Sendai virus-based anticancer therapy for
model and
companion animals has been reported in several scientific papers. The described studies demonstrate that Sendai virus has a potential of becoming a safe and effective therapeutic agent against a wide range of human cancers. High genomic stability of SeV is a very desirable trait for oncolytic viruses. SeV is not likely to evolve into a pathogenic strain or into a virus with decreased oncolytic potential. The cytoplasmic replication of the virus results in a lack of host genome integration and recombination, which makes SeV safer and more attractive candidate for broadly used therapeutic oncolysis compared to some DNA viruses or retroviruses. it has never been observed that it can cause human disease. Moreover, Sendai virus has been used in
clinical trials involving both adults
Model cancers For cancer studies, it is desirable that the
oncolytic virus be
non-pathogenic for experimental animals, but the Sendai virus can cause rodent disease, which is a problem for research strategies. Two approaches have been used to overcome this problem and make Sendai virus non-pathogenic for mice and rats. One of these approaches included the creation of a set of genetically modified
attenuated viral strains. Representatives of this set were tested on model animals carrying a wide range of transplantable human tumors. It has been shown that they can cause suppression or even eradication of
fibrosarcoma,
neuroblastoma,
hepatocellular carcinoma,''''
melanoma,
squamous cell and
prostate carcinomas. SeV construct suppresses
micrometastasis of head and neck squamous cell carcinoma in an orthotopic nude mouse model. Complete eradication of established
gliosarcomas in
immunocompetent rats has also been observed. SeV constructs have also been created with a modified protease cleavage site in the F-protein. The modification allowed the
recombinant virus to specifically infect cancer cells that expressed the corresponding proteases. The ultraviolet light treated virus can also kill human prostate cancer cells in culture by triggering their apoptosis and eradicate tumors that originated from these cells in immunodeficient model animals. Moreover, it can stimulate immunomodulated tumor regression of
colon and
kidney cancers in immunocompetent mice. Similar regressions caused by the replication-deficient Sendai virus have been observed in animals with transplanted
melanoma tumors.
Natural cancers Some cancer studies with non-rodent animals have been performed with the unmodified Sendai virus. Thus, after intratumoral injections of the virus,
complete or
partial remission of
mast cell tumors (
mastocytomas) was observed in dogs affected by this disease. It is also reported that the Moscow strain of SeV was tested by Dr. V. Senin and his team as an anticancer agent in a few dozen patients affected by various malignancies with metastatic growth in Russia in the 1990s. The virus was injected intradermally or intratumorally and it caused fever in less than half of the treated patients, which usually disappeared within 24 hours. Occasionally, the virus administration caused inflammation of the primary tumor and metastases. Clinical outcomes were variable. A small proportion of treated patients experienced pronounced long-term remission with the disappearance of primary tumors and metastases. Sometimes the remission lasted 5–10 years or more after virotherapy. Brief descriptions of the medical records of the patients that experiences long-term remission are presented in the patent.
Anticancer mechanism Direct cancer cells killing. Malignant cells are vulnerable to SeV infection. Sendai virus can infect and kill variable cancer cells (see section
Sensitive cell lines and virus strains). However, some malignant cells are resistant to SeV infection. There are multiple explanations for such resistance. Not all cancer cells have cell entry receptors for the virus and not all cancer cells express virus processing serine proteases. There are also other mechanisms that can make a cancer cell resistant to an oncolytic virus. For example, some cancer cells maintain interferon response system that completely or partially protects a host cells from a virus infection. Therefore, biomarkers needed to be developed to identify tumors that might succumb to SeV mediated oncolysis.
