassette can easily be amplified by PCRwith homology arms added to the primers (see Materialsand Methods)
Making a single base pair substitution
The general scheme for making mutations in BACs using galKselection is depicted in Figure 2 To test the galK selectionsystem for BAC recombineering we decided to introduce apoint mutation into a BAC containing the murine Nras gene(CITB clone 50J2) The sequence of the glycine-coding codon12 is GGT By changing this codon to GAT we would obtainthe desired mutation G12D In order to introduce this muta-tion into the BAC we first amplified the galK expressioncassette by PCR using primers with 50 bp of homology toeither side of the second position of the GGT codon Followinghomologous recombination this targeting would introduce a1 bp deletion into codon 12 in addition to inserting the galKselection cassette Instead of deleting the basepair the galKcassette could have been inserted right next to the basepairinstead SW102 cells containing the 50J2 BAC were heat-induced and made electrocompetent and then electroporatedwith the galK cassette Gal+ recombinant colonies were selec-ted for growth on galactose minimal medium with chloram-phenicol to maintain the BAC Bacteria grow more slowly onminimal media than on rich media and we generally pickcolonies after 2ndash3 days For this first step we do not expectany background colonies on the non-induced control plates ifthe pgalK plasmid is properly eliminated (see Materials andMethods) To purify the Gal+ colonies we streaked a fewcolonies on MacConkey galactose indicator plates to obtainsingle bright pinkred Gal+ colonies One of these single-cloned colonies was picked to initiate a culture for thenext step counterselection We find that there is no need toanalyze the Gal+ colonies further before proceeding tocounterselection
A 100 bp dsDNA oligo was then prepared by annealing twocomplementary oligos having 49 and 50 bp homologyrespectively to either side of the desired mutation a singleAT bp An aliquot of 200 ng of this oligo was then electro-porated into heat-induced and electrocompetent SW102 Gal+
cells containing the galK modified 50J2 BAC After electro-poration the bacteria were allowed 45 h outgrowth in a 32Cshaking waterbath The bacteria were then washed in M9 saltsto remove any rich medium and plated on minimal mediumwith glycerol DOG and chloramphenicol The 45 h out-growth is necessary to obtain complete segregation of therecombinant BACs containing the mutation After 3 dayswe obtained colonies with a ratio of 10ndash1001 when comparingplates with heat-induced to non-induced bacteria We picked12 colonies from the heat-induced plates for BAC minipreps
followed by SpeI restriction analysis (Figure 3A) Ten out ofthe twelve clones had the same restriction pattern as theunmodified 50J2 BAC DNA suggesting that the desiredreplacement of the galK gene by the point mutation hadoccurred This was confirmed by PCR amplification followed
Figure 2 Overview of the galK selection scheme The result of the firsttargeting event is the insertion of constitutively active galK into a definedposition on the BAC by selection on minimal medium containing galactoseand chloramphenicol to select for themaintenance of the BAC The bacteria arenow phenotypically Gal+ Next the galK cassette is replaced by a dsDNAoligoa PCR product or a cloned dsDNA fragment carrying a desired mutation(indicated by a star) and flanked by the same homology arms used in thefirst selection step This is achieved by negative selection using minimalmedium containing 2-deoxy-galactose (DOG) with glycerol as the sole carbonsource The bacteria become phenotypically Gal H1 and H2 homology arms1 and 2 respectively cat chloramphenicol acetyl transferase gene ori2 BACorigin of replication galK Ecoli galactokinase gene driven by a minimalpromoter
e36 Nucleic Acids Research 2005 Vol 33 No 4 PAGE 6 OF 12
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
31
Oncolytic Vectors
Advantages
bull Natural lytic cycle toxicity
bull Potential for enhanced virus spread within the tumor
bull Infection can be aborted with anti-HSV drugs
bull Can insert foreign genes
bull Ease of manufacture to high titer
bull Clinical experience is promising
Remaining Issues
Are current oncolytic viruses too attenuated
How best to achieve tumor targeting and improve initial vector distribution and methods of delivery
How to overcome the anti-viral response
How to induce anti-tumor immunity
How to combine with drug and radiotherapy
bull HSV Replication Defective
Advantages
bull Packaging potential is 40-50 Kb
bull Large or multiple transgenes
bull Removal of virus genes avoiding leakiness
bull Versatile construction in bacteria
bull High safety profile
bull Targeted Delivery and expression
Disadvantages
bull Transient gene expression
bull Highly defective viruses are difficult to manufacture
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
32
