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Acute myeloid leukemia (AML) is a clonal malignancy of hematopoietic stem cells (HSCs) characterized by expansion of myeloid blasts in the bone marrow. It has been shown that autophagy is a degradative process, which delivers cytoplasmic components to lysosomes to prevent malignant transformation by maintaining HSC integrity. Besides its function as a bulk degradation machinery to recycle cytoplasmic components during limited energy supply, autophagy also serves as an intracellular quality control mechanism. Selective autophagy requires autophagy receptors such as p62 to specifically bridge the targeted cargos into autophagosomes. p62 is known as a central signaling hub involved in pro-oncogenic signaling pathways and autophagic degradation pathways. However, little is known about the role of p62 as a selective autophagy receptor in AML. This study aims to elucidate the precise function of p62 as an autophagy receptor in leukemia development and maintenance.
In silico analysis revealed that high p62 expression was significantly associated with poor overall survival of adult patients with de novo AML, suggesting that p62 may promote leukemia maintenance. To address the functional role of p62 in leukemia, genome editing by CRISPR/Cas9 was used to knockout p62 in four human AML cell lines. Importantly, p62 loss reduced cell proliferation in all four cell lines. This observation could be transferred to a murine leukemia cell model in which leukemic transformation of lineage-depleted bone marrow (ldMBM) cells was induced by overexpression of the human transcriptional coactivator MN1. Knockdown of p62 by shRNA in MN1-driven leukemia cells impaired proliferation and decreased colony forming ability without altering apoptosis. This indicates that p62 is crucial for leukemia proliferation in vitro. To further characterize the role of p62 in leukemia development and maintenance a murine AML transplantation model was established. Therefore, ldMBM cells isolated from WT and p62-/- mice were transduced with MN1 and transplanted into lethally irradiated mice. As expected, all mice developed fatal myeloid proliferation. Notably, p62 loss in MN1-driven leukemia significantly prolonged survival in mice and caused a more immature phenotype. Consistent with the in vitro results, ex vivo analysis of p62-/- leukemic cells displayed decreased colony-forming ability, although p62 loss did not affect composition and function of HSCs. Moreover, re-transplantation of primary MN1-driven leukemia cells attenuated leukemia progression upon p62 loss. These findings support a decisive role of p62 in leukemia development and maintenance.
To gain molecular insight into the function of p62 during myeloid transformation an interactome analysis of murine MN1-driven leukemia cells was performed. This revealed first that p62 predominantly interacts with mitochondrial proteins and second that inhibition of autophagic degradation causes accumulation of p62-bound mitochondria. This leads to the first assumption that loss of p62 may provoke mitochondrial accumulation with increasing mitochondrial damage and second that p62 may mediate degradation of mitochondria by mitophagy. Indeed, in the absence of p62, accumulation of dysfunctional mitochondria was detected by morphological changes of the mitochondria, increased mitochondrial ROS and impaired mitochondrial respiration capacity. Furthermore, induction of PINK1/Parkin-independent mitophagy revealed that loss of p62 caused impaired degradation of mitochondrial proteins and reduced translocation of damaged mitochondria into autophagosomes. Taken together, p62 is required for effective degradation of dysfunctional mitochondria by mitophagy in AML.
Due to the fact that p62 is a multifunctional protein, rescue experiments with different mutants of p62 were performed to clarify if p62-mediated mitophagy contributes to leukemia proliferation. Notably, the autophagy-deficient mutant (disabled to bind autophagosomes) reduced cell growth and colony-forming ability to the same extent as knockdown of p62, as the clustering-deficient mutant (disabled to form aggregates) displayed an intermediate phenotype. Strikingly, only the autophagy-deficient mutant failed to rescue mitophagy.
In conclusion, this study demonstrates the prominent role of p62 as a selective autophagy receptor for mitochondrial quality control which contributes to leukemia development and maintenance. Therefore, targeting selective autophagy opens new venues in the treatment of AML.