Sendai virus cell entry receptors are often overexpressed in cancer cells. SeV receptors are potential
biomarkers for evaluation of the vulnerability of malignant cells to the virus. They represented by
glycoproteins and
glycolipids (see section "
SeV cell entry receptors").The expression of some molecules that can facilitate SeV cell entry (see section “
SeV cell entry receptors”), frequently, accelerates
carcinogenesis and/or
metastasis development. For example, the presence of
Sialyl-Lewisx antigen (cluster of differentiation 15s (CD15s)), which is one of SeV cell entry receptors, on the outer cell membrane, correlates with invasion potential of malignant cells, tumor recurrence, and overall patient survival for an extremely wide range of cancers. Therefore, SeV virus preferentially can enter such cells. Metastatic cancer cells frequently express a high density of glycoproteins or glycolipids - molecules that are rich in
sialic acid. Expression of the Vim2 antigen, which is another SeV cell entry receptor, is very important for the
extravascular infiltration process of acute
myeloid leukemia cells. GD1a,
ganglioside also serves as SeV receptor and is found in large quantities on the surfaces of
breast cancer stem cells. High cell surface expression of another SeV receptor -
ganglioside sialosylparagloboside /SPG/ NeuAcα2-3PG. characterizes
lymphoid leukemia cells. Among other receptors represented by gangliosides GT1b is highly expressed on the outer membranes of
brain metastases cells that originate from an extremely broad range of cancer, while GD1a, and GQ1b can be detected in human gliosarcomas. However, their quantity is not exceeding the quantity in normal frontal cerebral cortex. The
asialoglycoprotein receptors that bind Sendai virus. and serve as SeV cell entry receptors are highly expressed in
liver cancers. Cellular expression of glycoproteins can be evaluated by various molecular biology methods, which include RNA and protein measurements. However, cellular expression of
gangliosides, which are sialic acid-containing
glycosphingolipids, cannot be evaluated by these methods. Instead, it can be measured using anti-glycan antibodies, and despite the large collection of such antibodies in a community resource database, they are not always available for each ganglioside. Therefore, indirect measurement of ganglioside expression by quantifying the levels of
fucosyltransferases and
glycosyltransferases that complete
glycan synthesis is an alternative. There is evidence that expression of these enzymes and the production of gangliosides strongly correlate. It is also overexpressed in some cell lines originating from various malignant neoplasms. Thus, it is highly expressed in bladder carcinoma, human colon carcinoma
CaCo2 and
breast carcinomas SK-BR-3,
MCF7 and T-47d. TMPRSS2 is overexpressed in cervical and endocervical squamous cell carcinomas, along with colon, prostate, and rectum adenocarcinomas. It is also overexpressed in uterine corpus endometrial and uterine carcinosarcomas. It's especially high expression is observed in the human
mast cell line HMC-1, and in the human
erythroleukemia cell line HEL.
Plasminogen (
PLG), from which originates the mini-plasmin that can cleave the F-protein, is highly expressed in liver cancers.
Factor X (F10) is frequently expressed in normal liver and in liver cancers. SeV constructs were created with a modified protease cleavage site. The modification allowed the recombinant virus to specifically infect cancer cells that expressed the corresponding proteases, which can cleave a modified protease cleavage site. In Namalwa cells SeV virus stimulates an expression of many genes involved in immune defense pathways, such as type I and type II IFN signaling, as well as cytokine signaling. Among the ten most virus-induced mRNAs are
IFNα8,
IFNα13,
IFNβ,
IFNλ: (L28α,
IL28β,
IL29),
OASL,
CXCL10,
CXCL11 and
HERC5. However, despite stimulation of these genes expression by SeV, Namalwa cells can't protect themselves from the virus infection.
Ability of Sendai virus to inhibit interferon response in some cancer cells In HeLa cells SeV (in contrast to
Vesicular Stomatitis Virus) can counteract IFN-α pretreatment and keep a viral protein translation level similar to that in IFN-untreated cells.
Removing sialic acid residues from T-regulatory cell surfaces Viral neuraminidase has the ability to remove sialic acid residues from cell surfaces, including those on
T-regulatory (Treg) cells. Research indicates that the
Sialyl-Lewis x antigen is specifically found in activated, terminally differentiated, and highly suppressive CD4+ regulatory T (Treg) cells, which can be distinguished from nonsuppressive T cell. Removing the suppressive Treg cells from human blood has been shown to enhance immune responses against tumor and viral antigens in vitro. Moreover, the oncolytic potential of paramyxovirus can be enhanced by mutations in the fusion (F) gene
protease-cleavage site, which allows the F-protein to be more efficiently processed by cellular proteases. The introduction of the F gene of SeV in the form of a plasmid into the tumor tissue in mice by electroporation showed that the expression of the F gene increases the
T cell infiltration of the tumor with
CD4 + and
CD8 + cells and inhibits tumor growth. It was also shown in other similar experiments that cancer cells themselves, transfected with
plasmids that encode viral membrane glycoproteins with fusion function, cause the collective death of neighboring cells forming syncytium with them. Recruitment of bystander cells into the syncytium leads to significant regression of the tumor.
Killing of malignant cells by virus triggered anti-tumor immunity The virus triggers indirect
immunomodulated death of malignant cells using a number of mechanisms, which are described in a published review. Higher MHC I expression leads to higher presentation of viral and abnormal peptides from cancer cells to
cytotoxic T cells, while the immunoproteasome more efficiently processes these peptides for loading onto the MHC I molecule. Therefore, the recognition and killing of infected or malignant cells increases. Higher MHC II expression enhances presentation of viral and cancer peptides to
helper T cells; which are releasing cytokines (such as more interferons,
interleukins and other cytokines) that stimulate and co-ordinate the activity of other immune cells. By down regulation of
angiogenic stimuli produced by tumor cells interferon can also suppress
angiogenesis In addition, they suppress the proliferation of
endothelial cells. Such suppression causes a decrease in tumor
vascularization and subsequent growth inhibition. Interferons can directly activate immune cells including
macrophages and
natural killer cells. It has been demonstrated that SeV can also induce the production of IFN type III (IFN-lambda) by human
plasmacytoid dendritic cells.
