The vectors are El/partial E3 deleted vectors which contain a transgene operably linked to expression control sequences, preferably the CMV promoter. The invention is also directed to compositions comprising the adenoviral vectors of the invention and to methods for providing persistent expression of a transgene to the cells of an individual by administration of the compositions.

Background of the Invention Adenovirus is a non-enveloped, nuclear DNA virus with a genome of about 36 kb, which has been well-characterized through studies in classical genetics and molecular biology (Horwitz, M. S.,"Adenoviridae and Their Replication,"in Virology, 2nd edition, Fields et al., eds., Raven Press, New York, 1990). The viral genes are classified into early (known as E1-E4) and late (known as L1-L5) transcriptional units, referring to the generation of two temporal classes of viral proteins. The demarcation between these events is viral DNA replication.

Recombinant adenoviruses have several advantages for use as gene transfer vectors, including tropism for both dividing and non-dividing cells, minimal pathogenic potential, ability to replicate to high titer for preparation of vector stocks, and the potential to carry large inserts (Berkner, K. L., Curr. Top. Micro. Immunol. 158: 39-66, 1992; Jolly, D., Cancer Gene Ther. 1: 51-64,1994).

The cloning capacity of an adenoviral vector is proportional to the size of the adenovirus genome present in the vector. For example, a cloning capacity of about 8 kb

can be created from the deletion of certain regions of the virus genome dispensable for virus growth, e. g., E3, and the deletion of a genomic region such as E1 whose function may be restored in trans from 293 cells (Graham, F. L., J. Gen. Virol. 36: 59-72,1977) or A549 cells (Imler et al., Gene Ther. 3: 75-84,1996). Such El-deleted vectors are rendered replication-defective. The upper limit of vector DNA capacity is about 105%-108% of the length of the wild-type genome. Further adenovirus genomic modifications are possible in vector design using cell lines which supply other viral gene products in trans, e. g., complementation of E2a (Zhou et al., J. Virol. 70: 7030-7038, 1996), complementation of E4 (Krougliak et al., Hum. Gene Ther. 6: 1575-1586,1995; Wang et al., Gene Ther. 2: 775-783,1995), or complementation of protein IX (Caravokyri et al., J. Virol. 69: 6627-6633,1995; Krougliak et al., Hum. Gene Ther. 6: 1575-1586, 1995). Maximum carrying capacity can be achieved using adenoviral vectors deleted for all viral coding sequences (Kochanek et al., Proc. Natl. Acad. Sci. USA 93: 5731-5736, 1996; Fisher et al., Virology 217: 11-22,1996).

Transgenes that have been expressed to date by adenoviral vectors include p53 (Wills et al., Hum. Gene Ther. 5: 1079-188,1994); dystrophin (Vincent et al., Nature Genetics 5: 130-134, 1993; erythropoietin (Descamps et al., Hum. Gene Ther. 5: 979-985, 1994; ornithine transcarbamylase (Stratford-Perricaudet et al., Hum. Gene Ther.

1: 241-256,1990; We et al., J. Biol. Chem. 271; 3639-3646,1996;); adenosine deaminase (Mitani et al., Hum. Gene Ther. 5: 941-948,1994); interleukin-2 (Haddada et al., Hum.

Gene Ther. 4: 703-711,1993) ; and al-antitrypsin (Jaffe et al., Nature Genetics 1: 372-378, 1992); thrombopoietin (Ohwada et al., Blood 88: 778-784,1996); and cytosine deaminase (Ohwada et al., Hum. Gene Ther. 7: 1567-1576,1996).

The tropism of adenoviruses for cells of the respiratory tract has particular relevance to the use of adenovirus in gene therapy for cystic fibrosis (CF), which is the most common autosomal recessive disease in Caucasians. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene that disturb the cAMP-regulated Cl- channel in airway epithelia result in pulmonary dysfunction (Zabner et al., Nature Genetics 6: 75-83,1994). Adenoviral vectors engineered to carry the CFTR gene have

been developed (Rich et al., Hum. Gene Ther. 4: 461-476,1993) and studies have shown the ability of these vectors to deliver CFTR to nasal epithelia of CF patients (Zabner et al., Cell 75: 207-216,1993), the airway epithelia of cotton rats and primates (Zabner et al., Nature Genetics 6: 75-83,1994), and the respiratory epithelium of CF patients (Crystal et al., Nature Genetics 8: 42-51,1994). Recent studies have shown that administering an adenoviral vector containing a DNA sequence encoding CFTR to airway epithelial cells of CF patients can restore a functioning chloride ion channel in the treated epithelial cells (Zabner et al., J. Clin. Invest. 97: 1504-1511, 1996).

The use of adenoviral vectors in gene transfer studies to date indicates that persistence of transgene expression is often transient. At least some of the limitation is due to the generation of a host immune response to the viral proteins which are expressed antigenically even from a replication-defective vector, triggering a pathological inflammatory response which may destroy or adversely affect the adenovirus-infected cells (Yang et al., J. Virol. 69: 2004-2015,1995; Yang et al., Proc. Natl. Acad. Sci. USA 91: 4407-4411,1994; Zsengeller et al., Hum Gene Ther. 6: 457-467,1995; Worgall et al., Hum. Gene Ther. 8: 37-44,1997; Kaplan et al., Hum. Gene Ther. 8: 45-56,1997).

