retro and adeno virus mediated gene transfer

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    Retro and Adeno Virus mediated gene transfer

    Viruses have complex and precise structural features, which have adjusted through

    natural evolution for efficient transfection of specific host cells or tissues. Viral vector is the

    most effective means of gene transfer to modify specific cell type or tissue and can be

    manipulated to express therapeutic genes. Several virus types are currently being investigated for

    use to deliver genes to cells to provide either transient or permanent transgene expression. These

    include adenoviruses (Ads), retroviruses (g-retroviruses and lentiviruses), poxviruses, adeno-

    associated viruses, baculoviruses, and herpes simplex viruses.

    Retro virus mediated gene transfer

    Discovery of Retroviruses

    Retroviruses were discovered in 1908, the Danish physician-veterinarian team of Vilhelm

    Ellermann and Oluf Bang showed that chicken leukosis, a form of leukemia and of lymphoma,

    was caused by a virus. These agents are now known under the collective term avian leukosis

    virus or ALV. In 1911, Peyton Rous at the Rockefeller Institute in New York reported the cell-

    free transmission of a sarcoma in chickens known as Rous sarcoma virus. Together, these viruses

    constitute the avian C-type virus genus, often referred to as avian sarcoma/ leukosis viruses

    (ASLV).

    Classification of Retroviruses

    Retroviruses comprise a large and diverse family of enveloped RNA viruses defined by common

    taxonomic denominators that include structure, composition, and replicative properties. The

    family ofRetroviridae (reverse transcriptase oncoviruses) is classified into the two

    subfamilies; Orthoretroviriniae and Spumaretrovirinae. The first includes six genera (-, -, -,

    - and e-retroviruses, and lentiviruses); the genus foamy virus belongs to the latter subfamily.

    The first five genera represent mostly simple retroviruses. Because they possess oncogenic

    potential, they were formerly referred to as oncoretroviruses. Lenti- and spumaviruses are

    complex retroviruses. Distinguishable by the organization of their genomes, retroviruses are

    broadly divided into two categoriessimple and complex

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    Table: Classification of Retroviruses

    Genus Example Genome

    1. Avian sarcoma and leukosis viral group Rous sarcoma virus simple

    2. Mammalian B-type viral group mouse mammary tumor virus simple

    3. Murine leukemia-related viral group Moloney murine leukemia virus simple

    4. Human T-cell leukemiabovine leukemia viral human T-cell leukemia virus complex

    5. D-type viral group Mason-Pfizer monkey virus simple

    6. Lentiviruses human immunodeficiency virus complex

    7. Spumaviruses human foamy virus complex

    Morphology of Retroviruses

    The virions are 80100 nm in diameter, and

    their outer lipid envelope incorporates and

    displays the viral glycoproteins. The viral

    envelope is formed by a cell-derived lipid bilayer

    into which proteins encoded by the envregion of

    the viral genome are inserted. These consist of the

    transmembrane (TM) and the surface (SU)

    components linked together by disulfide bonds.

    Internal nonglycosylated structural proteins form

    the capsid core protein having a icosahedral

    structure encoded by the gag region of the viral

    genome. It enclosed the virion RNA which is 7

    12 kb in size, and it is linear, single-stranded,

    nonsegmented, and of positive polarity. The hallmark of the family is its replicative strategy

    which includes as essential steps reverse transcription of the virion RNA into linear double-

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    stranded DNA and the subsequent integration of this DNA into the genome of the cell. Also

    contained in the core are three enzymes, protease (PR), reverse transcriptase (RT), and integrase

    (IN), which are derived by proteolysis of a polyprotein product of thepolgene. The protease (PR)

    is derived from the gag pro gene.

    Genomic organization of Retroviruses

    Simple retroviruses usually carry only the elementary informationgag-pol-env, whereas complex

    retroviruses code for additional regulatory nonvirion proteins derived from multiply spliced

    messages

    (A) A simple retrovir al genome-The genetic map of an MMLV contains four major coding

    regions,gag,pro,pol, and env. Thepro gene is encoded in thegagreading frame. PBS- tRNA-

    primer binding site. The terminal noncoding sequences (long terminal repeats-LTR) include two

    direct repeats (R), a U5 (5'unique), and a U3 (3'unique) sequence, - psi-defines packaging

    sequence

    (B) A complex retroviral genome- The genetic map of HIV contains, besides the major coding

    domains, information for other regulatory proteins like revRNA binding protein to induce the

    transition from the early to the late phase of HIV gene expression, tatRNA binding protein that

    enhances transcription, nef- Disturbs T-cell activation and stimulates HIV infectivity, vpr -

    Mediates HIV to infect nondividing cells, vpu- Enhances the release of HIV-1 from the cell

    surface to the cytoplasm, vif- A polypeptide necessary for the replication of HIV-1.

