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Experimental Therapeutics, Preclinical Pharmacology |
Division of Gene Therapy, Department of Medical Oncology [J. G., V. W. V. B., C. M. F. D., D. S. P., H. J. H., H. M. P., D. T. C., W. R. G.], and Departments of Pathology [P. V. D. V., A. L.] and Neurosurgery [C. M. F. D., D. S. P.], University Hospital-Vrije Universiteit, 1007 MB Amsterdam, Netherlands; Department of Pediatrics, Gustave Roussy Institute, 94805 Villejuif, France [J. G.]; and Division of Human Gene Therapy, Departments of Medicine, Surgery, and Pathology, and the Gene Therapy Center, University of Alabama at Birmingham, Birmingham, Alabama 35249 [D. T. C.]
| ABSTRACT |
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vß5 integrins were often highly, but heterogeneously, expressed. We hypothesized that these receptors, overexpressed in tumor but not in normal brain, could serve as independent binding sites for alternative pathways of infection with targeted Ads. We examined this, using Ads that expressed the luciferase reporter gene under the cytomegalovirus promoter. Targeting to the EGFR was performed with a single-chain bispecific antibody directed against the human EGFR and against the fiber knob of the Ad. Targeting to the
v integrins was performed by insertion of an integrin-binding sequence, RGD-4C, in the HI-loop of the Ad. Increased luciferase gene transfer in primary glioma cells was observed in 8 of 13 samples with EGFR-targeting (211 times enhancement; median, 6) and in all of the samples with RGD-targeting (242 times enhancement; median, 12). Combining the two targeting motifs further enhanced the gene transfer in primary glioma cells in an additive manner (356 times; median, 20). The double-targeted Ads also strongly augmented gene transfer into organotypic glioma spheroids. Conversely, gene transfer into normal brain explants was reduced dramatically using Ads targeted to the tumor. Our findings demonstrate the feasibility and benefit of binding multiple ligands to the adenoviral fiber knob. These vectors have a great potential for clinical use in the context of tumors that are usually heterogeneous for target antigen expression at the single-cell level. | INTRODUCTION |
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Adenoviral vectors have been widely used to transfer genes because of their unique ability to accomplish efficient gene delivery in various tissues. The initial and limiting step of Ad3 infection depends on the binding of the virus to the CAR (6) . Several tumor cell lines have shown relatively low CAR expression, e.g., head and neck carcinomas (7) , melanoma (8) urological tumors (9) , and gliomas (10) , thus limiting the efficiency of Ad-mediated gene transfer.
Ads are able to infect glioma cells but also normal brain cells, including ependymal cells, astrocytes, and neurons in animal models and in humans (2
, 11)
. Expression of CAR is high in normal human brain tissue (12)
. Thus, in vivo, the recombinant virus may be sequestered by high CAR-expressing normal cells, whereas the true target cells, if low in CAR, are poorly transduced. Therefore, it is important to provide adenoviral vectors with an alternative, and more effective, entry pathway into the tumor cells. In recent years, adenoviral genetic targeting toward specific receptors became possible through ligand insertion in the adenoviral fiber [Refs. 13
, 14
; reviewed by Krasnykh et al. (15)
]. Alternatively, indirect targeting can be performed through a bispecific molecular bridge between the Ad and the target cell. In the latter approach, a neutralizing antibody against the fiber knob blocks the interaction with CAR, and the other binding moiety redirects the virus to a novel receptor (16, 17, 18)
. We have shown previously that redirecting Ads to the EGFR via a bispecific antibody can dramatically enhance gene transfer to various tumor cell lines, including glioma cell lines (10
, 18)
. Because the expression of EGFR is restricted to glioma cells and virtually absent in the normal brain, this target is relevant for glioma-specific gene therapy. In addition, insertion of an integrin-binding RGD-4C peptide in the fiber of the vector was previously shown to extend its tropism for target integrins, especially those containing the
v chain (14)
. Because these integrins are expressed on glioma cell lines (10)
and primary glioma (19)
but not in the normal brain (20)
, these genetically modified vectors may also have interesting targeting potency.
In glioma patients, however, tumor architecture and tumor-specific antigen expression are heterogeneous (21, 22, 23) notably for the EGFR (24 , 25) . Thus, it can be postulated that combined targeting approaches toward more than one antigen may provide better gene transfer based on the provision of a compensation mechanism for such heterogeneity.
