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Biosciences, IMPI and KFC

Karolinska Institutet, Stockholm, Sweden

The development of synthetic

gene delivery systems

Lars J. Brandén

Stockholm 2001

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Lagerstedt & Jonsson Screen AB Stockholm 2001

ISBN 91-628-4869-0

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Abstract of thesis:

This thesis describes a new platform technology. The technique is referred to as Bioplex (biological complex) in analogy with the nomenclature for other transfection reagents, since we attach biological functions to a nucleic acid complex via sequence-specific hybridisation. The technology is based on the use of two particular aspects of peptide nucleic acids, PNA (or analogues thereof), namely the high sequence specificity, making these molecules most suitable as genetic anchors, and the possibility of making a continuous peptide synthesis, allowing PNA and a peptide moiety to become adjacent without involving cumbersome linking chemistry and purification of the conjugated peptides. We use the anchor property (trans) as a means of incorporating, in a sequence- specific fashion, various functional elements in cis relative to the PNA. This enables modulation of nucleic acids, including multifunctional approaches that permit improved gene delivery. PNA is a synthetic compound based on the linkage of purines or pyrimidines to a neutral pseudo-peptide backbone instead of the charged pentose- phosphate moiety. The neutral charge contributes to an increased Tm value for PNA- DNA/RNA interactions versus “homotypic” DNA (DNA-DNA) or RNA (RNA- RNA), or RNA-DNA duplex formation. Under certain circumstances, these properties will permit “strand-invasion” at room temperature, i.e. allow a PNA molecule to invade a DNA duplex, a phenomenon dependent on the inherent DNA breathing activity.

Thus, this thesis describes how to link peptide functions directly to DNA via hybridisation instead of covalent linkage or via non-specific charge-interactions. This technique is applicable both in vitro and in vivo, and avoids the potential hazards of vectors based on viruses and other microorganisms.

In the first article we show that PNA can be used as an anchor for peptide functions and that it is possible to confer peptide functions both to oligonucleotides and plasmids in vitro (I). We subsequently investigated the in vivo activity of PNA-NLS molecules hybridised to fluorescent oligonucleotides. We introduced the denomination Bioplex to describe the category of transfection complexes where a function has been linked directly to a nucleic acid (II). The third work delves into the use of Bioplex mediated transfection without helper reagents such as polyethyleneimine. The intracellular localisation of the PNA-NLS hybridised nucleic acid was also investigated by deconvolution microscopy (III). Anchoring 1 or 4 RGD-PNA peptides to a fluorescently labelled oligonucleotide carrier and comparing the cellular fluorescence after transfection showed the synergistic effect of multiple ligands. By adding a PNA-NLS molecule to the DNA/(PNA-RGDx4) complex and using a lysosome disruptive reagent we showed the synergistic potentiation of using multivalent receptor targeting, endosome escape and subsequent nuclear translocation in combination (IV). Plasmid DNA is the main target for clinical Bioplex application. We investigated the parameters necessary to achieve PNA-anchor hybridisation and PNA-NLS mediated transfection efficacy. The reporter construct used is a 6.7 kb plasmid containing a GFP-Luciferase fusion gene. This allowed us to compare the read-out of two separate assay systems thus avoiding potential inherent problems in either one of them (V).

Keywords: gene transfer, synthetic vector, gene therapy, Bioplex, PNA, NLS

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Main references

This thesis is based on the following articles. They are referred to in the abstract with their roman numerals.

I Brandén LJ, Mohamed AJ and Smith CIE. A peptide nucleic acid-nuclear localization signal fusion that mediates nuclear transport of DNA

Nat Biotechnol 17:784-7, 1999

II Brandén LJ, Christensson B and Smith CIE. In vivo nuclear delivery of oligonucleotides via hybridising bifunctional peptides

Gene Ther 8:84-7, 2001 III Brandén LJ and Smith CIE

BIOPLEX TECHNOLOGY. A Novel, Synthetic Gene Delivery System Based on Peptides Anchored to Nucleic Acids Methods in Enzymology, in press

IV Brandén LJ and Smith CIE

Combinatorial Bioplex Transfection Manuscript

V Lundin K, Brandén LJ, Svahn M and Smith CIE

Bi-functional PNA-peptide hybridisation to plasmids and the effect on transfection efficacy

Manuscript

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CONTENTS 4

INTRODUCTION 7

Gene delivery 7

Naked DNA 9

Viral vectors 10

Transfection nomenclature 13

Lipoplex 14

Polyplex 16

In vivo transfection 18

Cellular receptor systems 19

Endocytosis, vesicle localisation and processing 20

Nuclear localisation signals 22

AIMS OF THE PRESENT STUDY 25

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METHODS 26

Fluorescence microscopy 26

Confocal- and deconvolution microscopy 26

RESULTS AND FUTURE DIRECTION 29

Bioplex 29

Future direction 33

ACKNOWLEDGMENTS 34

REFERENCES 36

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INTRODUCTION

GENE DELIVERY

Gene delivery is a fundamental part of molecular biology and of gene therapy applications. In order to investigate the function of nucleic acids it is necessary to transfer the genetic material into the cell and to the correct location within the cell. Before this is possible a vector and a method for gene delivery has to be chosen. For experimental work on established cell lines it is common to use plasmid DNA and a variety of transfection methods (1). The principle frequently used is to condense the DNA with a cationic reagent and to add the resulting complex to a cell culture to allow for cellular uptake of the transfection complex. The compounds used for this purpose are usually sold as a mixture consisting of DNA-condensing reagents and different enhancing components such as anionic, zwitterionic lipids or cholesterol derivatives (2). These components are meant to stimulate cellular attachment, intracellular release and subsequent nuclear translocation of the genetic material (3 4). Transfection reagents are based on unspecific DNA interactions of the condensing cations and the DNA. Due to the unspecific nature of these interactions, it is difficult to produce defined transfection complexes with a known number of plasmids in each complex although progress is being made (5 6). The formulation of the transfection complex as a drug is important as well, it has to be stable and uncomplicated to administer (7). The added compounds for cell adhesion, intracellular release and nuclear targeting, are randomly associated with the transfection complex and increase the difficulty of creating defined complexes. In order to control the cellular interactions of the transfection complex, it is preferable to be able to work with defined reagents which transfection reagents used today do not readily allow. Transfection reagents based on cationic lipids and polymers bind via proteoglycans located on the cell surface. The most charged proteoglycan, the heparan sulphate proteoglycan, is highly active in the internalisation process of cationic transfection complexes (8). The cationic polymers are more sensitive to low cell membrane levels of this anionic proteoglycan than the cationic lipid transfection reagents. When anionic and zwitterionic

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helper lipids and/or proteins are added in the lipid formulation, the dependency on heparan sulphate proteoglycan for endocytosis decreases (9 10).

