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Gene Therapy (2000) 7, 1011–1018  2000 Macmillan Publishers Ltd All rights reserved 0969-7128/00 $15.00 www.nature.com/gt

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RESEARCH ARTICLE

Intratracheal injection of manganese superoxide dismutase (MnSOD) plasmid/liposomes protects normal lung but not orthotopic tumors from irradiation MW Epperly, S Defilippi, C Sikora, J Gretton, A Kalend and JS Greenberger Department of Radiation Oncology, University of Pittsburgh Cancer Institute, 200 Lothrop Street, B346-PUH, Pittsburgh, PA 15213, USA

To determine whether intratracheal (IT) lung protective manganese superoxide–plasmid/liposomes (MnSOD–PL) complex provided ‘bystander’ protection of thoracic tumors, mice with orthotopic Lewis lung carcinoma-bacterial ␤galactosidase gene (3LL-LacZ) were studied. There was no significant difference in irradiation survival of 3LL-LacZ cells irradiated, then cocultured with MnSOD–PL-treated compared with control lung cells (D0 2.022 and 2.153, respectively), or when irradiation was delivered 24 h after coculture (D0 0.934 and 0.907, respectively). Tumor-bearing control mice showed 50% survival at 18 days and 10% survival at 21 days. Mice receiving liposomes with no insert or LacZ–PL complex plus 18 Gy had 50% survival at 22 days,

and a 20% and 30% survival at day 50, respectively. Mice receiving MnSOD–PL complex followed by 18 Gy showed prolonged survival of 45% at 50 days after irradiation (P ⬍ 0.001). Nested RT-PCR assay for the human MnSOD transgene demonstrated expression at 24 h in normal lung, but not in orthotopic tumors. Decreased irradiation induction of TGF-␤1, TGF-␤2, TGF-␤3, MIF, TNF-␣, and IL-1 at 24 h was detected in lungs, but not orthotopic tumors from MnSOD-PL-injected mice (P ⬍ 0.001). Thus, pulmonary radioprotective MnSOD–PL therapy does not provide detectable ‘bystander’ protection to thoracic tumors. Gene Therapy (2000) 7, 1011–1018.

Keywords: plasmid/liposomes; MnSOD; lung radioprotection

Introduction We have previously demonstrated in a mouse model that intratracheal (IT) injection of human manganese superoxide dismutase–plasmid/liposomes (MnSOD–PL) complex prevents irradiation-induced organizing alveolitis and increases survival.1–3 Lung expression of human MnSOD by IT injection of plasmid/liposomes was associated with a decrease in subsequent irradiation induction of endogenous murine MnSOD and inflammatory cytokines transforming growth factor-beta (TGF-␤1, TGF␤2) and tumor necrosis factor-alpha (TNF-␣).1–3 As delivery of gene therapy vectors has become a subject of intense investigation for potential use in the therapy of pulmonary diseases, the use of this route of administration for lung-specific transgene expression has raised several questions. Will vector-mediated pulmonary transgene expression affect other organs and, if so, by what mechanism? A question that followed from our experiments was whether gene therapy protection of normal lung may provide ‘bystander’ protection of a lung tumor. In the present studies, the levels of gene transcription for cytokines TGF-␤1, TGF-␤2, interleukin-1 (IL-1) and TNF␣, as well as transgene MnSOD, were measured in orthotopic tumor cells and in normal lung following

Correspondence: JS Greenberger Received 30 October 1999; accepted 8 March 2000

irradiation of mice that received MnSOD–PL or control liposome injections. The results indicated that effective lung radioprotective IT injections of MnSOD–PL complex did not produce detectable MnSOD transgene expression in orthotopic tumors, did not decrease irradiation induction of cytokine mRNA in tumors, and did not detectably protect 3LL-LacZ cells in culture or in orthotopic lung tumors from irradiation killing. Thus, pulmonary radioprotective MnSOD–PL gene therapy may be safe with respect to lack of bystander tumor protection.

Results Lack of detectable tumor cell expression of human MnSOD transgene following IT injection of PL in mice with 3LL-LacZ orthotopic tumors C57BL/6J mice (Jackson Laboratories, Bar Harbor, ME, USA) were IT-injected with 3LL-LacZ tumor cells. Ten days later, the mice were injected with MnSOD–PL complex and killed 24 h later. The lungs were removed and the 3LL tumors excised from the surrounding normal lung tissue. RNA was extracted from both the tumor and normal lung tissue, and nested reverse transcriptasepolymerase chain reaction (RT-PCR) performed. Nested RT-PCR reactions using primers specific for the human MnSOD transgene were used to attempt to detect expression of the human MnSOD transgene in explanted orthotopic 3LL-LacZ tumors, compared with normal lung

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in the same mice. Expression of the human MnSOD transgene was detected in all of the normal lungs of injected mice, but not in 3LL-LacZ tumors. Data on five representative mice are shown in Figure 1. There was no detectable human MnSOD mRNA in the lungs of mice IT-injected with LacZ-PL or empty liposomes (data not shown). The data confirm and extend our prior publication showing that IT injections of MnSOD–PL complex transfected normal lung tissue.1 The data establish that this technique did not result in detectable transgene expression in 3LL-LacZ orthotopic lung tumors in the same mice.

