Background
Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative disease (UC), is thought to result from abnormal interactions between gut associated lymphoid tissue and enteric microflora. This abnormal mucosal immune response is probably facilitated by defects in epithelial barrier function [
1]. Interleukin (IL)-10 plays a crucial role in mucosal immunoregulation, inhibiting aspects of both the innate and cell mediated inflammatory response [
2]. IL-10 has broad immunoregulatory activity and acts to suppress intestinal inflammation on several levels. Gene-targeted IL-10 knockout mice (IL-10−/−) and IL-10 receptor 2 deficient mice spontaneously develop an enterocolitis by 2–3 months of age with multifocal inflammatory lesions throughout the gastrointestinal tract [
3]. In addition, mutations in the gene encoding the IL-10 receptor subunit proteins have been found in IBD patients [
4]. IL-10 suppresses the release of many other proinflammatory cytokines and chemokines, including tumor necrosis factor alpha (TNF-α), IL-1, IL-6, and IL-8. Finally there is strong evidence that IL-10 acts to promote the differentiation and augment the activity of regulatory T cells [
5].
Administration of systemic IL-10 is sufficient to inhibit inflammation and abrogate experimental colitis models [
6,
7]. However, clinical trials in Crohn’s disease have shown that, although daily systemic IL-10 injections are safe and well tolerated, they have minimal therapeutic efficacy [
8,
9]. One explanation for these disappointing results is that daily systemic therapy does not deliver adequate mucosal levels of IL-10 that would be needed to control proinflammatory responses associated with active CD. Thus, strategies that result in greater mucosal exposure to IL-10 in the gastrointestinal tract may prove effective in treating IBD.
Several IL-10 delivery systems targeting the gastrointestinal mucosa have been reported; rectal administration using an adenovirus vector [
10], oral delivery using non-pathogenic bacteria (
Lactococcus lactis) [
11], and oral nanoparticles [
12]. Recently, we demonstrated the ability of a vesicular stomatitis virus envelope glycoprotein (VSV-G) pseudotyped lentiviral vector (LV) to infect colonic mucosal tissue via the apical surface
in vivo, after intraluminal instillation per rectum in a healthy murine model and
ex vivo in a human intestinal explant system [
13]. In this study, we tested whether efficient local gene transfer can be accomplished using LV expressed murine IL-10 (mIL-10) in a murine colitis model.
Methods
Vector construction and preparation
The pRRLsin-hCMV-fLuc vector was constructed by insertion of the firefly Luciferase (fLuc) gene [
14], and the pRRLsin-hCMV-mIL10 vector by insertion of the mIL-10 coding sequence from plasmid pORF5-mIL-10 (InvivoGen, San Diego, CA, USA), respectively, into the multiple cloning site (MCS) of pRRLsin-hCMV-MCS-pre, a third-generation, self-inactivating LV construct provided by Dr. Luigi Naldini (San Rafaelle Telethon Institute, Milan, Italy) [
15]. All constructs were reconfirmed by restriction digestion and DNA sequencing analysis. Vesicular stomatitis virus glycoprotein envelope (VSV-G)-pseudotyped LV virus was produced in 293 T cells using a third-generation packaging system as previously described [
16]. LV titers were determined by HIV-1 p24 ELISA (Coulter Immunotech, Miami, FL, USA) and expressed as p24 equivalent units (ng/ml).
