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  • RGD peptide-modified adenovirus expressinghepatocyte growth factor and X-linked inhibitor ofapoptosis improves islet transplantation

    Hao Wu1

    A.-Rum Yoon2

    Feng Li1

    Chae-Ok Yun2

    Ram I. Mahato1*

    1Department of PharmaceuticalSciences, University of TennesseeHealth Science Center, Memphis, TN,USA2Department of Bioengineering,College of Engineering,Hanyang University, Seoul, Korea

    *Correspondence to: R. I Mahato,Department of PharmaceuticalSciences, University of TennesseeHealth Science Center, 19 SManassas, RM 224, Memphis, TN381033308, USA.E-mail: [email protected]


    Background Islet transplantation has the potential for treating type I diabetes;however, its widespread clinical application is limited by the massive apoptoticcell death and poor revascularization of transplanted islet grafts.

    Methods We constructed a surface-modified adenoviral vector with RGD(Arg-Gly-Asp) sequences encoding human X-linked inhibitor of apoptosis andhepatocyte growth factor (RGD-Adv-hHGF-hXIAP). In vitro transgene expressionin human islets was determined by enzyme-liniked immunosorbent assay. RGD-Adv-hHGF-hXIAP-transduced human islets were transplanted under the kidneycapsule of streptozotocin-induced diabetic NOD/SCID mice. The blood glucoselevels of mice were measured weekly. The kidneys bearing islets were isolated atthe end of the experiment and subjected to immunofluorescence staining.

    Results The transduction efficiency on human isletswas significantly improvedusing RGD-modified adenovirus. HGF and XIAP gene expressions were dose-dependent after viral transduction. When exposed to a cocktail of inflammatorycytokines, RGD-Adv-hHGF-hXIAP-transduced human islets showed decreasedcaspase 3 activity and reduced apoptotic cell death. Prolonged normoglycemiccontrol could be achieved by transplanting RGD-Adv-hHGF-hXIAP-transducedhuman islets. Immunofluorescence staining of kidney sections bearing RGD-Adv-hHGF-hXIAP-transduced islets was positive for insulin and von Willebrandfactor (vWF) at 200days after transplantation.

    Conclusions These results indicated that ex vivo transduction of islets withRGD-Adv-hHGF-hXIAP decreased apoptotic islet cell death and improved isletrevascularization, and eventually might improve the outcome of human islettransplantation. Copyright 2011 John Wiley & Sons, Ltd.

    Keywords adenovirus; apoptosis; islets; RGD; revascularization


    Type 1 diabetes (T1D) is the result of autoimmune destruction of insulin-producingpancreatic b-cells and results in lifelong dependence on insulin injections. Islettransplantation has the potential to treat T1D. However, the widespread clinicalapplication of transplantation is limited because of the lack of sufficient numberof human islets from donors and the loss of islet viability after transplantation.Up to 70% of insulin-producing b-cells of transplanted islets is lost at the first24 h post-transplantation [1]. Therefore, restoring b-cell function against


    Received: 27 September 2011Revised: 02 November 2011Accepted: 04 November 2011

    Copyright 2011 John Wiley & Sons, Ltd.

    THE JOURNAL OF GENE MEDICINEJ Gene Med 2011; 13: 658669.Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/jgm.1626

  • inflammation after transplantation and protecting themfrom the immune reaction of the recipient are majorchallenges [2].

    Islets are challenged by inflammatory cytokines, hypoxicenvironment, and reactive oxygen species (ROS) at thetransplantation site [35]. Islet loss occurs mostly in the first2weeks after transplantation and decreases significantlythereafter because of successful revascularization [6]. There-fore, expression of an anti-apoptotic gene to prevent b-cellloss and expression of a growth factor gene to promote isletrevascularization in the early stage of islet transplantationmay be an effective strategy for improving islet survivaland function after transplantation [2]. We previouslydemonstrated that adenovirus (Adv) mediated transgeneexpression of caspase 3 small hairpin RNA and that interleu-kin (IL)-1Ra in human islets prevented apoptotic islet deathafter transplantationl [7,8]. In a recent study, we identifiedX-linked inhibitor of apoptosis (XIAP) as a better anti-apoptoticgene to improve islet transplantation because XIAP inhibited awider range of executor caspases [9]. Besides apoptotic celldeath, failure of revascularization is another reason for com-promised islet transplantation in early stage. It has beenreported that Adv-mediated hepatocyte growth factor (HGF)and vascular endothelial growth factor (VEGF) gene deliveryto islets to enhance revascularization and prolong graft func-tion [8,10,11]. We chose HGF in the present study because ofits well-characterized angiogenic effect, as well as its potentialfor preventing apoptotic islet death andpromoting the prolifer-ation of pancreatic b-cells [12].

    Because of the low level of the coxsackievirus and adeno-virus receptors on the cell surface, human islets are usuallyhard to transduce with traditional Adv [13,14]. To solve thisproblem,we genetically modified the viral genome by incor-porating the RGD (Arg-Gly-Asp) peptide sequence into theAdv fiber knob. We expected that the RGD modificationcould improve the transduction efficiency of Adv on humanislets by providing an alternative viral entry pathway intohuman islets [15,16].