PL showed four times the level of biochemically active MnSOD than that detected in the control lung cells (data not shown), and were more resistant to irradiationinduced DNA strand breaks, as measured by Comet assay (Table 2). Prior studies have shown that the

Irradiation survival of 3LL-LacZ cells cocultivated with lung cells from control or MnSOD–PL complex-injected mice Lung cells were isolated from control mice or mice injected 24 h earlier with MnSOD–PL complex. The lung cells were mixed with 3LL-LacZ cells at a ratio of 10:1. The cocultures were either irradiated immediately to doses ranging from 0 to 8 Gy, or were plated in four-well tissue culture plates 4.0 per ml Linbro four-well tissue culture plates (Flow Laboratories, McLean, VA, USA) and irradiated 24 h later. The plates were stained for LacZpositive colonies of ⭓50 cells per colony at day 7. The data demonstrated no difference in the irradiation survival curves for 3LL-LacZ cells cocultivated with normal lung cells or with lung cells from mice that had been injected with MnSOD–PL complex (Figure 2; Table 1). Cocultures were irradiated immediately after mixing and showed a D0 for blue 3LL-LacZ colonies of 2.022 ± 0.089 when mixed with normal lung cells, compared with a D0 of 2.153 ± 0.065 for 3LL-LacZ cells mixed with lung cells from mice that had been injected with MnSOD–PL complexes. The lung cells from mice injected with MnSOD–

Figure 1 Lack of detection of the human MnSOD transgene expression in 3LL-LacZ orthotopic tumors explanted from IT-injected MnSOD–PL mice. C57BL/6J mice were IT-injected with 3LL-LacZ cells. Ten days later, subgroups of mice received IT injection of MnSOD–PL complex. The mice were killed 24 h later and lungs removed. The tumor was separated from the lung tissue, RNA extracted from tumor or normal lung, and nested RT-PCR reactions for the human MnSOD transgene were performed (as described in the Methods). Human MnSOD transgene expression was detected in each normal lung sample (arrow), but was not detected in the 3LL-LacZ tumors. The pRK5-MnSOD plasmid is a positive control. Gene Therapy

Figure 2 Irradiation survival of Lewis lung carcinoma (3LL-LacZ) cells cocultivated with explanted control lung cells or MnSOD–PL in vivo injected lung cells. Lungs were removed from control C57BL/6J mice or mice that had been injected with MnSOD–PL complex 24 h earlier. Lung cells in single cell suspension were mixed with 3LL-LacZ cells (as described in the Methods). Cells were mixed at a ratio of 10 lung cells to each 3LL-LacZ cell. The cell cocultures were irradiated to doses ranging from 0 to 8 Gy either immediately (a) or 24 h (b) after mixing, and coculture in 4.0 ml dishes in DMEM supplemented with 10% FBS.5 Colonies were stained for LacZ expression 7 days later, and LacZ-positive colonies of ⭓50 cells were counted. The data were analyzed by using the linear quadratic and single-hit, multi-target models.28 There was no significant difference in the survival of 3LL-LacZ cells mixed with normal lung cells or lung cells from mice injected with MnSOD–PL complex (P = 0.02).

Orthotopic tumor killing during lung protection MW Epperly et al

Table 1 Irradiation survival of 3LL-LacZ cells in vitro cocultivated with explanted single cell suspensions of lung from control or MnSOD– PL-injected mice Cells 3LL-LacZ plus control lung cells (0 h) 3LL-LacZ plus MnSOD–PL lung cells (0 h) 3LL-LacZ plus control lung cells (24 h) 3LL-LacZ plus MnSOD–PL lung cells (24 h)

n

D0





2.376 ± 0.586

2.022 ± 0.089

0.161 ± 0.021

0.036 ± 0.004

2.317 ± 0.196

2.153 ± 0.065

0.146 ± 0.011

0.034 ± 0.002

7.258 ± 1.278

0.934 ± 0.029

0.098 ± 0.036

0.118 ± 0.005

0.907 ± 0.032

0.002 ± 0.002

0.082 ± 0.038

12.974 ± 2.10

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Single cell suspensions prepared from the lungs of control mice or mice that has been injected 24 h earlier with MnSOD–PL complex, as published.1 Lung cells were mixed with 3LL-LacZ cells at a ratio of 10:1. The mixtures were either irradiated immediately (0 h) or incubated for 24 h and then irradiated from 0 to 8 Gy. Cultures were plated at 103 cells per well, 104, 105 or 5 × 105 cells per well. Seven days later, cultures were stained for LacZ and LacZ-positive colonies of ⭓50 cells counted, and the data analyzed by linear quadratic and single-hit, multi-target models.28 There was no significant difference in the irradiation survival of 3LL-LacZ cells mixed with normal lung cells or lung cells from mice previously injected with MnSOD–PL complex.