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 647
copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
Indica7onsampaddressedampbyampampgeneamptherapyampclinicalamptrials
httpwwwwileycomlegacywileychigenmedclinical
Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Viral Vectors_ Vaccines
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
35
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29 Ledgerwood et al Chimpanzee Adenovirus Vector Ebloa Vaccine ndash Preliminary Report NEJM 26 November 2014 Rampling et al A Monovalent Chimpanzee Adenovirus Ebola Vaccine ndash Prelimiary Report NEJM 28January2015
NIHGSK Vaccine Candidate
bull Recombinant replication-defective Chimpanzee adenovirus type 3 (ChAd3)-derived vector encoding Ebolavirus Zaire (EBOV) glycoprotein (GP)
bull ChAds ndash evaluated as vaccine vectors in nonhuman primates and
human clinical trials ndash low world-wide seroprevalance in humans ndash not cross-neutralized by human anti-adenovirus sera
bull Immunological goal AEliginduction of effective antibody and CD8 T cell responses
bull Preclinical data AElig 100 protection in NHP model 5 weeks after a single dose of ChAd3-EBO-Z
bull Preliminary clinical data suggest vaccine has acceptable safety profile and is immunogenic
2
Chimpanzee Adenovirus expressing Ebolavirus Zaire Glycoprotein (ChAd3-EBO-Z vaccine)
Image credit Visualscienceru
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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copy 2015 Macmillan Publishers Limited All rights reserved
36
NIHGSK Vaccine Candidate
4
Encouraging survival data in the Cynomolgus Macaque model
Acute protection ndash 1 dose Challenge at 5 weeks post vaccination
Stanley et al Chimpanzee adenovirus vaccine generates acute and durable protective immunity against ebolavirus challenge Nature Medicine 201420(10)1126-29
EBOV IM challenge of 1000 PFU Mortality at 6-9 days
bull Acute protection associated with antibody responses
Ebolavirus challenge
0 1 2 3 4 5 Weeks
Vaccinate ChAd Ebola GP (n = 4group)
ChAd3-EBO-Z Vaccine Development
1 Scientific approachrationale - Vaccine candidate based on non replicative Chimpanzee adenovirus expressing GP of Ebola Zaire
(ChAd3-EBO-Z)
2 Supporting evidences - Protection data in NHP model 100 protection 5 weeks after single injection of ChAd3-EBO-Z - Acceptable safety and reactogenicity profile in Phase I studies - Highest dose induced statistically superior humoral immunogenicity after 1 dose with no difference
between populations
3 Current Status - NIH-sponsored efficacy study ongoing in Liberia
- Phase II part completed enrollment at 1500 (500 receiving ChAd3-EBO-Z) - Discussions ongoing about extending trial to Guinea
- Phase II safetyimmunogenicity study in West African Adults planned to start in June - Discussing with FDA and EMA approaches to confirm effectiveness if clinical efficacy is not feasible
11
Summary and Conclusion
37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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37
EbolavirusampGPampvaccineampinampAdMVA
doi101038nm3702
IMchallenge GSKNIAIDNIH
Animalsinsingle-shotgroupswerevaccinatedwithChAd3atthedosesindicatedandexposedtoalethaldoseofEBOV10monthsaftertheprimevaccinationAnimalsinprime-boostgroupswereprimedwithChAd3boosted8weekslaterandexposedtoalethaldoseofEBOVasinthesingle-shotgroups
38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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38
ChAd3-EBO-Z Dose decision 1x1011 vp
bull Analysis shared with Phase I investigators FDA EMA and African NRAsERCs
bull ChAd3-EBO-Z was shown to have an acceptable safety profile in Phase I ndash All doses are considered acceptable from an individual patient safety perspective ndash No suspected unexpected serious adverse reactions (SUSARS) reported ndash Majority of solicited adverse events that were reported were classified as mild ndash Local pain at the injection site headache and ldquoflu-likerdquo symptoms were the most common solicited adverse
events
bull ChAd3-EBO-Z was immunogenic in humans and demonstrated antigen-specific antibody responses against Ebola GP and T-cell responses
bull 1x1011 vaccine dose induced higher titers compared to the different lower doses based on both the observed or predicted values
8 Analysis contains unpublished data
Ebola Vaccine
40
Viral Vectors_ Viral Oncotherapy
42
Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Ebola Vaccine
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Viral Vectors_ Viral Oncotherapy
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Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Viral Vectors_ Viral Oncotherapy
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Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Viral Vectors_ Viral Oncotherapy
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Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Viruses 2016 8 9 3 of 22