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    Retrovirus life cycle

    (1) Binding and (2) Fusion: Interaction of the glycoprotein with a cellular receptor molecule

    is necessary for the successful infection of a cell.This entry into the cell represents the first step

    of the viral infection cycle interaction of the viral envelope proteins with the host cell surface

    receptors and loss of the envelope by fusion of the virus membrane with the cell membrane.

    (3) Uncoating and reverse transcription: After fusion of the lipid membranes of the virus

    and host cell, the genetic material of the virus and thepol-encoded proteins are transferred to the

    cytoplasm. Viral RNA is converted into DNA by reverse transcriptase. The sequences at the ends

    of the viral RNA, the long terminal repeats (LTRs), are duplicated and added at both ends of the

    newly synthesized DNA.

    (4) Nuclear entry: The dsDNA enters into the host cell nucleus. However, nuclear entry

    requires cell division for MLV and ALV. It can only integrate into the host genome of a cell that

    are undergoing mitosis, but is an active process for HIV.

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    (5) Integration: After nuclear translocation, the viral DNA is integrated into the host

    genomic DNA by the integrase, and is then termed 'provirus'.

    (6) Transcription: Proviral DNA transcription is performed and mRNA molecules

    transferred into the cytoplasm,

    (7) Translation: where they are translated by the cellular machinery.

    (8) Assembly:The full-length RNA and viral proteins are assembled and,

    (9) Budding:progeny viral particles bud from the plasma membrane, and

    (10) Maturation: further mature into infectious a particle which repeats the life cycle.

    The genomic structure of(A) an integrated provirus and its (B) transcription and (C) translation

    products.

    A. The viral genome consisting of the gag, pol, and env genes with the long terminal repeats

    (LTRs) subdivided into the U3, R, and U5 regions. SD and SA are splice donor and acceptor

    sites which defines the packaging sequence.

    B. Transcription- This integrated DNA is transcribed into both full length and spliced transcript.C. Translation- A Gag and Gag-Pol polypeptide are translated from the full genomic transcript,

    while the envelope (Env) protein is translated from the subgenomic transcript. Gag polyprotein

    has myristate modification on its N-terminus, encodes capsid core.

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    Retroviral Vector Derivation

    Retroviral vectors are typically used to induce the production of a specific protein in transduced

    cells. Most replication-defective retroviral vectors have been derived from the murine and avian

    retroviruses. Vector design involves the construction of a provirus that contains all of the

    signals needed in cis for vector packaging, reverse transcription, and integration, but which lacks

    the coding regions for most or all of the viral proteins, and a corresponding packaging cell line to

    produce the viral proteins required for viral assembly and transduction. Although it is in

    principle possible to derive vectors from any retrovirus, the complexity, toxicity, and regulatory

    intricacies of some retroviruses, especially the lentiviruses such as HIV, make construction of

    vectors more difficult, and the titers of such vectors are typically low. Since lentivirus can infect

    nondividing cells, the additional work needed to develop efficient vectors based on these viruses

    appears to be justified. The simplest approach is to use the promoter in the retroviral LTR to

    control the expression of a cDNA encoding the protein of interest. Changes can be made in the

    enhancer/promoter of the LTR to provide tissue-specific expression or inducibility. The presence

    of retroviral sequences between the viral promoter and the translational start codon of the

    inserted gene appears not to markedly affect gene expression, even though several ATG start

    codons are present in the 5-untranslated regions of commonly used vectors. Alternatively, a

    single coding region can be expressed by using an internal promoter.

    A. Schematic representation of MMLV-gag-pol-env flanked by LTRs B. Vector construct with deletion of major viral genes retaining LTRs and psi ()

    sequence

    C. More than one gene product or sequence can be expressed by use of an InternalRibosome Entry Site (IRES) sequence(I) or introduction of second promoter (P)

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    Selectable Markers

    Many different selectable markers have been used successfully in retroviral vectors. These

    include the bacterial neomycin and hygromycin phosphotransferase genes which confer

    resistance to G418 and hygromycin, respectively; a mutant mouse dihydrofolate reductase gene

    (dhfr*) which confers resistance to methotrexate; the bacterialgptgene which allows cells to

    grow in medium containing mycophenolic acid, xanthine, and aminopterin; the

    bacterial hisD gene which allows cells to grow in medium without histidine but containing

    histidinol; the multidrug resistance gene (mdr) which confers resistance to a variety of drugs; and

    the bacterial genes which confer resistance to puromycin or phleomycin. All of these markers are

    dominant selectable markers and allow chemical selection of most cells expressing these genes.