Cell culture in vitrogene transfer study
Three human colonic cancer cell lines of epithelial origin (CaCo-2, LoVo, and WiDr) were obtained from the American Type Tissue Collection (ATCC, Manassas, VA, USA) and grown at 37°C in 5% CO
2 in Dulbecco’s modified Eagle’s medium, Ham’s F12K medium, or RPMI 1640, respectively. All media were supplemented with 10% fetal bovine serum and 1% penicillin-streptomycin. Transductions were done using media containing polybrene (8 μg/ml) (Sigma, St. Louis, MO, USA) to enhance gene transduction [
17]. Each transduction was carried out with 1 × 10
5 cells. To assess the mIL-10 productive capacity of the LV constructs, 100 ng p24 of the LV-mIL-10 (equivalent to a biological infectious titer of 5 × 10
6 transducing units on the standardized cell line HEK-293 T [
18]) was added to monolayer cultures of the three specified cell lines at a multiplicity of infection (MOI) of 0.1, 1.0 or 10 (ratio of virus to cell number). Transduction was performed with the viral solution at 37°C for 12 hours followed by a change of medium and a second 24 hour incubation. After the 36 hour transduction period, supernatants were collected, filtered, and stored for batch quantification of mIL-10 level by ELISA.
Preliminary treatment to enhance mucosal delivery of the LV
Mucosal pretreatment with a 20% ethanol (EtOH) enema was used to enhance gene delivery into the colonic mucosa. Female Balb/c mice (weight: 19–23 grams, age: 6–8 weeks) (Charles River Laboratories, Inc., Wilmington, MA, USA) were housed in a specific pathogen-free environment prior to LV exposure. All in vivo studies were performed under the appropriate guidelines and with the approval of the UCLA Animal Research Committee.
Ex vivobioluminescence imaging
Ex vivo bioluminescence imaging (BLI) of transduced tissue from gastrointestinal (GI) organs was used to assess LV-guided gene transfer into the colonic mucosa. Two days following topical exposure to a LV expressing fLuc, GI tract organs from each group were harvested en bloc, bathed and imaged using a cooled charge-coupled device (CCD) system (Xenogen IVIS, Caliper Life Sciences, Alameda, CA, USA) where gray-scale background photographic images of the tissues were overlaid with color images of bioluminescent signals (Living Image and IGOR-PRO image analysis software, Wave Metrics, Portland, OR, USA).
LV-mIL-10 treatment effect on dextran sulfate sodium colitis
Colitis was induced by exposure to 3% (w/v) dextran sulfate sodium (DSS; molecular weight 36-50 kDa; ICN Pharmaceutical, Costa Mesa, CA) administered orally which reproducibly produces histologic inflammation mainly in the left colon [
19,
20]. Each mouse received 2 cycles of DSS oral treatment with each cycle consisting of 7 continuous days with DSS added to the drinking water followed by a 10 day period without DSS.
For this experimental design, mice were divided four groups (n = 8 mice/group): (i) non-exposed, healthy controls (NC), (ii) mock-exposed (plasmid complex solution without the mIL-10 vector), (iii) once-exposed treatment group (LV(1)) and (iv) twice-exposed treatment group (LV(2)). LV-mIL-10 was given on day 3 of each of the two DSS cycles. Mice were anesthetized with an intraperitoneal injection of 10 mg/kg xylazime and 100 mg/kg ketamine. Two hours following the preliminary EtOH enema treatment, 100 μl of 1000 ng/p24 viral solution was atraumatically injected intrarectally via a 1.2 mm diameter catheter. Mice were sacrificed on Day 10 (n = 4) or 32 (n = 4), following each DSS exposure.
Clinical, macroscopic and histologic assessments
The health status of all treated mice was followed closely and all mice were weighed 3 times/week. The clinical disease activity score (CDA; scores range from 0–4) was assessed using a previously published index incorporating body weight, stool consistency and occult blood [
19].
Postmortem, the entire colon was removed from the cecum to the anus, flushed with saline, and placed without tension on cellulose [
19,
20] where it was fixed in 4% paraformaldehyde overnight. Subsequently, the tissue was placed in 30% sucrose/PBS for 2 hrs, embedded in OCT compound with serial 5.0-μm-thick frozen sections sliced from the block and stained with hematoxylin and eosin (H&E) for histologic scoring (range: 0–6) by a pathologist, blinded to sample groupings. Macroscopic colonic damage score was assessed during colon removal as previously reported [
21] with minor modifications. The scoring, with ranges from 0–9, included scales for degrees of tissue adhesion, presence of ulceration, and wall thickness. A combined score was used next to assess injury from the macroscopic and the histologic grading [
22]. The scores for cell infiltration and tissue damage were added, resulting in a combined histologic score ranging from 0 to 6.
