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Module 1: Gene Delivery and Other Variants

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    Hello everyone. Welcome to another lecture of Drug Delivery Engineering and
    Principles.
    (Refer Slide Time: 00:33)

    We have been talking about Gene therapy for the last few classes now. So, in the last
    class, we particularly started looking into an aspect of gene therapy which is using genes
    as vaccines, also sometimes termed as DNA vaccines. And the major thing here is to be
    able to deliver your gene cytoplasmically or your protein cytoplasmically; however,
    having said that, you can still deliver your gene or protein of interest in the extracellular
    environment.
    So, the protein is something that is secreted out from the cell, then it is going to come out
    too. So, you can target both pathways - both extracellular as well as intracellular and
    depending on what pathway you are targeting, you will get different type of human
    response; it could be cytotoxic, it could be a IgGa mediated or it could be IgE mediated
    all depends on which pathway has been targeted. As I as previously described, IgGa is
    more towards the intracellular response and IgE is more towards your anaphylactic and

    more allergic type of response. So, all of this can be changed and out and we will we will
    go a little more detail into this in today’s class, but before that we also discussed PINC
    system, which is not forming complexes, but just forming hydrogen bonding with the
    polymer, acts as bulking agent.
    So, very simple system then we talked about particulate system we had only talked about
    cationic polymers and then this case we talked about particulate system where you make
    positively charged particles. And then you can put your DNA which is negatively charge
    on the surface which can then be used to deliver it in your target cell.
    (Refer Slide Time: 02:45)

    So, let us look at one example of how this was used in one of the paper. So, this is we are
    talking about an immunization against food allergy. So, food allergy is a fairly common.
    You find that lot of people have certain restrictions that they may or may not be able to
    eat any type of food especially something like crabs, fish. These things illicit quite a bit
    of allergies and not only the it does not have to be a non-veg food, it can also be
    something as simple as peanuts.
    This is a big problem actually, in western countries, where quite a bit of people; if the
    intake peanuts, they get a huge anaphylactic shock. They are unable to breathe
    sometimes and a lot of people actually die because of that. So, we will look into how this
    food allergy can be tackled; obviously, since its allergies; it is some response of the

    immune system. So, can we then train our immune system, do not cause allergies when
    we intake these food material.
    (Refer Slide Time: 03:56)

    And so, we will focus on peanut allergies for this example now. So, peanut allergies,
    they cause anaphylactic reactions and that is because you get this Th2 based cytokine
    response; immune response which results in IgE and IgG1. And this is potentially fatal or
    near fatal especially in children because lot of the time these babies and children are
    given food that may contain peanut without knowing that they may have allergies. And it
    may then result in quite a bit of immune response and they may not be close to a hospital
    setting and sometimes that even causes death unfortunately.
    And the major allergen is a protein in peanuts that is present and we will talk about that
    in a moment. But how about we immunize a body against this allergen present in the
    peanut? Would that prevent the immune response to mount in a certain way to cause this
    anaphylactic shock? That was the purpose of this study. And so, we are saying that this
    protein administration can cause this anaphylaxis. So, how can we develop some normal
    immunization method so that we do not cause this anaphylaxis.
    And then the oral immunization can be done with this because; obviously, all of this is
    taken orally. So, when we are taking food, we are taking it orally so, can we use oral
    immunization, because that will be fairly compatible. So, high patient compliance and
    ease of administration to mass vaccination, so, you can at a time as the babies are born,

    you can easily administer this and it is not a problem and you can generate mucosal
    immunity against infectious agent also through oral immunization, but in this case we are
    mostly focusing on food allergy.
    (Refer Slide Time: 06:05)

    So, here is what a typical patient lifecycle with this allergic response would look like. So,
    maybe the first time they eat it, they get sensitized; they get some small immune
    reaction. So, you can say minor reaction. The first time they eat it, depends on the
    quantity. So, minor reaction and now because of this minor reaction, the body is now
    exposed to this antigen which then means that the body is now getting trained. So, it is
    acting as a vaccine, but a bad vaccine at this point where the body is getting trained to
    tackle this in a much more serious manner when it comes again.
    So, the body has generated memory cells for this. It is now able to bind to it very
    strongly; it is able to produce lots of cytokines in presence of this. So, activate the
    immune response in a big way. And now the second time or the third time the patients or
    the folks suffering from this peanut allergy, take this peanut; the body is actually ready
    for it.
    And unfortunately in this case, the body mounts such a high immune response that there
    are so many cytokines, there are so many other immune responses that are generated that
    the body goes into anaphylactic shock. And what that is, the blood vessels dilate, that