    -galactosidase can also be considered a dominant marker; cells expressing -galactosidase canbe selected by using the fluorescence-activated cell sorter. In fact, any cell surface protein can

    provide a selectable marker for cells not already making the protein. Cells expressing the protein

    can be selected by using a fluorescent antibody to the protein and a cell sorter.

    Other selectable markers that have been included in vectors include the hprtand HSV

    thymidine kinase, which allow cells to grow in medium containing hypoxanthine, amethopterin,

    and thymidine. For these selectable markers to be useful, however, the target cells must initially

    be hprt- ortk-deficient.

    Types of replication vectors

    Retroviral vectors can either be

    replication-defective or replication-competent

    Replication-defective vectors:

    Replication-defective vectors are the most common choice in studies. They are capable of

    infecting their target cells and delivering their viral payload, but then fail to continue the typical

    lytic pathway that leads to cell lysis and death. This is accomplished by replacing most or all of

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    the coding regions of a retrovirus with the gene(s) or sequence elements to be transferred, so that

    the vector by itself is incapable of making proteins required for additional rounds of viral

    replication and packaging. Viral proteins needed for the initial infection can be provided

    in trans by a retroviral packaging cell; there is no need for retroviral protein synthesis in

    recipient cells for proviral integration. The process of gene transfer and expression by retroviral

    vectors is often referred to as transduction rather than infection to differentiate this process from

    productive viral infection by a replication-competent virus. Depending on the viral vector, the

    typical maximum length of an allowable DNA insert in a replication-defective viral vector is

    usually about 8-10 kB. While this limits the introduction of many genomic sequences, most

    cDNA sequences can still be accommodated.

    Replication-competent viral vectors:

    Conversely, replication-competent viral vectors contain all necessary genes for virion

    synthesis, and continue to propagate themselves once infection occurs. Because the viral genome

    for these vectors is much lengthier, the length of the actual inserted gene of interest is limited

    compared to the possible length of the insert for replication-defective vectors.

    For example, in Avian viruses, Rous sarcoma virus (RSV) carries thesrc oncogene in

    addition to a full complement of genes required for replication, and thus provides the earliest

    example of a replication-competent retroviral vector. RSV has been exploited as a vector by

    replacement of thesrc gene with other cDNAs. Vectors derived from RSV efficiently infect

    avian cells, and although they can infect mammalian cells, the efficiency of infection is quite

    low. Recently, the receptor for subgroup A RSV has been cloned whose expression in

    mammalian cells allows the efficient infection of those cells by the RSV(A)-based vectors.

    SD- Splice donor;

    SA- splice acceptor;

    DR- direct repeat;

    LTR- long terminal

    repeat

    http://www.news-medical.net/health/Viral-Vectors-What-are-Viral-Vectors.aspxhttp://www.news-medical.net/health/What-is-DNA.aspxhttp://www.news-medical.net/health/Genes-What-are-Genes.aspxhttp://www.news-medical.net/health/Genes-What-are-Genes.aspxhttp://www.news-medical.net/health/What-is-DNA.aspxhttp://www.news-medical.net/health/Viral-Vectors-What-are-Viral-Vectors.aspx
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    Advantages of Retroviral Vectors

    Retroviral vectors have the ability to transduce a wide range of cell types from differentanimal species,

    Used to integrate genetic material carried by the vector into recipient cells precisely, Used to express the transduced genes at high levels, They lack the spread of vector or production of viral proteins after infection, In contrast to typical vectors derived from oncoviruses, lentiviruses such as human

    immunodeficiency virus (HIV) useful for gene therapy applications, especially those

    involving in vivo gene transfer or transfer to slowly dividing cells such as hematopoietic

    stem cells.