The liver as the biggest endocrine gland of the human body plays a central role in many metabolic pathways such as detoxification, storage of carbohydrates and distribution of lipids. As the liver receives blood supply from the gut by the portal vein, liver cells are often challenged with high concentrations of nutrients and components of our commensal microbiota. Therefore, the immune system of the liver induces a tolerant state, meaning no or low inflammatory reactions to those constant stimuli. Yet, as various pathogens target the liver, the hepatic immune system also needs the capability to induce strong immune responses quickly. Chronical damage to the liver, which can be caused by alcohol, pathogens or toxins, might lead to liver cirrhosis, where the amount of functional liver tissue is decreased dramatically. This pathology can worsen and lead to acute-on-chronic liver failure, whose high mortality is due to high inflammation and multi-organ failure. Interleukin-7 is a cytokine known for its pro-survival functions especially in lymphopoiesis. However, it is also very important for maintenance of mature immune cells in the liver. As mouse experiments have demonstrated an induction of Interleukin-7 in the liver as a response to bacterial lipopolysaccharide, we aimed to characterize the role of Interleukin-7 in hepatic immunoregulation in both health and disease.
The experiments were mostly based on in vitro approaches. Induction of Interleukin-7 in liver cells was analyzed using ELISA, quantitative PCR, and Immunoblotting. Knockdown of signal transduction components was performed by siRNA transfection. Primary immune cells isolated from healthy donor buffy coat were studied for their ability to respond to Interleukin-7. Activation of downstream signal transduction was assessed by Immunoblotting. Functional consequences of Interleukin-7 signaling, such as alterations in cellular metabolism, cellular survival and endotoxin tolerance, were studied in monocyte-derived macrophages. Finally, serum concentrations of Interleukin-7 and frequencies of Interleukin-7 receptor positive immune cells were quantified in patients with compensated or decompensated liver cirrhosis or acute-on-chronic liver failure.
Interleukin-7 expression could be observed in human hepatic cell lines and primary hepatic sinusoidal endothelial cells when stimulated with IFNα or IFNγ, but not IFNλ. IRF-1 was identified as a key regulator of Interleukin-7 expression, as its transcription, translation and nuclear translocation were induced and enhanced upon IFNα or IFNγ, but not IFNλ treatment. We identified LPS-primed macrophages as innate immune target cells of Interleukin-7, which responded by an inhibitory phosphorylation of GSK3. This signal transduction led to enhanced production of pro-inflammatory cytokines and abolished endotoxin tolerance. In parallel, cellular fitness was reduced as demonstrated by reduced intracellular ATP concentration and intracellular WST-1 staining. Finally, we could identify components of the in vitro signal transduction also in liver cirrhosis patients. However, Interleukin-7 serum concentrations were significantly in liver cirrhosis patients compared to healthy controls. In addition, the frequencies of Interleukin-7 receptor positive immune cell populations differed in patients and controls.
We identify Interleukin-7 as a pro-inflammatory cytokine in hepatic immunoregulation. It is part of a cascade where its induction is regulated by type I and type II Interferons and mainly restricted by the presence of IRF1. We demonstrate the importance of Interleukin-7 also for innate immune cells, where the abolishment of endotoxin tolerance may provide an interesting strategy of liver cirrhosis patients. In addition, reduced viability of macrophages in response to Interleukin-7 is a striking contrast to the well-described survival functions in lymphocytes. The decrease of serum Interleukin-7 levels and alterations of Interleukin-7 receptor positive immune cell populations suggest an important role for Interleukin-7 also in the diseased liver. Due to the identified mechanisms of action, Interleukin-7 may be an interesting candidate for immunotherapeutic approaches of liver cirrhosis and acute-on-chronic liver failure.