    causes the blood flow to decrease everywhere, you may not be able to get enough
    oxygen in your brain, in your heart and suddenly it may cause death.
    And then the major reason for that is, in this particular case, is that the IgE mediated
    shock is given. So, IgE is a type of an antibody and in this particular case, this is a bad
    antibody.
    So, if it is a pathogen, it is actually a good antibody, but in this case it is a bad antibody
    because this will cause anaphylactic shock in presence of high amount of peanuts. And it
    causes all this histamine to be circulated, vascular leakage, I was talking about and that is
    not ideal. So, the whole concept here is - let us immunize these folk suffering from
    peanut allergy.
    Once we have immunized them, let us switch from an IgE mediated response to IgG2a
    mediated response which is a more Th1 response. We want to steer away from this IgE
    response which is a Th2. And since IgE is the major reason for causing the anaphylaxis
    in this patient, if the immune system, even though it still is acting against the peanut, if it
    acts through a Th1 pathway, then there is a chance that we may be able to protect the
    patient from any kind of harmful immune response effects.
    So, once you have done this and you have shifted the memory to this direction. So,
    earlier the memory was here, but because in a certain way that you have immunized
    instead of just taking peanuts, we have these authors have done something different and
    we will talk about that in a moment that has caused a more Th1 response. The memory
    bank of Th1 has increased and then now if the allergen is exposed, what you will have is
    a protection. Even though there is some immune response still being generated, it is not
    going towards the IgE and it is not going towards towards the anaphylactic response. So,
    that is the whole concept behind it. So, how do we do this?

    (Refer Slide Time: 09:53)

    So, in this particular paper, they are using DNA delivery with chitosan nanoparticles. So,
    we have already discussed chitosan being a natural polymer and also containing primary
    and tertiary amines, it is used quite a bit with DNA delivery and it is a mouse model that
    they have used. So, what they have done is they have now used the antigen which is the
    Arah2 and they have put a plasmid that codes for this and they have immunized it with
    either these chitosan nanoparticles or just the naked DNA.
    So, the whole concept here is, why do not we instead of having this allergen in an
    extracellular environment put it in an intracellular environment. So, this antigen because
    now it is intracellular, it is going to go more towards the Th1 pathway. So, as we already
    discussed a few times, intracellular will go towards Th1 and the extracellular is more
    towards Th2.
    So, right now it was going towards Th2 because; obviously, we do not have this
    particular antigen in our body being produced by ourselves in the cytoplasm. So, it is all
    extracellular when we eat it. So, that was causing the Th2 response. So, if we now
    deliver it onto a plasmid; that means, now the cells are going to produce this and this is
    also going to be present in your cytoplasm and that may shift it to Th1. And so, once you
    do this, you boost it again at 2 weeks. So, you make sure that there is enough immune
    response that is being generated against this Arah 2 through Th1. So, there is enough
    memory of it as well.

    So, in this case, the authors after two weeks gave the same dose again and then they
    actually sensitize it with peanut extracts. So, now, they essentially just challenged it to
    see what happens if you take peanuts, a crude extract of it and you then inject it three
    more times weekly to sensitize the animal. And then once your sensitize the animal, then
    you come in and start challenging with the Arah2 protein and see what is the outcome of
    all this process that you had done on the mouse earlier.
    So, you can collect the serum and then once you have the serum, you can then look for
    whether there is a IgA response whether there is a IG2a, IgE response, whether some of
    the vascular leakage is happening or not. So, anaphylaxis is happening or not or and
    similarly the plasma histamine which is another marker for anaphylaxis.
    (Refer Slide Time: 12:55)