Cytokine production
As described previously, tissue was homogenized in nine volumes of Greenberger lysis buffer (300 mM NaCl, 15 mM Tris HCl, 2 mM MgCl2, 2 mM, Triton (X-100), pepstatin A, leupeptin, aprotinin (all 20 ng/ml), pH 7.4) [
23,
24]. Tissue was lysed for 30 min on ice followed by two centrifugations at 14,000 g for 10 min each. Homogenates were stored at −20°C until further use. TNF-α, IL-6 and IL-10 protein concentrations (pg/mL) were measured by ELISA (R&D Systems, Abingdon, England).
Biodistribution analysis by real-time quantitative PCR (RT-qPCR)
To determine the lentiviral DNA copy number within the colorectal tissues following topical exposure, we performed qPCR. Genomic DNA was isolated from mouse colonic tissue using DNeasy Tissue Kit (Qiagen, Inc., Valencia, CA, USA). Quantification of vector copy numbers was performed in 25 μL reactions containing 300 ng genomic DNA (equivalent to 5 × 10
4 genomes) using TaqMan qPCR assay to detect the HIV-1 packaging sequences as a universal primer [
25]. Amplifications were carried out in an ABI PRISM 7700 sequence detector (Perkin Elmer, Wellesley, MA, USA). After the initial denaturation step (10 min at 95°C), amplification was performed with 40 cycles of 15 s at 95°C, and 60 s at 60°C. To calculate the copy number in the samples, a reference curve was prepared by amplifying serial dilutions of a LV-CMV-Luc plasmid in a background of genomic DNA obtained from untransduced murine colon. Genomic DNA from the PC3 cell line, a human prostate cancer cell line, transduced with LV-GFP was used as a positive control. PC3 cells were shown to have 100% transduction by flow cytometry and as these cells are hyperploid, the vector copy number in 300 ng of PC3 genomic DNA was quantitated as approximately 16,000 (data not shown).
Statistical analysis
All values were expressed as means ± SD. Comparisons between groups were made using the student t-test and the Mann–Whitney U test. A p value of less than 0.05 was considered statistically significant. Statistical analysis was performed using Graph Pad Prism (Version 4.00 for Macintosh; GraphPad Software, San Diego, CA, USA).
Discussion
In this study, we have demonstrated for the first time that an LV could be used as a novel gene delivery system for the treatment of DSS colitis. Topical gene therapy using a LV encoding mIL-10 was found to suppress not only the development but also the relapse of the colitis. The LV platform is efficient and provides a unique gene transfer system with a number of features that differentiate it from other topical gene therapy approaches that have been evaluated for the treatment and prevention of experimental models of colitis.
Adenovirus vectors [
10,
24,
26‐
29] and cationic lipids complexed to immunoregulatory genes [
30], have reported efficacy in the treatment of murine colitis. However, a major disadvantage of these systems is that the transgene expression is transient since genes are transduced into mucosal epithelial cells that only live for about 2–3 days. Alternatively, an approach using
Lactococcus lactis only transiently increased mucosal IL-10 concentration because the bacteria did not colonize the intestine [
11,
31].
Ex vivo retroviral gene transfer of CD4+ T cells with IL-10 did not have any therapeutic benefit in acute colitis of immunocompetent mice, though it did prevent induction of colitis in a transfer colitis model using immunodeficient mice [
32].
