Image-guided, intravascular hydrodynamic gene delivery to skeletal muscle in pigs.

Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
Molecular Therapy (Impact Factor: 7.04). 10/2009; 18(1):93-100. DOI: 10.1038/mt.2009.206
Source: PubMed

ABSTRACT Development of an effective, safe, and convenient method for gene delivery to muscle is a critical step toward gene therapy for muscle-associated diseases. Toward this end, we have explored the possibility of combining the image-guided catheter insertion technique with the principle of hydrodynamic delivery to achieve muscle-specific gene transfer in pigs. We demonstrate that gene transfer efficiency of the procedure is directly related to flow rate, injection pressure, and injection volume. The optimal gene delivery was achieved at a flow rate of 15 ml/second with injection pressure of 300 psi and injection volume equal to 1.5% of body weight. Under such a condition, hydrodynamic injection of saline containing pCMV-Luc (100 microg/ml) resulted in luciferase activity of 10(6) to 10(7) relative light units (RLU)/mg of proteins extracted from the targeted muscle 5 days after hydrodynamic gene delivery. Result from immunohistochemical analysis revealed 70-90% transfection efficiency of muscle groups in the hindlimb and persistent reporter gene expression for 2 months in transfected cells. With an exception of transient edema and elevation of creatine phosphokinase, no permanent tissue damage was observed. These results suggest that the image-guided, intravenous hydrodynamic delivery is an effective and safe method for gene delivery to skeletal muscle.

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    ABSTRACT: Gene therapy provides an opportunity to ameliorate several genetic disorders and treat numerous diseases by using nucleic acid-based materials to modulate gene activity. However, the greatest challenge for successful gene therapy applications remains delivery. Two general approaches are currently under investigation to improve gene delivery efficiencies. The first is by encapsulating therapeutic genes into modified viruses that are effective at transfecting cells but that have also caused serious side effects during clinical evaluations in 1999 and 2003. In contrast, non-viral gene therapy provides the safety of conventional pharmaceutical products, but possesses inadequate transfection efficiencies for clinical use. Successful non-viral gene delivery systems require evasion of the reticuloendothelial system (RES) while in circulation, a targeting ligand for efficient cellular uptake, and perhaps several additional components for efficient cellular disposition once the carrier has been internalized. Engineering sophisticated gene delivery systems requires modular designs that are well characterized and optimized to circumvent each limiting barrier associated with gene delivery. The following thesis is focused on developing stabilized DNA polyplexes for in vivo applications and coupling their administration with current physical methods of non-viral gene delivery. The aim behind this approach is to systematically prepare gene carriers and evaluate their ability to maintain DNA transfection competent in order to determine which bioconjugate is the most successful for ultimately creating gene carriers that do not require physical interventions for gene expression. The non-viral gene delivery systems presented in the thesis are based on PEGylated polyacridine peptides that bind to DNA predominantly by intercalation rather than by ionic interactions with DNA. The initial experimental chapters deal with the discovery of these novel DNA polyplexes, and the latter chapters focus on the optimization of their design for targeted in vivo gene delivery. The results demonstrate that PEGylated polyacridine DNA polyplexes possess improved compatibility for in vivo administration and that their flexible design is beneficial for preparing multi-component gene delivery systems.
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    ABSTRACT: Development of a safe and effective method for gene delivery to hepatocytes is a critical step toward gene therapy for liver diseases. Here, we assessed the parameters for gene delivery to the livers of large animals (pigs, 40-65 kg) using an image-guided hydrodynamics-based procedure that involves image-guided catheter insertion into the lobular hepatic vein and hydrodynamic injection of reporter plasmids using a computer-controlled injector. We demonstrated that injection parameters (relative position of the catheter in the hepatic vasculature, intravascular pressure upon injection, and injection volume) are directly related to the safety and efficiency of the procedure. By optimizing these parameters, we explored for the first time, the advantage of the procedure for sequential injections to multiple lobes in human-sized pigs. The optimized procedure resulted in sustained expression of the human α-1 antitrypsin gene in livers for more than 2 months after gene delivery. In addition, repeated hydrodynamic gene delivery was safely conducted and no adverse events were seen in the entire period of the study. Our results support the clinical applicability of the image-guided hydrodynamic gene delivery method for the treatment of liver diseases.Molecular Therapy-Nucleic Acids (2013) 2, e128; doi:10.1038/mtna.2013.52; published online 15 October 2013.
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