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The effectiveness of gene therapy as a therapeutic modality is hampered by the poor targeting capacity of gene therapy vectors1,2. The lack of proper targeting results in sub-therapeutic levels of transgene expression at the target location and leads to a wide dissemination of vectors to non-target organs3, including those responsible for mounting immune responses against both the vector and encoded therapeutic product4,5. One potential means to offset the promiscuity of transduction and to promote targeting is to introduce gene vectors at the desired location in a form that precludes their free dissemination via blood and lymph. Typically, such efforts rely on a locally injectable delivery systems comprising of either viral or non-viral vectors admixed with fibrin, collagen or hyaluronic acid hydrogel matrices6-10 that are capable of transiently sustaining gene vectors at the injection site by physically entrapping them in a polymeric network.
Another generally accepted paradigm for localized gene therapy utilizes immobilization of gene vectors on the surface of implanted prosthetic devices11,12. Permanent medical implants (endovascular, bronchial, urological and gastrointestinal stents, pacemakers, artificial joints, surgical and gynecological meshes, etc.) are used yearly in tens of millions of patients13. While generally effective, these devices are prone to complications that are inadequately controlled for by current medical practices14-17. Implantable prosthetic devices present a unique opportunity to serve as proxy platforms for localized gene therapy treatment. From the pharmacokinetic standpoint, surface derivatization of medical implants with relatively low input doses of gene vectors results in achieving both high local concentrations of gene vectors on the implant/tissue interface and slowing the kinetics of their elimination from this location. As a consequence of protracted residence and enhanced uptake by the targeted cell population, vector immobilization minimizes spread of the gene vector. Thus the inadvertent inoculation of non-target tissues is reduced.
Surface tethering of gene vectors on implantable biomaterials (also termed as substrate-mediated gene delivery or solid phase gene delivery) has been implemented in cell culture and animal experiments using both specific (antigen-antibody18-20, avidin-biotin21,22) and non-specific23-26 (charge, van der Waals) interactions. The covalent attachment of vectors to the surface of the implanted device has been previously considered as non-functional since excessively strong bonds with the surface preclude vector internalization by target cells. Recently it was demonstrated that this limitation can be overcome through the use of spontaneously hydrolysable cross-linker used as the tethers between the modified metallic surface of the stent and capsid proteins of the adenoviral vector27,28. Moreover, the vector release rate and time course of transgene expression in vitro and in vivo can be modulated with the use of hydrolysable cross-linkers exhibiting different kinetics of hydrolysis28.
The present paper provides a detailed protocol for the reversible covalent attachment of adenoviral vectors to activated metal surface and introduces a useful experimental setup for studying ensuing transduction events in vitro in cultured smooth muscle and endothelial cells and in vivo in the rat carotid model of stent angioplasty.