Viruses2016ȱ8ȱ0000ȱ 3ȱofȱ22ȱ
ȱFigureȱ1ȱMechanismsȱofȱtumourȱdestructionȱthroughȱoncolyticȱvirotherapyȱOncolyticȱvirusesȱ(OVs)ȱmayȱexertȱ theirȱantiȬtumourȱeffectsȱ throughȱseveralȱmechanismsȱOVsȱ induceȱ theȱdeathȱofȱatȱ leastȱsomeȱ tumourȱ cellsȱ inȱ aȱdirectȱwayȱbyȱ infectingȱ theseȱ cellsȱandȱ replicatingȱ thereinȱProgenyȱvirusȱparticlesȱareȱreleasedȱandȱ infectȱneighbouringȱ tumourȱcellsȱresultingȱ inȱamplificationȱofȱ theȱ inputȱOVȱdoseȱ(boxȱ1)ȱOVsȱoftenȱinduceȱanȱimmunogenicȱcellȱdeathȱ(boxȱ2)ȱTumourȬassociatedȱantigensȱpathogenȬassociatedȱ molecularȱ patternȱ (PAMPs)ȱ andȱ dangerȬassociatedȱ molecularȱ patternsȱ(DAMPs)ȱareȱreleasedȱfromȱdyingȱtumourȱcellsȱandȱcomeȱintoȱcontactȱwithȱantigenȬpresentingȱcellsȱsuchȱasȱdendriticȱcellsȱ inȱ theȱ tumourȱmicroenvironmentȱLocalȱ inflammationȱasȱ inducedȱbyȱvirusȱinfectionȱstimulatesȱtheȱmaturationȱofȱdendriticȱcellsȱandȱtheirȱmigrationȱtoȱdrainingȱlymphȱnodesȱwhereȱ theyȱcanȱpresentȱ tumourȬassociatedȱantigensȱ toȱTȱcellsȱUnderȱoptimalȱconditionsȱ thisȱmayȱelicitȱanȱantiȬcancerȱCD4+ȱandȱCD8+ȱeffectorȱTȱcellȱresponseȱthatȱhasȱtheȱpotentialȱtoȱkillȱinfectedȱandȱuninfectedȱ tumourȱ cellsȱ Inȱ additionȱ someȱOVsȱ disruptȱ theȱ tumourȬassociatedȱ vasculatureȱ (viaȱinfectionȱofȱtumourȱendothelialȱcellsȱexpressionȱofȱantiȬangiogenicȱviralȱproteinsȱandorȱOVȬinducedȱinflammatoryȱresponses)ȱleadingȱtoȱischemiaȱandȱnecroticȱdeathȱofȱuninfectedȱtumourȱcellsȱ(boxȱ3)ȱ
VirusȬinducedȱ cellȱ deathȱ followingȱ infectionȱ andȱ inȬcellȱ multiplicationȱ isȱ aȱ complexȱmultifacetedȱprocessȱwhichȱisȱtriggeredȱmainlyȱbyȱcytotoxicȱviralȱproteinsȱalthoughȱthisȱhasȱyetȱtoȱbeȱstudiedȱforȱsomeȱoncolyticȱvirusesȱinȱuseȱTheseȱproteinsȱhaveȱmultipleȱmodesȱofȱactionȱwhichȱoftenȱdifferȱ fromȱ thoseȱ activatedȱbyȱ conventionalȱ cancerȱ therapiesȱAsȱ aȱ resultȱ theȱ likelihoodȱofȱcancerȱcellsȱacquiringȱresistanceȱtoȱOVȱtreatmentȱasȱseenȱwithȱotherȱantiȬcancerȱmodalitiesȱhasȱnotȱbeenȱdocumentedȱ soȱ farȱ (inȱ contrastȱ toȱ theȱ resistanceȱdevelopedȱ toȱotherȱantiȬcancerȱmodalities)ȱHoweverȱitȱcannotȱbeȱruledȱoutȱthatȱsomeȱcancerȱcellsȱmayȱacquireȱresistanceȱtoȱOVsȱthroughȱtheȱlossȱofȱcellularȱpermissivenessȱfactorsȱegȱcellȱsurfaceȱreceptorsȱthatȱareȱessentialȱforȱvirusȱuptakeȱorȱ theȱalterationȱofȱsignallingȱpathwaysȱ requiredȱ forȱ theȱvirusȱ lifeȱcycleȱConverselyȱexamplesȱofȱOVsȱovercomingȱcancerȱcellsrsquoȱdrugȱresistanceȱhaveȱfrequentlyȱbeenȱdocumentedȱ[12]ȱFollowingȱcellȱlysisȱprogenyȱvirusȱparticlesȱareȱreleasedȱandȱcanȱinfectȱneighbouringȱtumourȱcellsȱInȱthisȱmannerȱ
Figure 1 Mechanisms of tumour destruction through oncolytic virotherapy Oncolytic viruses (OVs)may exert their anti-tumour effects through several mechanisms OVs induce the death of at least sometumour cells in a direct way by infecting these cells and replicating therein Progeny virus particles arereleased and infect neighbouring tumour cells resulting in amplification of the input OV dose (box 1)OVs often induce an immunogenic cell death (box 2) Tumour-associated antigens pathogen-associatedmolecular pattern (PAMPs) and danger-associated molecular patterns (DAMPs) are released fromdying tumour cells and come into contact with antigen-presenting cells such as dendritic cells inthe tumour microenvironment Local inflammation as induced by virus infection stimulates thematuration of dendritic cells and their migration to draining lymph nodes where they can presenttumour-associated antigens to T cells Under optimal conditions this may elicit an anti-cancer CD4+
and CD8+ effector T cell response that has the potential to kill infected and uninfected tumour cellsIn addition some OVs disrupt the tumour-associated vasculature (via infection of tumour endothelialcells expression of anti-angiogenic viral proteins andor OV-induced inflammatory responses) leadingto ischemia and necrotic death of uninfected tumour cells (box 3)
Virus-induced cell death following infection and in-cell multiplication is a complex multifacetedprocess which is triggered mainly by cytotoxic viral proteins although this has yet to be studied forsome oncolytic viruses in use These proteins have multiple modes of action which often differ fromthose activated by conventional cancer therapies As a result the likelihood of cancer cells acquiringresistance to OV treatment as seen with other anti-cancer modalities has not been documented so far(in contrast to the resistance developed to other anti-cancer modalities) However it cannot be ruledout that some cancer cells may acquire resistance to OVs through the loss of cellular permissivenessfactors eg cell surface receptors that are essential for virus uptake or the alteration of signalling
Mechanisms of tumour destruction through oncolytic virotherapy
Oncolytic viruses are a new class of therapeutic agents that promote anti-tumour responses through two distinct mechanisms of action