Here we chose to evaluate whether a LV encoding IL-10 was effective in treating or preventing DSS induced murine colitis for three reasons. Firstly, this colitis model induces profound epithelial barrier disruption that might facilitate LV transduction and access to the lamina propria [
19]. Secondly, this DSS colitis model shows severe inflammation in the distal colon [
19,
20,
22], the area known to have maximal LV transduction. Finally, mucosal CD4+ cells, an important target of LV transduction, also play a critical role in the pathogenesis of IBD colitis [
33]. Within the DSS model, increases in mucosal CD4+ T cells occur in a dose dependent fashion such that with 5% DSS induced colitis is associated with significantly more CD4+ T cells compared to 3% DSS colitis [
34]. Supporting our hypothesis, LV expressed mIL-10 showed efficacy against acute and relapsing murine DSS colitis.
Notably, we found that topical delivery of a LV encoding IL-10 could suppress not only the development but also prevent relapse of DSS colitis. This is a unique feature of the LV approach and has not been seen in other traditional vector systems. We suggest that the reason for this property might relate to the ability of the LV to transduce both colonic mucosal epithelial and mucosal CD4+ T cells following rectal administration [
13]. Mucosal CD4+ T cells play a dominant role in controlling gastrointestinal mucosal inflammation, especially regulatory CD4+ T cells through secretion of anti-inflammatory cytokines such as IL-10 [
5,
7]. Interestingly, although not statistically significant, administration of two vector doses showed a trend toward achieving more therapeutic efficacy than a single dose. In this context, it is notable that IL-10 levels were comparable between the single dose and double dose groups, perhaps due to feedback down regulation of endogenous IL-10 in response to vector-derived IL-10. Alternative explanations might include the induction of antibodies or other immunological processes that reduce the efficiency of lentiviral infection and or biological availability of IL-10 in the mucosal tissue. Additional studies are warranted to examine whether higher vector concentrations or frequency of administration might achieve further benefit.
In addition to the barrier disruption caused by DSS colitis, 20% ethanol pre-treatment was also required for optimal LV transduction, perhaps by helping to dissolve or wash away physical barriers obstructing vector access to the cellular surfaces of the mucosal epithelium. While 20% ethanol pre-treatment in itself induces no mucosal inflammation, in the presence of 3% DSS-induced colitis we obtained transduction levels comparable to those observed in our previous studies using 50% ethanol pre-treatment to enhance vector transduction efficiency in the absence of pre-existing mucosal inflammation [
13]. Furthermore, similar approaches have been tested both pre-clinically and in clinical trials, e.g., using ethanol or surfactants to improve transduction efficiency of vectors instilled into the bladder, and so this approach has potential for clinical translation in IBD.
There are a number of limitations to our study. Use of additional control groups such as an IL-10 plasmid or lentiviral vector without the IL-10 insert could have provided insight as to the independent contribution of the lentiviral vector and the IL-10 on the subsequent modulation of mucosal infection. In addition we did not measure plasma IL-10 or other immunological parameters that could have provided explanations as to why a second dose of the LV did not appear to provide benefits above or beyond those seen with a single dose of LV.
Acknowledgments
The authors would like to thank Justin Akin for his assistance in preparing this manuscript, the staff of the UCLA Center for Prevention Research (CPR), the UCLA Vector Core (#DK041301) and the Blinder Research Foundation for Crohn’s Disease at UCLA. This work was supported in part by a pilot award from the NIH-supported Center for AIDS Research (CFAR) at UCLA (#AI28697: IM and NK), the CFAR’s Mucosal Immunology Core (#AI28697). Additional Core facility support was obtained from the Molecular Biology/Gene Transfer Vector Core (NK) from the CURE Digestive Diseases Research Center (#DK041301) at UCLA and UCLA’s Jonsson Comprehensive Cancer Center (#CA16042).
Competing interests
The authors declare that they have no competing interest.
Authors’ contributions
HM conducted the majority of the experiments described in this paper. TK carried out the molecular genetic studies, made the lentiviral vector, and performed the statistical analysis of the experimental data. KH, IO, KH helped to analyze the in vivo animal data. NK provided technical assistance for the lentiviral vector experiments, PA collected the endoscopic biopsies, and IM supervised the research, and edited the final manuscript. All authors read and approved the final manuscript.