Table 2 Prevention of DNA strand breaks in normal lung by MnSOD–PL intratracheal injection Treatment

Comet length

5 Gy MnSOD–PL + 5 Gy

9.48 ± 0.58 6.82 ± 0.64 (P = 0.0029)

Control C57BL/6 mice or C57BL/6J mice intratracheally injected with MnSOD–PL 24 h previously, received 5 Gy irradiation to both lungs. The mice were immediately killed, lungs removed and placed in ice-cold PBS containing 5 mg/ml dispase, and incubated on ice for 30 min. Single cell suspensions were prepared and analyzed for DNA strand breaks using a Comet assay, as described in the Methods. Mice injected with MnSOD–PL had significantly decreased Comet lengths demonstrating protection of normal lung cells by intratracheal injection of MnSOD–PL.

MnSOD–PL transgene transfected lung cells produce intracellular, but not secreted MnSOD.1 There was no detectable difference in irradiation sensitivity of 3LLLacZ cells when cocultivated with either lung cell population 24 h before irradiation. The D0 for 3LL-LacZ cells cocultivated with lung cells from mice injected with MnSOD–PL complexes was 0.907 ± 0.032 Gy, compared with a D0 of 0.934 ± 0.029 Gy for lung cells from control mice. This difference was not significant (P = 0.02). Cocultures irradiated immediately after mixing showed an increased radioresistance relative to the cocultures cocultivated for 24 h before irradiation, but there was no difference between the groups. The reason for the increased radioresistance of freshly mixed cocultures is not known.

Unaltered radiation responsiveness of 3LL-LacZ orthotopic tumors following IT injections of MnSOD–PL complexes 24 h before irradiation Female C57BL/6Nsd mice (25 g) (Harlan Sprague Dawley, Indianapolis, IN, USA) were IT-injected with 5 × 105 3LL-LacZ cells. Twenty-four hours later, the mice were IT-injected with MnSOD or LacZ–PL complexes, according to our published methods,1 then irradiated 24 h later to 18 Gy to the thoracic cavity, and the mice were followed for survival (Figure 3). All animals in this study died of progressive tumor. The dose of 18 Gy has been shown to be associated with late organizing alveolitis at

Figure 3 Survival of mice bearing 3LL-LacZ orthotopic thoracic tumors following MnSOD–PL gene therapy, then 18 Gy whole lung irradiation. C57BL/6J mice were IT-injected with 1 × 105 3LL-LacZ cells. Subgroups of mice were injected 24 h later with MnSOD–PL or LacZ–PL complex and irradiated to 18 Gy 24 h later. Control groups received 3LL-LacZ cells only or 3LL-LacZ cells followed by 18 Gy irradiation 48 h after injection. The mice were followed for survival. Median survival was 15 days for mice receiving 3LL-LacZ cells only, 20 days for mice receiving 3LL-LacZ plus 18 Gy irradiation, 19 days for mice injected with LacZ–PL complex plus 18 Gy irradiation, and 37 days for mice receiving MnSOD–PL complex followed by 18 Gy irradiation. Mice injected with MnSOD–PL complex before irradiation had a significantly increased survival compared with all groups: mice receiving 3LL-LacZ cells only, 3LL-LacZ cells plus 18 Gy irradiation, or 3LL-LacZ cells plus LacZ–PL complex plus 18 Gy irradiation (P = 0.006, 0.0012 and 0.0046, respectively).

the later time-points of 100–150 days.1 Mice injected with 3LL-LacZ cells plus MnSOD–PL complex therapy before 18 Gy irradiation showed 50% survival at 37 days. Mice receiving 3LL-LacZ cells alone showed more rapid tumor growth leading to a 50% survival at 15 days. There was a 50% survival at 20 days for tumor-bearing mice receiving irradiation only to 18 Gy, and 19 days for tumor-bearing mice treated with IT LacZ–PL complex, then 18 Gy irradiation. The overall survival was significantly increased in the tumor-bearing mice receiving MnSOD– PL complex before 18 Gy irradiation, compared with all groups of mice receiving 3LL-LacZ cells only, 3LL-LacZ cells plus 18 Gy irradiation, or 3LL-LacZ cells plus LacZ– PL complex and 18 Gy irradiation (P = 0.0006, 0.0012 and 0.0046, respectively). At 60 days after irradiation, the Gene Therapy

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overall survival rate was 36% for irradiated tumor-bearing mice pretreated with MnSOD–PL complex, 11% for unirradiated tumor-bearing mice, and 5% for tumor-bearing receiving 18 Gy irradiation, or LacZ–PL complex before irradiation. The experiment was terminated at 60 days as all the remaining mice had persistent tumors and statistical significance for the MnSOD–PL group compared with the other groups had been reached.