i) selective replication within neoplastic cells resulting in a direct lytic effect on tumour cells and
ii) induction of systemic innate and tumour-specific adaptive immune responses
Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
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52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Nature Reviews | Drug Discovery
Oncolyticvirus
ROS
ROS
bull ER stressbull Genotoxic stress
Cancer cell
Viraloncolysis
CD8+ T cell
CD4+ T cell
NK cell
Antigen presenting cell
Cytokinereceptors
Cytokinereceptors
CD28
Cytotoxicity
Cytotoxicity
Activation
TCR
TCR
IL-2R
IL-2
MHC MHCTLR
MHC
CD40
CD40L
bull Type I IFNsbull DAMPsPAMPs
DAMPsPAMPs
bull Type I IFNsbull Cytokines
bull Viral proteinsbull Viral genome
bull Viral antigensbull TAAsneoantigens
bull CD80CD86bull Chemokine receptors
PAMPsbull Viral capsidsbull Viral DNAbull Viral dsRNAssRNAbull Viral proteins
DAMPsbull HSPsbull HMGB1bull Calreticulinbull ATPbull Uric acid
Cytokinesbull Type I interferonsbull TNF_bull IFNabull IL-12
Infection
Release Release
Antigenuptake
Releasesecrete
likely to be permissive to infection313637 Stromal cells such as cancer-associated fibroblasts may be infected by oncolytic viruses but are non-permissive to viral replication Thus fibroblasts may act as a decoy reservoir for oncolytic viruses reducing the delivery of infectious virions to cancer cells38 Another mechanism that may limit the overall effectiveness of oncolytic viruses is the susceptibility of cancer cells to apoptosis which may be induced by viral infection or other factors39 If cells undergo apoptosis too rapidly this will reduce the time
for viral replication and propagation and decrease the amount of active virus in the tumour ultimately limiting the active intratumoural dose
Development of oncolytic viruses as drugsAs oncolytic viruses are live viral particles the over-all design of oncolytic virus strategies must consider approaches to tumour cell targeting and attenuating viral pathogenesis as well as approaches to limit viral immunogenicity while promoting tumour cell killing
Figure 2 | The induction of local and systemic anti-tumour immunity by oncolytic viruses The therapeutic efficacy of oncolytic viruses is determined by a combination of direct cancer cell lysis and indirect activation of anti-tumour immune responses Upon infection with an oncolytic virus cancer cells initiate an antiviral response that consists of endoplasmic reticulum (ER) and genotoxic stress This response leads to the upregulation of reactive oxygen species (ROS) CPFVJGKPKVKCVKQPQHCPVKXKTCNE[VQMKPGRTQFWEVKQP415CPFE[VQMKPGUURGEKHKECNN[V[RG|+KPVGTHGTQPU+(0UCTGTGNGCUGF from the infected cancer cell and stimulate immune cells (antigen presenting cells CD8+6|EGNNUCPFPCVWTCNMKNNGT0-cells) Subsequently the oncolytic virus causes oncolysis which releases viral progeny pathogen-associated molecular patterns (PAMPs) danger-associated molecular pattern signals (DAMPs) and tumour associated antigens (TAAs) including neo-antigens The release of viral progeny propagates the infection with the oncolytic virus The PAMPs (consisting of viral particles) and DAMPs (comprising host cell proteins) stimulate the immune system by triggering activating receptors such as Toll-like receptors (TLRs) In the context of the resulting immune-stimulatory environment TAAs and neo-antigens are released and taken up by antigen presenting cells Collectively these events result in the generation of immune responses against virally infected cancer cells as well as FG|PQXQ immune responses against TAAsneo-antigens displayed on un-infected cancer cells CD40L CD40 ligand dsRNA double-stranded RNA HMGB1 high mobility group box 1 HSP heat shock protein IL-2 interleukin-2 IL-2R IL-2 receptor MHC major histocompatibility complex ssRNA single-stranded RNA TCR T cell receptor TNFα tumour necrosis factor-α
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copy 2015 Macmillan Publishers Limited All rights reserved
Mechanisms of oncolytic virus immunotherapy a Healthy cell
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSVbull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpes bull Adenovirusbull Vacciniabull+PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
IFNRIFN
IFN
IFNR
b Cancer cell
Cytoplasm
Nature Reviews | Drug Discovery
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
PKR
MYD88
NF-gB IRF7 IRF3
TRIFRIG-1
TRAF6 TRAF3
bull VSV bull NDVbull Measlesbull Vaccinia
bull IRF7bull PKR
bull Reovirusbull Herpesbull Adenovirus bull Vacciniabull +PȯWGPC
Translation
Apoptosis
NDV
NDV NDV
JAK
STAT
IRF9
STAT
IRF9
Type IIFNs
IRF7
IRF3
Pro-KPȯCOOCVQT[cytokines
NF-gB
dsRNA
Viral TLRligands
TLR
darr darr
darr
darr
darr
darr
Nucleus
Different viruses can also manipulate distinct aberrant signalling factors within tumour cells to block apoptosis which allows more time for the virus to complete its life cycle Following viral replication most oncolytic viruses induce cell death which can directly eliminate viable tumour cells but also sets the stage for initiating systemic immune responses Induction of host immune responses can be greatly aided by both the type of cell death and the