Immunologic reactions by the host to adenovirus infection include, inter alia, the generation of cytotoxic T-lymphocytes (CTL) which lyse infected cells displaying a viral antigen, cytolysis of virus-infected cells by tumor necrosis factor (TNF), synthesis of interferons, induction of apoptosis, production of antibodies, and other immunologic mechanisms (Smith, G. L., Trends Microbiol. 2: 81-88,1994). Because adenovirus does not integrate into the cell genome, host immune responses that destroy virions or infected cells have the potential to limit adenovirus-based gene delivery. An adverse immune response poses a serious obstacle for high dose administration of an adenoviral vector or for repeated administration (Crystal, R., Science 270: 404-410,1995).

In order to circumvent the host immune response which limits the persistence of transgene expression, various strategies have been employed, generally involving either the modulation of the immune response itself or the engineering of a vector that decreases the immune response.

The administration of immunosuppressive agents together with an adenoviral vector has been shown to prolong transgene persistence (Fang et al., Hum. Gene Ther.

6: 1039-1044, 1995; Kay et al., Nature Genetics 11: 191-197,1995; Zsellenger et al., Hum.

Gene Ther. 6: 457-467,1995).

The administration of adenoviral vectors with alternating serotypes has shown some circumvention of the host immune response (Mack et al., Hum. Gene Ther. 8: 99- 109,1997). Animal model studies have shown that persistence of transgene expression can vary among different mouse strains (Barr et al., Gene Ther. 2: 151-155,1995).

The lack of persistence in the expression of adenoviral vector-delivered transgenes may be due to limitations imposed by the choice of promoter or transgene contained in the transcription unit (Guo et al., Gene Ther. 3: 802-801,1996; Tripathy et al., Nature Med. 2: 545-550,1996).

Modifications to the adenovirus genomic sequences contained in the recombinant vector have been attempted in order to decrease the host immune response (Yang et al., Nature Genetics 7: 362-369,1994; Lieber et al., J. Virol. 70: 8944-8960,1996; Gorziglia et al., J. Virol. 70: 4173-4178; Kochanek et al., Proc. Natl. Acad. Sci. USA 93: 5731-5736, 1996; Fisher et al., Virology 217: 11-22,1996).

In addition to deletions in the adenovirus E1 region, first-generation adenoviral vectors often contain modifications to the E3 region in order to increase the packaging capacity of the vectors and to reduce viral gene expression (Yang et al., J. Virol. 69: 2004- 2015,1995; Zsengeller et al., Hum. Gene Ther. 6: 457-467,1995; Brody et al., Hum.

Gene Ther. 5: 821-836,1994). However, the adenovirus E3 regions contains certain proteins which modulate the host's antiviral immune response. The E3 transcription unit encodes the 12.5Kj 6.7K, gpl9K, 11.6K, 10.4K, 14.5K and 14.7K proteins (Wold et al., Trends Microbiol. 2: 437-443,1994). The E3 14.7K, 14.5K, and 10.4K proteins are able to protect infected cells from TNF-induced cytolysis. The adenovirus E3 gpl9K protein can complex with MHC Class I antigens and retain them in the endoplasmic reticulum, which prevents cell surface presentation and killing of infected cells by cytotoxic T- lymphocytes (CTLs) (Wold et al., Trends Microbiol. 437-443,1994), suggesting that its

presence in a recombinant adenoviral vector may be beneficial. The E3 11.6K gene (adenovirus death protein) is required for cell lysis and the release of adenovirus from infected cells (Tollefson et al., J. Virol. 70: 2296-2306,1996; Tollefson et al., Virology 220: 152-162,1996).

Earlier designs of adenoviral vectors in which the E3 region was modified have shown only transient expression of a transgene in the lungs of test animals (Yang et al., J.

Virol. 69: 2004-2015; Zsengeller et al., Hum Gene Ther. 6: 457-467,1995).

Modifications to the adenovirus E4 region have been introduced into adenoviral vectors in order to reduce viral gene expression and to further increase carrying capacity (Armentano et al., Hum. Gene Ther. 6: 1343-1353,1995). However, experiments in which adenoviral vectors were introduced into nude mice demonstrated that the context of the adenovirus E4 genomic region was a determinant in the persistence of expression, especially when the CMV promoter was used to control expression of the transgene (Kaplan et al., Hum. Gene Ther. 8: 45-56,1997; Armentano et al., J. Virol. 71: 2408-2416, 1997).

The current state of adenoviral vector-based gene delivery requires the development of novel adenoviral vectors which demonstrate a capability for persistence and sustained expression of a transgene.

Summary of the Invention The invention is directed to novel adenoviral vectors which are capable of facilitating persistent expression of a transgene which is delivered by the vector to a cell.

The vectors are E1/partial E3 deleted vectors which contain a transgene operably linked to expression control sequences, preferably the CMV promoter. The invention is also directed to compositions comprising the adenoviral vectors of the invention and to methods for providing persistent expression of a transgene to the cells of an individual by administration of the compositions.

Brief Description of the Drawings

Figure 1 shows a schematic diagram of pAd/E4+/E32\ 1. 6.

Figure 2 shows a schematic diagram of the Ad2/CFTR-16 vector.

Figure 3 shows a schematic diagram of the E3 modifications to the Ad2/CFTR-16 vector.