IT injection of MnSOD–PL decreases irradiation induction of normal pulmonary but not orthotopic tumor inflammatory cytokine mRNA The above results suggested that MnSOD–PL complex IT injections may have prolonged survival in the irradiated tumor-bearing mice by slowing tumor growth, and/or sensitizing the tumor to irradiation. Since no human MnSOD transgene mRNA was detected in the tumors, we tested whether there had been an effect of the MnSOD–PL transgene expression through its expression in normal lung on irradiation induction of cytokine mRNA levels in the tumors. A different form of tumoricidal ‘bystander’ effect in the tumor may have occurred which could be detected at the level of mRNA expression at 24 h after irradiation. C57BL/6J mice were next injected with 5 × 105 3LLLacZ cells at the carina and 10 days later, when tumors were approximately 0.3–0.5 cm in diameter,4 the mice were injected with MnSOD–PL complex or LacZ–PL complex as a control. Twenty-four hours later the mice were irradiated to 18 Gy and then after an additional 24 h were killed for mRNA quantification in lung and tumor (as described in the Methods). The lungs were removed and the tumor excised. The tumor and normal lung were then snap-frozen, mRNA was extracted, and cytokine mRNA quantified using an RNase Protection Assay Kit (PharMingen, San Diego, CA, USA). As shown in Table 3 and Figure 4, normal lung mRNA levels for TGF-␤3, MIF, IL-1␤ and IL-1R␣ were increased at 24 h after 18 Gy in empty liposome-injected mice. There was a detectable increase in TGF-␤3 and MIF expression in the normal lung of control empty liposomeinjected mice 24 h after irradiation (Figure 4a, b), and this increase was abrogated by MnSOD–PL therapy (Figure 4c). In contrast, the 3LL-LacZ tumors from control empty liposome-injected mice or mice injected with MnSOD–PL (Figure 4d) showed no effect of MnSOD–PL injection on irradiation-induced changes in cytokine mRNA levels within the tumors. In three animals, we observed an increase in the level of TNF-␣ and TGF-␤ mRNA in tumors of nonirradiated MnSOD–PL-injected mice (Figure 4d, lanes 4–6). The level of TNF-␣ mRNA increased after irradiation in one animal (Figure 4d, lane 7). This effect of MnSOD–PL injection on elevating tumor cytokine mRNA levels was seen in one of six nonirradiated mouse normal lung areas (Figure 4c, lane 5). These results confirm and extend our prior published data for the effect of MnSOD–PL IT injection on decreasing irradiation-induced cytokine mRNA levels.1 In contrast, with respect to orthotopic tumors, there was an induction of mRNA for MIF and IL-␤1 in irradiated tumor explants from control liposome-injected mice with no detectable effect of MnSOD–PL on MIF and little effect on IL-1␤. Gene Therapy

Discussion Protection of normal tissue from ionizing irradiation damage by MnSOD–PL complex application before irradiation has been demonstrated for the lung and esophagus.1–3,5,6 Protection of a tumor in the normal organ volume by this therapy has been a concern. ‘Bystander’ protection has been reported for irradiation models in vitro.7–9 However, in the literature of gene therapy models, ‘bystander effects’ reported have usually been in the transmission of killing of adjacent tissues by transgeneexpressing cells.7–17 Delivery of MnSOD–PL complex by IT injection did not facilitate expression of the MnSOD transgene as measured by nested RT-PCR in orthotopic 3LL-LacZ carinal tumors when it was uniformly detected in the normal lung tissue. This may have been due to lack of penetration of the PL complex into the tumor, or to the route of IT administration which distributed the PLs to the upper airway and bronchoalveolar cells that were not in direct contact with central areas of tumor. Radioresistant mediastinal tumors such as thymic carcinomas, soft tissue sarcomas, and mesotheliomas usually require high doses of fractionated irradiation for local control. However, normal lung must be transited by external beam irradiation directed at the tumor and may receive 50–70% of the tumor dose. These tumors, as well as non-small cell adenocarcinomas and squamous cell carcinomas of the lung, displace the normal lung tissue as they grow. Thus, intratracheal administration of PLs would not be expected to reach these tumors. IT injections of MnSOD–PL complex were also tested for indirect effects at protection of lung tumors. Irradiated cocultures of MnSOD–PL-treated or normal lung with 3LL-LacZ tumor, showed no differences in the irradiation survival curves of 3LL-LacZ cells under either cocultivation condition. Thus, overexpression of MnSOD in normal lung cells did not provide in vitro protection from irradiation killing of 3LL-LacZ cells. If MnSOD transgene expression in the normal lung tissue of MnSOD–PL complex-injected mice also protected the orthotopic 3LL-LacZ tumors in vivo, we expected to see rapid, continued tumor growth and decreased survival, perhaps even more rapid death from tumor than that observed in nonirradiated mice. Unexpectedly, tumor-bearing mice receiving MnSOD– PL complex before 18 Gy irradiation had a significantly increased 30 day survival (50%) and overall survival, compared with the other groups. Thus, overexpression in normal lung of the human MnSOD transgene did not protect 3LL-LacZ tumors from irradiation and may have improved tumor kill. The mechanism by which this tumor radiosensitization occurred may be related to the decreased cytokine mRNA expression in normal lung following irradiation in these mice.1–3 Following irradiation, there is a rapid increase over 48 h in the pulmonary levels of IL-1, TNF-␣ and TGF-␤ mRNA.1–3 Irradiation-induced increases in VEGF and other cytokines,18–21 and inflammatory response genes have been reported.19 Previously, we demonstrated that mice injected 24 h before irradiation with MnSOD–PL complex had decreased cytokine mRNA levels for IL-1 and TGF-␤ at 24 h, and TNF-␣ increase at 48 h compared with irradiated control.1–3 In the present study we detected at 24 h after irradiation, increases in TGF-␤3, IL-1␤, MIF and IL-1R␣ in normal lung and these levels were reduced by