An alternative to plasmid based DNA delivery is to utilise viral vector systems. The specific properties of the viruses make them into excellent carriers of genetic material. As every virus has unique characteristics, it is possible to select a virus that is optimal for each specific type of gene delivery (11). Since the virus is a defined entity it is possible to determine the composition of each virus regarding function.

The recent use of specific transposons as controllable vehicles for transfer and integration of foreign genes utilises the same principle as does the integrase in retroviruses, i.e. by inducing a double-stranded break in the target DNA and subsequently integrating a DNA fragment (Fig.1).

Fig.1.The principle for retro-transposon

integration into a host genome.

Barbara McClintock described the phenomenon of transposons in an article published in 1938 based on her studies of mobile genetic elements in corn where the kernel coloration was the indicator of transposon movement (12). These findings are now being used in plasmid based gene transfer systems where the gene of interest is flanked by transposon sequences. In this way it is possible to integrate DNA into the genome of a recipient cell without the use of virus vectors and to use the transposon techniques for advanced cloning procedures and transfections.

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NAKED DNA

As a means of gene delivery, naked DNA or pure plasmid DNA, is maybe the least efficient method. The cellular uptake is dependant on non-specific uptake of the DNA and diffusion into the nucleus although specific transcription-factor binding sequences can enhance nuclear translocation via protein-DNA interactions (13). No transfection reagents or virus components are added in naked DNA transfer. It has been used in different experimental clinical protocols such as DNA vaccination (14 15 16). Mainly three forms of naked DNA transfer are used today: Gene transfer via direct intravenous injection of the DNA in an appropriate buffer solution. It has been shown that under certain conditions, a high level of gene transfer can be achieved by direct intravenous injection. By using a large volume and rapid injection into the tail-vein of mice a high level of gene transfer into the liver can be detected (17). It is believed that the high efficacy of this type of gene delivery depends on two separate parameters. The physical properties of the murine vascular system, where the tail vein is in close proximity to the liver, allow a sudden influx via the tail-vein to pass first through the liver. Due to the specific properties of the hepatocytes, they allow a high uptake of nucleic acids under the momentarily high osmotic gradient caused by the rapid injection. The osmotic pressure is thought to cause the liver fenestrae to become temporarily permeable.

Electroporation can enhance transfection efficacy of direct nucleic acid injection (18). The pulses used for intramuscular delivery in vivo are of far lower intensity than the intensity used in vitro. The reasons for using a lower intensity electric pulse in vivo than in vitro is partly depending on the fact that while it is possible to accept a 80-90% cell death in vitro, this can not be accepted in an in vivo situation when f.ex the heart is the target for the transfection.

Ballistic gene delivery is useful in DNA vaccination (19). The DNA has been attached to gold-particles and introduced into the target tissue by accelerating the particles with a high-pressure gas flow, i.e.

shooting the particles into the target tissue similar to a shotgun. The physical availability of the target tissue is a limiting factor as well as tissue destruction as the nucleic acid-missile penetrates the target.

The plasmid construct can be modified to accomplish a highly efficient gene expression. The field of plasmid construction has been

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moving ahead at a steady pace during the last ten years. A few of the improvements are related to regulating gene expression such as IRES (Internal Ribosomal Entry Site) sequences for polycistronic mRNA and a range of cell type specific promoters (20212223)(Fig.2).

Fig.2 Schematic illustration of polycistronic, eucaryotic expression plasmid.

The DNA sequence itself is a matter of problem, since specific sequences can cause problems. Such sequences are f.ex. CpG-sites (24 25). In plasmids where multiple genes are to be studied, it is important to ensure that each gene is expressed. A common pitfall has been to use multiple promoters within the same plasmid. The problems this may cause depend on the type of construct, but some are general. If different promoters are used one will most likely be down regulated or turned off. Even if the same promoter is used for different genes there are no guarantees that both genes will be expressed. The complexity caused by multiple promoter constructs is often referred to as promoter inference.

VIRAL VECTORS

Nature has provided us with a blueprint of how to conduct efficient gene delivery as exemplified by viruses of different types.

Viruses are micro-organisms that only come to life after infecting a cell.

The nucleic acid of the virus contains information for how to redirect the infected cell into generating new viral particles. In the case of budding viruses, all cell types are converted into efficient secretory cells. By removing viral genes and substituting them with reporter genes or

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therapeutic genes, it is possible to transfer genetic material in an efficient way. The types of viruses most commonly used are from the retroviridae- and the adenoviridae-families although the parvo-viruses, represented by the adeno-associated virus, are becoming increasingly more used.

RNA viruses transfer the genetic material in the form of RNA. The single stranded (ss)RNA is converted into double stranded (ds)DNA as the virus infects the target cell. It is possible to study the evolutionary importance of an occasional error in the conversion of RNA to DNA and back again as is the case of the retroviruses. The mutation rate in retroviruses is very high and this is caused by inherent physical characteristics of the reverse transcription of retroviruses. The high rate of mutation is due to the fact that no proof-reading is taking place in the process of reverse transcription and thus inevitable errors occurring will not be corrected. This is a strong survival trait with the retroviruses and a constant challenge to the immune system as it creates a high degree of genetic variation after relatively few cycles of viral replication. The mechanism of reverse transcription can also lead to large deletions and incorporation of cellular sequences in the provirus, thus indicating a mechanism for retroviral acquisition of cellular genes (26).

The mechanisms of deletion can be divided into three categories:

1. Miss-alignment of the growing point

2. Incorrect synthesis and termination in the primer-binding sequence during synthesis of the plus-strand strong-stop DNA 3. Incorrect synthesis and termination before the primer-binding

sequence during synthesis of the plus-strands strong-stop DNA

As have been shown, this is a potential problem in the process of generating retroviral producer cell lines as the gene-of-interest, GOI, can become deleted (Fig.3)(27).

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Fig.3 Retrovirus producer clones where the Btk gene (GOI) has been deleted in clone LA6.

The prototype retrovirus that has been most used as a vector is the Murine Moloney Leukaemia Virus.

