Restoration of cytoskeleton homeostasis after gigaxonin gene transfer for giant axonal neuropathy.

Giant axonal neuropathy (GAN) is caused by loss of function of the gigaxonin protein. On a cellular level GAN is characterized by intermediate filament (IF) aggregation, leading to a progressive and fatal peripheral neuropathy in humans. This study sought to determine if re-introduction of the GAN gene into GAN-deficient cells and mice would restore proper cytoskeleton IF homeostasis. Treatment of primary skin fibroblast cultures from three different GAN patients with an adeno-associated virus type 2 (AAV2) vector containing a normal human GAN transgene significantly reduced the number of cells displaying vimentin IF aggregates. A proteomic analysis of these treated cells was also performed, wherein the abundance of 32 of 780 identified proteins significantly changed in response to gigaxonin gene transfer. While 29 of these responding proteins have not been directly described in association with gigaxonin, three were previously identified as being disregulated in GAN and were now shifted toward normal levels. To assess the potential application of this approach in vivo and eventually in humans, GAN mice received an intracisternal injection of an AAV9/GAN vector to globally deliver the GAN gene to the brainstem and spinal cord. The treated mice showed a nearly complete clearance of peripherin IF accumulations at 3 weeks post-injection. These studies demonstrate that gigaxonin gene transfer can reverse the cellular IF aggregate pathology associated with GAN.

Α1-giardin based live heterologous vaccine protects against Giardia lamblia infection in a murine model.

Giardia lamblia is a leading protozoan cause of diarrheal disease worldwide, yet preventive medical strategies are not available. A crude veterinary vaccine has been licensed for cats and dogs, but no defined human vaccine is available. We tested the vaccine potential of three conserved antigens previously identified in human and murine giardiasis, α1-giardin, α-enolase, and ornithine carbamoyl transferase, in a murine model of G. lamblia infection. Live recombinant attenuated Salmonella enterica Serovar Typhimurium vaccine strains were constructed that stably expressed each antigen, maintained colonization capacity, and sustained total attenuation in the host. Oral administration of the vaccine strains induced antigen-specific serum IgG, particularly IgG(2A), and mucosal IgA for α1-giardin and α-enolase, but not for ornithine carbamoyl transferase. Immunization with the α1-giardin vaccine induced significant protection against subsequent G. lamblia challenge, which was further enhanced by boosting with cholera toxin or sublingual α1-giardin administration. The α-enolase vaccine afforded no protection. Analysis of α1-giardin from divergent assemblage A and B isolates of G. lamblia revealed >97% amino acid sequence conservation and immunological cross-reactivity, further supporting the potential utility of this antigen in vaccine development. Together. These results indicate that α1-giardin is a suitable candidate antigen for a vaccine against giardiasis.

The Ezrin-radixin-moesin family member ezrin regulates stable microtubule formation and retroviral infection.

We recently identified the cytoskeletal regulatory protein moesin as a novel gene that inhibits retroviral replication prior to reverse transcription by downregulation of stable microtubule formation. Here, we provide evidence that overexpression of ezrin, another closely related ezrin-radixin-moesin (ERM) family member, also blocks replication of both murine leukemia viruses and human immunodeficiency virus type 1 (HIV-1) in Rat2 fibroblasts before reverse transcription, while knockdown of endogenous ezrin increases the susceptibility of human cells to HIV-1 infection. Together, these results suggest that ERM proteins may be important determinants of retrovirus susceptibility through negative regulation of stable microtubule networks.

Intracellular delivery can be achieved by bombarding cells or tissues with accelerated molecules or bacteria without the need for carrier particles.

To deliver non-permeable molecules into cells, one can utilize protocols such as microinjection, electroporation, liposome-mediated transfection or virus-mediated transfection. However, each method has its own limitations. Here we have developed a new molecular delivery technique where live cells or tissues are bombarded with highly accelerated molecules directly and without the need to conjugate the molecules onto carrier particles, which is essential in conventional "gene gun" experiments. Gene bombardments can be applied to well-differentiated cells, primary cultured cells/neurons or tissue explants, all of which are notoriously difficult to transfect. Exogenously made proteins and even bacteria can be effectively introduced into cells where they can execute their function or replicate. Our experimental results and physical model support the notion that accelerated chemicals, proteins, or microorganisms carry enough momentum to penetrate the plasma membrane. The bombardment process is associated with a transient (approximately 10 min) increase in cell permeability, but such membrane leakage has a minimal adverse effect on cell survival.

Required treatment margin for coronary endovascular brachytherapy with iridium-192 seed ribbon.