    Disadvantages of Retroviral Vectors

    They are generally not useful for systemic administration because of their inactivation byproteins and cellular components of human blood, thus used to transduce cells ex vivo

    They require cell division for efficient integration and thus not a very feasible vector forin vivo transductioninto pulmonary or renal cells which have quite silent cell turnover

    Integration has been associated with oncogene activation after transduction ofhematopoietic cells

    It is difficult to prepare high titres of viral stocks, and the retrovirus cannot carry verylarge amounts of transgenic material

    Expression of the transgene is difficult to control

    Experimental Applications

    Constitutive gene expression- Can efficiently transduce a wide variety of cells types fromdifferent species and to induce high levels of protein expression.For example, large

    cDNAs such as the insulin like growth factor I receptor (4.1-kb coding region) have been

    transmitted efficiently and expressed at high levels (>106

    molecules per cell) in

    transduced cells.

    Regulated gene expression-Retroviral vectors designed to provide regulated gene expressionare quite useful in the context of gene therapy, where it may be important to limit expression to

    specific cell types (e.g., red cells for globin), to regulate the overall level of expression (e.g., for

    clotting factors),

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    Cell lineage analysis- Retroviral vectors provide useful tools for cell lineage analysisbecause they integrate into the genome of the transduced cell and remain stable during

    cell division and differentiation. Retroviral vectors have been used to transduce neuronal

    cells in vivo in studies designed to follow the fates of the marked cells.

    cDNA library construction-The vectors can be used to transfer and express cDNAs in a widerange of cell types, including primary cells, providing an efficient means to transfer and express

    the cDNAs.

    Immunoglobulin rearrangement- by constructing retroviral vectors that contain sequencesfrom the immunoglobulin locus and studying the rearrangement of these sequences after the

    vector has been introduced into appropriate cells

    Transgenic animals- important in species where direct DNA transfer is difficult. For example,the reproductive physiology of chickens has made the direct injection of DNA into fertilized eggs

    quite difficult.

    Chromosome tagging-Retroviral vectors carrying selectable genes can also be used to markindividual chromosomes.

    Shuttle vectors- Origins of replication and drug resistance genes from bacterial plasmids(amp and neo) have been included in the vector to facilitate the cloning of vector and

    flanking sequences from cells containing integrated vectors.

    Cellular immortalization- the methods for generating immortal cell lines from the somaticcells, for example, infection of human fibroblasts with SV40, are relatively inefficient. Retroviral

    vectors expressing the SV40 T antigen are more efficient.

    Antisense RNA and Ribozyme production- Retroviral vectors have been used to inhibit theexpression of specific genes by the inclusion of transcriptional units intended to induce the

    synthesis of antisense RNA or specific ribozymes.

    Therapeutic Applications

    Preclinical Gene Transfer and Clinical Trials

    Studies of tissue repair and engineering- Because these vectors can be used to infectdividing cells without producing any immunogenic viral proteins while also becoming a

    permanent part of the host cell.

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    Studies of bone repair- used to deliver various growth factors and differentiation factorsto both mature bone cells and stem cells that have been used in tissue scaffolding, and

    used in repair of damaged cartilage and in the formation of tissue-engineered blood

    vessels for the treatment of cardiovascular disease.

    Used in clinical trials, to treat X-linked severe combined immunodeficiency (X-SCID) ininfants and preadolescents.

    Lentiviral vectors can infect mouse and rat embryos to generate transgenic animals withhigh tissue specific expression of transgene.

    Adenoviruses mediated gene transfer

    First discovered by Wallace Rowe and his colleagues in human adipose tissue (1953) Family Adenovirideae- which is divided into two genera: the Aviadenovirus genus and

    Mastadenovirus

    Human Adenoviruses are furtherclassified into six species (AF). subdivided into over 50 infective serotypes- recombinant adenoviral vectors are based on

    human adenovirus serotypes 2 (Ad2) and 5 (Ad5) of subgroup C and are most effective.

    These serotypes cause a mild respiratory disease in humans and are non-oncogenic,

    Morphology of Adenoviruses Non-enveloped, icosahedral protein shell-

    70100 nm in diameter.

    Capsid-12 identical copies of the trimerichexon protein, pentameric penton base

    protein is located at each vertex of the

    capsid, from it extends a trimeric fiber

    protein that terminates in a globular knob

    domain.

    Genome- linear, dsDNA (26-40kb), compact nucleosome like structure having invertedterminal repeats (ITRs) of 100-140bps

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    Genomic organization Adenoviruses

    Viral genome comprises two major transcription regions, the early region (E1, E2, E3,

    and E4- transcription units) and the late region (L1-L5).