    So, let us see what happens so; obviously, the title says here that this chitosan based oral
    DNA immunization is able to switch the immune response from Th2 to Th1 and here is
    some data to support it. So, they used a high molecular weight chitosan. So, if they give
    it only once and they are measuring for IG2a against this antigen which is the response
    and we wanted. So, this is the Th1 response as it is also written here.
    So, what you see is you get a lot more IG2a when you do the booster dose compared to if
    you just give a naked DNA or naive animals. So, naive animals are obviously not treated
    with anything, they were directly challenged and so, that is what the Th1 measured
    through the IG2a response. But if you do the same thing and measure for IgE which is

    the anaphylactic response which you do not want so, again you see that naive animals;
    you see quite a bit of the bad antibody in this case. So, more towards anaphylactic ratio,
    but in the cases where you given a booster dose, you see quite a bit reduced amount of
    that. Almost I mean if this is let us say, close to 40 nano gram per mL. Here you talking
    about let us say 8. So, we are talking about a 5 fold reduction. So, 5 fold reduction in a
    bad response in this particular case and similarly about 4 fold increase in a mode Th1
    response.
    (Refer Slide Time: 14:42)

    So, here are some more examples of that. So, then they looked at the mouse health. So,
    they looked how the mouse is behaving. So, they made scale in which they looked at this
    any sign of reactions. They do not see anything abnormal, then the mouse gets 0 as a
    score. If they are starting to scratch and rub their nose and head that means there is some
    toxicity that they are feeling with this so, then the score is given 1.
    Then you can also have if the mouse is actually struggling to breathe and trying to
    breathe quite heavily, it is puffing around its eyes then you give a certain score and then
    similarly as the severity increases. So, it cannot breathe very well its laboring with that or
    if it is not even moving around, it seems fairly sick and just tremoring. Then you give a
    certain score and if it dies then you give; obviously, the worst score and in their study,
    they measure what are the different scores they get. So, what you see is naive animal is

    of course, the worst where they are getting quite a bad response whereas, the animals that
    were given the chitosan with a booster dose, they do the best in this scenario.
    So, if this could be translated to humans. You can have protection of quite a lot of
    humans from this fatal based allergic toxicity and this is fairly quick. As you can see this
    is within the 70 minutes of or even in fact, 60 minutes of the administration of the
    antigen.
    (Refer Slide Time: 16:24)

    So, we have talked about some of these. Let us look at some other types of vaccines that
    cannot really be classified in one or the other, but can be used for various applications.

    (Refer Slide Time: 16:36)

    So, here is a vaccine that was being used to target dendritic cells and in this case, what
    they are doing is they are making a depot of the vaccine and so, what the authors have
    done in this paper is they are trying to attract the target cell to the site that they are
    injecting.
    So, far what we were doing is we were injecting particles or even injecting some naked
    DNA and relying it to move and translocate to wherever we want it to target. But what if
    we create a depot and have the immune cells come to the site themselves. So, what they
    have done is they have created these polymer rods. These rods are in this case, they made
    it out of polyethylene copolymer and they are releasing an antigen which in this case is
    ovalbumin.
    And along with that, what they have done is, they have also put another rod which is
    releasing a protein called MIP-3 alpha and this is a chemo attractant. And what does it
    do? It actually attracts the immune cells to the site especially the dendritic cells which
    are major antigen presenting cells.
    So, because of this now there is a gradient of MIP-3 alpha that is created wherever you
    implant this and these rods are big; I mean these we are talking about greater than
    millimeter ranges. So, these cannot really move around. They are too big to move in the
    human body. So, what will happen is they will create a depot wherever they were
    injected or wherever they were implanted and because this MIP-3 alpha was being

    released, these concentration of MIP-3 alpha, if I say that this is my axis, if this is 0 and
    this is increasing x. So, what you will find is the concentration is highest near the rods as
    the rods are the one that are producing it and then MIP-3 alpha was diffusing out into the
    system.
    So, as you further move away from it you will see that the concentration of MIP-3 alpha
    is decreasing away from the site. So, these dendritic cells will sense this gradient and
    they will start to move towards the MIP-3 alpha rods. Now it is not only the MIP-3
    alpha, the Ovalbumin is also being released. So, you have now this protein that is also
    being released and then this can be uptaken by these APCs, macrophages, dendritic cells
    whatever is called to the site. And can activate them and generate them immune response
    against that particular antigen, in this case, ovalbumin.
    (Refer Slide Time: 19:37)

    So, here is just some data from an animal study. So, if they only put BSA rod, this is a
    zoomed in image. Then green is your dendritic cells that are in the surrounding.
    You see that some dendritic cells have come in and started interacting with the surface
    whereas, and then and so, green is actually leucocytes. So, its dendritic cells as well as
    some other immune cells and if they have a MIP-3 alpha rod, you see quite a large
    number of influx of your leukocytes and immune cells coming to the site. So, just
    reinforcing that yeah, you can actually create a depot and have immune cells come to
    that depot if you release these chemoattractants.