Human MSCs are currently deployed in a wide range of clinical applications and disease models, because of their regenerative and immune modulatory potential. Unfortunately, the fate of MSCs after systemic administration and the related interactions within the blood circulation are still not fully understood. The majority of i.v. or i.a administered MSCs accumulate in the lungs and loose traceability after 3-4 days in vivo144. Since engraftment rate and long term persistence of injected MSCs seems rather low, we tried to improve in vivo kinetics by using hyperosmolaric injection media (HyperHAES) in order to describe the impact on biodistribution, cell morphology and survival rate. In vitro culture related changes in morphology and surface expression patterns were analysed using flow cytometry and brightfield morphology scan in correlation with calibrated microbeads. In vivo tracking of male PKH67 labeled human MSCs in an immunecompetent mouse model were achieved using SRY-gene qRT-PCR analysis and flow cytometry/fluorescence microscopy at different time points. Kinetics, viability and cell-cell interaction of HyperHAES coinjected MSCs in comparison to NaCl 0.9% injection media were assessed with a combination of altering mitochondrial membrane potential (MMP), caspase 3/7-activity, additional survival and surface markers. Incubation of human MSCs in hyperosmolaric injection media (HyperHAES) shortly before i.v. injection decreased average diameter of culture expanded MSCs about 30% (from 48.7±2.29μm to 34.6±2.04μm) and improved viability and retrieval rate of injected MSCs within 24h. HyperHAES decreased significantly the loss of MMP and the signal intensity of the dead cell marker PI in comparison to isotonic control. HyperHAES treated MSCs are detected at higher frequencies in most murine tissues but didn`t result in alterations of interaction with the host immune system or caspase activation. Additionally, HyperHAES seemed to enable MSCs to reach organs with smaller microcirculation like the spleen. Functional impairment of MSC in HyperHAES was analysed with Phalloidin A staining for cytoskeletal activation and showed no signs of disturbed actin polymerization, whereas nuisance of migration and immunemodulatory characteristics were not addressed. PKH67 labeled MSCs decrease in size after i.v. injection in mice, acquire apoptotic and phagocytic cell markers, and accumulate in lungs and liver. This process could be delayed but not reverted by preincubation of MSCs in HyperHAES. Our findings help to explain the rapid loss of traceable MSCs after systemic delivery.
In addition to infectious viral particles, hepatitis B virus-replicating cells secrete high amounts of SVPs, which are ssembled by HBsAg in the shape of spheres and filaments but lack any capsid and genome. Filaments are characterized by a much higher amount of the surface protein LHBs as compared to spheres. Spheres are
released via the constitutive secretory pathway, while viral particles are ESCRT-dependently released via MVBs. The interaction of virions with the ESCRT machinery is mediated by α-taxilin that connects the PreS1 domain of LHBs with the ESCRT-component tsg101. Since viral particles and filaments contain a significant amount of LHBs, it is unclear whether filaments are secreted as spheres or released like viral particles. To study the release pathways of HBV filaments in the absence of viral particles, A core-deficient
HBV mutant (1.2×HBVΔCore) was generated by site-directed mutagenesis based on wt1.2x HBV. The start codon of core protein was mutated into stop codon, which was confirmed by DNA sequencing. Data from HBsAg ELISA, Western blot, immunofluorescence microscopy and immunoelectron microscopy showed that the lack of core protein did neither affect the production nor the secretion of HBV SVPs. The intracellular distribution of
LHBs and SHBs showed no difference between wtHBV and the core-deficient mutant expressing cells. Therefore, this system is suitable to investigate the release pathway of HBV filaments in the absence of viral particles. Confocal microscopy analysis of cells cotransfected core-deficient mutants with peYFPRab7 as marker for the endosomal/MVB pathway or with pGalT-eGFP as marker for the trans Golgi apparatus showed that YFP-Rab7, but not GalT-GFP, partially colocalized with LHBs. Furthermore, LHBs could be found in dilated MVBs by immune electron microscopy of ultrathin sections. This was confirmed by isolation of MVBs by cell fractionation using discontinuous sucrose gradient ultracentrifugation and percoll-based linear gradient ultracentrifugation, indicating that filaments enter MVBs in the absence of virion formation. Moreover, inhibition of MVB biogenesis by the small molecular inhibitor U18666A significantly abolished the release of filaments in a dose-dependent manner, but no inhibition could be observed in the production. In contrast, no inhibition on the secretion and production of spheres could be
detected. Inhibition of ESCRT-functionality by coexpression of transdominant negative mutants (Vps4A, Vps4B, CHMP3) abolished the release of filaments while secretion of spheres was not affected. These data indicate that in contrast Abstract 73 to spheres while are secreted via the secretory pathway, filaments are released via ESCRT/MVB pathway like infectious viral particles.