Orthotopic tumor killing during lung protection MW Epperly et al

Table 3 Irradiation induction of cytokine mRNA in 3LL-LacZ tumors compared with adjacent normal lung in MnSOD–PL IT-injected mice (normalized to GAPDH) at 0 and 24 h after 18 Gy Cytokine

MnSOD–PL + 18 Gy lung 0h

24 h

TNF-␣ TGF-␤1 TGF-␤3

0.017 ± 0.005 0.021 ± 0.007 0.035 ± 0.006

0.020 ± 0.009 0.030 ± 0.009 0.034 ± 0.005

MIF

0.113 ± 0.030

0.146 ± 0.027

IL-1␣ IL-1␤

0.059 ± 0.031 0.157 ± 0.078

0.063 ± 0.017 0.120 ± 0.04

IL-1R␣

0.124 ± 0.046

0.71 ± 0.018

Liposomes + 18 Gy lung 0h

24 h

0.005 ± 0.002 0.008 ± 0.005 0.016 ± 0.004 0.017 ± 0.002 0.032 ± 0.005 0.045 ± 0.005* (0.015) 0.052 ± 0.007 0.113 ± 0.014* (0.002) 0.275 ± 0.221 0.762 ± 0.115 0.095 ± 0.047 0.718 ± 0.141* (P = 0.0038) 0.028 ± 0.024 0.149 ± 0.043* (P = 0.049)

MnSOD–PL + 18 Gy tumor

1015

Liposomes + 18 Gy tumor

0h

24 h

0h

24 h

0.020 ± 0.010 0.029 ± 0.005 0.088 ± 0.034

0.007 ± 0.005 0.050 ± 0.019 0.054 ± 0.015

0.001 ± 0.001 0.006 ± 0.005 0.035 ± 0.009

0.001 ± 0.001 0.001 ± 0.001 0.033 ± 0.006

0.145 ± 0.062

0.113 ± 0.013

0.031 ± 0.062

0.052 ± 0.007

0.000 ± 0.000 0.000 ± 0.000

0.009 ± 0.009 0.030 ± 0.026

0.068 ± 0.029 0.281 ± 0.098

0.069 ± 0.031 0.432 ± 0.223

0.000 ± 0.000

0.005 ± 0.004

0.189 ± 0.040

0.085 ± 0.085

C57BL/6J mice were IT-injected with 5 × 105 3LL-LacZ cells. A subgroup of mice were injected with MnSOD–PL and a subgroup with empty liposomes 10 days later. All mice were irradiated 24 h after IT injection of MnSOD–PL and mice were killed at either 0 or 24 h after irradiation. The lungs were excised, normal lung separated from the tumor and tissues immediately frozen in liquid nitrogen. RNA was extracted from the samples, and 10 ␮g was used in the RiboQuant RNase Protection Assay. RNA expression for each of the various cytokines was determined by densitometry readings on the radiographic films from the RNase protection assay and normalized to expression of GADPH. The 24 h values were compared with the expression at 0 h using a Student’s t test with significant differences indicated by an asterisk (*), and the P values indicated by a parenthesis. Significant increases were detected in mRNA levels for TGF-␤3, MIF, IL-1␤ and IL-1R␣ expression in normal lung 24 h after irradiation in mice injected with liposomes only. There was no detectable increase in expression of mRNA for these cytokines in mice treated with MnSOD–PL 24 h before irradiation. These differences were significant for all four levels of each mRNA. The mRNA levels were below the limit of detection of the assay for levels of IL-6, IFN-␥, IFN-␤, TGF-␤2, IL-10, IL-11, p35, IL-12, p40 and IGIF (Figure 4). The mRNA levels in tumors showed a clear but not statistically significant irradiation induction of MIF and IL-1␤ in control empty liposome-injected mice with no effect of MnSOD–PL injection on MIF, and little effect on IL-1␤.

