Adeno-associated virus (AAV), a single-stranded DNA virus of the family
Parvoviridae, genus
Dependovirus, is among the smallest known viruses. The serotype 2 virus has a genome of 4,680 bases contained in an icosahedral capsid of ≈24 nm (
31). The defining characteristic of this class of viruses is their dependence on coinfection with a helper virus (or certain perturbed cellular states) to provide the functions necessary for productive infection (
5). Despite a recent study demonstrating low-level AAV virus production in a differentiated epithelial cell system, the latent state appears to predominate in healthy infected cells (
4,
23).
AAV is unique among animal viruses in that its latent state involves insertion into the host genome at a preferred site (
17,
28). This site, referred to as AAVS1 (
27), is found at chromosome 19q13.4qter and has been mapped to the first exon of myosin binding subunit 85 of protein phosphatase 1 (
33). Although the molecular mechanisms of AAV integration have not been fully elucidated, the sequence requirements necessary in both the virus and the host are known. In the host, a 34-bp sequence is both necessary and sufficient for efficient integration (
11,
19). In the virus, sequences in the viral promoter at map unit 5 (p5) are required for efficient integration (
26,
27). Furthermore, integration has been associated with gross disruptions in the AAVS1 locus, including both duplications and deletions (
12). Disruption of a nearby gene has also been reported in one case (
8).
The virus contains two open reading frames (ORFs) (
5). The right ORF encodes the structural capsid proteins, and the left ORF encodes the nonstructural Rep proteins. The Rep proteins are required for all phases of the viral life cycle, including transcription, replication, encapsidation, integration, and rescue from the latent state (
5). The larger Rep proteins, Rep 78 and 68, in tandem with the p5 integration sequence element, are able to mediate all of the required virus-based steps of integration (
27,
32).
Rep activation of the AAVS1 site reflects many of the known replication activities of this protein. In vitro, the AAVS1 site was found to be functionally equivalent to a viral origin of replication (
35,
37). Three
cis elements are present, a Rep binding site, a terminal resolution site, and a spacer element between the Rep binding site and terminal resolution site, which has both sequence and length constraints (
19,
22). Rep mediates activation of DNA synthesis at the AAVS1 site in vitro and in vivo and forms a putative integration complex between AAV and AAVS1 (
35,
38).
Recent studies have also defined the viral sequences required for site-specific integration. In contrast to AAVS1, replication at the viral terminal resolution site does not appear necessary (
40). In fact, an integration efficiency element (p5IEE) that is present in the AAV p5 promoter sequence is the sole
cis requirement for high-efficiency integration of plasmid DNA into AAVS1 (
26,
27). With the exception of an absolute requirement for Rep protein, no other viral factors, including the inverted terminal repeats, are required to mediate efficient AAV site-specific integration (
27). While replication at the viral inverted terminal repeats appears to be unnecessary for integration, sequences in the p5IEE promoter can function as an origin of replication (
36). Replication and/or nicking at this site during integration cannot be ruled out.
Although virus infection appears to be widespread, with over 80% of humans testing seropositive, AAV causes no known pathology (
5). The infectivity, moderate immunogenicity, and apparent lack of pathogenicity have made AAV a promising candidate as a vector for human gene therapy (
20). Recently, random integration and subsequent activation of cellular genes have created safety concerns about retrovirus vectors (
13), and recombinant AAV vectors have also been shown to disrupt cellular genes (
16,
25). Also, randomly integrating recombinant AAV vectors are severely compromised in integration efficiency (
26). Site-specific integration as mediated by AAV may have both safety and efficiency advantages in certain gene therapy applications.
MATERIALS AND METHODS
Cells and viruses.
HeLa cells were obtained from the American Type Culture Collection (ATCC) and grown in Dulbecco's modified Eagle's medium (DMEM) (Gibco-BRL, Gaithersburg, Md.) supplemented with 5% fetal bovine serum and 5% bovine calf serum (HyClone, Logan, Utah) and grown at 37°C in 5% CO
2. HeLa cells were converted to suspension by growth in suspension minimal essential medium (Gibco-BRL, Gaithersburg, Md.) supplemented with 10% horse serum (HyClone). Adenovirus type 5 was grown and purified by CsCl gradient centrifugation. Wild-type AAV was grown by infecting HeLa-spinner cells with AAV2 at a multiplicity of infection (MOI) of 5 and adenovirus type 5 at an MOI of 10. At full cytopathic effect, virus was purified by iodixanol step centrifugation followed by heparin-agarose column purification (
41), with the following modifications: crude viral lysate was heated to 56°C for 30 min to inactivate contaminating adenovirus; 50 mg of DNase I per ml was used instead of benzonase treatment to reduce viscosity. Wild-type AAV was titered with an infectious center assay, and particle number was determined with a dot blot assay for genome content as previously described (
14). The viral stock was 10
12 particles/ml, with 50 particles/infectious unit.