release of danger signals from virus-infected cells For example necrosis or pyroptosis are more immunogenic forms of cell death than apoptosis
Induction of systemic anti-tumour immunity The induction of systemic innate and tumour-specific adaptive immune responses appears to be a critical element for tumour eradication with oncolytic viruses Following oncolytic
Figure 1 | Oncolytic viruses can exploit cancer immune evasion pathways a | Following viral infection most normal cells activate an antiviral pathway that allows to contain viral infections The antiviral machinery can be triggered by viral pathogen-associated molecular patterns (PAMPs) that activate Toll-like receptors (TLRs) or through the detection of viral nucleic acids by retinoic acid-inducible gene 1 (RIG-1) Once a virus is detected a signalling ECUECFGVJTQWIJUGXGTCNV[RG|+KPVGTHGTQP+(0GNGOGPVUCPWUMKPCUG- signal transducer and activator of transcription (STAT) and interferon regulatory factor 9 (IRF9)) results in a programmed transcriptional pathway that limits viral spread and can target infected cells for apoptosis or necrosis Local IFN production induced by the innate immune response to viral infections may also promote antiviral activity through the IFN receptor (IFNR) TLRs signal via the myeloid differentiation primary response protein MYD88 TIR-domain-containing adapter-inducing IFNβ (TRIF) IRF7 IRF3 and nuclear factor-κB (NF-κ$KPFWEKPIVJGRTQFWEVKQPQHRTQKPHNCOOCVQT[E[VQMKPGUCPFV[RG|++(0U 6JGV[RG|++(0UUKIPCNVJTQWIJVJG-s566UKIPCNNKPIRCVJYC[TGUWNVKPIKPVJGWRTGIWNCVKQPQHEGNNE[ENGTGIWNCVQTUUWEJCURTQVGKPMKPCUG42-4CPF+4(YJKEJNKOKVXKTCNURTGCFD[DKPFKPIVQXKTCNRCTVKENGUCPFVTKIIGTKPIV[RG|++(0transcriptional pathways promoting abortive apoptosis of infected cells and the production of cytokines that alert the immune system to the presence of a viral infection b | In cancer cells however this process is disrupted Cancer cells may downregulate key signalling components within the innate signalling pathway including RIG-1 IRF7 and IRF3 (REF 1) This limits detection of viral particles by TLR and RIG-1 making cancer cells more susceptible to viral TGRNKECVKQP(WTVJGTOQTGECPEGTEGNNUOC[FQYPTGIWNCVGMG[EQORQPGPVUQHVJGV[RG|++(0UKIPCNNKPIRCVJYC[2ndash7 VJGTGD[NKOKVKPIVJGRTQCRQRVQVKECPFEGNNE[ENGTGIWNCVQT[GHHGEVUQHV[RG|++(0UNVJQWIJFCVCCTGNKOKVGFVJGHKIWTGdepicts individual viruses near the factors andor pathways that are known to promote viral elimination in normal cells (part a) or that support viral replication owing to factor deficiency in cancer cells (part b) dsRNA double-stranded RNA NDV Newcastle disease virus TRAF TNF-associated factor VSV vesicular stomatitis virus
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44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
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copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
44
Development of oncolytic viruses as drugs
Targeting oncolytic viruses to cancer cells
Exploiting aberrant signalling pathways in cancer
Augmenting anti-tumour immunity
Enhancing lytic activity
Limiting antiviral immune responses
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 649
copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
Nature Reviews | Drug Discovery
HVEMCAR
ICAM-1
NectinIntegrins
LDLR
SARs
DAF
CD155
CD46
SLAM
Poliovirus
Measlesvirus NDV
VSV
Seneca ValleyVirus
Coxsackievirus
Adenovirus
Vaccinia virus
Herpesvirus
Parvovirus
Reovirus
prostate cancer63 This virus does not produce E1A in healthy cells and these cells undergo apoptosis thereby restricting viral proliferation in healthy tissue However in prostate cancer cells the PSA promoter is highly active and E1A is selectively expressed resulting in proliferation of the adenovirus and virus-mediated cell lysis In a similar manner the oncolytic adeno-virus KH901 was engineered to express E1A under the control of the human telomerase reverse transcriptase (TERT) promoter which is activated in a large num-ber of cancers64 Furthermore two binding sites of the transcription factor E2F1 (a regulator of the cell cycle) were included in the TERT promoter to restrict prolif-eration to actively dividing cells Another example is the oncolytic adenovirus CG0070 for which replication is restricted to retinoblastoma (Rb)-defective cells (a com-mon mutation in cancer) because E1A expression was placed under the regulation of the E2F1 promoter65 In healthy cells Rb inhibits E2F thus inhibiting E1A transcription66 Furthermore adenoviruses have been engineered to selectively replicate in hypoxic environ-ments such as those found inside tumours by placing the E1A gene under transcriptional regulation by the