MnSOD–PL treatment. Thus, the present study confirms our prior results with TGF-␤ and IL-1 at 24 h after irradiation and extends these findings to include macrophage migration inhibitory factor (MIF) and IL-1R␣. The importance of cytokine production in local irradiation repair within tumors was recently demonstrated by injection of a VEGF antisense mRNA into irradiated mice bearing 3LL carcinoma and showing more effective tumor kill.22 Under conditions of normal tissue cytokine expression, some tumors may have a greater capacity for repair of irradiation-induced damage, reflected as decreased irradiation responsiveness. Delivery of MnSOD–PL complex to the lung reduces the organs stress response to irradiation by decreasing mRNA levels for inflammatory cytokines.1–3 This response may not only have protected normal lung, but may have limited lung tumor repair of irradiation damage resulting in an improved survival. Further studies will be required to determine the mechanism of the increased survival of irradiated tumor-bearing mice that received pulmonary radioprotective IT MnSOD–PL gene therapy. Antioxidant gene therapy of the lung has been considered for hyperoxia, as well as the ischemia response from injury.23 MnSOD–PL therapy to prevent irradiation injury has been reported by us previously,1–3,24 and now we extend this model to tumor-bearing animals showing not only safety but an unexpected tumor radiosensitization. As delivery of new inhalation gene therapy vectors becomes feasible,25 use of radioprotective gene therapy programs in fractionated radiotherapy of thoracic tumor volumes or in total body irradiation patients3 may become practical for reducing side-effects, including those mediated by lung tissue radiation damage.26–29

Materials and methods Orthotopic 3LL-LacZ tumors in C57BL/6J mice The 3LL carcinoma cell line has been described.4 Cells were cotransfected with the pIEP-LacZ plasmid and pSVneo plasmids using lipofectin (Gibco/BRL, Grand Island, NY, USA) at a ratio of 10:1. G418-positive colonies were isolated and stained for LacZ expression. A clone expressing LacZ (3LL-LacZ) was isolated and uniformly expressed LacZ in vitro in ⬎95% of cells over a 3 month passage in vitro in Dulbecco’s modified Eagle’s medium (DMEM) plus 10% fetal calf serum (FCS).1 Groups of C57BL/6J female mice (25 g) (20–25 per group) were ITinjected with 1 × 105 3LL-LacZ cells. Each group was ITinjected 24 h later with either the human MnSOD–PL or LacZ–PL complex (500 ␮g DNA in 50 ␮l of H2O plus 28 ␮l of lipofectant), or lipofectant alone (empty liposomes). Mice were irradiated using a Varian linear accelerator (dose-rate of 200 cGy/min) (Varian Oncology Systems, Palo Alto, CA, USA), 24 h later to 18 Gy, a dose shown previously to induce both an acute increase in pulmonary mRNA for IL-1, TNF-␣ and TGF-␤ and the late lesion (organizing alveolitis) in control mice at around 100–500 days;1 and in preliminary experiments, to produce a detectable decrease in orthotopic tumor growth measurable as increased survival beyond 15 days. The mice were shielded (as published), so that only the thoracic cavity was irradiated. Nested RT-PCR for human MnSOD transgene expression After IT injection of 1 × 105 3LL-LacZ cells, at several time-points from 1 to 10 days later, human MnSOD–PL or control LacZ–PL complex, respectively, was injected Gene Therapy

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Figure 4 Cytokine mRNA expression in orthotopic tumors and normal adjacent lung following 18 Gy detected by RNase Protection Assay. C57BL/6J mice were IT-injected with 5 × 105 3LL-LacZ cells. A control irradiated group received IT-injected empty liposomes. The experimental group received IT MnSOD–PL injection as described in the Methods. All mice were irradiated 24 h later to 18 Gy to the pulmonary cavity and were killed at either 0 or 24 h after irradiation. The lungs were excised, and areas of 3LL-LacZ tumors were separated from the normal sections of lung. RNA was extracted from tumor compared with normal lung, and cytokine expression determined using an RNase Protection Assay Kit (PharMingen RiboQuant MultiProbe Template Set). Densitometry was performed on the resulting radiographic film and each cytokine mRNA expression was normalized to GAPDH mRNA expression to normalize for RNA loading. Lung tissue results from areas with no tumor in control liposome-injected mice are shown in Figure 4a and b. In (a) lanes 2–8 (0 h) are before irradiation, and lanes 9–15 are 24 h after irradiation. Lane 1 contains the unprotected probe. Lane 16 is a mouse spleen mRNA (positive control). (b) shows the same samples as (a), reprobed for the indicated cytokines. The asterisks show increases. (c) shows data with normal lung from mice that received MnSOD–PL before irradiation. Lanes 1–6 represent MnSOD–PL mice killed at 0 h, and lanes 7–12 represent MnSOD–PL mice killed at 24 h. Lane 13 is the positive mouse spleen mRNA control, and lane 14 is the negative yeast plus RNA control. (d) shows results with mRNA from 3LL-LacZ tumors from the same mice as in (c). Lanes 2 and 3 are from nonirradiated control mice at 0 h, and lanes 4–6 are from MnSOD–PL-treated, nonirradiated mice at 0 h. Lanes 7–9 are from MnSOD–PL-injected mice killed at 24 h after irradiation.