Figure 4 shows expression of human CFTR from the Ad2/CFTR-16 vector in the lungs of immune-competent and nude C57B1/6 mice.

Figure 5 shows expression of human CFTR from the Ad2/CFTR-16 vector in the lungs of immune-competent C57B1/6 mice.

Figure 6 shows expression of human CFTR from the Ad2/CFTR-16 vector in the lungs of immune-competent BALB/c mice.

Figure 7 shows expression of human CFTR from the Ad2/CFTR-16 vector in the lungs of immune-competent BALB/c mice.

Figure 8 shows expression of human CFTR from the Ad2/CFTR-16 vector in the lungs of immune-competent C3H mice.

Figure 9 shows an analysis of hCFTR expression relative to endogenous mCFTR expression in mice.

Figure 10 shows (a) a comparison of basal potential difference and (b) hyperpolarization in treated and untreated CFTR mutant mice.

Figure 11 shows CTL response to vector administration in C57B1/6 and BALB/c mice.

Figure 12 shows transgene expression following repeat administration in BALB/c mice.

Detailed Description of the Invention The invention is directed to novel adenoviral vectors which are capable of facilitating persistent expression of a transgene that is operably linked to expression control sequence, preferably the cytomegalovirus immediate early (CMV) promoter.

These vectors are advantageous in that they provide longer duration of expression of a transgene, thereby reducing the need for repeated administration of a vector to achieve a specific phenotypic result.

The adenoviral vectors of the invention comprise an adenoviral genome which is deleted for all or part of the E1 region and all or part of the E3 region. The adenovirus E4 region is preferably retained in the vector to increase the persistence of expression from a transgene under the control of the CMV promoter.

The adenoviral vectors of the invention are preferably replication-defective, e. g.. they are deleted for genes which are essential to autonomous replication of the virus.

Such deletions create vectors which are safer for administration to individuals and have the additional advantage that they can carry larger DNA inserts. In a preferred embodiment, the vectors of the invention contain a deletion in the E1 genomic region of the virus which removes the coding sequences for the E 1 A protein required for autonomous replication and which may remove all or part of the E 1 B region of the virus genome.

The protein IX coding sequences in the adenovirus genome may be retained in the vectors of the invention in order to optimize packaging capacity. In a particular embodiment of the invention, the protein IX coding sequences may be relocated from their position at the border of the E 1 sequences to another location in the adenovirus genome, e g., into the E4 region of the virus. Such a relocation decreases the ability of these sequences to mediate recombination with homologous adenovirus sequences in packaging cell lines which can result in the generation of replication-competent adenoviruses (RCA) during vector production (Hehir et al., J. Virol. 70: 8459-8467, 1996).

The adenoviral vectors of the invention retain all or part of the adenovirus E2 genomic region.

The adenoviral vectors of the invention retain all or part of the adenovirus E4 genomic region. Such sequences appear to facilitate the persistence of transgene

expression in nude mice when contained in an adenoviral vector containing a transgene under the control of a CMV promoter (Armentano et al., J. Virol. 71: 2408-2416,1997).

Preferably, the adenoviral vectors of the invention retain the coding sequences for the E4 ORF3 gene in order to facilitate persistent transgene expression.

The adenoviral vectors of the invention retain all or part of the adenovirus E3 genomic region. Modifications to the E3 region such as truncations of the E3 coding sequence or deletions that remove particular open reading frames are permissible, providing that these alterations do not interfere with persistent expression of the transgene. Preferably, the modifications to the E3 region retain the gene for the gpl9K protein, due to its particular immunomodulatory role in preventing viral antigen presentation, thereby limiting the CTL response to adenovirus-infected cells (Wold et al., Trends Microbiol. 437-443,1994). The retention of the genes for other immunomodulatory proteins such as 10.4K, 14.5K and 14.7K is also within the scope of the modifications contemplated for the E3 region.

In a preferred embodiment of the invention, the gene for the E3 11.6K protein is not retained in the adenoviral vectors of the invention. This protein is involved in the lysis of adenovirus-infected cells (Tollefson et al., J. Virol. 70: 2296-2306,1996; Tollefson et al., Virology 220: 152-162,1996). Overexpression of E3 open reading frames other than the 11. 6K gene may also result in diminishing the effect of the expression of the 11. 6K gene.

In a preferred embodiment of the invention, the adenoviral vector is Ad2/CFTR- 16, which contains the CMV promoter to which a transgene may be operably linked and further contains an E1 deletion and a partial deletion of 1.6 kb from the E3 region. This is a replication defective vector containing a deletion in the El region into which a transgene and its expression control sequences can be inserted, preferably the CMV promoter contained in this vector. It further contains the wild-type adenovirus E2 and E4 regions. The vector contains a deletion in the E3 region which encompasses 1549 nucleotides from adenovirus nucleotides 29292 to 30840 (Roberts, R. J., et al., Adenovirus DNA, in Developments in Molecular Virology, W. Doerfler, ed., 8: 1-51,

1986). These modifications to the E3 region in vector Ad2/CMV/E3A1. 6 result in the following: (a) all the downstream splice acceptor sites in the E3 region are deleted and only mRNA jazz would be synthesized from the E3 promoter (Tollefson et al., J, Virol.

