Hepatocyte Heparan Sulfate Is Required for Adeno-Associated Virus 2 but Dispensable for Adenovirus 5 Liver TransductionIn Vivo
ABSTRACTAdeno-associated virus 2 (AAV2) and adenovirus 5 (Ad5) are promising gene therapy vectors. Both display liver tropism and are currently thought to enter hepatocytesin vivothrough cell surface heparan sulfate proteoglycans (HSPGs). To test directly this hypothesis, we created mice that lackExt1, an enzyme required for heparan sulfate biosynthesis, in hepatocytes.Ext1HEPmutant mice exhibit an 8-fold reduction of heparan sulfate in primary hepatocytes and a 5-fold reduction of heparan sulfate in whole liver tissue. Conditional hepatocyteExt1gene deletion greatly reduced AAV2 liver transduction following intravenous injection. Ad5 transduction requires blood coagulation factor X (FX); FX binds to the Ad5 capsid hexon protein and bridges the virus to HSPGs on the cell surface. Ad5.FX transduction was abrogated in primary hepatocytes fromExt1HEPmice. However, in contrast to the case with AAV2, Ad5 transduction was not significantly reduced in the livers ofExt1HEPmice. FX remained essential for Ad5 transductionin vivoinExt1HEPmice. We conclude that while AAV2 requires HSPGs for entry into mouse hepatocytes, HSPGs are dispensable for Ad5 hepatocyte transductionin vivo. This study reopens the question of how adenovirus enters cellsin vivo.IMPORTANCEOur understanding of how viruses enter cells, and how they can be used as therapeutic vectors to manage disease, begins with identification of the cell surface receptors to which viruses bind and which mediate viral entry. Both adeno-associated virus 2 and adenovirus 5 are currently thought to enter hepatocytesin vivothrough heparan sulfate proteoglycans (HSPGs). However, direct evidence for these conclusions is lacking. Experiments presented herein, in which hepatic heparan sulfate synthesis was genetically abolished, demonstrated that HSPGs are not likely to function as hepatocyte Ad5 receptorsin vivo. The data also demonstrate that HSPGs are required for hepatocyte transduction by AAV2. These results reopen the question of the identity of the Ad5 receptorin vivoand emphasize the necessity of demonstrating the nature of the receptor by genetic means, both for understanding Ad5 entry into cellsin vivoand for optimization of Ad5 vectors as therapeutic agents.