IT, as described above,1 and mice were killed 24 h later. The 3LL-LacZ tumors and normal lung areas were removed, snap-frozen in liquid nitrogen, the tissue then thawed and placed in 3 ml Triazol (Gibco/BRL, Gaithersburgh, MD, USA), and homogenized using a Polytron Model PT2000 (Brinkman Instruments, Westbury, NY, USA). The samples were then incubated for 5 min at room temperature, followed by addition of 0.6 ml of chloroform, then vortexed, and incubated for 3 min at room temperature. The samples were centrifuged at Gene Therapy

12 000 g for 15 min at 4°C, followed by transfer of the aqueous phase to a new centrifuge tube and addition of 1.5 ml of isopropyl alcohol. The samples were then incubated at room temperature for 10 min and centrifuged at 12 000 g for 10 min at 4°C. The pellets were next washed with 70% ethanol, centrifuged 7500 g for 5 min at 4°C, airdried, and resuspended in 500 ␮l of diethylpyrocarbonate (DEPC)-treated water (Sigma Chemical Company, St Louis, MO, USA). Two micrograms of each RNA samples were mixed with 1.0 ␮l of poly-dT (20 pmol/␮l) and

Orthotopic tumor killing during lung protection MW Epperly et al

incubated for 10 min at 70°C, then placed on ice for 10 min. Each tube received 200 U of Superscript II reverse transcriptase (Gibco/BRL) and 10 mm mixture of dCTP, dATP, dGTP and dTTP, and incubated for 10 min at room temperature, 42°C for 50 min, 95°C for 10 min, followed by incubation at 4°C. From each reverse transcriptase (RT) reaction, 1 ␮l of a 1:100 dilution of the RT reaction was mixed with the first set of 5⬘ and 3⬘ oligonucleotide primers, 10 mm mixture of dATP, dCTP, dGTP and dTTP, and 0.4 U Taq DNA polymerase (Boehringer Mannheim, Indianapolis, IN, USA). The mixture was subjected to 20 cycles of 94°C (30 s), 60°C (50 s) and 72°C (90 s) in a Perkin Elmer Model 9600 Gene Amp PCR system (Perkin Elmer, Foster City, CA, USA). For the second reaction (detecting only the human transgene), 1 ␮l of the first reaction was diluted in 99 ␮l of DEPC-treated water in the presence of the inner oligonucleotide primers. The second set of primers was chosen to be internal of the first set of primers and did not overlap in sequences.1 Thermocycling was identical to that of the first PCR reaction, except the reaction was for 35 cycles. The PCR products were electrophoresed on a 1% agarose gel and stained with ethidium bromide. For MnSOD, the first set of oligonucleotide sequences consisted of a 5⬘ primer of CGGCGGCATCAGCGGTAAGCCAGCACTA (nucleotides 61–69), and a 3⬘ primer of TGAGCCTTGGACACCAACAGATGCA (nucleotides 505–529). The internal primers consisted of a 5⬘ primer of GCTGGCTCCGGCTTTG GGGTATCTG (nucleotides 128–152), and a 3⬘ primer of GCTGAGCTTTGTCCAGAAAATGCTC (nucleotides 388–412). The expected size of the correct nested human MnSOD PCR product is 284 base pairs.1

