# Patent

## Title
Methods and reagents for the enhancement of virus transduction in the bladder epithelium

## Abstract

Agents and methods for enhancing recombinant virus transduction in the bladder epithelium are described. A first method involves contacting the luminal surface of the bladder with a composition comprising a transduction enhancing agent and an oncolytic virus. Alternatively, the luminal surface of the bladder can be contacted first with a pretreatment composition comprising a transduction enhancing agent and, subsequently, with a composition comprising an oncolytic virus. Bladder treatment compositions comprising a transduction enhancing agent and an oncolytic virus are also described.

## Background
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates generally to the treatment of bladder cancer with viral therapy agents and, in particular, to agents and methods for enhancing recombinant oncolytic virus transduction of the bladder epithelium.
2. Background of the Technology
Bladder cancer is a commonly occurring cancer and more than 50,000 new cases are diagnosed every year. Bladder cancer is a superficial disease confined to the mucosa in the majority of patients. Of the various therapeutic modalities available, transurethral resectioning of the tumor is considered to be the most effective treatment for the management of superficial bladder cancer. However, 70% of these superficial bladder tumors will recur after endoscopic resectioning, and 20% progress to life-threatening invasive diseases within 2 years of cystectomy. See Raghavan, et al., “Biology and Management of Bladder Cancer”, N. Engl. J. Med., 322, 16, 1129-1138 (1990).
Gene therapy has also been used for the treatment of bladder cancer. See, for example, Brewster et al., Eur. Urol. 25, 177-182 (1984); Takahashi, et al., Proc. Natl. Acad. Sci. USA 88, 5257-5261 (1991); and Rosenberg, J. Clin. Oncol., 10, 180-199 (1992).
In vitro studies using cell lines derived from human bladder tissues have demonstrated efficient transgene expression following infection with recombinant adenovirus. Bass, et al., Cancer Gene Therapy 2, 2, 97-104 (1995). Experiments in vivo have also shown adenovirus transgene expression in the urinary bladder of rodents after intravesical administration. Bass, et al., supra; Morris, et al., J. Urology, 152, 506-550 (1994). In vitro experiments with wild-type adenovirus demonstrate that virus attachment and internalization is not influenced by benzyl alcohol, but do demonstrate an enhanced uncoating of the virion. Blixt, et al., Arch. Virol., 129, 265-277 (1993).
In vivo studies have demonstrated that various agents (e.g. acetone, DMSO, protamine sulfate) can break down the protective “mucin” layer that protects the bladder epithelium from bacteria, viruses and other pathogens. See, for example, Monson et al., J. Urol., 145, 842-845 (1992) and Parsons, et al., J. Urol., 143, 139-142 (1990). Methods of modifying the bladder surface to enhance gene transfer have also been disclosed. Siemens, et al., “Evaluation of Gene Transfer Efficiency by Viral Vectors to Murine Bladder Epithelium”, J. of Urology, 165, 667-671 (2001).
U.S. Pat. No. 6,165,779 discloses a gene delivery system formulated in a buffer comprising a delivery-enhancing agent such as ethanol or a detergent. The gene delivery system may be a recombinant viral vector such as an adenoviral vector.
There still exists a need, however, for improved gene therapy methods and agents which can accomplish direct, optimal, in vivo gene delivery to the bladder epithelium.
SUMMARY OF THE INVENTION
According to a first aspect of the invention, a method for treating cancer of the bladder is provided. According to this aspect of the invention, the method involves: contacting the luminal surface of the bladder with a pretreatment composition comprising a transduction enhancing agent; and subsequently contacting the luminal surface of the bladder with a composition comprising an oncolytic virus; wherein the transduction enhancing agent is a mono-, di-, or poly-saccharide having a lipophilic substituent. The transduction enhancing agent can have the following general formula (I) or the following general formula (II):




wherein X is a sulfur or oxygen atom, R1 is an alkyl group and each R2 is independently hydrogen or a moiety represented by:





wherein R1 is an alkyl group. The pretreatment composition can further include an oxidizing agent. The oncolytic virus can be an oncolytic adenovirus such as CG8840. The oncolytic virus composition can further include a chemotherapeutic agent such as docetaxel.