Another virus type commonly used for gene transfer is the adenovirus. It is a double-stranded DNA virus with the capacity to infect non-dividing cells. After infection the capsid rapidly moves to the nuclear membrane and the genetic material is translocated to the nucleus (28 29). It has been shown that the intracellular fate of the virus capsid is not only depending on the properties of the capsid i.e.

whether or not it has nuclear localisation signals. The specificities of the viral infection are also governed by more than one receptor interaction (30 31). The key factor seems to be the exact combination of cellular receptors that the virus binds to in the initial phases of the infection. This can be seen in the example of the adenovirus, CAR (coxsackie adenovirus receptor) and SAR (secondary adenovirus receptor) binding (32)

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Retroviridae Adenoviridae Parvoviridae Herpesviridae Poxviridae

ssRNA genome dsDNA genome SsDNA genome dsDNA genome dsDNA genome

Enveloped Non enveloped Non enveloped Enveloped Enveloped

Moloney Leukemia virus

HIV-1 virus (333435)

Adenovirus type V

virus Adeno Associated

Virus Herpes Simplex virus

Epstein-Barr virus Vaccinia virus 8 kb insertion

capacity

HIV-1 vectors have potential to infect non-dividing cells

30 kb insertion capacity Long half-life, Immunogenic (in the case of adenovirus)

4.7 kb insertion capacity. Low immunogenicity, long half-life. Wild-type has the capacity of chromosome 19 specific integration

+30 kb insertion capacity

Herpes simplex vector has potential to infect neurons Complex virus genome

+30 kb insertion capacity

High expression levels suitable to use as immune stimulatory vector or DNA vaccination vector Complex genome Receptors: REC1,

ATRC-1, Glvr, SEAR, CD4, CCR5, GPR15 etc.

Receptors: CAR, SAR Receptors: Heparan sulphate

proteoglycan as primary receptor and FGFr and αVß5 co- receptors

Receptors: Not known, probably many types of receptors

Receptors: Probably EGF and other as well

Table. 1 The characteristics of some of the more commonly used viral systems for gene transfer.

The viruses used today have problems connected with the fact that natural tropism and points of entry makes them unsuitable as vectors.

Pseudotyping is used as a way to circumvent this problem. Since a virus has evolved to function in a specific sequential manner it is important that the natural infection pathway is followed. If a novel receptor ligand is used in place of the wild-type ligand, multiple problems can occur. Such problems can be viral packaging defects, cross-infectivity and incorrect intra-cellular processing of the virus particle.

TRANSFECTION NOMENCLATURE

The nomenclature of transfection was decided in 1997 by the collective consensus of an international group of scientists (36). In a recent article we have added to the nomenclature after carefully discussing the issue with Professor Jean-Paul Behr, member of the 1997 consensus group. The Bioplex denomination is used when a functional entity is directly added to the nucleic acid, whether it is through a chemical binding to the nucleic acid backbone or via a piggy-back hybridisation approach.

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Transfection

reagent Function Name Sequence

specificity Selected examples

Cationic lipid DNA condensing activity Lipoplex36 No Lipofectamine

Cationic polymer DNA condensing activity Polyplex36 No Polyethyleneimine

Nucleic acid fused to functional moiety

Multiple functions including or excluding DNA

condensing activity Bioplex78 Yes/No

Nucleic acid- Nuclear Localisation Signal, (NLS) fusion 76

77 78

Table 2. The transfection nomenclature

The majority of the new generation of lipid based transfection reagents contain cationic lipids for the DNA condensation and zwitterionic and/or anionic components enhancing intracellular release of the transfected material. The novel types of polymeric compounds available today include reagents such as antennapedia-based oligonucleotide transfection reagents and transferrinated polyethyleneimine. The polymeric transfection compounds used are often based on variants of polyethyleneimine. The chemical properties of the polyethyleneimine makes it an excellent substance to modify. Many of the modifications are easily performed in the hands of molecular geneticists and organic chemists alike. Some examples of such modifications are galactosylation and transferrination (37). These alterations confer new qualities to the modified molecule and thus also of the complete transfection complex. The galactose group enables a high uptake of the transfection complex by hepatocytes whereas transferrin enables facilitated transfection of haematopoietic cells as well as a path through the blood-brain barrier.

LIPOPLEX

By using cationic lipids to condense RNA and DNA, it is possible to create transfection complexes that can easily be taken up by a wide variety of cell types. The efficacy of the lipid transfection reagent is very much depending on the cell type used. The composition of the cell membrane and the microenvironment of the vesicle containing the transfection complex can explain many of the differences between cell

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types. The potency of the formulation regarding efficient cellular uptake and low toxicity has improved since the first generation. Many reagents still used today are highly toxic to the cells, such as lipofectamine, thus making an in vivo approach impossible with these compounds (38). The first cationic lipid formulation used consisted of DOTMA as a cationic lipid component and DOPE as helper-lipid, mixed at an equal weight ratio. Anionic- and zwitterionic-lipid components aid in the endosomal/lysosomal escape of the nucleic acid (Fig.4).

Fig.4 Lipoplex mediated uptake and release of plasmid DNA. (Adapted from Szoka et al. 19964).

When the pH drops in the maturing endosome, lipid components from the transfection complex switch position between the liposome/DNA complex and the cellular vesicle membrane. By this exchange, pores or channels from the liposome can be created leading into the intracellular compartment. Since the intracellular position of the vesicle is depending on the targeting molecules associating with the transfection complex, it could be that targeting the right combination of receptors is more important than to have a readily dissociating transfection complex. Newer formulations based on a variety of cationic lipids and different cholesterol variants, have proven to be efficient reagents for in vivo transfection due to decreased toxicity. By adding different functional molecules to the lipids it is

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possible to achieve a certain level of tissue targeting. Cell-surface antigen recognising antibodies have been cross-linked to liposomes, which are thereby targeted to a specific cell type. The specificity is not absolute, due to the fact that liposomes have non-specific affinity for cell membranes and to the reticuloendothelial system, RES, in particular.

Viral components and whole, inactivated viruses are frequently used to confer viral functions to liposomes. The fusogenic properties of the Sendai-virus have been used to make virosomes based on cationic liposomes where the UV-inactivated viruses are linked to the surface of the liposome. When Sendai-viruses are used in context of liposomes, both lymphocyte specificity and fusogenic properties are added to the liposome. The nucleic acid degradation in the endosome/lysosome pathway is one of the limiting steps in lipofection and the fusogenic properties derived from the Sendai-virus are alleviating some of these problems. Isolated viral peptides such as the HA-2 peptide from the influenza virus (39 40) and whole proteins from Sendai-virus have been introduced into liposomes by fusing peptides and proteins to the DNA loaded liposome. Transferrin is another commonly used receptor-ligand in transfections. When different targeting functions are combined, exemplified by Transferrin and the unspecific membrane-affinity of the cationic lipids, it is difficult to predict the effect and therefore also difficult to foresee what combination of lipid and targeting ligand that will be optimal. The formulation of the transfection complex becomes increasingly more complicated as the need to define the exact composition of the transfection reagents rises (41).