On this basis, the aim of this study was to evaluate: (a) the availability of adenoviral receptors and alternate targets on primary glioma cells and tumors; (b) the gene transfer efficacy of untargeted and targeted Ads into primary glioma cells in vitro; and (c) the feasibility and usefulness of combined targeting strategies.
| MATERIALS AND METHODS |
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Primary Glioma Cell Cultures and Spheroids.
We used fresh material collected during brain tumor surgery from adult patients. Primary glioma cell cultures were obtained after mechanical dissociation, according to the technique described by Darling (26)
. The cells were cultured in DMEM or HAM-F12 supplemented with 10% FCS and antibiotics. Glial origin was confirmed by morphology and by staining with anti-GFAP MoAb clone 6F2 (Dako, Glostrup, Denmark). All of the experiments on these cells were done before passage 5, usually between passage 1 and 2. From tumor sample VU-1, two morphologically and phenotypically different subsets could be derived after two passages, VU-1.1 growing in HAM-F12 and VU-1.2 growing in DMEM. They were used as distinct samples in the experiments.
Organotypic multicellular glioma spheroids were grown from small explants of fresh human tumor in 48-well plates coated with agarose, one spheroid per well, according to the technique originally described by Bjerkvig et al. (27) . After checking for viability by morphology and trypan blue exclusion, spheroids of similar diameter (400500 µm) were used for gene transfer experiments. Spheroids made from the Gli-6 cell line served as control. In addition, explants of normal brain of patient VU-15 could be made and cultured for 1 week.
IHC Reagents.
Mouse anti-CAR monoclonal antibody, RmcB (28)
, prepared as ascites fluid, was obtained from Dr. R. L. Crowell (Hahnemann University, Philadelphia, PA). Anti-
vß5 integrin MoAb clone P1F6 was purchased from Life Technologies (Breda, the Netherlands). Anti-
vß3 integrin MoAb clone LM609 was purchased from Chemicon (Temecula, CA). Supernatant of the 425-hybridoma (29)
culture, purchased from the American Type Culture Collection, was used as a source for anti-EGFR MoAb.
Flow Cytometry.
Cultured cells were trypsinized, washed with PBS, and centrifuged. Cells (500,000) were incubated with first antibody diluted in PBS containing 0.1% BSA for 1 h on ice. Concentrations of the first antibody were 10 µg/ml, 2.5 µg/ml and 10 µg/ml for RmcB, P1F6, and LM609, respectively. For the 425 MoAb, undiluted supernatant of the hybridoma was used at a concentration of 1 µg/ml of IgG1 as measured by ELISA. The irrelevant first antibody used was a mouse monoclonal IgG1 antibody 323A3 directed against an epithelial marker not expressed on glioma cells at a concentration of 10 µg/ml Subsequently, the cells were washed and incubated with FITC-conjugated rabbit antimouse antibody (Dako) for 30 min on ice and in the dark. After washing in PBS, the cells were resuspended in 500 µl of PBS containing 1% formaldehyde. Analysis was performed on a FACScan (Becton Dickinson, Erembodegem-Aalst, Belgium). Human glioma-derived cell line U373 MG served as positive control for CAR, EGFR,
vß3 and
vß5 integrins because high positivity for these four antigens has been shown previously, and U118 MG served as negative control for CAR (10)
.
The fluorescence intensity of each sample was quantified as the ratio between median fluorescence intensity of the stained sample and median fluorescence intensity of the irrelevant antibody control. These ratios were compared with those of the positive control cell line, U373, and expressed as a percentage of the latter value. Levels of the target antigens were considered as high if they were at least 50% of that of the positive control cell line.
IHC.