Plasmid constructs.
Plasmid p78Rep was constructed as previously described (
26). The inverted terminal repeat-deleted integration-substrate plasmid was generated by cloning a 138-bp PCR fragment of the AAV p5 promoter element (corresponding to AAV nucleotides 151 to 289) upstream of a chloramphenicol acetyltransferase (CAT) reporter gene in place of the cytomegalovirus promoter element in plasmid pAdCMVCAT (
27).
Wild-type AAV infection efficiency.
Suspended HeLa cells were counted and resuspended at 106 cells/ml in DMEM; 1 ml of cells was infected with wild-type AAV at various MOIs for 1 h at 37°C and then placed in 10-cm plates with 10 ml of DMEM plus 10% fetal bovine serum. At 24 h, cells were superinfected with wild-type adenovirus type 5 at an MOI of 10 by removing the cell medium and replacing it with 1 ml of DMEM containing wild-type adenovirus type 5 for 1 h and then overlaying it with 9 ml of DMEM plus 10% fetal bovine serum. At 20 h post-adenovirus infection, single-cell suspensions were made by digestion with Accutase (Innovative Cell Technologies, San Diego, Calif.). These suspensions were diluted with 1× phosphate-buffered saline-0.1% bovine serum albumin to a final concentration of ≈10 cells/ml, and 5 ml of each dilution was filtered onto Hybond+ positively charged nylon membranes (Amersham, Piscataway, N.J.). The cells were lysed in situ by placing the filters cell side up for 5 min on Whatman paper soaked in 0.5 M NaOH-1.5 M NaCl and neutralized by the same method with 1 M Tris, pH 7.0. Filters were probed with a 32P-labeled Rep gene fragment, as described below, to score for productively infected cells. Membranes were then stripped and reprobed with HeLa genomic DNA (isolated according to protocols described in the Southern blot protocol) to score for total cells.
AAV rescue assay.
HeLa cells were infected with wild-type AAV at specific MOIs and plated in 96-well plates to make single-cell clones. Three weeks postinfection, the wells were microscopically examined for the presence of individual clones. Clonal cell lines were replated in 96-well dishes and infected with wild-type adenovirus type 5 at an MOI of 10. At full cytopathic effect (48 to 72 h), cells were lysed by addition of NaOH and EDTA to 0.4 M and 10 mM, respectively, and denatured for 15 min at 68°C. Lysates were filtered onto Hybond+ nylon membranes with a dot blot apparatus and probed for the presence of wild-type AAV Rep DNA as described above.
Southern blot analysis.
Whole-cell DNA was isolated from HeLa cell lines with a standard salting-out protocol (
24). Designated restriction endonucleases were used to digest 10 μg of DNA from each clone, and digested DNA was separated on 1% agarose gels. After transferring DNA fragments to nylon membranes, hybridization was carried out with
32P-labeled probes at a concentration of 3 × 10
6 cpm per ml of Sigma PerfectHyb hybridization solution, according to the manufacturer's instructions.
The following DNA fragments were generated for DNA probes. The 800-bp Rep PCR fragment was generated from oligonucleotides GATCGAAGCTTCCGCGTCTGACGTCGATGG and GGACCAGGCCTCATACATCTCCTTCAATGC; the AAVS1 2-kb PCR product was obtained with oligonucleotides GCGCCGTGACGTCAGCACGC and CACCAGATAAGGAATCTGCC; the CAT DNA fragment of 700 bp was PCR amplified with oligonucleotides GCTAGCTTGAGGTGTGGCAGGC and GGCATGATGAACCTGAATCGC; the a 650-bp β-actin DNA fragment was PCR amplified with oligonucleotides TGACGGGGTCACCCACACTGTGCCCATCTA and CTAGAAGCATTTGCGGTGGACGATGGAGGG. DNA probes were 32P labeled with the Rediprime II kit (Amersham, Piscataway, N.J.) according to the manufacturer's instructions. Bands were visualized by autoradiography. Quantitation was performed with a Storm phosphorimager system with ImageQuant software as per the manufacturers' instructions (Sigma-Aldrich, St. Louis, Mo.).