POLYPLEX

The cellular uptake mechanism of lipoplexes and polyplexes in the native state, i.e. without modulating additives, depend on the specific transfection reagent used. When an early endosome matures to lysosome, the pH drops. This triggers the escape of the nucleic acids from within the vesicle. The mechanism of vesicle escape differs drastically between different reagents. The positional switching of anionic and zwitterionic components enables an efficient escape of lipofected nucleic acids.

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Cationic polymer compounds depend on different mechanisms for endosome escape, although also triggered by the pH drop. 25 kD polyethyleneimine, PEI, is frequently used as a standard transfection reagent (42). The amino groups in PEI can accept protons and will act as a buffer in the maturing endosome. It is believed that the vesicle will swell and eventually disrupt by increasing osmotic pressure and thus release the nucleic acids contained in the transfection complex (Fig.5) (43).

Fig.5 The cationic PEI/DNA complexes are taken up via enodocytosis.

By transfecting cells with fluorescent nucleic acids and subsequently use lysosome staining reagents such as Lysotracker™ from Molecular probes, it is possible to visualise this. Fluorescent vesicles emitting light of the wavelength corresponding to the labelled nucleic acid do not co-localise with the lysosomal marker. The 25 kD PEI is often used since it is available as a bulk chemical at relatively low price compared to commercial transfection reagents. The cost is roughly 50.000x higher for high-end transfection reagents as compared to 25 kD PEI bought in bulk. When tested on a range of transformed, healthy, adherent cells, the difference between 25 kD PEI and some of the more commonly used transfection reagents differed by no more than 2-3%

(data unpublished). The usefulness of many of the polymer based transfection reagents, are based on the simplicity of linking proteins to them via peptide bonds as well as their buffering capacity and ability to condense negatively charged nucleic acids (44 45). Poly-L-Lysine was used early as a transfection reagent and has been modified to carry ligands such as transferrin. The 800 kD and the 25 kD PEI types were the first to be used and the 25 kD is still a good alternative to other

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commercially available transfection reagents due to the fact that it is sold as a bulk chemical and is thus very affordable (46). Other polymeric transfection reagents have been manufactured, such as the fractured dendrimeres (47). Some of these compounds are now commercially available from molecular biology companies.

IN VIVO TRANSFECTION

To be able to perform efficient in vivo gene delivery, it is necessary to avoid inactivation by serum components as well as reaching the intended target tissue (48 49). The classical transfection techniques depend on DNA condensation of nucleic acids via cationic compounds. The optimal ratio of charge distribution between nucleic acid and transfection reagent for in vitro transfection should result in a positively charged transfection complex. The complement system as well as the macrophages, has a strong binding affinity to cationic complexes. The complement is grouped together with an undefined collection of serum components named opsonins. Antibodies also belong to this group of serum proteins. When the charge-ratio between nucleic acids:cationic transfection reagent is optimised for in vivo use, the net-charge tends to be weakly positive. The lowered charge of the complex leads to less opsonisation via Fc, complement and other opsonins. The weak charge is only able to induce low level of binding to the heparan sulphate proteoglycans, thus reducing the efficacy of the transfection. To alleviate this problem it is necessary to use receptor- mediated endocytosis and shield the inner, positively charged, nucleic acid complex with a neutral outer layer. Wagner et al. (50) have used PEGylation of the transfection complex and subsequently conjugated the exterior terminal parts of the PEG-molecule with cellular receptor ligands. This has the beneficial effects of neutralising the transfection complex and at the same time target a specific cellular receptor thus achieving a degree of cell restricted targeting.

Depending on the gene which is to be transferred, there are different issues that need to be addressed. If the transferred gene is transforming or toxic in some cell types, the expression and/or the targeting need to be cell restricted to avoid negative effects of the

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gene product in question. Another regulating possibility is to use inducible promoters. There exist a number of alternatives today where the regulation based on the tetracycline response element is the most frequently used. It has been used in transient in vitro experiments as well as in transgenic mice (20 21).

CELLULAR RECEPTOR SYSTEMS

By targeting the correct cellular receptor system it is possible to confer a high level of cell-type specificity (51 52). Together with the right promoter sequences is possible to create a highly specific gene expression system. The knowledge from virus studies tells us that endocytosis is a complex path for entry into a cell (53). To use the viruses as tools to study endocytosis pathways is highly informative. One receptor functions as the main binding receptor and a secondary function as the trigger for internalisation. The native properties of the virus capsid ensure that the capsid can escape the endocytic vesicle at the right time, usually when the pH drops below a certain threshold.

Examples of ligands to receptors are:

Metabolic ligands

Extra cellular matrix ligands

Endogenous serum components

Endogenous vasoactive epitopes

Opportunistic ligands

Transferrin RGD Albumin EGF Cholera toxin

Folate Laminin Tuftsin VEGF Diphtheria toxin

Lipoprotein Fibronectin Fc-fragment PDGF Enterotoxins

Vitellogenin Sialyl-glyco-conjugates Sialic acid TNF Riboflavin

Table 3. A selection of available ligands usable for targeting of transfection complexes.

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ENDOCYTOSIS, VESICLE LOCALISATION AND PROCESSING

Endocytosed particles are processed in the complex machinery of the cell. The mechanism that is used for different types of endocytosis can be divided in uptake via:

n Clathrin-coated pits n Non-clathrin-coated pits n Caveolae

The clathrin-coated pit uptake is based on receptor-mediated endocytosis where the dissociation of the receptor from the vesicle, off- rate, is depending on the local concentration of receptor-ligand complexes in the vesicle. Examples of receptors that are endocytosed via clathrin-coated pits are:

n Transferrin

n Asialoglycoproteins n Growth factors n Diphtheria toxin n Immunoglobulins

Endocytosis via non-clathrin coated pits involves cytoskeletal rearrangements as compared to the clathrin-coated uptake. The uptake of adenoviruses and adeno-associated viruses are examples of this type of receptor-mediated uptake where the RGD/integrin interaction is important (54 55). The combinations of viral receptor ligands seem to be important to achieve a correct and rapid migration of the viral capsid to the nuclear membrane (5657).

As an alternative route of uptake, the caveolae can be targeted.

The major difference between the two types of endocytosis described above and caveolae mediated endocytosis, is that vesicles resulting from this type of receptor-ligand interaction does not dissociate from

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the plasma membrane, as the cargo is unloaded. It is possible that the caveollin-lined endosome can fuse with other endosomal vesicles as it is internalised. The uptake of folate is an example of caveolae- mediated endocytosis, potocytosis (58 59 60). The vesicle does not seem to go through a lowering of pH as other types of maturing endosomes does. The folate receptor is a glycosyl-phosphatidylinositol-, GPI-, anchored membrane protein and is aggregated in raft-like structures in the plasma membrane. To enable receptor mediated uptake via folate it is necessary to use bivalent binding entities that cross-link two receptors.