IHC was done on frozen sections of 4 µm fixed with acetone. We used a frozen pellet of 293 cells and normal human liver as positive controls for CAR. Normal human skin was used as positive control for EGFR and normal human tonsil as positive control for
vß3 and
vß5 integrins. Nonspecific antibody binding was blocked by incubation with 2% normal rabbit serum. Tumor slides and positive controls were incubated for 1 h at room temperature in blocking buffer (1% BSA in PBS) with the same mouse monoclonal antibodies that were used for cytometry. Concentrations were 1 µg/ml for 425 and 10 µg/ml and for RmcB and for LM609 and P1F6, respectively. Two negative controls were used for each staining. These negative controls were treated either with blocking buffer only or with normal mouse IgG1
. Specimens were then washed in PBS and incubated with biotinylated rabbit antimouse IgG antibody (Dako A/S Glosdrup, Denmark) diluted 1/500 in PBS for 30 min. Second antibody binding was visualized with a peroxidase conjugated streptavidin ABC kit (Dako A/S) diluted 1:200 in PBS for one h. The slides were counterstained with hematoxylin. Immunoreactivity was graded (-) if no tumor cells were positive, (+) if less than 5% of tumor cells were positive, (++) if 550% of tumor cells were positive, (+++) if 5080% of tumor cells were positive, and (++++) if >80% of cells were positive.
Recombinant Ads.
A recombinant E1-deleted Ad expressing the luciferase reporter gene under the CMV promoter, AdCMVLuc, was provided by Dr. R. D. Gerard (University of Texas Southwestern Medical Center, Dallas, TX). A similar Ad that also expresses the luciferase from the CMV promoter but contains an integrin-targeting peptide within the HI-loop, Ad5lucRGD, was generated as described previously (14)
. The presence of the RGD-binding motif in the HI-loop was confirmed by PCR and restriction enzyme analysis. The functionality of the RGD-binding motif was checked by the ability of the vector to enhance gene transfer in CAR-negative cell lines (CHO and U118 MG). Recombinant Ads were propagated on the permissive 293 cell line and were purified using cesium chloride gradient banding. Subsequently, they were titered in parallel in particles by the A260 method and in plaque-forming unit by end point titration on 293 cells. The titers were 3.3 x 10+12 particles/ml and 4.1 x 10+12 particles/ml for AdCMVLuc and Ad5lucRGD, respectively. The ratio infectious particles:particles was 1 in 4 and 1 in 10 for AdCMVLuc and Ad5lucRGD, respectively. When the two viruses were compared, the same number of particles was used.
Bispecific scFvs.
Bispecific scFv antibodies were produced in mammalian cells as described previously (18)
. The 425-S11 fusion protein recognizes on one side the EGFR (30)
, and on the other side the fiber knob (31)
.
Supernatant of transiently transfected COS-7 cells was used for the targeting experiments. The optimal ratio between COS-7 cell supernatant and viral particles was determined by targeting experiments on A431 and U118 MG (18) . One single batch of supernatant of transfected COS-7 cells was used for all of the experiments.
Gene Transfer Assays.
To assess adenoviral infection on cell lines, 10+5 cells/well were plated in a 24-well plate in triplicate and were incubated overnight in 1 ml of culture medium to allow adherence. Before infection, 10+8 vp of Ad were incubated with 25 µl of the 425-S11 supernatant for 30 min at room temperature. Next, the mixture was diluted in DMEM containing 2.5% FCS to a concentration of 5x 10+7 vp/ml, and 200 µl were added to each well, i.e., 100 vp/cell. The cells were incubated at 37°C in 5% CO2 for 1 h, washed with PBS, and then supplemented with 1 ml of DMEM containing 10% FCS. Twenty-four h after infection, the cells were assayed for luciferase expression.
To assess adenoviral infection on primary glioma cells, a similar procedure was used but with 10+4 cells per well in a 96-well plate in quadruplicate. The viruses were five times more diluted than for the cell lines and only 100 µl of the solution were added to each well, i.e., 100 vp/cell.
To assess adenoviral infection on spheroids, each spheroid was plated in a separate well of a 96-well plate coated with agarose, in 150 µl of DMEM with 10% FCS. Ten+7 vp of the conjugated viruses or of the control viruses, diluted in 50 µl of DMEM containing 2.5% FCS, were added to the wells.
Luciferase assay was performed after 24-h incubation at 37°C in 5% CO2.
Luciferase Assay.
To measure luciferase activity in the cells, we used the luciferase assay system (Promega, Madison, WI). After removing the culture medium, lysis buffer was added to the wells and the whole plate was snap-frozen on dry ice. After thawing, the luciferase activity was measured during 10 s immediately after initiation of the light reaction in a Lumat LB 9507 luminometer (EG&G Berthold, Bad Wildbad, Germany). Values were normalized per number of viable cells (trypan blue exclusion).