Acute myeloid leukemia is a hematopoietic stem cell disorder and a type of acute leukemia which is characterized by clonal proliferation of myeloid precursors with a reduced capacity to differentiate into more mature cellular elements. Clinically AML is characterized by a high degree of heterogeneity with respect to chromosome abnormalities, gene mutations, and changes in expression of multiple genes and microRNAs. Cytogenetic abnormalities can be detected in approximately 50% to 60% of newly diagnosed AML patients. Majority of AML cases are associated with chromosomal aberrations, more specifically translocations that often result in gene arrangements and expression of aberrant fusion proteins. This study was carried out with two fusion proteins: PML/RARα and DEK/CAN which results from the translocations t(15;17) and t (6,9) respectively. PML/RARα is the most common translocation (97%) and the main driver in Acute Promyelocytic Leukemia (APL), a wellcharacterized and well treatable subtype of AML. In contrast, DEK/CAN occurs in 1-5% of AML, associated with poor prognosis and defines a high risk group in AML. The expression of PML/RARα results in a fusion protein that acts as a transcriptional repressor by interfering with gene expression programs involved in differentiation, apoptosis, and selfrenewal. Current therapy focused on the targeting of PML/RARα fusion protien. Success has been achieved by using either ATRA, anthracyclines and Arsenic trioxide or their combinations. These agents induce differentiation in PML/RARα positive AML and hence called differentiation therapy. In comparison with ATRA, ATO and anthracyclines are poor cellular differentiation agents. Despite early promise, several studies have reported that differentiation therapy is unable to target/eradicate leukemic stem cells or eradicate the disease. Therefore current therapeutic focus is to eliminate leukemic stem cells and achieve complete molecular remission not only in APL but also in acute lymphoblastic leukemia and chronic myeloid leukemia as well. Key enzymes of the eicosanoid pathways in the arachidonic acid metabolism, such as COX1/2 as well as the 5-LO have been shown to be good targets for leukemic stem cell therapy approach in AML by interfering with the Wntsignaling which is known to be indispensable for the pathogenesis of AML. Recently it was reported that the third eicosanoid pathway based on the cytochrome P450 (CYP) enzymes interferes with Wnt-signaling as well as with the proliferation and mobilization of hematopoietic stem cells...
Hematopoietic stem cells (HSCs) have the unique abilities of life-long self-renewal and multi-lineage differentiation. They are routinely used in BM or stem cell transplantations to reconstitute the blood system of patients suffering from malignant or monogenic blood disorders. For an adequate production of each blood cell lineage in homeostasis and under stress conditions, the fate choice of HSCs to either self-renew or to differentiate must be strictly controlled. The incomplete understanding of the molecular mechanisms that control this balance makes it still impossible to maintain or expand undifferentiated HSCs in culture for advanced regenerative medical purposes.
The aim of this thesis was the identification and molecular characterisation of mechanisms that control the decision of HSCs to self-renew or to differentiate, and how they are connected to extrinsic cytokine signaling control. Prior to this thesis, a screening for genes upregulated under self-renewal promoting thrombopoietin (TPO) signaling via the transcription factors STAT5A/B in HSCs was conducted, and Growth arrest and DNA damage inducible 45 gamma (Gadd45g) was one of the regulated genes. GADD45G was described as stress sensor, DNA-damage response and tumor suppressor gene, that is epigenetically silenced in many solid tumors and leukemia. Furthermore, Gadd45g is upregulated in aged HSCs with impaired multi-lineage reconstitution abilities, and it is induced by differentiation promoting cytokines in GM-committed cells. However, the function of GADD45G in LT-HSCs was unknown. All these points warrant further investigation to unravel the function of GADD45G on early cell fate decisions of HSCs in hematopoiesis.
