Hepatitis C virus (HCV) is a major global pathogen estimated to infect over 170 million people worldwide. A recent study has shown that vaccination with adenoviral vectors, based on rare human and simian serotypes encoding the non-structural (NS) proteins of HCV, induces highly potent, multi-specific and durable T cell responses in healthy human volunteers. In this thesis I assess the safety and immunogenicity of these vaccines (ChAd3–NSmut and Ad6-NSmut), for the first time in HCV infected patients. This work also explores whether vaccine-induced T cell responses target in vivo circulating HCV antigens and common naturally occurring epitope variants. Patients with treatment naive chronic genotype 1 HCV infection were vaccinated (i.m.) with ChAd3-NSmut and Ad6-NSmut in a heterologous prime boost schedule, either with or without current IFN and ribavirin (IFN/RBV). Epitope-specific T cell responses were defined by fine mapping using HCV peptides. Circulating viral genomic sequence was determined in vaccinated patients at baseline and at any point of viral relapse. Cross-reactivity of vaccine-induced T cell responses was determined in T cell assays, using peptides corresponding to both circulating host virus and common population HCV epitope variants. An in vitro dendritic cell /T cell priming model was used to identify possible candidates for a cross-reactive vaccine immunogen at the most immunodominant epitope, NS3₁₄₀₆. 33 patients were vaccinated. Vaccination was well tolerated. At the highest vaccine dose (2.5 x 10¹⁰vp) vaccine-induced T cell responses were detectable in 11/20 patients receiving concurrent IFN/RBV and 2/4 patients receiving vaccination alone. In total 14 antigenic targets were identified, 2 of which have not previously been described. However, T cell responses were of lower magnitude and more narrowly focused than those observed in healthy volunteers vaccinated with the same regimen. Analysis of viral sequence showed that in many cases vaccine-induced T cells did not target the circulating virus. At the most immunodominant epitope (NS3₁₄₀₆), T cells induced by vaccination failed to target common circulating genotype 1 HCV variants. An in vitro model suggested that in order to target all genotype 1 sequences at this epitope, it would be necessary to insert both a genotype 1a and 1b version of this epitope into a vaccine immunogen. Vaccination with adenoviral vectors induces T cell responses in patients with chronic HCV infection, however immune responses are attenuated compared with healthy volunteers. Ultimately a successful therapeutic or prophylactic vaccine strategy will rely on inducing responses that target conserved or cross-reactive epitopes.

Sialidosis is caused by the accumulation of the ganglioside GM3 and other sialoglycoproteins within the cells of the liver, kidney and brain. Currently there is no treatment for sialidosis, while other lysosomal storage disorders are being treated through enzyme replacement therapy or bone marrow transplantation. The helper-dependent, or "gutless" adenovirus system (HD) has recently been improved upon with reportedly less immunogenicity than its first-generation (FG) predecessor and lifelong transgene expression produced in its hosts. To this end, the complete mouse lysosomal sialidase gene was cloned into a HD-vector (AdmsialHD) and a FG-vector (AdmsialFG) in an attempt to rescue the sialidase deficiency and associated phenotype in B6.SM fibroblasts and in the SM/J mouse. Lysosomal sialidase levels were increased to normal levels in vitro following both AdmsialHD and AdmsialFG infections while SM/J mouse infections at doses of 5 x 10^9 particles/mouse did not yield any increase in lysosomal sialidase activity or correct the associated phenotype. Interestingly, AdmsialHD only up-regulated sialidase to high levels in sialidase-null cells whereas AdmsialFG up-regulated sialidase significantly in all cell lines tested. Together, these data suggest that the therapeutic dose for both AdmsialFG and AdmsialHD should be elevated at least 10-fold in order to achieve phenotypic rescue and that FG-vectors possess some viral property, perhaps the E4 gene products, enabling them to attain greater transgene expression relative to HD-vectors. / Thesis / Master of Science (MSc)