To measure luciferase activity in the spheroids, they were removed from the wells, rinsed with PBS and resuspended individually in 100 µl of lysis buffer. After two cycles of freeze-thawing and vortexing to insure complete lysis of the spheroids, the luciferase measurement was performed using 25 µl of the sample. Values were expressed per spheroid.
| RESULTS |
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Table 1
summarizes the results of IHC analyses for expression of CAR, EGFR, and
vß3 and
vß5 integrins, performed on 12 primary tumors. Fig. 1
shows, as an example, the primary tumor of patient VU-10, which was positive for all of the four antigens tested. In one case (VU-9), the frozen sample contained only a few tumor cells infiltrating the normal brain, and no conclusion could be made from the IHC study.
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In all of the cases but one (VU-1), there were isolated tumor cells positive for the
v integrins spread throughout the tumor. However, more than 10% of positive tumor cells were observed in only three cases for
vß3 and in only four cases for
vß5. As expected, the tumor vessels were largely positive for
v integrins (Fig. 1)
.
The reactive astrocytes in the normal brain invaded by the tumor were strongly positive for CAR in a typical stellate pattern but not for the other three antigens tested.
In conclusion, the staining pattern of this unselected sample of gliomas in adults was heterogeneous both within one given tumor and among the whole group of tumors. The adenoviral receptor CAR was absent in a significant number of primary tumors and could thus lead to inefficient Ad-mediated gene transfer. On the basis of these findings, we chose to retarget the Ads toward both EGFR and the integrins to be able to infect as many tumor cells as possible.
Flow Cytometry on Primary Human Glioma Cells.
Flow cytometry analysis was done on early passages (before passage 5 but usually passage 1 or 2) of the short-term cultures from patients gliomas to quantify the expression of CAR, EGFR, and
v integrins.
Some of the samples exhibited intrasample heterogeneity in the expression of these target antigens. Subsets of cells expressing different levels of target antigens than the mainstream population were observed in some cases. For example, only a few VU-5 cells expressed CAR and few VU-10 cells expressed
vß5 integrins. The heterogeneity of these cell populations was also visible on light microscopy (data not shown). In addition, the two subpopulations of primary cells grown from patient VU-1, VU-1.1 and VU-1.2, showed a markedly different pattern of EGFR and integrin
vß5 expression (Fig. 2)
.
Fig. 2
shows the level of expression of the four antigens tested on 12 different short-term cultures. For VU-2 and VU-12, we could not grow enough cells to perform FACS analyses.
CAR expression was scored high in only 3 of the 12 samples but was always lower than in the positive control human glioma cell line U373 MG except for one primary cell culture, VU-6.
vß3 integrin expression was found high in only 3 of 12 samples and was lower than in U373 MG except for VU-7. Conversely,
vß5 integrin was highly expressed more often, i.e., in 8 of 12 cases, and the level of expression of
vß5 integrin was similar or higher for most of the positive samples than in the positive control U373 MG. EGFR levels varied widely, ranging from negative to higher than the positive control.
These observations confirmed that the latter two candidate receptors on the primary human glioma cells might serve as useful targets for gene transfer.
Gene Transfer with Untargeted Ads.
Human primary glioma cells were infected with untargeted adenoviral vector, AdCMVLuc, (100 vp/cell). Twenty-four h later, mean luciferase activities measured with a chemiluminescent assay differed almost two log between different samples (Fig. 3)
. In about one-half of the samples, gene transfer was poor. For 11 samples, both FACS data and gene transfer data were available. When median gene transfer level and median CAR-expression were used as cutoff, two distinct populations of samples could be identified: on one hand, those with low CAR-expression and low gene transfer and, on the other hand, those with higher CAR-expression and better gene transfer (Fig. 3)
.
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Feasability of a Combination of Immunological and Genetic Targeting.
We have shown previously that targeting of Ads to the EGFR with 425-S11 bispecific scFv markedly enhances gene transfer efficiency into various human cell lines via the EGFR pathway (18)
. These experiments were done using adenoviral vectors without capsid modifications. Here, we explore the possibility to similarly target vectors with a modified fiber knob carrying a RGD motif in the HI loop that mediates CAR-independent gene transfer through binding to integrins (14)
. Fig. 4
shows how the different adenoviral vectors used in this study were derived using both immunological and genetic targeting strategies.