70: 2296-2306,1996; Tollefson et al., Virology 220: 152-162,1996); (b) the E3A poly A site has been deleted, but the E3B poly A site has been retained; (c) the E3 gpl9K (MHC I binding protein) gene has been retained; and (d) the E3 11.6K (Ad death protein) gene has been deleted.

The adenoviral vectors of the invention can utilize adenovirus genomic sequences from any adenovirus serotypes, including but not limited to, adenovirus serotypes 2,5, and all other preferably non-oncogenic serotypes.

The adenoviral vectors of the invention may contain a transgene that is within a transcription unit which allows persistent expression of the transgene. Persistent expression by an adenoviral vector of the invention is defined as generating a sustained level of expression of a transgene over time.

Transgene is defined herein as any gene that is not native to the adenovirus genome.

The transcription unit of the adenoviral vectors of the invention is defined herein as the DNA sequences encoding a transgene, any expression control sequences such as a promoter or enhancer, a polyadenylation element, and any other regulatory elements that may be used to modulate or increase expression, all of which are operably linked in order to allow expression of the transgene. The use of any expression control sequences which facilitate persistent expression of the transgene is within the scope of the invention. Such sequences or elements may be capable of generating tissue-specific expression or may be inducible by exogenous agents or stimuli.

Preferably, the cytomegalovirus (CMV) immediate early promoter (Boshart et al., Cell 41: 521-530,1985) is used to control expression of the transgene in a transcription unit, or a truncated fragment of this promoter which functions analogously may be used.

The CMV promoter is positioned 5'to the transgene in a transcription unit. Portions of the full-length promoter can be tested for their ability to allow persistent expression of a

transgene using assays described below. In a preferred embodiment, the CMV promoter region from nucleotides-523 to-14 is used in an adenoviral vector of the invention.

Polyadenylation signals which may be positioned at the 3'end of the transgene in a transcription unit include, but are not limited to, those derived from bovine growth hormone (BGH) and SV40.

Transgenes which can be delivered and expressed from a transcription unit in the adenoviral vectors of the invention include, but are not limited to, those encoding enzymes, blood derivatives, hormones, lymphokines such as the interleukins and interferons. coagulants, growth factors, neurotransmitters, tumor suppressors, apoliproteins, antigens, and antibodies, and other biologically active proteins. Specific transgenes which may be encoded by the transcription units of the invention include, but are not limited to, cystic fibrosis transmembrane regulator (CFTR), dystrophin, glucocerebrosidase, tumor necrosis factor, p53, retinoblastoma (Rb), and adenosine deaminase (ADA). Transgenes encoding antisense molecules or ribozymes are also within the scope of the invention.

The transcription unit can be inserted into an adenoviral vector of the invention in any site from which expression of the transgene is possible. Preferably, the transcription unit is inserted into the E1 deletion in an adenoviral vector of the invention.

In a particularly preferred embodiment of the invention, the adenoviral vector is Ad2/CFTR-16, containing the gene for the cystic fibrosis transmembrane regulator protein (CFTR) operably linked to the CMV promoter and inserted into the deleted E1 region, and also containing a 1.6 kb deletion from the E3 region, which is capable of facilitating persistent expression of the CFTR transgene in the cells of an individual to which it is administered.

It will be recognized by those skilled in the art that transient expression of a transgene, where desired, may be achieved using adenoviral vectors which are deleted for those components which confer persistent expression, e. g., removal of the E4 region or specific open reading frames contained therein.

To create the recombinant adenoviral vectors of the invention which contain a transcription unit, a plasmid containing the transcription unit inserted into an adenovirus genomic fragment is co-transfected with a linearized viral genome derived from an adenoviral vector of interest into a recipient cell under conditions whereby homologous recombination occurs between the genomic fragment and the virus. Preferably, the transcription unit is engineered into the site of an El deletion. As a result, the transcription unit encoding a desired transgene is inserted into the adenoviral genome at the site in which it was cloned into the plasmid, creating a recombinant adenoviral vector.

Following the homologous recombination, the vector genome is encapsidated into virions as evidenced by the formation of viral plaques. Preparation of replication-defective vector stocks can be accomplished using cell lines that complement viral genes deleted from the vector, e. g., 293 or A549 cells containing the deleted adenovirus El genomic sequences. After amplification of plaques in suitable complementing cell lines, the viruses can be recovered by freeze-thawing and subsequently purified using cesium chloride centrifugation. Alternatively, virus purification can be performed using chromatographic techniques (e. g., as set forth in International Application No.

PCT/US96/13872, filed August 30,1996, incorporated herein by reference).

Titers of replication-defective adenoviral vector stocks can be determined by plaque formation in a complementing cell line,, 293 cells. For example, end-point dilution using an antibody to the adenoviral hexon protein may be used to quantitate virus production (Armentano et al., Hum. Gene Ther. 6: 1343-1353,1995).

Assays may be performed in tissue culture systems to determine the persistence of expression of a transgene. Cell lines which may be infected with the adenoviral vectors of the invention are suitable for assays which measure the level and duration of expression of a contained transgene. The transgene may encode a biologically useful protein or may encode a marker protein used to test the ability of the adenoviral vector to deliver a transgene which is capable of persistent expression. Relevant molecular assays to determine the persistence of expression for a desired transgene include the measurement of transgene mRNA, by, for example, Northern blot, S 1 analysis or reverse

transcription-polymerase chain reaction (RT-PCR). The presence of a protein encoded by a transgene may be detected by Western blot, immunoprecipitation, immunocytochemistry, or other techniques known to those skilled in the art.

