Evaluation of Replication Competent and Replication Incompetent Adenovirus-Mediated Toxicity in Human Adrenocortical Cells

Objectives: Experimental studies indicate that adenoviruses have a natural tropism for the adrenal gland, thus, the systemic use of adenoviral vectors might be associated with side effects due to adrenal gland infection. In this study, human ACC cells were used to assess the toxicity of replication competent adenovirus type 5 (Ad5) and replication deficient E1-/E3- adenoviral vectors. Methods: To test the susceptibility of human ACC cells (SW13 and NCI-H295R) to adenoviral infection, expression of coxsackie and adenovirus receptor(CAR) and integrins was evaluated in ACC cells as well as in normal human adrenocortical tissues and in benign and malignant adrenocortical tumor samples by quantitative real-time RT-PCR. ACC cells were infected with Ad5 and tested for virus production at different time points pi. Recombinant E1-/E3- Ad5 vector expressing green fluorescent protein (Ad5-EGFP) was used to test adenovirus infectivity by fluorescent microscopy and FACS analysis. To assess the toxicity of replication competent and replication incompetent adenoviral vectors in the adrenal gland, Ad5, Ad5-EGFP and Ad5-HSV-TK were employed. In this regard, at different time points pi, we examined the effect of adenoviral infection on gene expression profile by DNA microarray analysis and on cell growth by proliferation assay, cell cycle analysis, and apoptosis test. The influence of adenoviral infection on steroid hormone production was also analyzed. Results: CAR expression was demonstrated in ACC cells and in normal and neoplastic adrenocortical tissues. Both ACC cells demonstrated productive Ad5 replication and efficient Ad5-EGFP transduction. Time- and dose-dependent induction of cell death was found only in Ad5-infected ACC cells, whereas Ad5- EGFP and Ad5-HSV-TK had no apparent effect on cell proliferation, cell cycle, and cell death as compared to uninfected control. ACC cells did not show marked alterations of gene expression after Ad5-EGFP infection, as demonstrated by microarray analysis in time course infection experiments. In the early phase of infection, genes involved in cell proliferation, stress and innate immune response were transiently upregulated. Moreover, expression of genes encoding steroidogenic enzymes was modulated toward cortisol hypersecretion. With regard to steroidogenesis, ACC cells infected with Ad5 showed decreased basal steroid hormone production in the early phase pi, followed by increased steroid hormone release at 72 h pi. At variance, Ad5-EGFP markedly induced cortisol and estradiol production, but not aldosterone production, at all time points pi. Conclusions: These results, which provide insight into the host response following adenoviral infection of ACC cells, contribute to the understanding of the adrenal involvement during natural adenovirus infection and vector administration for gene therapy.