    Transcription

    unit Function

    E1A Activates early-phase transcription and induces the S phase of the host cell

    E1B Codes for E1B 19K and E1B 55K, which inhibits apoptosis and allow for viral

    replication

    E2 Codes for DNA polymerase (pol), preterminal protein (pTP), and DNA binding

    protein (DBP)

    E3 Codes for proteins that block natural cellular responses to viral infection

    E4 Codes for a variety of proteins that perform in DNA replication, mRNA transport,

    and splicing

    Adenoviral life cycle

    The early phase of adenoviral DNA invasion begins when the virus comes in contact with a host

    cell and ends at the onset of DNA replication. The globular knob domain of the viral capsid has a

    high affinity for the coxsackie virus and adenovirus receptor (CAR), which can be found on a

    variety of cells throughout the human body. When the virus locates a host cell, the process of

    binding and internalization begins. The virushost cell affinity between the fibrous knob and the

    CAR is heightened by the interaction of the penton base protein with secondary cellular

    receptors. The virus then travels through the cell membrane via receptor-mediated endocytosis,

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    the virion is released, and the genome escapes the protein capsid and makes its way into the host

    cell nucleus, as depicted in Figure.

    The virion then escapes from the endosome and localizes to the nuclear pore, whereupon its

    genome is translocated to the nucleus. Transcription of viral DNA begins when the genomeenters the host cell nucleus. At this time, the E1A transcription unit of the early phase is

    transcribed, followed quickly by the E1B unit. Together, these two units help to prepare the

    genome for further transcription, shift the host cell into the S phase of replication, and inhibit

    apoptosis of the host cell. The E2 unit, the next to transcribe, encodes for DNA polymerase, a

    preterminal protein, and a DNA-binding protein, all of which are necessary for DNA replication.

    This process is followed by the transcription of the E3 unit, which inhibits the host cell from

    responding to the viral invasion. Finally, the E4 unit is transcribed to produce a variety of

    proteins required for DNA replication and movement into the late phase. The late phase begins at

    the onset of viral DNA replication. This process begins at the origins of replication in the ITRs

    on either end of the viral genome, and the terminal protein at each end of the chromosome acts as

    the DNA primer. The products of late-phase transcription are expressed after a 20-kb section of

    the major late promoter has been transcribed. This section then undergoes multiple splicing

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    cycles to return five encoding proteins of the late mRNA. These proteins are later used either to

    form the viral capsid or to assist in assembling the viral progeny. The host cell finally

    disintegrates and the virus is released.

    Design and Construction of Adenovir al Vectors

    The first-generation vectors are the most commonly used viral vectors in gene-therapy trials.

    These vectors, based on Ads 2 and 5 of species C, have the E1 region of the genome deleted to

    allow more genomic space for foreign DNA. The E3 region may also be deleted for viral DNA to

    be replicated in culture. These eliminations allow the insertion of approximately 7.5 kb of DNA

    into the vector. Another vector form used in gene therapy is known as the gutted vector, in

    which all adenoviral DNA is excised except for the ITRs and packing signals. These vectors

    allow up to 36 kb of foreign DNA to be accommodated within the viral vector.

    Advantages of adenoviral vectors

    Adenovirus does not go through an RNA intermediate, and thus inserted sequences neednot be compatible with transcription of the complete viral genome and its subsequent

    reverse transcription as for retroviral vectors.

    With a genome size of 36 kb, there is considerable room for additional DNA inadenoviral vectors.

    They have the ability to infect both dividing and quiescent cells Adenoviral recombinant vectors are stable and non-oncogenic Vector titers can be very high, up to 1012 transducing units per milliliter.

    Disadvantages of adenoviral vectors

    Possess tropism of the parent viruses which can infects all cells that possess appropriatesurface receptors, which precludes the targeting of specific cell types

    Long-term correction not allowed Humoral and cellular immune response from high vector doses

    Therapeutic Applications

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    Preclinical Gene Transfer and Clinical Trials

    Studies of cancer treatment- successfully delivered tumor suppressor genes p53 and p16to tumor growths.

    Suicide gene therapy, or prodrug therapy, has also been studied as a cancer treatmentoption. Suicide therapy uses viral proteins to metabolize nontoxic drugs into a toxic form,

    resulting in cell death. Recently, a phase I/II suicide-gene-therapy clinical trial has been

    completed in prostate-cancer patients, using an E1/E3-deleted replication deficient Ad

    (CTL102) encoding the bacterial nitroreductase enzyme in combination with prodrug

    CB1954.