Irradiation survival of 3LL-LacZ cells cocultivated with lung cells from mice injected with MnSOD–PL complex or other control lung cell preparations Control C57BL/6J mice or mice which had been injected with MnSOD–PL complex 24 h earlier were killed and the lungs perfused by injecting 1 ml of 0.9% NaC1 solution into the right ventricle. The lungs were expanded by injecting 1 ml of dispase via IT injection, followed by a 0.5 ml injection of low-melt agarose (1% stored at 45°C), covered immediately with crushed ice, and incubated for 2 min at room temperature. The lungs were then removed and transferred to 7 ml of 0.01% DNase solution in DMEM. The digested lung was teased from the airway and swirled for 5–10 min at room temperature. The resulting suspension was filtered through a 40 ␮m filter and centrifuged at 1000 r.p.m. for 10 min at 4°C. The cell pellet was counted and mixed with 3LL-LacZ cells at a ratio of 10 lung cells to each 3LL cell. Half of the cells were immediately irradiated to doses ranging from 0 to 8 Gy, plated in 4.0 per ml Linbro four-well tissue culture plates (Flow Laboratories) at concentrations of 500, 1000 or 5000 3LL cells per well, and incubated at 37°C in a humidified CO2 incubator. The remaining cells were plated at 500, 1000 or 5000 cells per plate, incubated overnight at 37°C in a humidified CO2 incubator, and irradiated 24 h later at doses of 0.09 to 8 Gy. Five days later, the plates were stained for LacZ by fixing the cells in 0.5% glutaraldehyde for 10 min at 4°C, washing the cells in 1 mm MgCl2 in phosphate-buffered saline (PBS), and covering the cells in a solution of 1 mg/ml X-gal in KC stock solution (20 × KC stock solution consists of 0.82 g K3Fe(Cn)6 and 1.05 g K4Fe(Cn)6, 3H2O in 25 ml of

1 mm MgCl2 in PBS). The plates were placed in a humidified CO2 incubator at 37°C for at least 2 h. The plates were rinsed in 1 mm MgCl2, fixed in 4% paraformaldehyde for 10–20 min, and rinsed in 1 mm MgCl2. LacZpositive colonies of ⭓50 cells were counted and analyzed by linear quadratic and single-hit, multi-target models.5,30

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Quantification of irradiation-induced DNA fragmentation in lung cells by Comet assay Control C57BL/6J female mice or mice which had been IT-injected with MnSOD–PL 24 h previously, were irradiated to 5 Gy. The mice (four per group) were immediately killed, lungs perfused with 5 ml PBS, excised, placed in ice-cold PBS containing 5 mg/ml dispase, and incubated on ice for 30 min. Single cell suspensions were made by teasing the lungs apart with forceps and filtering the cells successively through 100 ␮m and 40 ␮m filters. For each mouse, 1200 cells were resuspended in 1% low-melt agarose and plated on three slides precoated with 1% agarose which were kept on ice. The cells were lysed with alkaline lysis buffer and neutralized with 0.4 m Tris. The proteins and RNA were digested by incubating the cells with proteinase K and RNase A, and the DNA electrophoresed for 1 h at 100 mA. The DNA was stained with propidium iodide and the length of the Comet tails measured using units established for Comet length, using a standard curve of Comet length.31,32 At least 150 comets were measured for each mouse lung specimen. The data were analyzed using the Mann–Whitney confidence interval and test.32 Quantification of cytokine mRNA in the lungs following irradiation and modulation by prior overexpression of MnSOD transgene C57BL/6J mice were IT-injected with 5 × 105 3LL-LacZ cells. Ten days later, the mice were injected with MnSOD–PL complex (500 ␮g, plasmid DNA, as described above) and irradiated to 18 Gy. At 0 or 24 h after irradiation, the mice were killed, lungs removed and snap-frozen in liquid nitrogen, and RNA extracted as described above. Cytokine mRNA expression was determined using a RiboQuant In Vitro Transcription Kit (PharMingen) which utilizes an RNase protection assay by hybridizing 10 ␮g of RNA with a P32-labeled probe for mCK-3b or mCK-2b mouse cytokine Multi-Probe Template Sets (PharMingen) (TNF-␣, TNF-␤, LT-␤, IL-6, IFN-␥, IFN-␤, TGF-␤1, TGF- ␤2, TGF-␤3 and MIF; or IL1␣, IL-1␤, IL-1R␣, IL-6, IFN-␥, IL-10, IL-12, p35, IL-12, p40, IGIF and MIF, respectively). The RNA hybrids were then treated with RNase for 45 min at 30°C and proteinase K for 15 min at 37°C. The RNA was extracted using chloroform/phenol, precipitated by incubation at −70°C for 30 min, centrifugation at 14 000 r.p.m. at 4°C for 5 min, and the pellet then air-dried and electrophoresed in a 5% acrylamide gel. The gel was absorbed on Whatman filter paper, placed in a gel dryer under vacuum for 1 h at 80°C, placed in an autoradiographic cassette and covered with radiographic film. The film was developed and densitometry on the bands performed with a Molecular Dynamics Personal Densitometer SI (Molecular Dynamics, Sunnyvale, CA, USA). The cytokine expression was normalized to a known nonirradiationinducible mRNA4 using L32 and GADPH probes included in the mCK-3b and mCK-2b Multi-probe Template Sets. Gene Therapy

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Acknowledgements This paper is supported in part by the National Institutes of Health, research grant No. RO1-HL60132. We thank Valerie Dewald, RTT, for technical assistance, and Dr William Gooding for the biostatistics. This paper was supported by Research Grants RO1-HL-60132 of the National Institutes of Health.

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