Many cells can perform phagocytosis and the different mechanisms involved have been investigated in depth (61). The macrophage uses two main forms of phagocytosis: FcγR mediated phagocytosis and CR3 mediated phagocytosis (62). The leucocytes contain different types of FcγR where one is connected to so called ITAMs, immuno receptor tyrosine-based activation motifs, and another is connected with ITIMs, immuno receptor tyrosine-based inhibition motifs. It is only the ITAM-coupled receptor that can trigger a phagocytic event.

When the FcγR is bound to its ligand, a chain of events is initiated.

Multiple signalling molecules are activated, such as Syk, Wasp, Cdc42 and Rac. The effect is a cytoskeletal rearrangement that leads to pseudopodia formation and particle uptake (63).

In the case of the CR3 triggered phagocytosis there are similarities in the structural cytoskeletal re-arrangements to FcγR induced phagocytosis but not in the signalling pathway leading to it. F-actin and α-actin are mobilised via an initial Talin binding to the activated CR3 molecule (64 65 66). The phagocytosis is then triggered by Vinculin and Paxillin recruitment, which acts in concerted fashion with Rac and Rho to initiate the rearrangements of the actin-filaments (outside-in signalling) (67).

The targeting of vesicles is depending on proteins such as SNAREs and RABs (68). SNARE proteins associated with vesicles are known as v- SNAREs and those on target membranes are known as t-SNAREs. These molecules interact in a promiscuous way and different adaptors are needed to convey specificity and initial contact. The Rab family of proteins is performing some of these targeting functions, where different Rab proteins interact with membrane tethering proteins such as giantin

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and early endosome antigen 1, EEA1. Once first contact and binding is initiated, the v- and t-SNARE function as a key-lock mechanism initiating the vesicle fusion with the target membrane (69). The association of targeting proteins to vesicles is dependant on multiple receptor interactions relating to the initial receptor-ligand interaction and the specific combination of receptors that are cross-linked (70). This can be exemplified when the fibres of adenoviruses are switched between serotypes, leading to differential intracellular localisation and processing.

NUCLEAR LOCALISATION SIGNALS

All cellular proteins that at some time point is present in the nucleus need to have means of nuclear translocation (71). The transport mechanism consists of amino acid sequences positioned in the protein to be transported, as in the case of the classical large T antigen from the SV40 virus. The SV 40 NLS has been fused to large proteins such as the IgM molecule and still retain nuclear transport function (Fig.7)(72).

The protein can either interact with different NLS receptors or translocate in a NLS receptor independent as exemplified by the KNS-h hnRNP K that has a shuttling activity (73). This has been reported for signal transduction proteins such as the Btk protein, (Bruton’s Tyrosine Kinase).

Protein Core NLS sequence NLS receptor Type of NLS

SV40 T-ag PKKKRKV α/ß-karyopherin Linear aa sequence

Angiogenin RRRGL α/ß-karyopherin Linear aa sequence

Cofilin PEEVKKRKKAV α/ß-karyopherin Linear aa sequence

Lamin LI VRTTKGKRKRIDV α/ß-karyopherin Linear aa sequence

hGlucocorticoidR RK-10 aa spacer-RKTKK α/ß-karyopherin Bi-partite sequence

Nucleoplasmin KR-9 aa spacer-KKKKL α/ß-karyopherin Bi-partite sequence

hEstrogen receptor RK11 aa spacer-RKDR α/ß-karyopherin Bi-partite sequence

Matα2 MNKIPIKDLLNPQ α/ß-karyopherin Non-polar/polar

MyoD VNEAFETLKRC α/ß-karyopherin Non-polar/polar

Rev KAVRLIKllyqsnpppnpegtrqarRNRRRRWR ß-karyopherin Linear aa sequence

Mouse α-importin RLNRFKNKgkdstemrrrrievnvelRKAKK ß-karyopherin Linear aa sequence

Rch1 RLHRFKNKgkdstemrrrrievnvelRKAKK ß-karyopherin Linear aa sequence

M9-h hnRNP A1 NQSSNFGPMKGGNFGGRSSGPYGGGGQYFAKPRNQG

GY ß-karyopherin Shuttling

KNS-h hnRNP K YDRRGRPGDRYDGMVGFSADETWDSAIDTWSPSEWQM

AY Independent shuttling

Tablel 4. Representation of different NLS classes.

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The SV40 core NLS consist of a positively charged heptamer, PKKKRKV. The consensus sequence of this type of NLS is found in many cellular proteins. Located in the more proximal amino-terminal part of the SV40 virus large T antigen are many regulatory sequences, which can become phosphorylated (pr) (Table 5) (74). The different phosphorylation sites regulate the kinetics of the nuclear translocation (Fig.7).

Fig.7 The phosphorylation sites stabilises the binding of the SV 40 NLS to the karyopherin-α and thereby increase the stability of complex formation between the karyopherin-α and karyopherin-ß thus increasing the rate of nuclear transport. The dissociation of the NLS/karyopherin complex is controlled by the concentration gradient of Ran-GTP.

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Protein Phosphorylation site (underlined)/interaction(bold,) Activity Function

SV40 T-ag SSDDEATADSQHSTPPKKKRKV CK2, dsDNA-PK Kinetic increase

Lamin B2 RSSRGKRRRRIE PK-C Kinetic increase

dHSF VREQEQQKRQOLKENNKLRRQAGDVILDAGD NLS activation Stress response

Adenov. E1a FV-20 aa spacer-MCSLCYMRTCGMF NLS activation Development

response

Table 5. Regulatory sites for increased nuclear translocation.

The SV40 core NLS can be transported by both Rch 1 and NPI-1.

Qip-1 NLS receptor transports helicase Q1 preferentially. The import of NLS-carrying complexes is a sequential function. The SV 40 NLS moiety first bind to the karyopherin α−subunit and subsequently the NLS/karyopherin-α binds to a karyopherin-ß subunit. The complete complex is transported through the nuclear pore. The different regulatory sequences influencing the nuclear localisation kinetic of different proteins contribute to the cell-signalling machinery (75). By phosphorylation of sequences neighbouring the NLS, is it possible to increase the rate of nuclear import 50-fold. In the same manner that phosphorylation can increase the rate of nuclear translocation, there are regulatory sequences to decrease the rate of nuclear translocation or rather stimulate cytoplasmic retention.