Plasmid integration assay.
We washed 1.6 × 106 HeLa cells with phosphate-buffered saline and resuspended them in 200 μl of electroporation buffer (21 mM HEPES [pH 5.05], 137 mM NaCl, 0.7 mM KCl, 6 mM glucose). Cells were electroporated (280 V, 960 μF) with plasmid DNA (30 μg in 30 μl of Tris-EDTA, including 5 μg of pEGFP [Invitrogen]) in a 4-mm gap width electroporation cuvette. At 48 h posttransfection, green fluorescent protein-positive cells were sorted and isolated by flow cytometry with a Beckman-Coulter Altra cell sorter. Cells were plated at 1 cell per well into 96-well plates, and clonal cell lines were grown in Dulbecco's modified Eagle's medium containing 5% calf serum and 5% fetal calf serum. Whole-cell DNA was harvested at 6, 12, and 18 weeks posttransfection, digested with various restriction endonucleases, and separated on 1% agarose gels. The DNA was transferred to nylon membranes and hybridized to 32P-labeled probes (Southern blot protocol described above).
DISCUSSION
In this study, we characterized the effect of MOI on the efficiency of Rep-mediated site-specific integration with AAV. The results obtained indicate several new insights into the biology of AAV Rep-mediated site-specific integration, provide important supporting data for aspects of AAV integration that have previously been implied but not directly demonstrated, and corroborate and extend early studies that characterized AAV rescue from latently infected cells.
What is an infectious unit of AAV? Standard protocol for determining AAV infectious units have relied on limiting dilutions of AAV and coinfection with wild-type adenovirus, which results in a high-yield AAV replication (
14). This assay, although an accurate reflection of one aspect of the biology of AAV (i.e., that occurring in coincidence with helper virus infection), may not provide the most useful insight into the biology of latent wild-type AAV or recombinant AAV vectors. Helper virus has been shown to potentially influence the biology of AAV by facilitating virus transport to the nucleus (
39) and by enhancing conversion of the single-stranded AAV genome into a transcriptionally active duplex DNA substrate (
9,
10). In the absence of helper virus, AAV is dependent on interaction with the cell for internalization and genome transport to the nucleus. One of the most striking observations made in our studies was the observed disparity between the efficiency of infection as characterized by traditional techniques and our characterization of viral rescue, AAVS1 disruptions, and AAV integrants into the AAVS1 site. These studies were performed in actively dividing cells. There may be differences between dividing and nondividing cells with respect to infection, uncoating, and integration efficiencies that have not been addressed in this report. Our studies demonstrate that AAV integration into chromosome 19 may be a useful alternative measurement of the AAV infectious unit.
High MOI, then, may be a necessary requirement for AAV site-specific integration. Certainly, high MOI was correlated with both latency and integration in several studies prior to the discovery of site-specific integration (
3,
7). Interestingly, in these early studies, low MOIs (0.25 and 2.5) failed to yield persistent antigen-producing cells after 40 passages, whereas 29% of the cell lines established after 40 passages postinfection with an MOI of 250 were able to produce viral antigen (
4). Considering differences in techniques and cell lines, we find a remarkable consistency between our observations of integration efficiency and those of earlier studies. The data suggest that, for wild-type AAV, latency, integration, and site-specific integration may in fact be different ways of measuring the same event.
What are the steps that lead to AAV integration into AAVS1? Studies in dividing cells demonstrate that AAV uptake is efficient, and virions localize to the perinuclear region within 2 h postinternalization (
1,
29,
39). The efficiency of capsid uncoating and transport of viral DNA to the nucleus is a potential rate-limiting step that may be influenced by viral MOI. The model presented in Fig.
7 indicates a proposed sequence of events that occur during the process of AAV integration. Following localization to the nucleus, cellular replication and/or DNA repair mechanisms are essential for second-strand synthesis of the AAV genome. Alternatively, in the absence of efficient second-strand synthesis, a second pathway for production of transcriptionally active duplex AAV genome would be through plus- and minus-strand hybridization. Subsequent to the formation of duplex genome production, the p5 promoter is activated to transcribe Rep (Fig.