In order to determine the persistence of transgene expression using the invention, animal models are particularly relevant in order to assess transgene persistence over time against a background of potential host immune response. Such an animal model may be chosen with reference to such parameters as ease of delivery of the adenoviral vector, identity of transgene, relevant molecular assays, and potential for assessment of clinical status. Where the transgene encodes a biologically active protein, an animal model which is representative of a disease state that responds to the provision of such a protein may optimally be used in order to assess clinical improvement. For example, transgenic mice which are engineered with mutant CFTR genes can be used to test the restoration of function provided by the provision of wild-type CFTR from the adenoviral vectors of the invention. The mouse strain FABP-hCFTR (Zhou et al., Science 266: 1705-1708,1994), obtained from the Jackson Laboratory (Bar Harbor, Maine) can be used in such experiments.

Relevant animals in which the adenoviral vectors of the invention may be assayed include, but are not limited to, mice, rabbits, rats and monkeys. Suitable mouse strains in which the adenoviral vectors of the invention may be tested include, but are not limited to, C3H, C57B1/6 (wild-type and nude) and BALB/c (available from Taconic Farms, Germantown, New York).

Where it is desirable to assess the host immune response to vector administration, testing in immune-competent and immune-deficient animals may be compared in order to define specific adverse responses generated by the immune system. The use of immune- deficient animals,"., nude mice, may be used to characterize vector performance and transgene expression independent of an acquired host response, and to identify other determinants of transgene persistence.

Specific parameters of a host immune response in immune-competent animal models or treated individuals may be determined after vector administration in order to

determine the magnitude of the host immune response. Both humoral and cell-mediated immune responses may be determined. Relevant assays for cell mediated host immune responses include T cell proliferation assays and CTL assays (Kaplan et al., Gene Ther.

3: 117-127,1996) from cells isolated from the spleens of treated animals. The infiltration of T cells into an infected site is also indicative of a host immune response (Ginsberg et al., Proc. Natl. Acad. Sci. USA 88: 1651-1655,1991). The level of anti-adenovirus antibodies or anti-transgene antibodies in serum and other fluids can be measured to assess the host humoral response to the administration of the vector, using standard immunological techniques.

In a particular embodiment where the transgene in an adenoviral vector is CFTR which is administered to the respiratory epithelium of test animals, persistence of expression of CFTR may be assayed in the lungs of relevant animal models, for example, C57B1/6 or BALB/c mice, cotton rats, or Rhesus monkeys. Molecular markers which may used to determine the persistence of expression include the measurement of CFTR mRNA, by, for example, Northern blot, S 1 analysis or RT-PCR. The presence of the CFTR protein may be detected by Western blot, immunoprecipitation, immunocytochemistry, or other techniques known to those skilled in the art.

The adenoviral vectors of the invention may be engineered to express a surface molecule that facilitates targeting specific cell types, gag., an adenoviral fiber or penton protein modified to interact with a specific cell surface receptor. Although adenoviral vectors may be most frequently introduced to a cell by infection, other forms of delivery of the vectors disclosed herein are within the scope of the invention,, using cationic amphiphiles complexed with the adenoviral vectors of the invention to mediate delivery to cells. Cationic amphiphiles have a chemical structure encompasing polar and non- polar domains wherein the polar domain attaches to a biologically useful molecule and the non-polar domain facilitates entry of such a molecule across a lipid membrane.

Preferred cationic amphiphiles for such delivery are described in PCT Publication No.

W096/18372, published June 20,1996, incorporated herein by reference.

The adenoviral vectors of the invention can be used to deliver and express any number of transgenes to cells in order to achieve a specific phenotypic result.

The present invention is further directed to compositions containing the adenoviral vectors of the invention which can be administered in an amount effective to deliver one or more desired transgenes to the cells of an individual in need of such transgenes so as to provide persistent expression of a transgene encoding a biologically active protein.

The compositions can include physiologically acceptable carriers, including any relevant solvents. As used herein,"physiologically acceptable carrier"includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like. Except insofar as any conventional media or agent is incompatible with the active ingredient, its use in the compositions of the invention is contemplated.

Routes of administration for the compositions containing the adenoviral vectors include conventional and physiologically acceptable routes such as direct delivery to the target organ or tissue, intranasal, intravenous, intramuscular, subcutaneous, intradermal, oral and other parenteral routes of administration.

The invention is further directed to methods for using the compositions of the invention in vivo or ex vivo applications in which it is desirable to deliver one or more transgenes into cells using the adenoviral vectors of the invention so as to provide persistent expression of a transgene encoding a biologically active protein. In vivo applications involve the direct administration of an adenoviral vector of the invention formulated into a composition to the cells of an individual. Ex vivo applications involve the transfer of the adenoviral vector directly to harvested autologous cells which are maintained in vitro, followed by readministration of the transduced cells to a recipient.