Um dos mais versáteis mecanismos de reparo de DNA é o reparo por excisão de nucleotídeos (nucleotide excision repair- NER). Defeitos genéticos associados a esta via podem gerar diferentes síndromes com deficiência de reparo. Dentre essas, Xeroderma pigmentosum (XP) é a que apresenta maior sensibilidade à luz solar, resultando em um grande aumento na incidência de tumores em regiões expostas da pele e, em alguns casos, degeneração neurológica progressiva e envelhecimento prematuro. Na primeira parte deste projeto é apresentado o uso de adenovírus recombinantes portando genes da via de NER para identificar a deficiência gênica de três pacientes portadores de XP. Na segunda parte do trabalho os estudos de reparo de DNA são estendidos a modelos animais, com deficiências nos mesmos genes carregados pelos vetores adenovirais. A expressão gênica do vetor foi avaliada pela detecção de proteína e por visualização da fluorescência de EGFP na pele dos animais infectados. Em resumo, este trabalho apresenta o uso eficiente de vetores adenovirais portando genes de reparo em ensaios in vitro e in vivo, e descreve duas mutações deletérias no gene XPC de pacientes XP brasileiros, incluindo uma mutação nova. / One of the most versatile mechanisms of DNA repair is the nucleotide excision repair (NER). Genetic defects in NER can generate different syndromes. Among these, Xeroderma pigmentosum) presents the highest sensitivity to sunlight, resulting in a large increase in the incidence of skin cancer, especially in areas exposed to the sunlight, and in some cases, progressive neurological degeneration and premature aging. In the first part of this project, adenoviral vectors carrying NER genes were used to identify genetic deficiency of three XP patients. The second part of work was extended to animal models, deficient for the same XP genes carried by adenoviral vectors. The genetic expression of vector was evaluated by detection of protein and EGFP fluorescence visualization in the skin of animals transduced. In summary, this work presents the use of adenovirus, carrying DNA repair genes for in vitro in vivo studies reports two deleterious mutations in Brazilian XP patients, including a new mutation.

Um dos mais versáteis mecanismos de reparo de DNA é o reparo por excisão de nucleotídeos (nucleotide excision repair- NER). Defeitos genéticos associados a esta via podem gerar diferentes síndromes com deficiência de reparo. Dentre essas, Xeroderma pigmentosum (XP) é a que apresenta maior sensibilidade à luz solar, resultando em um grande aumento na incidência de tumores em regiões expostas da pele e, em alguns casos, degeneração neurológica progressiva e envelhecimento prematuro. Na primeira parte deste projeto é apresentado o uso de adenovírus recombinantes portando genes da via de NER para identificar a deficiência gênica de três pacientes portadores de XP. Na segunda parte do trabalho os estudos de reparo de DNA são estendidos a modelos animais, com deficiências nos mesmos genes carregados pelos vetores adenovirais. A expressão gênica do vetor foi avaliada pela detecção de proteína e por visualização da fluorescência de EGFP na pele dos animais infectados. Em resumo, este trabalho apresenta o uso eficiente de vetores adenovirais portando genes de reparo em ensaios in vitro e in vivo, e descreve duas mutações deletérias no gene XPC de pacientes XP brasileiros, incluindo uma mutação nova. / One of the most versatile mechanisms of DNA repair is the nucleotide excision repair (NER). Genetic defects in NER can generate different syndromes. Among these, Xeroderma pigmentosum) presents the highest sensitivity to sunlight, resulting in a large increase in the incidence of skin cancer, especially in areas exposed to the sunlight, and in some cases, progressive neurological degeneration and premature aging. In the first part of this project, adenoviral vectors carrying NER genes were used to identify genetic deficiency of three XP patients. The second part of work was extended to animal models, deficient for the same XP genes carried by adenoviral vectors. The genetic expression of vector was evaluated by detection of protein and EGFP fluorescence visualization in the skin of animals transduced. In summary, this work presents the use of adenovirus, carrying DNA repair genes for in vitro in vivo studies reports two deleterious mutations in Brazilian XP patients, including a new mutation.