7A.2). Transcription from the p5 promoter and translation of Rep mRNA yield the multifunctional Rep proteins (for the sake of simplicity, we will focus on Rep 68 and 78 because they are able to mediate integration in the absence of the smaller Rep proteins [42 and 50]). Production of the duplex genome is a necessary prerequisite for p5 transcription of the
rep gene and is a likely substrate target DNA for integration, as duplex plasmid DNA integrates with high efficiency. We could not distinguish between duplex formation or Rep expression levels as a specific rate-limiting entity.
An additional limitation may simply be template copy number at low MOI. In a latent infection, Rep expression levels are presumably very low, and we were unable to detect either rep mRNA or protein in the absence of helper virus coinfection. Following Rep protein expression, there are three biologically active target DNAs that Rep can bind relevant to integration: Rep binds to the AAVS1 site on chromosome 19; Rep binds to the p5 Rep binding site of AAV; Rep binds to the inverted terminal repeat Rep binding site. Data obtained through transfection of plasmid DNA corroborate previous studies which show that the inverted terminal repeat elements are not required for efficient integration; therefore, we view the role of the inverted terminal repeat as essential for maintaining the fidelity of the integrating genome and for rescue from latency but not as playing a role in mediating a Rep-dependent integration event.
In our view, integration efficiency is defined by Rep interaction with the AAVS1 site (Fig.
7B) and by Rep interaction with the p5 promoter (Fig.
7A). We have illustrated Rep to function as a hexameric complex, but this has not been confirmed to be the complex that is acting on the AAVS1 site or on p5. We have demonstrated that Rep expression in the absence of helper virus or in the absence of integration substrate mediates a rearrangement of the AAVS1 site. The AAVS1 site rearrangements are consistent with a local amplification event (depicted in Fig.
7B.3 and 7C.2) and demonstrate a significant increase in restriction fragment length size (roughly 5 to 10 kb). The amplification event, as measured by phosphoimager quantitation of Southern analysis, indicates a ≈2-fold increase in AAVS1. Since HeLa cells are aneuploid and have been characterized as having three copies of chromosome 19, we would predict that, if localized to a single chromosome, the rearrangement would contain on average three new repeat elements of the AAVS1 region being probed (Fig.
7C). When an integration substrate (Fig.
7A.2) is present in sufficient quantities, localization of the p5IEE integration substrate to the AAVS1 integration site takes place, and integration occurs through what is predicted to be a strand switch mechanism (
19) or perhaps ligation between cellular and viral DNA mediated by Rep (
30). In our characterization of AAV integration, increasing the copy number of input virus above an MOI of 100 had no significant effect on the final yield of integration products. These observations indicate that the process of integration is at some level regulated autonomously.
One important level of autonomous regulation of AAV integration is through regulation of Rep expression. Rep binding to the p5 promoter (p5IEE) has been shown to bring about a stringent block to Rep transcription (
2,
18). The repression of
rep transcription therefore implies that there is a narrow window of opportunity for Rep-mediated site-specific integration to occur. Consistent with this hypothesis, Huser et al. demonstrated that maximal integration of AAV into chromosome 19 occurs within the first 4 days postinfection (
15). Studies by Giraud et al. demonstrated that targeting to plasmid-based AAVS1 targets occurred by 24 h postinfection (
11). Based on our measurements of integration yield as a function of input virus, at an input MOI of 100, 80% of cell lines demonstrate AAVS1 rearrangement and half of those cell lines contain integrants. These are the maximal number of events that occur regardless of input viral dose.
In our view, this result offers a critical insight into the integration pathway. Because increasing the dose of virus does not yield an increase in the occurrence of integrants, we would argue that there is an inherent limit to the number of discernible recombination events that can occur when a cell is infected, regardless of the number of available integration substrate targets. In this model, activation of AAVS1 establishes the kinetics of integration. Presentation of an integration substrate during the time of AAVS1 rearrangement creates the opportunity for a copy choice mechanism to integrate the AAV substrate DNA. Since we consistently found that half of the AAVS1 rearrangements contained integrants, perhaps recombination occurs during cellular DNA replication and /or cell division. In all cell lines examined, regardless of the viral dose used for infection, we always found at least one copy of an intact chromosome 19 AAVS1 locus.
In addition to providing insight into the biology of integration, the data presented in this study revealed a high correlation between rescuable replication-competent AAV in cell lines and cell lines that contain site-specific integrants (Table
1). Furthermore, careful analysis of selected MOI 100 cell lines revealed that virtually all integrations were site specific. These remarkable correlations provide strong support for a model in which the AAV genomes that persist in human cells do so primarily as AAVS1 integrants.