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AIMS OF THE PRESENT STUDY

The concept of creating the Bioplex system based on a sequence specific hybridisation as exemplified by the PNA-based Bioplex system was conceived in the first months of 1996. The initial idea was to use PNA as a genetic anchor to attach a nuclear localisation signal to a plasmid containing the cognate sequence of the PNA-NLS dual function peptide. The NLS sequence was selected as the proof-of- principle function since nuclear translocation of the transfected plasmid DNA was identified as one of the key issues critical to establish a highly efficient transfection methodology.

General aims:

n Define the critical points for gene delivery

n Investigate the possibility to create a functional transfection unit from isolated, functional peptides attached to nucleic acids n Develop a system for gene delivery in vivo

Specific aims were to produce proof-of principle for the:

n Bioplex concept using a single peptide function in vitro

n Enhanced transfection efficacy via Bioplex technology using reporter genes in vitro

n Function of the Bioplex concept in vivo n Combinatorial Bioplex transfection

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METHODS

FLUORESCENCE MICROSCOPY

For analysis of transfected cells for intracellular distribution of fluorescent-labelled nucleic acids, microscopy was performed with a Leica DMRXA microscope (Leica Microsystems Gmbh, Wetzlar, Germany) equipped with a cooled CCD camera (Model S/N 370 KL 0565, Cooke Corporation, NY, USA). Filter sets for DAPI/Hoechst, FITC, Cy3 and Cy5 were obtained from Chroma Technology (Brattleboro, VT, USA). The images were acquired and analysed using the image processing software SlideBook 2.1.5 (Intelligent Imaging Innovations Inc, Denver, Colorado, USA). Images were post-processed and mounted in Adobe Photoshop 5.0 (Adobe Systems Inc, San Jose, CAL, USA). Colour- separated images were imported into NIH image software and histograms along lines of measurement were assembled, thus showing the Cy-3, Cy-5 and/or DAPI fluorescence intensities plotted against each other. In this manner it was possible to objectively verify the visual assessment of active translocation of nuclear-targeted oligonucleotides.

CONFOCAL- AND DECONVOLUTION MICROSCOPY

The instruments used to study the vesicle movements and processing have to be selected accordingly. The best instrument available today for in vivo studies of vesicle movements are the confocal microscopes based on the spinning-disc technique first described by Nipkow in the 50’s, when he designed the first confocal microscopes based on wide-field microscopy. The systems used today utilise methods to enhance the efficiency of the original techniques.

The idea is to use a spinning disc with an array of holes each covered by a micro-lens that is necessary to focus the laser beam. This focusing technique is vital for the sensitivity of the Nipkow confokal microscope.

Every hole function as a confocal aperture thus giving a multiple of sensitivity or speed of data acquisition depending on how many

(29)

apertures that are located above the target. The maximum speed of acquisition of the Wallac system “Ultraview™” is 700 frames/second (Fig.8).

Fig.8 Nipkow system with micro lens adaptation for focusing of the laser on to the sample (Adapted from Perkin-Elmer)

This in combination with a high quality CCD camera enables scientists today to visualise the movements of fluorescent vesicles. The use of auto-fluorescent proteins and fluorescent dyes of various types in combination with advanced microscopy techniques have revealed many facts about the cellular vesicle machinery. By labelling a whole virus such as the adenovirus, it is possible to monitor the process of viral adsorption and intracellular virus localisation. The difficulties are the quantum-yield of the fluorophore used. The number of photons emitted from the cyanin-dyes are not enough for this technology but new dyes such as the Alexa™ dyes from Molecular probes have a higher quantum-yield and could thus enable in vivo tracing of the endocytosed transfection complexes at a high temporal and spatial

(30)

An alternative technique to confocal microscopy based on coherent laser light sources, is the possibility to use deconvolution algorithms on wide-field fluorescence images. The method of deconvolution is based on algorithms describing the spreading of light from a point source, a point-spread function (Fig.9).

Fig.9 A point-spread function

All the parameters necessary to perform the calculations are included in the specifications of the microscope and the specific fluorescence filters used. The camera type used can be of the same type as described in the section “Fluorescence microscopy” above. By using techniques based on integration of the signal from a CCD- camera, it is possible to confirm intra- cellular presence of dim particles and structures (Fig.10)

Fig.10 By defining the thickness of the pointspread-function, i.e the optical thickness, it is possible to remove out- of-focus light.

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The laser intensity needed in conventional confocal microscopy bleaches the specimen within seconds. It is thus impossible to use any other technique available today for confocal microscopy other than deconvolution techniques on dim objects.

RESULTS AND FUTURE DIRECTION

BIOPLEX

Classical transfection reagents such as poly-L-lysine and different lipid-based formulations rely on charge condensation of the anionic nucleic acids. By linking functions directly to the nucleic acid backbone it is possible to circumvent many of the problems of more traditional transfection reagents (76 77 78). Instead of creating a mix of compounds performing different tasks, it is possible to add each of the desired functions via different methods to the target nucleic acid. One of the first attempts to do this was by adding the charged, 7 amino acid long SV40 core NLS directly to plasmid DNA (79). Due to the charge of the NLS peptide it can bind to and condense plasmid DNA when added in great molar excess. The strength of the PNA based Bioplex technology is the capacity to hybridise to a specific location on a nucleic acid via the sequence specific PNA/nucleic acid interaction (80 81 82). The target nucleic acid, containing different anchor sequences, acts as a scaffold for the functional entities in the Bioplex. The ready complex may consist of a mixture of peptides that can be modified, contain catalytic components and target sequences for cellular processing. It may be desirable to attach combinations of receptor ligands to a nucleic acid, in order to achieve a specific targeting capacity of the resulting Bioplex (83). Depending on the micro-environment of the endocytosed transfection complex, it can also be beneficial to add pH-sensitive, fusogenic peptides such as the HA2 peptide from the influenza virus.

The PNA-part of the bi-/multi-functional molecule has the capacity of dsDNA invasion (84). Strand-invasion of the PNA molecule is most efficient in super-coiled plasmid DNA. This is due to the increased energy content in a super-coiled plasmid (85 86). The high energy

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content lead to increased DNA-breathing and thus facilitates the strand-invasion of the PNA anchor (Fig.11)(87).

Fig.11 The increased energy content of super-colied plasmid DNA enhances the DNA-breathing , thus allowing strand invasion of the PNA-NLS peptide.

The PNA has capacity to form PNA/DNA/PNA triplexes where the second PNA molecule binds in a Hoogstein-fasion after the first PNA molecule has bound in the classical Watson-Crick way. The formation of a triplex structure is highly dependent on the base sequence in the PNA anchor. To achieve a triplex-formation, only purins, G and A should be used in the composition of the PNA-anchor sequence.