La dystrophie musculaire de Duchenne (DMD) est une maladie très sévère, progressive et sans traitement vraiment efficace. Elle est caractérisée par l’absence fonctionnelle de la dystrophine, une protéine essentielle au maintien des muscles squelettiques. La thérapie génique est actuellement envisagée comme approche thérapeutique pour livrer la dystrophine dans les muscles. Les vecteurs adénoviraux de troisième génération (Helper-dependent adenoviral vector, HD) sont des véhicules de transfert génique très prometteurs pour traiter la DMD. Puisque les gènes adénoviraux ont été enlevés complètement du HD, ils sont peu toxiques, faiblement immunogéniques et ils possèdent un espace cargo suffisant pour transporter l’ADN codant complet de la dystrophine. Bien que le HD puisse fournir la dystrophine de façon thérapeutique chez des souris dystrophiques (mdx), l’expression du gène thérapeutique est progressivement perdue plusieurs mois suivant l’injection intramusculaire. Deux stratégies innovantes furent explorées dans cette thèse dans le but de stabiliser l’expression de la dystrophine. La première stratégie vise à l’intégration de l’ADN du HD dans les chromosomes cellulaires, ce qui pourrait le protéger contre son élimination progressive des muscles. Une intégrase site-spécifique issue du phage ΦC31 a été utilisée pour catalyser l’intégration d’un HD transportant un marqueur de sélection. Dans les cellules humaines et les myoblastes murins, l’activité de l’intégrase a été évaluée d’après son efficacité d’intégration (après sélection) et sa spécificité (dans les clones résistants). L’efficacité atteint jusqu’à 0,5 % par cellule et jusqu’à 76 % des événements d’intégration ont été réalisés de façon site-spécifique. Bien que des délétions aient été trouvées aux extrémités du vecteur, 70 % des clones analysés montraient une seule copie du vecteur intégré (le nombre attendu). Seulement une petite augmentation du nombre de brisures double-brin a été mesurée dans les myoblastes exprimant l’intégrase. En conclusion, l’intégration du HD est relativement efficace, spécifique et sécuritaire. Cette méthode est très prometteuse, car la dystrophine peut être livrée dans le muscle avec l’aide du HD et l’intégration de l’ADN du HD pourrait stabiliser son expression in vivo. La deuxième stratégie implique l’utilisation d’un nouveau promoteur musculospécifique (ΔUSEx3) pour réduire la toxicité induite liée à une expression trop étendue de la dystrophine. Dans cette étude, nous avons investigué l’effet du contexte viral sur l’activité du promoteur. Un HD et un vecteur lentiviral (LV) ont été construits avec le promoteur ΔUSEx3 pour contrôler l’expression d’un gène rapporteur. Les résultats démontrent que ΔUSEx3 confère une expression puissante, musculospécifique et stable (via le LV) in vitro. L’injection intramusculaire du HD a conduit à une expression puissante du transgène. Ces résultats contrastent avec ceux du LV, car après l’injection de ce dernier, l’expression était faible. La livraison du HD dans le muscle, mais aussi dans plusieurs organes démontre la musculospécificité de ΔUSEx3. Par conséquent, le contexte du vecteur et l’environnement musculaire modulent tous les deux l’activité de ΔUSEx3. Bien que ΔUSEx3 soit musculospécifique, d’autres études sont requises pour déterminer si le promoteur peut stabiliser l’expression de la dystrophine in vivo. / Duchenne muscular dystrophy (DMD) is a severe, progressive and orphan disease that is characterized by the absence of the functional muscle protein dystrophin. Gene therapy is currently investigated as a therapeutic approach to deliver dystrophin into muscles. Helper-dependent adenoviral vectors (HD) are promising gene transfer vehicles for gene therapy of DMD. Because HD are devoid of all adenoviral genes, they are weakly toxic, poorly immunogenic and possess sufficient cargo capacity to carry the full-length dystrophin cDNA. Although HD can provide dystrophin therapeutically in dystrophic mice, gene expression decays months after intramuscular injection. Two strategies that both aimed to stabilize dystrophin expression were explored here. The first strategy involved the integration of HD DNA into cellular chromosomes. Stabilizing HD DNA could prevent its elimination from muscles. A site-specific integrase from phage ΦC31 was used to integrate an HD carrying a selection marker in human cells and murine myoblasts. Efficacy of integration (obtained after selection) reached up to 0.5% per cell, and up to 76% of integration events (in clones) were mediated site-specifically. Although some deletions in HD extremities occurred, 70% of clones analyzed showed one integrated copy of HD (as expected). Only a small increase in the number of double-strand breaks was found in myoblasts expressing the integrase. In conclusion, HD integration was relatively efficient, specific and safe. This method could be used to stabilize dystrophin expression in vivo. The second strategy involved using a muscle-specific promoter (ΔUSEx3) to reduce potential toxicity induced by widespread expression of dystrophin. Because ΔUSEx3 would be delivered by HD, we investigated whether or not the viral context could affect ΔUSEx3 activity. We constructed an HD and a lentiviral vector (LV) carrying a reporter gene under its control. Strong, muscle-specific and stable (with LV) expression was obtained in vitro. Intramuscular injection of HD resulted into a powerful transgene expression contrasting with LV, where expression was relatively weak. Delivery of ΔUSEx3 in multiple tissues by HD demonstrated its muscle-specificity. Therefore, both the viral context and the muscular environments modulate ΔUSEx3 activity. Further studies are required to determine whether or not ΔUSEx3 can stabilize dystrophin expression in vivo.