Dosage of an adenoviral vector of the invention which is to be administered to an individual to provide persistent expression of a transgene encoding a biologically active protein is determined with reference to various parameters, including the condition to be treated, the age, weight and clinical status of the individual, and the particular molecular

defect requiring the provision of a biologically active protein. The dosage is preferably chosen so that administration causes persistent expression of the transgene and a specific phenotypic result, as measured by molecular assays or clinical markers. For example, determination of the persistence of expression of a transgene encoded by an adenoviral vector of the invention containing the CFTR transgene which is administered to an individual can be performed by molecular assays including the measurement of CFTR mRNA, by, for example, Northern blot, S 1 or RT-PCR analysis or the measurement of the CFTR protein as detected by Western blot, immunoprecipitation, immunocytochemistry, or other techniques known to those skilled in the art. Relevant clinical studies which could be used to assess a specific phenotypic result from delivery of the CFTR transgene include PFT assessment of lung function and radiological evaluation of the lung. Demonstration of the delivery of a transgene encoding CFTR can also be demonstrated by detecting the presence of a functional chloride channel in cells of an individual with cystic fibrosis to whom the vector containing the transgene has been administered (Zabner et al., J. Clin. Invest. 97: 1504-1511,1996; U. S. Patent No.

5,670,488, issued September 23,1997, incorporated herein by reference). The persistence of transgene expression in other disease states can be assayed analogously, using the specific clinical parameters most relevant to the condition.

Dosages of an adenoviral vector of the invention which can be used in providing a transgene contained in a vector to an individual for persistent expression of a biologically active protein encoded by the transgene and to achieve a specific phenotypic result range from approximately 108 infectious units (I. U.) to 10"I. U. for humans.

It is especially advantageous to formulate parenteral compositions in dosage unit form for ease of administration and uniformity of dosage. Dosage unit form as used herein refers to physically discrete units suited as unitary dosages for the subjects to be treated, each unit containing a predetermined quantity of active ingredient calculated to produce the specific phenotypic result in association with the required physiological carrier. The specification for the novel dosage unit forms of the invention are dictated by and directly depend on the unique characteristics of the adenoviral vector used in the

formulation and the limitations inherent in the art of compounding. The principal active ingredient (the adenoviral vector) is compounded for convenient and effective administration with the physiologically acceptable carrier in dosage unit form as discussed above.

Maximum benefit and achievement of a specific phenotypic result from the administration of an adenoviral vector of the invention to deliver one or more transgenes to an individual may require repeated administration. Such repeated administration may involve use of the same adenoviral vector, or, alternatively, may involve the use of different vectors engineered to carry the same transgene but which are rotated in order to alter viral antigen presentation and decrease host immune response.

The practice of the invention employs, unless otherwise indicated, conventional techniques of protein chemistry, molecular virology, microbiology, recombinant DNA technology, and pharmacology, which are within the skill of the art. Such techniques are explained fully in the literature. See, gag., Current Protocols in Molecular Biology, Ausubel et al., eds., John Wiley & Sons, Inc., New York, 1995, and Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Co., Easton, PA, 1985.

The invention is further illustrated by the following specific examples which are not intended in any way to limit the scope of the invention.

Example 1: Adenoviral Vectors The recombinant adenoviral vector Ad2/CFTR-16 was generated by homologous recombination between the plasmid pAd/E4+/E3A1. 6 (Figure 1) and viral DNA isolated from the Ad2/CFTR-5 virus. Ad2/CFTR-5 contains human CFTR (hCFTR) as the transgene under the control of the CMV promoter (nucleotides-523 to-14, Boshart et al., Cell 41: 521-530,1985) and the BGH polyA signal, which is inserted at the site of a deletion in the E1 region. The E2 and E3 regions of Ad2/CFTR-5 contain wild-type adenovirus serotype 2 sequences (Ad2) and all E4 sequences have been deleted except for E40RF6. Plasmid pAd/E4+/E3AI. 6 contains the right hand end of adenovirus 2 from the

SpeI site at nucleotide 27123 until the right inverted terminal repeat (ITR). The E3 region contains a 1549 bp deletion (Ad2 nucleotides 29292 to 30840).

Ad2/CFTR-5 DNA was cleaved at the unique Pad site at Ad2 nucleotide position 28612. Plasmid pAd/E4+/E3A1. 6 was linearized by cleaving at the unique Clal site which is immediately downstream of the ITR. These two DNAs were used to co- transfect 293 cells by the CaPO4 precipitation method. Viral plaques were isolated, expanded and recombinant viruses identified by restriction digestion of total DNA from virally infected cells.

The Ad2/CFTR-16 virus that results from this recombination contains wild-type E2 and E4 regions (Figure 2) and has the 1549 bp E3 deletion. The extent of the modification to the E3 region is shown in Figure 3.

The construction of Ad2/CFTR-2 has been described previously (Kaplan et al., Gene Ther. 3: 117-127,1996). Ad2/CFTR-2 contains hCFTR as the transgene driven by the PGK promoter, wild type (w. t.) E2 and E3 regions, and the E4 transcription unit has been replaced with open reading frame 6 (ORF6) of E4.

Example 2: Persistent Transgene Expression In Immune-competent and Nude Mice Methods C57B1/6 (wild-type and nude) and BALB/c mice were purchased from Taconic Farms (Germantown, New York) and instilled with the vector Ad2/CFTR-16 using approximately 2 x 109 infectious units (I. U.) by the intranasal route. RNA was isolated as described below and the levels of human CFTR (hCFTR) expression was determined at different time points by quantitative RT-PCR.