    In the present study, we constructed an RGD-modifiedadenovirus, RGD-Adv-hHGF-hXIAP and determined itspotential to improve the outcome of human islet transplan-tation by preventing apoptotic islet death and promotingfunctional revascularization.

    Materials and methods

    Culturing islets

    Human islet preparationswere received from the IntegratedIslet Distribution Program funded by the National Instituteof Diabetes and Digestive and Kidney Diseases and withsupport from the Juvenile Diabetes Research FoundationInternational. Upon arrival, islet preparations were sub-jected to quality control assessment for viability by usingcalcein AM/propidium iodide staining and for purity byusing dithizone staining. Dithizone binds zinc ions presentin the b-cells of islets and therefore stains the islets red.

    Other exocrine tissue also present in the preparations doesnot bind dithizone, and is therefore not stained [17]. Isletpreparations with purity and viability> 90% were culturedin CMRL-1066medium (Sigma Aldrich, St Louis, MO, USA)containing 10% fetal bovine serum (Gibco, Gaithersburg,MD, USA) in an incubator at 37 C.

    Construction of RGD-modified Adv

    RGD-Adv-GFP was a kind gift from Dr Hiroyuki Mizuguchi,Osaka University, Japan. Adv-GFP was constructed andpassaged in our laboratory. To generate RGD-modifiedAdv, the genome encoding the fiber in adenovirus sero-type 5 (Ad5) (from 2859230470) was cloned into theSacII-KpnI site of pBluescript II SK(+) (Stratagene, La Jolla,CA, USA), creating pSK5543, and the genome encoding thefiber in Ad5 (from 3212332836) was cloned into theEcoRI-HindIII site of pSP72 (Promega, Madison, WI, USA),creating pSP72(713). For ease of incorporating the RGD epi-tope between the HI-loop (LNVTQETGDTTPSAYSMSFSWD)of the fiber knob, immediately downstream of the following,the 11th threonine, new BamHI andMroI sites were added bypolymerase chain reaction (PCR)-mediated site-directedmu-tagenesis. For PCR-mediated site-directed mutagenesis, theprimer set used was: 5-GAA ACA GGA GAC ACA GGA TCCGCG TCC GGA ACT CCA AGT GCA TAC-3 as the senseprimer and 5-GTA TGC ACT TGG AGT TCC GGA CGC GGATCC TGTGTC TCCTGT TTC-3 as the antisense primer. AfterPCR amplification, the resulting mutated PCR product,containing BamHI and MroI sites (underlined) to makepSP72 [713-BM], was verified using an ABI PRISM 337 auto-matic DNA sequencer (Applied Biosystems, Foster City, CA,USA). To construct a vector encoding the RGD epitopebetween the HI-loop of the fiber knob, two complementaryoligonucleotides were synthesized and annealed to form aDNA duplex. This DNA duplex was designed to contain aBamHI overhang 5 end and anMroI overhang 3 end, so thatthe fragment could be inserted into the BamHI andMroI sitesof the pSP72[713-BM] vector. The RGD epitope consisted ofa nine-amino acid sequence, CDCRGDCFC. Sequences of theoligonucleotides were 5-GA TCC TGT GAC TGC CGC GGAGAC TGT TTC TGC T-3 and 5-CC GGA GCA GAA TCA GTCTCC GCG GCA GTA ACA G-3. These oligonucleotidesencoded the RGD epitope (boldface and italicized). Theresulting plasmid was then digested with NcoI and MfeIand cloned into pSK5543 to generate an Adv fiber shuttlevector, pSK[5543-RGD]. To generate the RGD-modifiedAdv, the newly-constructed Adv fiber shuttle vector pSK[5543+RGD] was digested with SacII and XmnI, andthe viral vector dl324 was digested with SpeI for homolo-gous DNA recombination in Escherichia coli BJ5183.

    Generating RGD-Adv-hHGF-hXIAP

    To generate an Adv encoding HGF and XIAP at the E1 andE3 regions, respectively, we first constructed an E3 shuttlevector expressing XIAP. The XIAP gene was cloned from

    Gene therapy to improve the outcome of islet transplantation 659

    Copyright 2011 John Wiley & Sons, Ltd. J Gene Med 2011; 13: 658669.DOI: 10.1002/jgm

  • pSport6-XIAP by using 5-CG GGATCC ATG ACT TTT AACAGT TTT GAA GGA TCT AAA-3 and 5-CG GGATCC TTAAGA CAT AAA AAT TTT TTG CTT GAA AGT-3 primersand subcloned into the Adv E3 shuttle vector, pSP72-E3[18], generating a pSP72-XIAP. The newly-constructedpSP72-XIAP shuttle vector was linearized with XmnI diges-tion and then co-transformed with a replication-incompetentAdv, dl324-RGD, into E. coli BJ5183. It was then digestedwith SpeI for homologous recombination, yielding Adv-encoding plasmid, dl324-XIAP (E3)-RGD. Structures of theresulting recombinant vectors were then confirmed byrestriction enzyme digestion and PCR analysis.