According to a second aspect of the invention, a method for treating cancer of the bladder is provided. According to this aspect of the invention, the method includes contacting the luminal surface of the bladder with a pretreatment composition comprising about 0.01 to about 0.2% by weight sodium oxychlorosene and, subsequently, contacting the luminal surface of the bladder with a composition comprising an oncolytic virus.
According to a third aspect of the invention, a method of treating cancer of the bladder is provided. According to this aspect of the invention, the method includes: contacting the luminal surface of the bladder with a pretreatment composition comprising a transduction enhancing agent having a structure represented by the chemical formula:




wherein x and y are positive integers; and subsequently contacting the luminal surface of the bladder with a composition comprising an oncolytic virus. According to a preferred embodiment of the invention, x is 6 and y is 8-10 and the pretreatment composition comprises about 0.02 to about 0.05 wt. % of the transduction enhancing agent.

According to a fourth aspect of the invention, a method of treating cancer of the bladder is provided. According to this aspect of the invention, the method includes: contacting the luminal surface of the bladder with a pretreatment composition comprising a transduction enhancing agent having a structure represented by the following general formula (I) or the following general formula (II):




wherein x is a positive integer and subsequently contacting the luminal surface of the bladder with a composition comprising an oncolytic virus.

According to a fifth aspect of the invention, a composition comprising a transduction enhancing agent and an oncolytic virus is provided. According to this aspect of the invention, the transduction enhancing agent is a mono-, di-, or poly-saccharide having a lipophilic substituent. For example, the transduction enhancing agent can be a compound having the following general formula (I) or the following general formula (II):




wherein X is a sulfur or oxygen atom, R1 is an alkyl group and each R2 is independently hydrogen or a moiety represented by:





wherein R1 is an alkyl group. The oncolytic virus can be an oncolytic adenovirus such as CG8840. The oncolytic virus composition can further include a chemotherapeutic agent such as docetaxel. A method for treating cancer of the bladder comprising contacting the luminal surface of the bladder with a composition as set forth above is also provided.

According to a sixth aspect of the invention, a composition comprising sodium oxychlorosene and an oncolytic virus is provided. The oncolytic virus can be an oncolytic adenovirus such as CG8840. The oncolytic virus composition can further include a chemotherapeutic agent such as docetaxel. A method for treating cancer of the bladder comprising contacting the luminal surface of the bladder with a composition as set forth above is also provided.



