[HTML][HTML] Transient pretreatment with glucocorticoid ablates innate toxicity of systemically delivered adenoviral vectors without reducing efficacy

SS Seregin, DM Appledorn, AJ McBride, NJ Schuldt… - Molecular Therapy, 2009 - cell.com
SS Seregin, DM Appledorn, AJ McBride, NJ Schuldt, YA Aldhamen, T Voss, J Wei, M Bujold…
Molecular Therapy, 2009cell.com
More than 300 human clinical trials utilize recombinant adenoviruses (rAds) as a gene
transfer vector, confirming that rAds continue to be of high clinical interest. A primary
weakness of rAds is their known propensity to trigger an innate, proinflammatory immune
response rapidly after high-dose, systemic administration. In this study, we investigated what
affects that pre-emptive treatment with anti-inflammatory glucocorticoids might have upon Ad
vector-triggered inflammatory immune responses. We found that a simple pretreatment …
More than 300 human clinical trials utilize recombinant adenoviruses (rAds) as a gene transfer vector, confirming that rAds continue to be of high clinical interest. A primary weakness of rAds is their known propensity to trigger an innate, proinflammatory immune response rapidly after high-dose, systemic administration. In this study, we investigated what affects that pre-emptive treatment with anti-inflammatory glucocorticoids might have upon Ad vector-triggered inflammatory immune responses. We found that a simple pretreatment regimen with Dexamethasone (DEX) can significantly reduce most Ad-induced innate immune responses. DEX prevented rAd induction of systemic cytokine/chemokine releases in a dose-dependent fashion, with higher dosages preventing rAd induction of acute thrombocytopenia, endothelial cell activation, proinflammatory gene induction, and leukocyte infiltration into transduced organs. Transient glucocorticoid pretreatment also significantly reduced rAd-induced adaptive immune responses, including a decreased induction of Ad-neutralizing antibodies (NAbs). Importantly, use of DEX did not reduce the efficacy of rAd-mediated gene transduction nor rAd-derived transgene expression. Our results demonstrate that a simple, pre-emptive and transient glucocorticoid pretreatment is a viable approach to reduce rAd-associated acute toxicities that currently limit the use of Ad vectors in systemic clinical applications.
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