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Replication-competent oncolytic viral therapies have shown great promise preclinically and in clinical trials for the treatment of various cancers. They are able to preferentially and selectively propagate in cancer cells, consequently destroying tumor tissue via cell lysis, while leaving noncancerous tissues unharmed. Currently, biopsy is the gold standard for monitoring of viral tumor colonization and oncolysis. This may be feasible in preclinical or early clinical trials; however, a noninvasive method facilitating ongoing monitoring of viral therapy is needed for human studies. The tracking of viral delivery could give clinicians the ability to assess the biodistribution of oncolytic viruses to ensure safety and correlation with treatment efficacy. This work centers on the construction and testing of a VACV strain, GLV-1h153, carrying the human sodium iodide symporter (hNIS) as a marker gene for non-invasive tracking of virus by imaging. Thus, this project aimed to help develop imaging techniques for use in clinical trials of oncolytic viral therapy. Further, the feasibility and effectiveness of virally induced targeted radiotherapy as an anti-cancer strategy was also investigated. hNIS is an intrinsic plasma membrane protein which mediates the active transport and concentration of iodide in the thyroid gland and some extra-thyroidal tissues. It is also one of several human genes currently being used as reporters in preclinical studies and has already been used in clinical studies for imaging viral replication in prostate cancer. hNIS gene transfer via viral vector may allow infected tumor cells to concentrate several carrier-free radionuclide probes such as Iodide-124 (124I), Iodide-131 (131I), and 99m-Technecium Pertechtenate (99mTcO4), which have long been approved for human use. hNIS also has the advantage of being of human origin thus minimizing immunogenicity, and its transporter based system allows intracellular signal amplification. GLV-1h153 was tested in pancreatic adenocarcinoma cell line PANC-1. GLV-1h153 infected, replicated within, and killed PANC-1 cells in cell culture as efficiently as GLV-1h68 and provided dose-dependent levels of hNIS transgene expression in infected cells. Immunofluorescence detected successful transport of the protein to the cell membrane prior to cell lysis, which enhanced dose and time-dependent intracellular uptake of 131I. In vivo, GLV-1h153 was as safe and effective as GLV-1h68 in regressing pancreatic cancer xenografts. Tumor infection by virus was confirmed via optical imaging and histology. GLV-1h153 further facilitated deep tissue imaging of virus replication in tumors via Iodide-124I positron emission tomography (PET) as well as 99mTcO4-mediated gamma scintigraphy. This was possible with both intratumoral and intravenous injection of the virus with radiouptake retained as long as 24 and 48 hours after radiotracer injection. PET image quantitation of radiouptake in tumors was found to correlate well with tissue radiouptake counts. Autoradiography of GLV-1h153-infected tumors revealed a need for presence of virus (visualized with green fluorescent protein expression), viable tissue, and adequate blood flow to enhance radiouptake in tumors. Dosimetric analysis of uptake in infected tumors displayed potential for therapeutic doses of radiotherapy to be delivered systemically to tumors. When GLV-1h153 was combined with 131I for treatment, a modest additive effect was seen as compared to GLV-1h153 alone. Therefore, GLV-1h153 is a promising new candidate for treating pancreatic cancer and noninvasively imaging viral therapy. These findings warrant further investigation into possible long term monitoring of viral therapy, as well as synergistic or additive effects of radioiodine combined with this novel treatment and imaging modality.
The present work investigated the neural mechanisms underlying cognitive inhibition/thought suppression in Anderson’s and Green’s Think/No-Think paradigm (TNT), as well as different variables influencing these mechanisms at the cognitive, the neurophysiological, the electrophysiological and the molecular level. Neurophysiological data collected with fNIRS and fMRI have added up to the existing evidence of a fronto-hippocampal network interacting during the inhibition of unwanted thoughts. Some evidence has been presented suggesting that by means of external stimulation of the right dlPFC through iTBS thought suppression might be improved, providing further evidence for an implication of this region in the TNT. A combination of fNIRS with ERP has delivered evidence of a dissociation of early condition-independent attentional and later suppression-specific processes within the dlPFC, both contributing to suppression performance. Due to inconsistencies in the previous literature it was considered how stimulus valence would influence thought suppression by manipulating the emotional content of the to-be-suppressed stimuli. Findings of the current work regarding the ability to suppress negative word or picture stimuli have, however, been inconclusive as well. It has been hypothesized that performance in the TNT might depend on the combination of valence conditions included in the paradigm. Alternatively, it has been suggested that inconsistent findings regarding the suppression of negative stimuli or suppression at all might be due to certain personality traits and/or genetic variables, found in the present work to contribute to thought inhibition in the TNT. Rumination has been shown to be a valid predictor of thought suppression performance. Increased ruminative tendencies led to worse suppression performance which, in the present work, has been linked to less effective recruitment of the dlPFC and in turn less effective down-regulation of hippocampal activity during suppression trials. Trait anxiety has also been shown to interrupt thought suppression despite higher, however, inefficient recruitment of the dlPFC. Complementing the findings regarding ruminative tendencies and decreased thought inhibition a functional polymorphism in the KCNJ6 gene, encompassing a G-to-A transition, has been shown to disrupt thought suppression despite increased activation of the dlPFC. Through the investigation of thought suppression at different levels, the current work adds further evidence to the idea that the TNT reflects an executive control mechanism, which is sensitive to alterations in stimulus valence to some extent, neurophysiological functioning as indicated by its sensitivity to iTBS, functional modulations at the molecular level and personality traits, such as rumination and trait anxiety.