BRIEF DESCRIPTION OF THE DRAWINGS
The present invention may be better understood with reference to the accompanying drawings in which:
FIGS. 1A and 1B are photographs showing a murine bladder after pretreatment with a 15% ethanol solution followed by infection with Ad-LacZ wherein FIG. 1A shows the outside surface of the bladder and FIG. 1B shows the luminal bladder surface;
FIGS. 1C and 1D are photographs showing a murine bladder after pretreatment with a 20% ethanol solution followed by infection with Ad-LacZ wherein FIG. 1C shows the outside surface of the bladder and FIG. 1D shows the luminal bladder surface;
FIGS. 1E and 1F are photographs showing a murine bladder after pretreatment with a 25% ethanol solution followed by infection with Ad-LacZ wherein FIG. 1E shows the outside surface of the bladder and FIG. 1F shows the luminal bladder surface;
FIGS. 1G and 1H are photographs showing a murine bladder after pretreatment with a 30% ethanol solution followed by infection with Ad-LacZ wherein FIG. 1G shows the outside surface of the bladder and FIG. 1H shows the luminal bladder surface;
FIG. 2A ia a photograph showing a cross section of a murine bladder control;
FIGS. 2B and 2C are photographs showing the cross section of a murine bladder after pretreatment with a 30% ethanol solution followed by infection with Ad-LacZ;
FIGS. 3A-3F are photographs showing the cross section of a murine bladder after pretreatment with a 25% ethanol solution followed by infection with Ad-LacZ wherein FIGS. 3A, 3C and 3E were taken at 40× and FIGS. 3B, 3D and 3F were taken at 100× magnification;
FIGS. 4A-4F are photographs showing the cross section of a murine bladder after pretreatment with a 30% ethanol solution followed by infection with Ad-LacZ wherein FIGS. 4A, 4C and 4E were taken at 40× and FIGS. 4B, 4D and 4F were taken at 100× magnification;
FIGS. 5A-5D are photographs showing two murine bladders after pretreatment with a 4% poloxomer 407 solution followed by infection with Ad-LacZ wherein FIGS. 5A and 5B show the outside and luminal surfaces, respectively, of the first bladder and FIGS. 5C and 5D show the outside and luminal surfaces, respectively, of the second bladder;
FIGS. 6A-6D are photographs showing two murine bladders after infection with a composition comprising lipofectamine and Ad-LacZ wherein FIGS. 6A and 6B show the outside and luminal surfaces, respectively, of the first bladder and FIGS. 6C and 6D show the outside and luminal surfaces, respectively, of the second bladder;
FIGS. 7A-7D are photographs showing two murine bladders after infection with a composition comprising In vivo geneSHUTTLETM and Ad-LacZ wherein FIGS. 7A and 7B show the outside and luminal surfaces, respectively, of the first bladder and FIGS. 7C and 7D show the outside and luminal surfaces, respectively, of the second bladder;
FIGS. 8A-8N are photographs showing seven murine bladders after pretreatment with a 0.2% oxychlorosene solution for 5 minutes followed by infection with Ad-LacZ wherein FIGS. 8A and 8B show the outside and luminal surfaces, respectively, of the first bladder, FIGS. 8C and 8D show the outside and luminal surfaces, respectively, of the second bladder, FIGS. 8E and 8F show the outside and luminal surfaces, respectively, of the third bladder, FIGS. 8G and 8H show the outside and luminal surfaces, respectively, of the fourth bladder, FIGS. 8I and 8J show the outside and luminal surfaces, respectively, of the fifth bladder, FIGS. 8K and 8L show the outside and luminal surfaces, respectively, of the sixth bladder, and FIGS. 8M and 8N show the outside and luminal surfaces, respectively, of the seventh bladder;
FIGS. 9A-9N are photographs showing seven murine bladders after pretreatment with a 0.2% oxychlorosene solution for 15 minutes followed by infection with Ad-LacZ wherein FIGS. 9A and 9B show the outside and luminal surfaces, respectively, of the first bladder, FIGS. 9C and 9D show the outside and luminal surfaces, respectively, of the second bladder, FIGS. 9E and 9F show the outside and luminal surfaces, respectively, of the third bladder, FIGS. 9G and 9H show the outside and luminal surfaces, respectively, of the fourth bladder, FIGS. 9I and 9J show the outside and luminal surfaces, respectively, of the fifth bladder, FIGS. 9K and 9L show the outside and luminal surfaces, respectively, of the sixth bladder, and FIGS. 9M and 9N show the outside and luminal surfaces, respectively, of the seventh bladder;
FIGS. 10A and 10B are photographs showing the cross section of the murine bladders of FIGS. 8C and 8I, respectively;
FIGS. 11A and 11B are photographs showing the cross section of the murine bladders of FIGS. 9C and 9I, respectively;
FIGS. 12A-12F are photographs showing the cross section of a murine bladder after pretreatment with a 0.2% oxychlorosene solution for 5 minutes followed by infection with Ad-LacZ wherein FIGS. 12A, 12C and 12E were taken at 40× and FIGS. 12B, 12D and 12F were taken at 100× magnification;
FIGS. 13A-13F are photographs showing the cross section of a murine bladder after pretreatment with a 0.2% oxychlorosene solution for 15 minutes followed by infection with Ad-LacZ wherein FIGS. 13A, 13C and 13E were taken at 40× and FIGS. 13B, 13D and 13F were taken at 100× magnification;