Tissue samples from the lungs of each mouse were homogenized in RNA Stat-60 solution (Tel-Test B, Inc). RNA was extracted according to the acid guanidinium/phenolchloroform method (Chomczynski et al., Anal. Biochem. 162: 156- 159,1987) in a Mini-Beadbeater (Biospec Corp, Bartlesville, OK). RNA samples were pooled for animals in each group per time point.

Total RNA (7.5mg) was subjected to DNase treatment. In addition to the sample RNA, 103 or 102 molecules of synthetic competitive RNA (a 469 bp CAT transcript with CFTR sequences at both ends) were added to the reaction mix. Reverse transcription was performed with a cDNA kit from Invitrogen (San Diego, CA). Following reverse transcription, cDNA from each test group was amplified using conditions and reagent concentrations as stated above for the PCR reaction. The PCR product from the hCFTR sequence is 544 bp; the competitor product is 469 bp. The ratio of the intensity of the products was compared to those of a DNA standard curve containing log concentrations of Ad2/CFTR-8 DNA (Hehir et al., J. Virol. 70: 8459-8467,1996) (from 10'to 106) run with the appropriate number of copies of competitor DNA to quantitate gene expression.

Results As shown in Figure 4, Ad2/CFTR-16 gave rise to persistent expression of hCFTR up to 30 days in nude C57B1/6 mice and in immune-competent C57B1/6. hCFTR mRNA expression was then measured at intervals out to 70 days. As shown in Figure 5, Ad2/CFTR-16 gave rise to expression of hCFTR in immune-competent C57B 1/6 at day 70 that was not markedly different from that measured at day 3.

In immune-competent BALB/c mice, persistent expression of hCFTR provided by Ad2/CFTR-16 was observed up to day 45 (Figure 6), and has been further observed to persist to day 70 (Figure 7). Such persistent expression of hCFTR in the lungs of immune-competent animals has not been observed in previous studies beyond 2-3 weeks using first generation (E2+, E4+) adenoviral vectors.

Ad2/CFTR-16 gave rise to expression of hCFTR at day 70 in C3H mice that was not markedly different from that measured at day 3 (Figure 8).

Example 3: Persistent Transgene Expression Relative to Endogenous Gene Methods

An alternate method of RNA detection was also employed to confirm the results obtained by the quantitative RT-PCR method. This method assesses the levels of hCFTR mRNA derived from the Ad/CFTR vector relative to endogenous murine CFTR mRNA.

RT-PCR was performed on RNA isolated from lung tissue using primers that amplify both murine CFTR mRNA and the Ad-vector derived hCFTR mRNA. The RT-PCR products were then digested with MspI, which cleaves only hCFTR, and analyzed by gel electrophoresis.

Results As seen in Figure 9, murine CFTR mRNA was present at steady levels throughout the experiment, and served as an internal control for the RT-PCR reactions. The levels of Ad2/CFTR-16-encoded hCFTR mRNA did not vary markedly over the time course of the experiment. Expression of hCFTR mRNA from Ad2/CFTR-5, however, declined to background levels by day 45. Although this method is not quantitative, the levels of hCFTR mRNA expressed from the Ad2/CFTR-16 vector in the mouse lung appear to be equal to or greater than the levels of endogenous mouse CFTR mRNA expression over the time course of this experiment (70 days).

Example 4: Persistence of Ad2/CFTR-16 Gene Expression in Nasal Epithelium of CFTR Mutant Mice Methods To measure the ability of Ad2/CFTR-16 to correct the CF chloride secretion defect, gene transfer experiments were carried out in the nasal cavity of mice defective for CFTR activity. The mice employed in these experiments bear a knock-out deletion within the endogenous CFTR gene, but are transgenic for hCFTR cDNA controlled by an intestinal-specific promoter (Zhou et al., Science 266: 1705-1708,1994). This genetic composition renders the animals functionally defective for CFTR within the respiratory tract, including the nasal epithelium. 109 IU of Ad2/CFTR-16 was administered to the nasal mucosa of these mice as described previously (Jiang et al., Hum. Gene Ther. 8: 671-

680,1997). Briefly, mice were anesthetized with an intraperitoneal injection of 2,2,2- tribromoethanol (0.4 mg/g) and t-amyl alcohol (0.4, ul/g) in 0.9% NaCl. The solution containing Ad2/CFTR-16 (109 IU in 100 ul PBS) was perfused into the nasal cavity using a catheter (pulled from PE20 tubing) connected to a 1 ml syringe mounted in a microperfusion pump at a rate of 1.6 ul/min. By continuous perfusion, the mouse nasal epithelium was constantly exposed to the adenovirus vectors over 1 hr. The PD across the nasal epithelia of the CF mice was measured as described previously (Grubb et al., Amer. J. Physiol. 266: C1478-C1483, 1994; Jiang et al., Hum. Gene Ther. 8: 671-680, 1997; Zeiher et al., J. Clin. Invest. 96: 2051-2064,1995).

Results Figure 1 Oa shows that the initial basal potential difference (PD) was significantly more negative in untreated double transgenic CF (-/-) mice than in wild type mice.

Perfusion of the nasal epithelia with Ringer's solution resulted in a decline in the basal PD of both wild type (+/+) and CF (-/-) mice. Subsequent perfusion with Ringer's solution containing amiloride (100, uM) resulted in further decreases in the PD for all groups. This reduction was significantly greater in CF (-/-) than wild type (+/+) mice (data not shown).

