Recombinant adeno-associated virus vector: Is it ideal for gene delivery in liver transplantation?

Recombinant adeno-associated virus vector (rAAV) is an effective and safe gene-delivery tool. However, its application in solid-organ transplantation has not been addressed. The present study is designed to introduce human cytotoxic T-lymphocyte-associated antigen 4 immunoglobulin G (hCTLA4Ig) by rAAV (rAAV-hCTLA4Ig) into rat liver grafts to analyze the effects of virus titer, exposure time, and route of administration on transgene expression and possible side effects caused by the gene-delivery approach. Different rAAV-hCTLA4Ig titers were introduced into liver grafts through back-table portal vein perfusion and preserved for a certain time. rAAV-hCTLA4Ig also was administered by intravenous and intramuscular injection. Transgene expression in grafts and plasma was detected by immunohistochemistry and enzyme-linked immunosorbent assay. Intragraft cytokine level was detected by reverse-transcriptase polymerase chain reaction. Anti-hCTLA4Ig antibodies in plasma were detected by flow cytometry. A higher virus titer (1 x 10(12) viral genomes/animal) introduced through back-table portal vein perfusion and a longer preservation time (3 hours) achieved a greater level of transgene expression until day 180. Back-table portal vein perfusion induced a greater level of hCTLA4 expression in plasma than intramuscular or intravenous injection. Increased interleukin-2 and interferon-gamma messenger RNA levels were detected in grafts with rAAV-hCTLA4Ig gene transfer compared with those without virus delivery, but the response was minor. Such a cellular immune response could be suppressed by low-dose FK506 administration during the first 3 postoperative days. Anti-hCTLA4Ig antibodies could be detected in long-term surviving animals, but the extent of humoral response was not severe. This study shows that rAAV can be an effective and safe vector for gene delivery in liver transplantation.