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v integrin expression and the efficiency of gene transfer with RGD-targeted Ads, probably because most of the samples exhibited high amounts of
vß5 integrin (Fig. 2)The combination of Ad5lucRGD with 425-S11 bispecific scFv was usually better than each of the two targeting approaches alone. The effect of the combination was, in general, additive, but in five cases, the gene transfer with double targeting was better than the addition of each targeting. Gene transfer enhancement, compared with the untargeted Ads, ranged from 3- to 56-fold (median, 21.1-fold increase). The differences between the four groups were highly significant (P = 0.002). The largest improvement of gene transfer was observed for the cells that were difficult to transduce with untargeted Ads. Whereas the absolute gene transfer values with untargeted Ads varied widely over almost a two-log range, the distribution of double-targeted gene transfer values was confined to only a single log range. Hence, double-targeting improves also the reproducibility of gene transfer to human gliomas.
Gene Transfer with Targeted Ads into Glioma Spheroids.
Short-term cultures of glioma cells, albeit closer to a patients tumor than cell lines, still represent a selection of cells able to attach and grow in the tissue culture plates. Therefore, we wanted to confirm the potential of the double-targeted vectors on organotypic spheroids. Spheroids derived from patients material can be cultured on agarose for several weeks and retain most of the characteristics of the primary tumor (tumor cell heterogeneity, cellular composition, histology, GFAP immunoreactivity; 33
). IHC on established organotypic spheroids derived from patient material showed the maintained expression of CAR,
v integrins, and EGFR for at least 1 month after start of culturing (data not shown).
Organotypic spheroids from the tumor of eight patients and from the adjacent normal brain of one patient were infected either with untargeted Ads (AdCMVLuc) or with double-targeted Ads (Ad5lucRGD + 425-S11 conjugate). As shown in Fig. 7
, double-targeting enhanced the gene transfer on all of these primary gliomas cultured as spheroids (median, 5.9-fold; range, 3.3- to 7.6- fold). Conversely, in the explants from the normal brain of patient VU-15, gene transfer with the double-targeted vector was markedly decreased compared with the untargeted vector. For this particular patient, the double-targeted Ads increased gene transfer 6.6-fold into the tumor and decreased gene transfer in the normal brain 18.3-fold. The ratio of gene transfer in tumor:normal brain was 0.7 with untargeted Ads and 90.6 with double-targeted Ads. Hence, double-targeting of the Ad modified the therapeutic index from an unfavorable better transduction of the brain tissue with untargeted viruses into a high tumor transduction together with a low normal brain infection.
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| DISCUSSION |
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v integrins (14)
, to the EGFR (10
, 18)
, and to the pan-carcinoma antigen, EpCAM (17)
. In this study, we have explored the basis of glioma refractoriness to adenoviral vector infection, as well as two strategies to overcome the limitation of these vectors by targeting to tumor-specific antigens, and the usefulness of their combination.
We studied an unselected sample of patient materials from which we derived short-term cultures and organotypic spheroids. The presence of CAR,
vß3/5 integrins and EGFR were assessed by IHC in the tumor and spheroids or by flow cytometry on the isolated cultured cells. Both in primary tumors and in tumor-derived cells, CAR deficiency was frequently found. In addition, CAR staining on tumor tissue was often restricted to the reactive astrocytes. The gene transfer efficiency of unmodified adenoviral vectors correlated with the presence of CAR on these glioma cells in short-term cultures, as has been previously shown on several tumor cell lines (7, 8, 9, 10
, 32
, 36
, 37)
. Thus, one can assume that unmodified adenoviral vectors injected in the tumor may infect preferentially those CAR-positive astrocytes and infect less the CAR-negative tumor cells. In this situation, the therapeutic ratio may be unfavorable with normal tissue being at higher-risk for the toxic effect of the Ad and its transgene. It is thus understood that any modification of the adenoviral vector to increase gene delivery to the tumor cells, without enhancement of the gene transfer into the normal surrounding tissue, will have important impact on gene therapy of glioblastoma. EGFR, and
v integrins were more widely expressed on tumor cells than CAR. However, the percentage of positive cells varied largely for each of the antigens tested. This intratumoral heterogeneity may predict that a vector directed to only one of these alternate receptors may not be able to infect all of the tumor cells. We thus postulated that adenoviral vectors, with redirected tropism toward both EGFR and
v integrins, could enhance gene transfer into glioma cells more than either targeting approach alone could achieve.