In the untreated double transgenic CF (-/-) mice, in the presence of amiloride (100 , uM), substitution of NaCl with NaGluconate (low Cl) in the Ringer solution caused a small depolarization (Figure 1 Ob) as observed previously in the CF null mice (Grubb et al., Amer. J. Physiol. 266: C1478-C1483, 1994; Jiang et al., Hum. Gene Ther. 8: 671-680, 1997; Zeiher et al., J. Clin. Invest. 96: 2051-2064,1995). These results suggest that the electrophysiologic properties of the nasal epithelia of the bitransgenic CF mice are similar to that of CF null and AF508 mice (Grubb et al., Amer. J. Physiol. 266: C1478-C1483, 1994; Jiang et al., Hum. Gene Ther. 8: 671-680,1997; Zeiher et al., J. Clin. Invest.

96: 2051-2064,1995). Administration of Ad2/CFTR-16 resulted in a decease in basal PD (Figure 1 Oa) and restored the hyperpolarization in response to low Cl (Figure l Ob), indicating the presence of functional CFTR within the nasal epithelium. Furthermore,

these electrophysiologic changes were not significantly reduced at 15 days after vector administration, the longest time point tested. In contrast, previous experiments showed that correction of the electrolyte transport induced by administration of Ad2/CFTR-5 was diminished within a week (Jiang et al., Hum. Gene Ther. 8: 671-680,1997). These data suggest that, in the nasal epithelia of CF mice, Ad2/CFTR-16 gives rise to more persistent expression of functional CFTR as compared to Ad2/CFTR-5.

Example 5: Anti-Ad Vector CTLs Are Present in Immunocompetent Mice Treated with Ad2/CFTR-16 Methods To test whether the longevity of expression from Ad2/CFTR-16 could be explained by an unforeseen failure to provoke a CTL response, leading to an escape from immune surveillance, we investigated the CTL response following intranasal delivery of Ad2/CFTR-16.

The detailed protocol for CTL assays is essentially as described previously (Kaplan et al., Hum. Gene Ther. 8: 1095-1104,1997; Scaria et al., Gene Ther. 4: 611-617, 1997; Wadsworth et al., J. Virol. 71: 5189-5196,1997). Briefly, spleen cells from animals in the same group were pooled and stimulated in vitro with syngeneic fibroblasts infected with Ad2/CFTR-16 at a multiplicity of infection (MOI) of 100. Cytolytic activity was assayed after 5-7 days of culture. Target fibroblasts were infected with Ad2/CFTR-16 at an MOI of 100 and were treated with recombinant mouse y-interferon (Genzyme, Cambridge, MA) for approximately 24 hr before use to enhance MHC Class I expression and antigen presentation to effector CTLs. The fibroblasts were labeled with 5'Chromium (5'Cr ; NEN) overnight (30 pCi/105 cells) and added to the wells of a round-bottom 96 well plate in a 100 ul volume (5x103 fibroblasts/well). Effector cells were added in a 100 pl volume at various effector: target cell ratios in triplicate. After 5 hours of incubation at 37°C/5% CO2, 20 p1 of cell-free supernatant was collected from each well and counted in a Microbeta Trilux Liquid Scintillation Counter (Wallac Inc., Gaithersburg, MD). The percentage lysis was calculated as follows:

% Lysis = (Sample cpm)- (Spontaneous cpm') x 100 (Total cpm)- (Spontaneous cpm) Results A vector-specific CTL response was observed in C57B1/6 and BALB/c mice (Figure 11). A CTL response specific for hCFTR has not been demonstrated.

Example 6: Repeat Administration with Ad2/CFTR-16 Methods The CTL response against an Ad vector expressing a weakly immunogenic transgene is ineffective after a single administration of the vector to the lung, as has been demonstrated previously for adminstration to the liver (Wadsworth et al., J. Virol.

71: 5189-5176,1997). An important issue for effective use of gene therapy vectors for treatment of CF is the immune response following repeated administration. Effective repeated administration of Ad vectors can be achieved through the use of immunomodulatory drugs such as antibody to CD40 ligand (Scaria et al., Gene Ther.

4: 611-617,1997) or deoxyspergualin (Kaplan et al., Hum. Gene Ther. 8: 1095-1104, 1997). The use of such agents depresses the neutralizing antibody response and allows for repeated gene transfer but also obscures investigation of the nature of the cellular immune response to repeated vector administration. To circumvent these issues, BALB/c mice were treated with a priming dose (5 x 10 8 IU) of Ad2/CFTR-16 or an empty Ad vector lacking the hCFTR cDNA (Ad2/EV) on day 0, and were then challenged with a dose of Ad2/CFTR-16 on day 14.

Results During the time interval of the experiment, a CTL response to vector antigens is stimulated but neutralizing antibodies do not reach inhibitory levels. At the day 0 time point, a parallel group of animals was treated with a dose of 109 IU of Ad2/CFTR-16, and the vector-derived hCFTR mRNA levels were measured out to day 59 (Figure 12). There

was no indication that previous exposure of animals to either Ad2/CFTR-16 or Ad2/EV had any impact on the duration of expression from the challenge dose of Ad2/CFTR-16 as compared to animals receiving only a single vector dose.