PURPOSE: Preliminary clinical trials (SCRIPPS I, WRIST and Gamma 1) employing catheter-based endovascular brachytherapy (EVBT) with iridium-192 (Ir-192) seeds show promising results in reducing restenosis after coronary intervention. Failure analysis of these studies showed a significant number of restenosis at the treatment margin called "edge effect." The objective of this study is to investigate the factors that contribute to the adequacy of treatment margin. METHODS AND MATERIALS: The factors contributing to the margins are penumbra effect at the end of the seed train, uncertainty in target localization, longitudinal seed movement during cardiac cycle and barotrauma due to stent deployment. The magnitudes of the penumbra effect, which refers to the tapering off the prescribed isodose line near the ends of the source train, were calculated for various source lengths of Ir-192 seed ribbon using AAPM TG-43 algorithm. Uncertainty in target localization refers to the fact that the visual estimation of proximal and distal extent of the injury is not accurate, and this can be obtained by comparing the "estimate" from the interventional cardiologist with careful review of the cine-angiogram. Longitudinal seed movements relative to the coronary vessel during the cardiac cycle were determined by frame-by-frame reviewing cine-angiograms of 30 patients. The proximal and distal source points were measured in reference to branching vessels during the contrast phase of the cine-angiogram. The maximum proximal and distal longitudinal movement was captured and source displacement was measured from the closest proximal and distal branching vessel. Barotrauma, additional injury to the vessel arising from the stent deployment balloon, was obtained by reviewing specifications from commercially available stent delivery systems. RESULTS: The penumbra effect ranges from 3.9 to 4.5 mm for 6-22 Ir-192 seed ribbons. The uncertainty in target localization is within 3 mm for our interventional cardiologists. The results of seed movements were categorized by three major coronary vessels and by proximal versus distal ends. The mean and standard deviation of seed movement are 1.1 and 0.8 mm, respectively. The average length of barotrauma beyond the stent margins for reviewed stents was 1.7 mm, ranging from 0.5 to 2.5 mm. CONCLUSION: A minimum of 8-mm treatment margin is recommended for coronary vascular brachytherapy with Ir-192 seed ribbon. This was derived by considering the above contributing factors. Excessive margins should be avoided due to possible increase risk of late effect. By providing adequate treatment margins, one can avoid geographic miss; hence, one can further improve the effect of EVBT in reducing restenosis.

Morphological and physiological restorations of hereditary form of dilated cardiomyopathy by somatic gene therapy.

TO-2 strain hamsters with dilated cardiomyopathy, gene deletion of delta-sarcoglycan (SG) and no expression of alpha-, beta-, gamma-, and delta-SG proteins are useful for developing the potential gene therapy of intractable heart failure. We prepared recombinant adeno-associated virus vector including normal delta-SG gene driven by CMV promoter and intramurally administered in vivo. The transfected myocardium induced robust expression of both transcript and transgene for 2/3 period of the animal's life expectancy. Immunostaining demonstrated reexpression of not only delta-SG but also other three SGs in 40% cells in the transfected region and normalization of the diameter of transduced cardiomyocytes. Hemodynamic study revealed preferential amelioration of the diastolic indices (LVEDP, the dP/dt(min) and CVP). These results provide the first evidence that supplementation of a specific gene with efficient and sustained transfection capability restores the genetic, morphological, and functional deteriorations.

Novel adjuvant systems.

Vaccination remains the single most valuable tool in the prevention of infectious disease. Nevertheless, there exists a need to improve the performance of existing vaccines such that fewer boosts are needed or to develop novel vaccines. For the development of effective vaccines for humans, a great need exists for safe and effective adjuvants. A number of novel adjuvants have been reported in recent years including: i) bacterial toxins such as cholera toxin, CT, and the Escherichia coli heat-labile enterotoxin, LT; ii) less toxic derivatives of CT and LT; iii) endogenous human immunomodulators, such as IL-2, IL-12, GM-CSF; iv) hormones; v) lipopeptides; vi) saponins, such as QS-21; vii) synthetic oligonucleotides containing CpG motifs (CpG ODN); viii) lipid 'A derivatives, such as monophosphoryl lipid A, MPL, and ix) muramyl dipeptide (MDP) derivatives. Herein, we will review recent findings using these novel adjuvant systems.

Full functional rescue of a complete muscle (TA) in dystrophic hamsters by adeno-associated virus vector-directed gene therapy.

Limb girdle muscular dystrophy (LGMD) 2F is caused by mutations in the delta-sarcoglycan (SG) gene. Previously, we have shown successful application of a recombinant adeno-associated virus (AAV) vector for genetic and biochemical rescue in the Bio14.6 hamster, a homologous animal model for LGMD 2F (J. Li et al., Gene Ther. 6:74-82, 1999). In this report, we show efficient and long-term delta-SG expression accompanied by nearly complete recovery of physiological function deficits after a single-dose AAV vector injection into the tibialis anterior muscle of the dystrophic hamsters. AAV vector treatment led to more than 97% recovery in muscle strength for both the specific twitch force and the specific tetanic force, when compared to the age-matched control. Vector treatment also prevented pathological muscle hypertrophy and resulted in normal muscle weight and size. Finally, vector-treated muscle showed substantial improvement of the histopathology. This is the first report of successful functional rescue of an entire muscle after AAV-mediated gene delivery. This report also demonstrates the feasibility of in vivo gene therapy for LGMD patients by using AAV vectors.