hypoxia-induced transcription factor HIF-1α this strategy was shown to be effective in a murine xenograft model of glioma67 Several oncolytic adenoviruses includ-ing ONYX-015 and H101 have been designed with a deletion in the gene coding for the protein E1B which can bind to and inactivate the pro-apoptotic protein p53 (REFS 8586) Thus healthy cells that are infected with these viruses can undergo p53 - mediated abor-tive apoptosis whereas cancer cells that commonly inactivate p53 remain susceptible to viral infection Furthermore these adenoviruses preferentially prolifer-ate in and lyse p53-deficient cancer cells which account for nearly 50 of all cancers
Another approach to improve post-entry tumour specificity has been to encode synthetic miRNA target-ing sequences (miRTS) into the 3ʹ untranslated region (UTR) of the fusion gene of the measles virus These sequences bind cellular microRNAs (mi RNAs) and repress viral replication Because normal and cancer cells exhibit differential expression of cognate miRNA elements the engineered oncolytic virus with miRTS can be blocked from replicating in normal cells where specific mi RNAs are expressed Such a construct was
Figure 3 | Mechanisms of viral entry into cancer cells Oncolytic viruses utilize several mechanisms to enter host cells including cell surface receptors that are frequently overexpressed on cancer cells Some viruses are able to via more than one receptor and some receptors can promote the entry of more than one type of virus Some viruses use endocytosis through membrane fusion and syncytia formation to enter cells Certain oncolytic viruses are known to preferentially target cancer cells but the cell surface receptor for entry has not been identified CAR coxsackievirus-adenovirus receptor DAF decay accelerating factor HVEM1 herpesvirus entry mediator 1 ICAM-1 intercellular adhesion molecule 1 LDLR low-density lipoprotein receptor NDV Newcastle disease virus SARs sialic acid receptors SLAM signalling lymphocytic activation molecule VSV vesicular stomatitis virus (VSV)
REV IEWS
NATURE REVIEWS | DRUG DISCOVERY VOLUME 14 | SEPTEMBER 2015 | 649
copy 2015 Macmillan Publishers Limited All rights reserved
overexpressedonsomecancercells
includingmelanomaand
variouscarcinomasoverexpressedincancerssuchas
multiplemyelomamelanomaandbreastcancer
ectopicallyexpressedincertaincancers
suchasglioblastomamulbformeandplaysanimportantroleintumorcellmigrabon
invasionandmetastasis
Targeting oncolytic viruses to cancer cells
Natural tropism for cell surface proteins that a r e a b e r r a n t l y expressed by cancer cells
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
Tumoramptarge7ngbull ReceptortargeMng
AltermeaslesvirusHAtotargettumormarkers
HSVglycoproteinDengineeredtocontainIL13orsinglechainanMbodiesagainsthumanepithelialgrowthfactorreceptor2ongliomasandbreasttumors
AdenovirusinserMonofdomainsthatrecognizetumorAgintofiber
Hexoninterlacingprotein
Adaptorsthatbindfiberandretarget
to express a single-chain anti- body that recognizes carcinoembryonic antigen (CEA) a tumour antigen that is selectively expressed on certain adenocarcinomas
Ad3Fiber
Ad3
Ad3Fiber
Enhances the infectivityo n h uma n o v a r i a nadenocarcinoma cel llinesandprimaryhumanovariancancercells
OV can also be engineered to directly target unique cell surface receptors expressed by cancer cells
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
47
Post8entryamptarge7ng
doi101038nrmicro3140
selectively promotes the expression of viral genes (ej E1A) or engineered transgenes in target cells using tumour- specific transcriptional control
restricts infection in non-target cells using tissue-specific miRNAs that recognize target sequences that have been engineered into oncolytic virus genomes (UTR)
Tumour-associated
restrict virus replication in off-target tissues
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
E1b55k-deleted Ad (H101 or Onyx-015)
normal cell
Ad ΔE155k
tumor cell (p53 mutated or deleted) Ad ΔE155k
Apoptosis before viral replication
p53p53
p53
E155k
Apoptosis inhibitionp53
Only replicates in p53 deficient tumors
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
49
Armingampviralampvectors
bull EnhancetherapeuMcefficacyofoncolyMcvirushardtoinfect100ofcells
bull Strategiesthatkilltumorcellssurroundingthoseinfectedbystanderkilling
bull Prodrugconvertases
bull Iontransportprotein
bull ImmunosMmulatoryfactors
Arming viral vectors
lsquobystander cell killingrsquogt a protein that is expressed by the ov sensitizes both the infected cell and surrounding uninfected cells to subsequent combination therapies or immune destruction
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
50
Armingampwithampprodrugampconvertases
bull Thymidinekinaseconvertsganciclovirtoganciclovirtriphosphate
bull Cytosinedeaminaseconverts5fluorocytosineto5fluorouracil
bull ThesenucleosideanaloguesstopDNAreplicaMonoftumorcells
httpwwwncbinlmnihgovpubmed24292552