The expression of Gadd45g was stimulated by hematopoietic cytokines TPO, IL3 and IL6 both in HSCs and MPPs, making GADD45G an interesting target to focus on. To simulate the cytokine-induced expression GADD45G was lentivirally transduced in HSCs. Surprisingly, GADD45G did not induce cell cycle arrest or cell death in hematopoietic cells neither in vitro nor in vivo, as reported in many cell lines. Instead GADD45G revealed an enhanced and markedly accelerated differentiation of HSCs into mainly myelomonocytic cells, similar as observed for IL3 and IL6 containing cultures. Also in vivo, GADD45G rapidly initiates the differentiation program in HSCs at the expense of self-renewal and long-term engraftment, as shown by serial HSC transplantation experiments. Along the same line, HSCs from Gadd45g-knock out mice exhibited an increased self-renewal. In vitro, Gadd45g-/- progenitors showed higher and prolonged colony formation potential and slower expansion after cytokine stimulation. The loss of Gadd45g increased HSC self-renewal and improved repopulation in secondary recipients, determined by serial competitive transplantations. Taken together, GADD45G could be identified as molecular link between differentiation-promoting cytokine signaling and rapid differentiation induction in murine LT-HSCs.
As presented in this thesis the differentiation induction of GADD45G was mediated by the activation of the cascade of MAP3K4 – MKK6 –p38 MAPK. Small molecule inhibition of p38, but not JNK, blocked the GADD45G-induced differentiation. GADD45G binds to MAP3K4 and releases its auto-inhibitory loop by a change in confirmation, initiating this cascade. Phosphoflow cytometry demonstrated the activation of p38 and a downstream kinase MK2 by GADD45G expression in MPPs. Furthermore, the expression of constitutive active MAP3K4 and MKK6 were able to phenocopy GADD45G-induced differentiation, which could be blocked by p38 inhibition.
The other two family members GADD45A and B also induced accelerated differentiation in LT-HSCs. Interestingly, only GADD45G suppressed the differentiation into megakaryocyte and erythrocyte (Mek/E) lineage cells suggesting a role of GADD45G in lineage choice. Long-term time-lapse microscopy-based cell tracking of single LT-HSCs and their progeny revealed that, once GADD45G is expressed, the development of LT-HSCs into granulocyte-macrophage-committed progeny occurred within 36 hours, and uncovered a selective lineage choice with a severe reduction in Mek/E cells. Furthermore, no megakaryocytic-erythroid progenitors (MEPs) could develop from HSPCs in BM 2 weeks after transplantation suggesting a very early selection against Mek/E cell fates. In line with these findings, GADD45G-transduced MEPs could not expand or form colonies in vitro, demonstrating that the differentiation program induced by GADD45G is not compatible with Mek/E lineage fate. Gene expression profiling of HSCs indicated that GADD45G promotes myelomonocytic differentiation programs over programs for self-renewal or megakaryo-/ erythropoiesis. The here identified differentiation induction potential of GADD45G is so strong that the expression of GADD45G in primary acute myeloid leukemia (AML) cells inhibited their expansion accompanied by enhanced differentiation and increased apoptosis.
The here presented work shows that IL3 and IL6 induce a differentiation program in HSCs via GADD45G and p38 closing the link of extrinsic cytokine signaling and differentiation induction. Since the loss of Gadd45g increased the self-renewal and slowed HSC differentiation, this may be utilized, i.e. by p38 inhibition, to ex vivo maintain and expand HSCs by preventing cytokine-induced differentiation. Furthermore, Re-expression of GADD45G may overcome the differentiation block in leukemia to eliminate these cells by driving them into terminal differentiation and apoptosis.
HIV vaccine preclinical testing is difficult because HIV’s only relevant hosts are humans and no correlates of protection are known. To this end, we are working on the humanization of different mouse strains with human peripheral blood mononuclear cells (PBMCs) as well as human hematopoietic stem cells (HSC) to generate a useful small animal model.
We generated immune deficient mice (NOD Scid IL2gc -/- /NOD Rag1-/- IL2gc -/-) expressing human MHC class II (HLA-DQ8) on a mouse class II deficient background (Ab-/-). Here, the human HLA-DQ8 should interact with the matching T cell receptors of transferred matching human PBMCs and therefore could support the functionality of the transferred human CD4+ cells in the mice.