Since it is desirable to link multiple functions to a plasmid, it is important to select the PNA-anchor sequence with that in mind. If the absolute number of ligands in each Bioplex is vital to the function, it is then important to ensure that the binding characteristics of the PNA- anchor is appropriate and that the PNA-receptor ligand complex is well characterised. The addition of receptor ligands to the transfection reagent of choice can be cumbersome and require a high level of expertise in order to perform some of the chemical conjugations adequately (88).

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Paper I

In this work we choose the SV 40 core nuclear localisation signal, PKKKRKV, as the function to link to our reporter oligonucleotide. We identified nuclear translocation as one of the most important steps in efficient gene transfer. By hybridising a PNA-NLS dual function peptide to an oligonucleotide carrying the cognate sequence of the PNA part of the PNA-NLS molecule, we were able to confer a peptide function via direct, sequence specific, hybridisation to a nucleic acid (Fig.12).

We cloned the PNA target site into different plasmids containing lacZ or GFP reporter genes.

Fig.13 Principle of PNA based Bioplex. Bi-functional PNA-NLS peptides can hybridise to their cognate site in a target nucleic acid.

By introduction of a concatemeric stretch of PNA-target sites we were able to hybridise the PNA-NLS molecule to the plasmids and thereby increase the transfection efficacy up to 8-fold. With these experiments we established that it is indeed possible to create Bioplexes carrying active co-factors linked via a genetic anchor such as the PNA- molecule and that enhanced transfection efficacy via Bioplex technology is possible.

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Paper II

To develop the Bioplex system further it was important to verify that the technology could function in vivo. By repeating the strategy from the first work, we injected the PNA-NLS/oligonucleotide Bioplex into different tissues of mice and assayed for preferential nuclear translocation of the PNA-NLS hybridised oligonucleotide. We found that the targeted nucleic acid was over represented in the nuclei of various murine tissue-types. We thus established that it is possible to have active, Bioplex linked, functions in vivo.

Paper III

In paper III, we identify issues connected with basic transfection technology. We used high-resolution deconvolution microscopy techniques to visualise the nuclear distribution of NLS-targeted oligonucleotides compared to inverted NLS-PNA hybridised oligonucleotides. To verify the importance of active nuclear translocation, we performed transfection on confluent cell cultures with PNA-NLS hybridised plasmids. The stability of PEI complexed 70-mer oligonucleotides were investigated and found to be dependant on the protection via the transfection reagent. We have identified and addressed some of the critical points for gene delivery in this article and showed that we can apply Bioplex technology to solve them.

Paper IV

Combinatorial Bioplex transfection indicates additions of multiple functional moieties directly to a nucleic acid of interest. By designing oligonucleotides to contain multiple target sites for different bi- functional PNA molecules we added 1 or 4 RGD-peptides and 1 SV40 NLS to the carrier oligonucleotide. Our results indicate a synergistic effect of multiple RGD-peptide moieties in the cellular uptake of Bioplexes. The cellular uptake of oligonucleotides carrying 4 RGD-PNA target sites was very high and in contrast, could we not detect significant levels of fluorescence when 1 RGD peptide was hybridised to the carrier oligonucleotide. When a PNA-NLS peptide was added to the 4xRGD/oligonucleotide complex, we could detect increased nuclear levels of oligonucleotides. The combinatorial complex with both RGD and NLS functions translocated to the nucleus more efficiently when a pH-dependent lysosomal disruption reagent was added to the transfection.

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This finding is proof-of-principle that a combinatorial approach has pot- ential to incorporate many functions into the Bioplex concept thus partially mimicking viral functions.

Paper V

In order to analyse Bioplex transfection methodology, we have invested considerable time and energy to optimise assay methods for analysing the efficacy of Bioplex mediated plasmid transfection. We have been able to verify the conditions to be used for optimal hybridisation of the PNA-anchor to its cognate site on a plasmid. We found that super-coiled plasmid is more readily accessible to strand invasion by PNA than other forms of DNA. This may be due to the increased energy content conferred by the twists in the DNA caused by the DNA-gyrase.

FUTURE DIRECTIONS

We are now in the process of developing in vivo gene delivery systems where we combine tissue targeting, endosome escape and nuclear localisation. We are constantly evaluating new concepts for the use of the Bioplex technology (89). We believe that the most important application of Bioplexes is the capacity to combine functions in a sterically defined manner, thus we should be able to construct defined macro-complexes via sequential, sequence specific hybridisation of multiple PNA-entities using a nucleic acid sequence as scaffolding for the final Bioplex. It is our hope that by introducing new functions in a concerted fashion we will be able to considerably improve gene transfer.

(36)

ACKNOWLEDGMENTS

I would like to thank everybody who made this possible:

Ted Smith for his patience with me and pushing at the times when I really needed a shove.

Ted is one of the few people with whom I can have an inspired discussion with and almost every time come up with a new principle, angle, application or what not. I hope we will have many more such discussions. I believe we listen to what is said, as much as what is not said, and this is why we can come up with the good ideas.

Erna Möller for being absolutely fabulous and a fan of Björn Borg.

Birger Christensson for the good times spent talking in a damp, freezing cold or way to warm, window-less, cramped room, full of inspiring toys that I cannot afford to have at home.

Birgitta Axelsson, you have been a rock. It is good to be able to escape from the buzz at Novum and talk about what ever it is that is bugging me.

Jan-Åke Gustafsson for creating Novum

Henrik Garoff for sharing his knowledge in virology

KIAB for supporting new ideas and giving a solid structure that is applicable in the world outside the academic institutions.

Bengt-Olle Bengtsson for his enthusiasm and his recommendation letter to Ted.

Anita, Inger och Lill-Britt for doing such an excellent job and being so nice even when I do everything wrong.

Micke Andäng, well, I am finally done now. Do you think we ever will find the time to do all those things we really, really would like to do, or do we need a department of our own?

Fredrik Cederholm for having an excellent project to pour all new ideas into. We should convince Micke that we should do it again, but better.

Mairon for all the help during hectic times and for knowing where to go and who to talk to.

Donald Kohn and Karen Pepper for making my stay in LA possible. Don and Karen tutored me in the ways of virus technology. Karen made me take the “Black Belt” in cell culture and made me realise that being paranoid is a good thing, especially when working with cells and viruses.

Staffan Larsson, who is the creative force behind the HS-media department. Staffan helped me a lot when I did not have the skills to make my own slides or pictures. I hope that we will continue our work and take the best from the graphics and combine that with good science.

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Lennart Hammarström for always having his door open and having time to talk

Magnus, Sten, José,Anna, Beston, Jessica, Karin, Alar, Hayrettin, Abdi, Leonardo, Tahmina, Lotta, Berri, Britt-Marie and Ludmilla; for making the lab a stimulating environment.