    (Refer Slide Time: 20:25)

    So, very similar concept here; so, in this case again you are injecting a collagen gel and
    you are creating a vaccination site. So, this is a big gel as you can see, it is about a
    millimeter by 3 millimeter, and what you are doing here is you are encapsulating
    whatever antigen and whatever chemoattractants you want and that will cause the
    immune cells to come to the site. Here is another example. So, in this case, you are
    putting in alginate microspheres. These alginate microspheres are encapsulating both,
    first of all, antigen carrying nano particles. So, you have these nano particles which are
    encapsulating the antigen and then you have also encapsulated chemokines which are the
    chemo attractants.
    So, like your rod in the previous case you will have these things release out. They will
    attract more and more immune cells, dendritic cells to these alginate microspheres. And
    when these come in, they will take up your particles containing the antigen and then
    mount an effective immune response against whatever antigen that you are delivering.
    So, basically what you are doing is you are creating a depot where all this interaction is
    happening. So, rather than moving around and finding your target through the whole
    body, what do you have done is you have given that job to the immune system that this is
    where you got to come and get activated and depending on how large and how faster
    degrading, this can stay there for quite a bit of time and continue to activate the
    immunity against the antigen that you are using.

    (Refer Slide Time: 22:01)

    So, here is some more data on the alginate microspheres that were used. So, if you use
    just the antigen nano particle, you and you look for the cells. What do you find is if any
    look for cells that have encapsulated or taken up the ovalbumin, which was your antigen
    which is labeled by a fluorophore.
    What you find is compared to your control; you see a very minor increment in your
    uptake of your antigen. So, this is antigen whereas, if you compare this with the
    microspheres, they were also releasing MIP-3 alpha. Then you see that in vivo you have
    quite a bit high almost 6 fold or 5 fold increment in the amount of cells that are positive
    for your antigen. And the more cells that are positive for antigen; that means, the more
    immune and response is going to get activated against this.

    (Refer Slide Time: 23:13)

    So, here is another type of vaccine. So, in this case they are utilizing the lymphatic
    transport and they are also using the complement activation as one of the innate
    pathways to trigger the immunity and so, these are nano particles vaccines. So, what
    these authors have done is they have made two sizes of particle. One is the 100
    nanometer particle and another is the 25 nanometer particle and then what they are
    showing here is this is a injection in the rat tail. So, these are the base of the tail. So, once
    it is taken in the rat tail what is happening is then they are imaging and these particles are
    of course, fluorescent.
    So here is your injection sites and then what they are looking for is, then they are starting
    to image the rest of the tail. And so, what they see is if you have 100 nanometer particle,
    those particles are not able to move around quite a bit and they rely on some cells to
    come in and take them up and they have also form a depot. However, if you have
    particles in the size in your 25 nanometer, what you see is a very organized flow of these
    25 nanometer particles through the tail. And this is nothing, but this is the lymphatic
    system that these particles are now small enough to enter the lymphatic system. These
    are lymphatic vessels which is slightly more leaky compared to your blood vessels.
    So, 100 nanometer particles are potentially too big to be able to go through this, but 25
    nanometer particle are able to go through and that is what you are seeing. So, their
    transport through the lymphatics has increased dramatically. Now all the lymphatics are