Mice that were adoptively transferred with human HLA-DQ8 PBMCs only showed engraftment of CD3+ T cells. Surprisingly, the presence of HLA class II did not significantly change the repopulation rates in the mice. Also, the presence of HLA class II did not advance B cell engraftment, such that humoral immune responses were undetectable. However, the overall survival of DQ8-expressing mice was significantly prolonged, compared to mice expressing mouse MHC class II molecules, and correlated with an increased time span until onset of GvHD.
To avoid GVHD and to increase and maintain the level of human cell reconstitution over a long period of time, the same mouse strains were reconstituted with human HSC. Compared to PBMC-repopulated mice, HSC-reconstituted mice develop almost all subpopulations of the human immune system detectable at week 12 after HSC transfer. These mice developed adaptive immune responses after Tetanus Toxoide (TT) immunizations. In addition, we are testing the susceptibility of these humanized mice to different HIV strains with a detailed look at immune responses.
Inhibitor of Apoptosis (IAP) proteins are expressed at high levels in many cancers and contribute to apoptosis resistance. Therefore, they represent promising anticancer drug targets. Here, we report that small molecule IAP inhibitors at subtoxic concentrations cooperate with monoclonal antibodies against TRAIL receptor 1 (Mapatumumab) or TRAIL receptor 2 (Lexatumumab) to induce apoptosis in neuroblastoma cells in a highly synergistic manner (combination index <0.1). Importantly, we identify RIP1 as a critical regulator of this synergism. RIP1 is required for the formation of a RIP1/FADD/caspase-8 complex that drives caspase-8 activation, cleavage of Bid into tBid, mitochondrial outer membrane permeabilization, full activation of caspase-3 and caspase-dependent apoptosis. Indeed, knockdown of RIP1 abolishes formation of the RIP1/FADD/caspase-8 complex, subsequent caspase activation and apoptosis upon treatment with IAP inhibitor and TRAIL receptor antibodies. Similarly, inhibition of RIP1 kinase activity by Necrostatin-1 inhibits IAP inhibitor- and TRAIL receptor-triggered apoptosis. By comparison, over-expression of the dominant-negative superrepressor IκBα-SR or addition of the TNFα-blocking antibody Enbrel does not inhibit IAP inhibitor- and Lexatumumab-induced apoptosis, pointing to a NF-κB- and TNFα-independent mechanism. Of note, IAP inhibitor also significantly reduces TRAIL receptor-mediated loss of cell viability of primary cultured neuroblastoma cells, underscoring the clinical relevance. By demonstrating that RIP1 plays a key role in the IAP inhibitor-mediated sensitization for Mapatumumab- or Lexatumumab-induced apoptosis, our findings provide strong rationale to develop the combination of IAP inhibitors and TRAIL receptor agonists as a new therapeutic strategy for the treatment of human cancer.
Gene therapy is a promising therapeutic strategy that emerged from the attractive idea of targeting therapy at the molecular level. For many patients who suffer from genetic and acquired diseases that cannot be effectively treated by conventional treatment approaches gene therapy remains a huge hope of cure in spite of the hurdles regarding efficacy and safety that need to be overcome. The development of efficient gene transfer vehicles, mainly retroviral vectors, led to the first successful gene therapy trial, to treat patients suffering from X-linked severe combined immunodeficiency syndrome (X-SCID) using gene modified stem cells (Hacein-Bey-Abina, Le Deist et al. 2002). Despite the success of this trial, it revealed the danger of retroviral insertional mutagenesis as a major adverse event of gene therapy using gene-modified stem cells (Hacein-Bey-Abina, von Kalle et al. 2003). In contrast to stem cells, T cells are relatively resistant to insertional mutagenesis and transformation even after transduction with potent oncogenes using retroviral vectors (Newrzela, Cornils et al. 2008). However, mature T cells can self-renew, proliferate and survive for long periods. These criteria are supposed to render T cells prone to transformation. Therefore, the questions of mature T cells transformability and the control mechanism limiting their transformation are still elusive.