PNP purine nucleoside phosphorylase gt fludarabine phosphate into 2-fluoro- adenine
to activate non-toxic precursors which generate highly toxic metabolites in the tumour microenvironment
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
51
Arming with immnunoestimulatory factors
bull Expression of GM-CSF to stimulate the production of granulo- cytes and monocytes which in turn stimulate adaptative immunity against tumour-associated antigens
Nature Reviews | Microbiology
Prodrug activationa
Prodrug
Toxic metabolite
Bystander cells
No treatment Virotherapy
Radioactive iodide
Immune cell
Activated immune cell
Stimulatory peptides
NIS
Uninfected tumour cell Dying tumour cell
Virus
Radiosensitizationb
Immunostimulationc
Ionizing radiation
γ-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy electromagnetic γ rays
β-emitting isotopesRadioactive isotopes that emit ionizing radiation in the form of high-energy high-speed electrons or protons
out of the infected cell and into surrounding cells98103 to induce chemotherapeutic bystander killing (FIG 4a) making them clinically relevant arming strategies for virotherapy We focus in this section on the most clini-cally advanced viruses that are armed with the cytosine deaminase and PNP transgenes as well as on promis-ing preclinical viruses that are ready to enter future clinical trials
Cytosine deaminase and PNP have both been incorporated into several virus classes that have been preclinically tested including viruses that are based on Herpesviridae104 Adenoviridae105 Poxviridae106107
Paramyxoviridae108109 and Rhabdoviridae110 The most advanced cytosine deaminase virus is a replication-competent retrovirus known as Toca 511 which inte-grates the cytosine deaminase transgene into the genome of infected cells to establish permanent reservoirs of tumour cells that are sensitive to subsequent rounds of chemotherapy using 5-FC19 Toca 511 is currently being tested in combination with 5-FC in Phase I and II clini-cal trials using intratumoural administration in patients with grade 4 glioblastoma multiforme (TABLE 1) HSV and VSV viruses that express cytosine deaminase are also being preclinically developed for combination therapies using 5-FC104110
Intratumoural administration of an adenovirus with the PNP transgene in combination with intrave-nous fludarabine has been used to treat patients with head and neck tumours111 (clinicaltrialsgov identifier NCT01310179) In general cytosine deaminase and PNP transgenes can be applied to many virus fami-lies because their small sizes and low cellular toxicities incur minimal negative effects on in vitro virus fitness or production However the timing of prodrug dosing in vivo must be optimized to ensure that virus repli-cation and spread is sufficient for maximal synergistic effects with the chemotherapeutic prodrug104109112 In this respect a PNP-expressing measles virus that has been retargeted to CD20 has been extensively tested in combination with fludarabine in preclinical models of lymphoma108109
Radiosensitization The normal physiological func-tion of the human sodiumndashiodide symporter (NIS) is to transport iodide ions into cells which occurs pre-dominantly in the thyroid but also in the stomach salivary glands and mammary glands113114 When NIS is expressed from the genome of an oncolytic virus infected cells concentrate iodide or similar isotopes intracellularly During virotherapy γ-emitting isotopes such as 123I and pertechnetate can be administered to visualize virus replication using single-photon emis-sion computed tomography (SPECT BOX 2) whereas β-emitting isotopes such as 131I and 188Re can be admin-istered to specifically induce radiation poisoning within the tumour microenvironment (FIG 4b) in analogy to the clinically well-established radiotherapy that is used for metastatic thyroid cancer
The NIS transgene system has undergone extensive preclinical development in multiple virus families and radiovirotherapy has consistently achieved synergistic tumour destruction in several radiosensitive preclini-cal disease models115ndash117 Measles virus is an especially efficacious virus for NIS-mediated imaging (BOX 2) and radiovirotherapy Preclinical studies of lymphoma118 ovarian cancer119 myeloma120 and mesothelioma121 in addition to many other disease models117 have used NIS expression and SPECTndashcomputed tomography (SPECTndashCT) imaging to visualize and quantify virus replication and enhance disease regression using com-bination radio virotherapy Phase I clinical trials using NIS-expressing measles virus have been initiated for ovarian cancer myeloma mesothelioma and head and
Figure 4 | Arming strategies that induce bystander cell killing a | Convertase enzymes that are expressed in infected cells metabolize prodrugs into toxic metabolites that diffuse and kill uninfected tumour cells b | The sodiumndashiodide symporter (NIS) concentrates radioactive ions in infected cells which induces radiation poisoning of uninfected bystander tumour cells c | Immunostimulatory transgenes that are expressed in infected cells prime responses against tumour antigens which causes the systemic destruction of tumour cells