    directly connected to lymph nodes which are the secondary lymphoid organs. So, this is
    lymph nodes.
    So, these lymphatics are flowing and then they flow into a depot which you call lymph
    node, this is this is where lots of immune cells reside and this sample out whatever is
    coming and flowing through the lymphatics and so, now, what you ensure is because you
    have 25 nanometer entering in, you are ensuring much higher delivery of these particles
    into the lymph node which is a site of quite a bit immune cells.
    So, if you are looking to generate immunity this side is very attractive for your targeting
    because all the immune cells are there already. So, and that is what they have seen. So,
    they have image the lymph nodes and you can see how if they do not see any 100
    nanometer particles in the lymph node which is closest to the tail vein, but what they see
    is in the 25 nanometer case, they see a very nice flow of these particles into the lymph
    node through the lymphatics. And then whatever these particles are carrying and then
    release at the site and activate the immune response.
    So, here again further quantification. So, this is the site of injection and you do not see
    any much movement away from the site of injection whereas, in these smaller particles
    you do see that in these lymphatics. And then you also quantify how much dendritic cells
    have taken up these nano particles at the lymph node and you find that hundred
    nanometer is fairly low. Whereas, 25 nanometer particles have a much higher amount, in
    fact, almost 50 percent half of your dendritic cells and now positive for your particles in
    that site.
    So, that is quite a bit a bit of achievement compared to the 100 nanometer particle. So,
    that is fairly straightforward and intuitive that of course, the smaller particle will be able
    to translocate to the lymphatics much more easily compared to the bigger particle. Now
    what these authors have done is they have also targeted the complement system which is
    not very well studied much in terms of targeting using bioengineering approaches. So,
    that is what causes this paper to stand out in that scenario.

    (Refer Slide Time: 27:47)

    So, what they did is, they took this 25 nanometer particle and they put different
    functional groups on the surface. So, they have put hydroxyl or they have put methyl
    group on this. And the whole idea here was that, if you remember our initial classes of
    lymphatics and the complement system, what we find is on nucleophilic membranes,
    those that contain OH, the complement activation is much higher.
    So, one of the strategies we said if we want to prevent complement activation is to not
    have your membranes or your implants to be nucleophilic whereas, in this particular
    case, they want to activate the complement system as one of the pathways to cause the
    immune response to go up against their antigen. So, what they have done is they have
    now played around with different functional groups.
    So, this is not nucleophilic whereas this is and what they see is the amount of C3a that
    they measure and you can clearly see that, if you have particles which contain these
    hydroxyl groups, you see quite fold quite a much fold increase compared to the basal
    level. So, with the with the OCH3 particle, they get about twenty percent increment, but
    with the hydroxyl particle they get all the way up to 80-85 percent increment in the
    amount of C3a.
    So, this is going to act as a good activation for lots of immune cells and then if you now
    present antigen, it is going to generate much more immunogenic response than without
    this complement activation. And this is then here further looked into. So, what you are

    seeing here is you have 100 nanometer particles with hydroxyl, you have 25 nanometer
    particles with hydroxyl and you have 25 nanometer particles with this CH3O. And what
    you are looking at is the activation of your cells, in this case, your antigen presenting
    cells and so, these are activation markers.
    So, CD 86, CD 80 and CD 40 - these are all activation markers that get up regulated if
    the immune response is activated through various PAMPS, the pathogen derived factors
    and all.
    (Refer Slide Time: 30:45)

    So, complement is one of the way to do this and what they find and they have a positive
    control, which is LPS is a bacterial derived lipid. Remember we talked about that LPS is
    very good in activating your cells and so, you do see that actually. So, antigen presenting
    cell express a lot more receptor on their surface when they have LPS in the surrounding.
    So, this is your PBS. So, this is the basal level and this is after activation in positive
    control and now if you then compare it with what happens in the scenario, where you are
    delivering either a bigger particle or a particle which is not as nucleophilic. So, you see
    that it is very similar to PBS in this case. However, if you do deliver it with hydroxyl
    particles, you get very similar activation. In fact, in some cases a slightly higher
    activation compared to your positive control which was LPS in this case.

    (Refer Slide Time: 31:47)

    And then you can then exploit this to see if you then deliver antigens in this case
    ovalbumin along with PBS or ovalbumin along with these particles or the positive
    control in this case is LPS now. You see that you can get quite a lot of IFN gamma cells
    which is showing that functional increase in that. If you do not get it as much as LPS in
    this case, but you do get compared to naive and compared to non nucleophilic particles,
    you get much higher response of this and similarly the antibody titers can also be
    measured.
    And you see that if you have a wild type so, let us look at the filled circles first. And so,
    you get a certain response; if you just give the antigen. In some cases you get a better
    response, if you put some methyl terminated particles and you do not really get a whole
    lot of response with a bigger particle.
    But if you use this 25 nanometer particle with hydroxyl, you see quite a bit of response
    which gets completely knocked down in a knockout animal which does not have
    complement. So, this shows that this activation is mainly through the complement
    system that is causing the upregulation of all these markers as well as functional benefits.
    So, that is where we will stop now and we will talk about more vaccines in future
    classes.
    Thank you.