    Study of various liver diseasesbecause of the vectors ability to affect nondividing cellsand its high concentration in the liver after administration. A recent study has assessedthe therapeutic effect of an Ad vector carrying PAI-1 small interfering RNA (siRNA) on

    hepatic fibrosis.

    Studies of stem cell differentiation, AIDS, cardiovascular disease, and pulmonarytuberculosis.

    Biosafety measures using viral vectors

    Requires implementation of biosafety level-2 containment (BSL-2) practices. Protocolmust be approved by the Institutional Biosafety Committee (IBC)

    Risks associated with Retroviral vectors

    Generation of replication competent retroviruses (RCR) in target cells or tissues Increase in target cell range of the vector increases the risk of RCR Nature of the vector coding sequence-genes involved in oncogenesis, growth regulation,

    innate or adaptive immunity, or infectious diseases carry a greater risk

    Host Range: dependent on the specificity of the viral envelope- ecotropic env geneinfects rodent cells, amphotropic env gene infects murine and non-murine cells, including

    human.

    Mode of Transmission: by direct contact or blood-borne.

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    Risks associated with Adenoviral vectors

    Can be infective and quite stable - after extracting with ether and/or chloroform unlikeHIV or herpes

    does not integrate into the host cell genome but can produce a strong immune response Possess tropism of the parent viruses- infects all cells that possess appropriate surface

    receptors, which precludes the targeting of specific cell types

    Host Range: Humans are the natural reservoir for wild type Adenovirus 5. RecombinantAdenovirus vectors infect a variety of mammalian cell types.

    Mode of Transmission:by droplet, aerosol, injectionLaboratory Practices

    Usage of eye protection, masks, gloves, Biosafety cabinets Vacuum lines must be fitted with a hydrophobic and HEPA filter. Biohazard waste containers should be disinfected and autoclaved before disposing. Most effective germicides Phenol (5%), Sodium hypochlorite (household bleach diluted

    to 200 ppm or 10%) with a minimum 15 mins contact time must be used.

    Viral vectors must be tested for presence of replication competent viruses after heatinactivation.

    Severely immunocompromised individuals should not go into a room with retroviralagent.

    No standard tests and/or surveillance methods are available to determine possible

    viral vector infection although serious illness can be managed by treating symptoms and

    complications of the infection.

    Characteristics of Viruses Used to Derive Gene Transfer Vectors

    Virus Genome

    Insert capacity

    (kb)

    Specific

    integration

    Long-term

    maintenance

    RNA

    intermediate Titer

    Retroviruses ssRNA 712 kb 7 Y Y Y 106107

    Adenovirus dsDNA 36 kbp 8 N N N 10111012

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    Virus Genome

    Insert capacity

    (kb)

    Specific

    integration

    Long-term

    maintenance

    RNA

    intermediate Titer

    Adeno-associated virus ssDNA 4.7 kb 4.5 Y Y N 10 10

    Herpes simplex virus dsDNA 150 kbp 25 N Y N 10 10 The ability of viruses to deliver foreign DNA to cells for therapeutic purposes has been

    exploited in numerous different contexts. The diverse nature of different vectors and the

    variability of different diseases mean that there will almost certainly be no one size fits all

    vector. Clinical trials have shown that certain vectors have great potential for specific diseases.

    For example, retroviral vectors have had great success in treating X-SCID, whereas lentiviral

    vectors have been used to target various neurological diseases, including Parkinsons and ALD,

    and other clinical trials have employed AAV vectors to treat monogenic disorders, such as

    Duchenne muscular dystrophy and hemophilia B. Although no viral vector has yet received

    clinical approval in Europe or the USA, the encouraging results from clinical trials, coupled with

    continual improvements in vector design and safety, shows that this technology has immense

    potential.

    References:

    Coffin JM, Hughes SH, Varmus HE, editors. (1997),Retroviruses. Cold Spring HarborLaboratory Press (NY).

    William C. Heiser (Editor), Methods in Molecular Biology-Gene Delivery to mammaliancells, Vol 2, Viral gene transfer techniques, Vol 246, Humana Press.

    Otto-Wilhelm Merten and Mohamed Al-Rubeai (eds.),(2011),Viral Vectors for GeneTherapy: Methods and Protocols, Methods in Molecular Biology, vol. 737 ,Springer,

    Science+Business Media, LLC.