Ingrid Hacksell, you have always been someone to talk to and getting sensible answers from.

Kleanthis and Paschalis for making me grow character and understand myself

Mohammed, José, Mona, Micke, Jenny, Sara, Sari, Marie, Olle, Suss Giannis, Tassos, Sara, Jane, Anette, Knut-Rune, Tova, Ke-Jun, Gunnel, Pan, Bill and Christine, Antonio, Anders, Igor, Inger, Monika, Kahlid, Helmi, Åsa, Paulo, Lillian, Mats Gåfvels, Mats Nilsson, Per F, Per A, Gezan and everybody else for making Novum the good place it is and have been.

Cia for sharing her desk with me when I first arrived.

Lotta, Anki, Tove, Ylva, Mickan and Henrik for being good friends.

Mohammed for being a great guy and friend.

Pontus, it always feels good go to GTC when you, Kristina and Jenny are there.

Bengt, thank you for all the times you have helped me out. I hope that I will get more good wine-tips and theatre reviews from you in the future.

Pia och Helene, I look forward to every time you come to Novum.

Berndt who is the one fixing everything that was not done the right way from the beginning.

I think I will need a new computer table soon.

The service unit that makes science not only fun but manageable; Inger Holstensson, Inger Eriksson and Inger Palm

The computer service and first aid team headed by Erik Lundgren

All my students that have put up with me during these years, especially Jocke, Patrick, Wolle, Oscar, Balsam, Mathias, The “gang of three” and all the others that I have honed my pedagogic skills on.

Mamma och Pappa who have supported me even when they did not understand what I talked about.

My sister Karin and her family, Ellen, Theo and my brother in law, Alex

Inger, who have made sure that I did not work my self into an anemic academic and have shared my life during these years.

I love you.

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REFERENCESES

1 Erbacher P, Remy JS, Behr JP.

Gene transfer with synthetic virus-like particles via the integrin-mediated endocytosis pathway.

Gene Ther. 1999 Jan;6(1):138-45.

2 Davis SC, Szoka FC Jr.

Cholesterol phosphate derivatives: synthesis and incorporation into a phosphatase and calcium- sensitive triggered release liposome.

Bioconjug Chem. 1998 Nov-Dec;9(6):783-92.

3 Zelphati O, Szoka FC Jr.

Mechanism of oligonucleotide release from cationic liposomes.

Proc Natl Acad Sci U S A. 1996 Oct 15;93(21):11493-8.

4 Xu Y, Szoka FC Jr.

Mechanism of DNA release from cationic liposome/DNA complexes used in cell transfection.

Biochemistry. 1996 May 7;35(18):5616-23.

5 Blessing T, Remy JS, Behr JP.

Monomolecular collapse of plasmid DNA into stable virus-like particles.

Proc Natl Acad Sci U S A. 1998 Feb 17;95(4):1427-31.

6 Talsma H, Cherng J, Lehrmann H, Kursa M, Ogris M, Hennink WE, Cotten M, Wagner E.

Stabilization of gene delivery systems by freeze-drying.

Int J Pharm. 1997 Nov 28;157(2):233-238.

7 Talsma H, Cherng J, Lehrmann H, Kursa M, Ogris M, Hennink WE, Cotten M, Wagner E.

Stabilization of gene delivery systems by freeze-drying.

Int J Pharm. 1997 Nov 28;157(2):233-238.

8 Barron LG, Gagne L, Szoka FC Jr.

Lipoplex-mediated gene delivery to the lung occurs within 60 minutes of intravenous administration.

Hum Gene Ther. 1999 Jul 1;10(10):1683-94.

9 Mislick KA, Baldeschwieler JD.

Evidence for the role of proteoglycans in cation-mediated gene transfer.

Proc Natl Acad Sci U S A. 1996 Oct 29;93(22):12349-54.

10 Belting M, Petersson P.

Protective role for proteoglycans against cationic lipid cytotoxicity allowing optimal transfection efficiency in vitro.

Biochem J. 1999 Sep 1;342 ( Pt 2):281-6.

11 Kaplitt MG, Pfaff DW.

Viral Vectors for Gene Delivery and Expression in the CNS Methods. 1996 Dec;10(3):343-50.

12 McClintock B 1938 The production of homozygous deficient tissues with mutant characteristics by means of the aberrant behaviour of ring-chaped chromosomes. Genetics, 21, 315.

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13 Vacik J, Dean BS, Zimmer WE, Dean DA.

Cell-specific nuclear import of plasmid DNA.

Gene Ther. 1999 Jun;6(6):1006-14.

14 Apostolopoulos V, Plebanski M.

The evolution of DNA vaccines.

Curr Opin Mol Ther. 2000 Aug;2(4):441-7.

15 Talwar GP, Diwan M, Razvi F, Malhotra R.

The impact of new technologies on vaccines.

Natl Med J India. 1999 Nov-Dec;12(6):274-80.

16 Restifo NP, Ying H, Hwang L, Leitner WW.

The promise of nucleic acid vaccines.

Gene Ther. 2000 Jan;7(2):89-92.

17 Liu F, Song Y, Liu D.

Hydrodynamics-based transfection in animals by systemic administration of plasmid DNA.

Gene Ther. 1999 Jul;6(7):1258-66.

18 Maruyama H, Ataka K, Gejyo F, Higuchi N, Ito Y, Hirahara H, Imazeki I, Hirata M, Ichikawa F, Neichi T, Kikuchi H, Sugawa M, Miyazaki J.

Long-term production of erythropoietin after electroporation-mediated transfer of plasmid DNA into the muscles of normal and uremic rats.

Gene Ther. 2001 Mar;8(6):461-8.

19 Lin MT, Pulkkinen L, Uitto J, Yoon K.

The gene gun: current applications in cutaneous gene therapy.

Int J Dermatol. 2000 Mar;39(3):161-70.

20 Gossen M, Bujard H.

Tight control of gene expression in mammalian cells by tetracycline-responsive promoters.

Proc Natl Acad Sci U S A. 1992 Jun 15;89(12):5547-51.

21 Hasan MT, Schonig K, Berger S, Graewe W, Bujard H.

Long-term, noninvasive imaging of regulated gene expression in living mice.

Genesis. 2001 Mar;29(3):116-22.

22 Krieg AM.

The role of CpG motifs in innate immunity.

Curr Opin Immunol. 2000 Feb;12(1):35-43.

23 Jang SK, Wimmer E.

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Genes Dev. 1990 Sep;4(9):1560-72.

24 Anderson KV.

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Curr Opin Immunol. 2000 Feb;12(1):13-9.

References

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