Drug toxicity and viral resistance limit long-term efficacy of antiviral drug treatment for HIV
infection. Thus, alternative therapies need to be explored. Previously, group of “Prof. von Laer”
tested the infusion of T lymphocytes transduced with a retroviral vector (M87o) that expresses an
HIV entry inhibitory peptide (maC46). Gene-modified autologous T cells were infused into 10
HIV-infected patients with advanced disease and multidrug resistant virus during antiretroviral
combination therapy. T cell infusions were tolerated well with no severe side effects. A
significant increase of CD4 counts was observed post infusion. At the end of the one-year
follow-up, the CD4 counts of all patients were still around or above baseline. Gene-modified
cells could be detected in peripheral blood, lymph nodes and bone marrow throughout the oneyear
follow-up, whereby marking levels correlated with the cell dose. No significant changes of
viral load were observed during the first four months. Four of the seven patients that changed
their antiviral drug regimen thereafter responded with a significant decline in plasma viral load.
In conclusion, the transfer of gene-modified cells was safe, led to sustained levels of gene
marking and may improve immune competence in HIV-infected patients with advanced disease
and multidrug resistant virus. However, the low level of gene marking and the lack of substantial
long-term in vivo accumulation of gene-protected cells observed in this trial clearly demonstrate
the requirement for new vectors with new strategy.
In this thesis self‐inactivating lentiviral vectors harboring internal promoters and RNA elements
were therefore evaluated for their potential use in a clinical gene‐therapy trial. The results from
this work provide the basis for the selection of a suitable candidate vector for extensive
preclinical testing. Apart from being capable of transducing non‐dividing cells, lentiviral vectors
incorporate a number of additional features that are of potential value for gene therapeutic
applications. These include a larger packaging capacity, higher titers than γ‐retroviral vectors
and, most importantly, a reduced risk of deregulating cellular genes due to its natural integration
profile. The use of internal promoters to drive expression of the therapeutic transgene maC46
should further improve the safety profile of these new‐generation vectors, while an additional
artificial splice acceptor (SA) into the 5‟UTR of the transgene over all elevate transgene
expression. The rationale for this is that hematopoietic stem and progenitor cells will be
Summary
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protected from enhancer‐mediated transactivation effects and also from potential side effects due
to the aberrant expression of maC46 while at the same time the full clinical benefit for the
patients is maintained.
In order to find a suitable candidate for preclinical studies, two candidate therapeutic vectors
harboring different regulatory elements were selected based on results from pilot experiments.
The internal promoters used to drive expression of codon optimized maC46 were the PGK
promoter and MPSV promoter. This work focuses on the transgene expression levels in
lymphoid cells and antiviral activity. The issues of long term expression, propensity to
methylation mediated silencing of the promoters, and genotoxicity were also touched. In a first
step the performance of different vectors was evaluated in the human T cell lines. Based on
promising data from ex vivo human peripheral blood mononuclear cells, the vector carrying the
MPSV promoter along with intron were selected for in vivo transplantation experiments.
In summary, the ex vivo data suggested the long term survival of lentiviral gene modified cells,
along with maintained expression of introduced genes. It was observed that the expression of
these constructs depends strongly on the activation and differentiation status of the targeted T
cells. This regulation was not linked to any specific promotor. In vivo study shows that maC46
can be introduced into murine multiple hematopoietic lineages via lentiviral vector and expressed
at high levels in their mulilineage progeny, without altering the hematopoiesis. There was no
sign of any kind of hematopoietic or lymphoid malignancies. Although gene-modified
lymphocytes persisted in-vivo, the downregulation of transgene expression was consistent with
the ex-vivo observation. In contrast to that the T cells transplanted group showed delayed
engraftment of donor cells and there was no expression of C46 in blood and lymphatic organs. .
In conclusion, when considering HIV gene therapy focusing CD4+ T cells, potential problems of
T cell activation status as related to the desired clinical effect must be addressed. These results
might open the way for a gene therapy targeting mainly or exclusively activated T cells and
could be exploited for immunostimulatory as well as suppressive approaches.