As a first component to derive such a double-targeted vector, we used an adenoviral vector capable of achieving CAR-independent gene transfer via integrins (14) . In glioma cell lines and in cultured primary glioma samples, we observed a markedly enhanced gene delivery compared with unmodified adenoviral vectors. In general, more than one log of enhancement was observed.
As a second component to derive the double-targeted vector, we used a bispecific scFv mini-antibody to bridge the Ad to the EGFR (18) . Using this immunological approach, gene delivery was enhanced in 8 of 13 samples of short-term glioma cell cultures studied, and this improvement could reach one log differential in some cases.
The combined targeting approach was first tested on the human glioma cell line U118 MG. This cell line was used as a surrogate for primary glioma cells because its pattern of expression of the target receptors is similar to that of most primary human glioma cells, i.e., negative for CAR, but heterogeneous for integrins and EGFR. As a whole, gene transfer could be enhanced by almost 100-fold with combined targeting compared with untargeted vectors. This effect led us to evaluate this double-targeting approach on primary human glioma cells.
The combination of immunological targeting of EGFR with genetic targeting of
v integrins improved gene transfer into primary glioma cells in short-term cultures by almost two orders of magnitude. The effect of the combination was usually better than the effect of each of the targeting approaches alone. As expected, only in cases in which EGFR targeting did not enhance gene transfer, its combination with RGD-targeting did not enhance the effect of RGD-targeting alone. In general, the effect of the combination was additive, but in some cases, we observed a supra-additive effect. This suggests that there may exist a cooperation between the two different entry pathways. Clustering of the integrins together with the binding to the internalizing receptor EGFR could thus enhance adenoviral entry into the target cells. Furthermore, the double-targeted vectors also enhanced gene transfer into primary human glioma spheroids. In contrast, gene transfer into the normal brain explants was markedly reduced. The combination, thus, represents an improvement over available targeting approaches.
In conclusion, in this study, analyzing unselected patient material, we confirm the potential impact of targeted adenoviral vectors for gene therapy of glioma. Moreover, we show that the therapeutic index can be improved by providing the vector with multiple targeting ligands. The achieved enhancement of gene transfer into the tumor cells while sparing the normal brain may permit the lowering of the viral dose required to achieve adequate tumor transduction. This may have a major impact on the dose-related in vivo toxicity of these vectors. In the context of brain tumors, in which one of the goals of any therapy is to spare the normal tissue more than in any other organ, targeted vectors such as those described here are likely to have a high level of significance for realizing the full therapeutic potential of gene therapy.
| FOOTNOTES |
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1 Supported by a grant from the Association pour la Recherche sur le Cancer (to J. G.), by the Spinoza Award (to H. M. P.), and by National Cancer Institute Grants RO1 HLDK-50277, RO1 CA-74242, and RO1 CA-68245 (to D. T. C.). This work was presented in part at the 91st Annual Meeting of AACR in San Francisco, CA (April 15, 2000). ![]()
2 To whom requests for reprints should be addressed, at Division of Gene Therapy, Department of Medical Oncology, University Hospital-Vrije Universiteit, Postbus 7057, 1007 MB Amsterdam, The Netherlands. Phone: 31-20-444-8423; Fax: 31-20-444-8168; E-mail: j.grill.oncol{at}med.vu.nl ![]()
3 The abbreviations used are: Ad, adenovirus; FACS, fluorescence-activated cell sorter; CAR, Coxsackie-Ad receptor; EGFR, epidermal growth factor receptor; MoAb, monoclonal antibody; CMV, cytomegalovirus; vp, viral particle(s); scFv, single-chain Fv; IHC, immunohistochemistry. ![]()
Received 8/15/00; revised 12/ 4/00; accepted 12/14/00.
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v-integrin does not correlate with adenovector targeting in vivo indicating anatomical vector barriers. Gene Ther., 6: 1520-1535, 1999.[CrossRef][Medline]
vß3 integrin. J. Clin. Investig., 88: 1924-1932, 1991.
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