REVIEWS
30 | JANUARY 2014 | VOLUME 12 wwwnaturecomreviewsmicro
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
52
Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
54
ONCOS 02
56
57
of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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Figure1Schematicdiagramshowingtheherpessimplextype1virusfromwhichT-VECwasdeveloped(A)andthemodifiedvectorknownastalimogenelaherparepvec(T-VEC)(B)ViralICP345neurovirulencegeneandtheICP47immunogenicitygenehavebeendeletedinT-VECThehumanGM-CSFgenedrivenbyaCMVpromoterhasbeeninsertedintotwodeletedICP345lociandthedeletedICP47resultsinearlyactivationoftheUS11promoterAbbreviationsIRinternalrepeatLlongSshortTRterminalrepeatUuniqueGM-CSFgranulocyte-macrophagecolonystimulatingfactorT-VECtalimogenelaherparepvecCMVcytomegalovirusICPinfectedcellproteinpApolyAtailUSuniqueshort
BasicbiologyofT-VEC
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of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
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of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
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of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
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652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
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of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved
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of replicating cells resulting in the termination of DNA synthesis and ultimately cell death97 In this system the expression of TK is restricted to cells with an active osteo-calcin promoter and this increases their susceptibility to treatment with the thymidine analogue ganciclovir However as ganciclovir can block viral replication this approach may inhibit oncolytic virus activity9899
Two other suicide genes that have been tested are bacterial cytosine deaminase (CD) and adenovirus death protein (ADP)100101 CD can transform 5-fluoro-cytosine into 5-fluorouracil (5-FU) which is cytotoxic ADP is a nuclear membrane glycoprotein that is required in the late stages of adenovirus infection for efficient cell lysis and release of viral particles Enhanced
Table 3 | Key oncolytic viruses in clinical trials
Virus Manufacturer Modification Number of clinical trials Cancers
2JCUG|+ 2JCUG|++ 2JCUG|+++
Adenovirus
Onyx-015 Onyx Pharmaceuticals
6[RG|EJKOCGTC E1B deletion
6 6 0 Head and neck cancer pancreatic cancer ovarian cancer colorectal cancer gliomas lung metastases and liver metastases
H101 Shanghai Sunwaybio
E1B deletion partial E3 deletion
1 2 1 Squamous cell carcinoma and head and neck cancer
DNX-2401 DNAtrix Δ24-RGD insertion 4 0 0 Glioblastoma ovarian cancer
VCN-01 VCN Biosciences PH20 hyaluronidase insertion
2 0 0 Pancreatic cancer
Colo-Ad1 PsiOxus Therapeutics
Chimeric Ad113 group B 1 2 0 Colon cancer NSCLC renal cancer bladder cancer and ovarian cancer
ProstAtak Advantagene 6-KPUGTVKQP 4 1 1 Pancreatic cancer lung cancer breast cancer mesothelioma and prostate cancer
Oncos-102 Oncos Therapeutics
Δ24-RGD-GM-CSF insertion 1 0 0 Solid cancers
CG0070 Cold Genesys GM-CSF and E3 deletion 1 1 1 Bladder cancer
Vaccinia virus
Pexa-vac
GPPGTGZBiotherapeutics
)5(KPUGTVKQP6-disruption
7 6 0 Melanoma liver cancer colorectal cancer breast cancer and hepatocellular carcinoma
GL-ONC1 Genelux 6-FKUTWRVKQPJCGOCIINWVKPdisruption F145L disruption
4 1 0 Lung cancer head and neck cancer and mesothelioma
Herpesvirus
T-VEC Amgen ICP345 deletion US11 deletion GM-CSF insertion
2 3 2 Melanoma head and neck cancer and pancreatic cancer
G207 Medigene ICP345 deletion UL39 disruption
3 0 0 Glioblastoma
HF10 Takara Bio UL56 deletion selected for single partial copy of UL52
2 1 0 Breast cancer melanoma and pancreatic cancer
SEPREHVIR (HSV1716)
Virttu Biologics ICP345 deletion 5 1 0 Hepatocellular carcinoma glioblastoma mesothelioma neuroblastoma
OrienX010 OrienGene Biotechnology
ICP345 deletion ICP47 deletion GM-CSF insertion
1 0 0 Glioblastoma
Reovirus
Reolysin Oncolytics Biotech
None 15 9 0 Glioma sarcomas colorectal cancer NSCLC ovarian cancer melanoma pancreatic cancer multiple myeloma head and neck cancer
Seneca Valley Virus
SVV-001 Neotropix None 3 1 0 Neuroendocrine-featured tumours neuroblastoma and lung cancer
Coxsackievirus
Cavatak (CVA21)
Viralytics None 3 1 0 Melanoma breast cancer and prostate cancer
)5(ITCPWNQE[VGsOCETQRJCIGEQNQP[UVKOWNCVKPIHCEVQT05PQPUOCNNEGNNNWPIECPEGT4)ampTI)N[UROQVKH6-VJ[OKFKPGMKPCUG75WPKSWGshort 11 glycoprotein
REV IEWS
652 | SEPTEMBER 2015 | VOLUME 14 wwwnaturecomreviewsdrugdisc
copy 2015 Macmillan Publishers Limited All rights reserved