Non interferons Sendai virus can induce the production of many
cytokines that enhance
cellular immune responses against cancer cells. SeV stimulates the production of
macrophage inflammatory protein-1α (MIB-1α) and –β (MIB-1β),
RANTES (CCL5),
tumor necrosis factor-alpha (TNF-alpha),
tumor necrosis factor-beta (TNF-beta),
interleukin-6 (IL-6 ),
interleukin-8 (IL-8),
interleukin-1 alpha (IL1A),
interleukin-1 beta (IL1B),
platelet-derived growth factor (PDGF-AB) and small concentrations of
interleukin-2 (IL2) and
GM-CSF. SeV induces the production of
B cell-activating factor by monocytes and by some other cells. Heat-inactivated SeV virus induces the production of IL-10 and IL-6 cytokines by
dendritic cells (DC). Most likely, F protein is responsible for this induction because reconstituted liposomes containing F protein can stimulate IL-6 production by
DC. The production of IL-6 in response to SeV infection is restricted to conventional dendritic cells (DCs) subsets, such as
CD4+ and double negative (dnDC). =====
Neuraminidase (NA) removal of
sialic acid from the surface of malignant cells stimulates
natural killers cells and
cytotoxic T lymphocytes ===== Increased
sialylation levels on the cell membrane have been linked to a heightened potential for invasion and metastasis in cancer cells. This correlation has been observed across various models, including murine, rat, and human, and is associated with the progression of malignancy. Some
sialylation inhibitors can make cancer cells less malignant. One possible explanation for the relationship between increased
sialylation and a malignant phenotype is that sialylation results in a thick layer of coating on the cell membrane that masks cancer antigens and protects malignant cells from immune surveillance. The activity and cytotoxicity of
NK cells is inhibited by the expression of
sialic acids on the tumor cell surface. Removal of sialic acid residues from the surface of tumor cells makes them available to
NK cells and
cytotoxic T lymphocytes and, therefore, reduces their growth potential. Moreover, treating tumor cells with
sialidase improves activation of NK cell secretion of
IFN-γ. NA also promotes cell fusion, which helps the nascent virions to avoid contact with host antibodies and thus enables the virus to spread within tissues.
Sialidase treatment of cells causes loss of
sialic acid residues. This loss significantly increases the ability of malignant cells to activate
cytotoxic T lymphocytes. Variable sialidases can cause this effect, and 2,8-linkages between sialic acid residues.
In vitro, there was no significant difference between NAs from
Newcastle disease virus, SeV and
mumps virus with respect to
substrate specificity. These results suggest that treating a tumor with the virus results in
desialylation of malignant cells, which contributes to increased anti-tumor immune surveillance. Therefore, the ability of SeV sialidase (NA) to remove sialic acid from the surface of malignant cells most likely helps to ensure the availability of tumor antigens for recognition by
cytotoxic T lymphocytes. The activation of NK requires several receptors, among which are
natural killer proteins 46 (NKp46) and
44 (NKp44). Studies have shown that the only paramyxovirus protein that activates NK is
HN. HN protein binding to NKp46 and/or NKp44 results in the lysis of cells whose surfaces display the HN protein or its fragments. It can be assumed that NK activation and tumor suppression by UV-treated SeV within 60 minutes. When activated DCs that carry non-transmissible variants of SeV are administered, survival of animals injected with melanoma, colorectal cancer, hepatic cancer, neuroblastoma, and prostate cancer The enzymatic removal of sialic acids from the surface of dendritic cells by sialidase significantly promote the antigen-induced activation of naive T cells, while concurrently enhancing the resurgence of effector T cells. It is plausible that sialidase from Sendai virus (SeV) could execute this function. The removal not only improves antigen cross-presentation but boosts anti-tumor immune responses as well. Dendritic cells with reduced sialylation form higher avidity interactions with CD8+ T cells. SeV can replicate to high titers in human monocyte-derived DCs.
SeV suppression of regulatory T cells Experiments with animal models have shown that, even after UV inactivation, SeV can block T-cell-mediated regulatory immunosuppression in tumors. The blocking mechanism is associated with the stimulation of SeV inactivated virions of
interleukin 6 (IL-6) secretion by mature DCs. These effects lead to the eradication of most model tumors and inhibit the growth of the rest. It has been shown that F protein alone can trigger IL-6 production in DC in a fusion-independent manner. == As a vector ==