FIG. 14A is a photograph showing the luminal surface of a murine bladder after pretreatment with a 0.1% oxychlorosene solution followed by infection with Ad-LacZ;
FIGS. 14B and 14C are photographs showing the cross section of the murine bladder of FIG. 14A wherein FIG. 14B was taken at 40× and FIG. 14C was taken at 100× magnification;
FIG. 15A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% oxychlorosene solution followed by infection with Ad-LacZ;
FIGS. 15B and 15C are photographs showing the cross section of the murine bladder of FIG. 15A wherein FIG. 15B was taken at 40× and FIG. 15C was taken at 100× magnification;
FIG. 16A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.2% oxychlorosene solution followed by infection with Ad-LacZ;
FIGS. 16B and 16C are photographs showing the cross section of the murine bladder of FIG. 16A wherein FIG. 16B was taken at 40× and FIG. 16C was taken at 100× magnification;
FIG. 17A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.4% oxychlorosene solution followed by infection with Ad-LacZ;
FIGS. 17B and 17C are photographs showing the cross section of the murine bladder of FIG. 17A wherein FIG. 17B was taken at 40× and FIG. 17C was taken at 100× magnification;
FIG. 18A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.4% oxychlorosene solution followed by infection with Ad-LacZ;
FIGS. 18B and 18C are photographs showing the cross section of the murine bladder of FIG. 18A wherein FIG. 18B was taken at 40× and FIG. 18C was taken at 100× magnification;
FIG. 19A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.02% polidocanol solution followed by infection with Ad-LacZ;
FIGS. 19B and 19C are photographs showing the cross section of the murine bladder of FIG. 19A wherein FIG. 19B was taken at 40× and FIG. 19C was taken at 100× magnification;
FIG. 20A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.02% polidocanol solution followed by infection with Ad-LacZ;
FIGS. 20B and 20C are photographs showing the cross section of the murine bladder of FIG. 20A wherein FIG. 20B was taken at 40× and FIG. 20C was taken at 100× magnification;
FIGS. 21A and 21B are photographs showing the outside and luminal surfaces, respectively, of a first murine bladder after pretreatment with a 0.05% polidocanol solution followed by infection with Ad-LacZ;
FIGS. 21C and 21D are photographs showing the cross section of the murine bladder of FIG. 21A wherein FIG. 21B was taken at 40× and FIG. 21C was taken at 100× magnification;
FIGS. 22A and 22B are photographs showing the outside and luminal surfaces, respectively, of a second murine bladder after pretreatment with a 0.05% polidocanol solution followed by infection with Ad-LacZ;
FIGS. 22C and 22D are photographs showing the cross section of the murine bladder of FIG. 22A wherein FIG. 22B was taken at 40× and FIG. 22C was taken at 100× magnification;
FIG. 23A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% polidocanol solution followed by infection with Ad-LacZ;
FIGS. 23B and 23C are photographs showing the cross section of the murine bladder of FIG. 23A wherein FIG. 23B was taken at 40× and FIG. 23C was taken at 100× magnification;
FIG. 24A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.2% polidocanol solution followed by infection with Ad-LacZ;
FIGS. 24B and 24C are photographs showing the cross section of the murine bladder of FIG. 24A wherein FIG. 24B was taken at 40× and FIG. 24C was taken at 100× magnification;
FIG. 25A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.02% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ;
FIGS. 25B and 25C are photographs showing the cross section of the murine bladder of FIG. 25A wherein FIG. 25B was taken at 40× and FIG. 25C was taken at 100× magnification;
FIG. 26A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.02% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ;
FIGS. 26B and 26C are photographs showing the cross section of the murine bladder of FIG. 26A wherein FIG. 26B was taken at 40× and FIG. 26C was taken at 100× magnification;
FIG. 27A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.05% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ;
FIGS. 27B and 27C are photographs showing the cross section of the murine bladder of FIG. 27A wherein FIG. 27B was taken at 40× and FIG. 27C was taken at 100× magnification;
FIG. 28A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.05% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ;
FIGS. 28B and 28C are photographs showing the cross section of the murine bladder of FIG. 28A wherein FIG. 28B was taken at 40× and FIG. 28C was taken at 100× magnification;
FIG. 29A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ;
FIGS. 29B and 29C are photographs showing the cross section of the murine bladder of FIG. 29A wherein FIG. 29B was taken at 40× and FIG. 29C was taken at 100× magnification;
FIG. 30A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% sodium salt of dedecyl benzenesulfonic acid solution followed by infection with Ad-LacZ; and
FIGS. 30B and 30C are photographs showing the cross section of the murine bladder of FIG. 30A wherein FIG. 30B was taken at 40× and FIG. 30C was taken at 100× magnification.



DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present invention is directed to the use of transduction enhancing agents to render the bladder umbrella cell layer more susceptible to infection with a viral gene delivery vehicle than it would be without treatment. Exemplary transduction enhancing agents according to the invention include: dodecyl surfactants; dodecylmaltosides; dodecyl alcohol polyoxyethylene ethers (i.e., polidocanol); and sodium dodecylbenzenesulphonic acid/hypochlorous acid complex (i.e., oxychlorosene).
According to the invention, the luminal surface of the bladder can be treated with a composition comprising a transduction enhancing agent prior to infection with a viral gene delivery vehicle. The viral gene delivery vehicle can be an oncolytic virus used to treat bladder cancer. Oncolytic viruses for use in practicing the invention include, but are not limited to, adenovirus, herpes simplex virus (HSV), reovirus, vesicular stomatitis virus (VSV), newcastle disease virus, vacinia virus, influenza virus, West Nile virus, coxsackie virus, poliovirus and measles virus. Of particular interest in practicing the invention are oncolytic viruses that exhibit preferential expression in particular tissue types (i.e., in the bladder urothelium). An oncolytic adenovirus of this type is disclosed, for example, in Zhang, et al., “Identification of Human Uroplakin II Promoter and Its Use in the Construction of CG8840, a Urothelium-specific Adenovirus Variant that Eliminates Established Bladder Tumors in Combination with Docetaxel”, Cancer Research, 62, 3743-3750 (2002) and in co-owned U.S. patent application Ser. No. 09/814,292, which is expressly incorporated by reference herein. Chemotherapeutic agents for use in combination therapy with oncolytic viruses are described, for example, in co-owned U.S. patent application Ser. No. 09/814,357, which is expressly incorporated by reference herein.
Alternatively, the viral gene delivery vehicle can be any gene therapy delivery vehicle known in the art for use in gene therapy, including, but not limited to, an adenovirus, an adeno-associated virus (AAV), a lentivirus, a retrovirus, a herpes virus, etc. Exemplary gene therapy adenoviral agents are disclosed in U.S. Pat. No. 6,165,779. The present inventors have found that pre-treating mouse bladders with aqueous solutions of various compounds consistently increased transduction to greater than 60% of the bladder surface, versus an untreated percent transduction of no more than 10%.
In addition to pre-treatment of the bladder surface with the transduction enhancing agent, the present invention includes co-administration of the viral gene delivery vehicle and the transduction enhancing agent to the bladder and to co-formulations of any one of the transduction enhancing agents with a recombinant viral gene delivery vehicle.
Composition and Chemistry of Reagents Used to Enhance Adenovirus Transduction in the Bladder Epithelium
Several classes of compounds, surfactants, and pre-made reagents were tested in order to find those which increased gene transfer or transduction by a viral gene delivery vehicle in the bladder. An oncolytic adenovirus, CG884, was used as an exemplary viral gene therapy vehicle. The reagents evaluated can be classified by their physical or chemical properties and structure.
First, the reagents can be grouped as a single compound or as a mixed reagent (i.e., a mixture of compounds). Single compounds evaluated include non-ionic surfactants, alcohols, polymers and ionic surfactants. The ionic surfactants evaluated included: 4% Poloxamer 407 (Pluronic® 127); 4% poloxamer 188 (Pluronic® F68); 0.02%-0.5% Polidocanol; 0.1% n-dodecyl-b-D-glucopyranoside (which can also be classified as a sugar-based surfactant); 0.02-0.5% n-dodecyl-b-D-maltoside (which can also be classified as a sugar-based surfactant); 0.1% Tween® 20; 0.1% Triton® X-100; 0.1% Forlan® C-24 (PEG Cholesterol); 0.1% decyl-b-D-maltoside (which can also be classified as a sugar-based surfactant); 0.1% 6-cyclohexylhexyl-β-D-maltoside (which can also be classified as a sugar-based surfactant); and 0.1% Tromboject® (sodium tetradecyl sulfate).
Alcohols evaluated include 0.1%-3% benzyl alcohol and 10%-30% ethanol. Polymers evaluated include 0.4% HPMC 2910; 0.4% PVA; 0.4% PVP; and 100 mg/ml Poly-Lysine. Ionic surfactants evaluated include: 0.1% DC-Chol [Cholesteryl 3b-N-(dimethylaminoethyl)carbamate]; 0.2% sodium salt of Dodecyl benzenesulfonic acid; and 0.1% sodium dodecyl sulfate. Mixed reagents evaluated include: In vivo GeneSHUTTLETM (a reagent comprising DOTAP+Cholesterol available from Qbiogene of Carlsbad, Calif.) and 0.1%-0.4% Oxychlorosene (sodium dodecylbenzenesulphonic acid/hypochlorous acid complex).
Effect of Ethanol Pretreatment on Adenovirus-Mediated Gene Transfer and Expression in The Bladder Epithelium of Rodents
A study was conducted to evaluate the effect of ethanol pretreatment on adenovirus-mediated gene transfer and expression in the bladder epithelium of rodents.
Test Materials
Ad-βgal virus was made as a frozen formulation using standard conditions known in the art for freezing and formulation of adenovirus. The vehicle for the virus arm was PBS plus 10% glycerol. Pretreatment agents were 5%, 10%, 15%, 20% and 30% GLP grade ethanol, respectively, in PBS-10% glycerol solution.
Animals
80 female BALB/c mice were used for this study. Female animals are chosen because of the ease of urethral cannulation and vesicle instillation. The mice were approximately 10 to 12 weeks on the day of the start of the experiment.
Treatment Regimen
Animals were assigned to each group as shown in the following table.







TABLE 1







Effect of Ethanol pretreatment














Animals



Virus dose



Group
per
Test

Ethanol
(particles/


No.
group
Article
Route
pretreatment
animal)
Dose Regimen





1
8-10
Vehicle
Intravesical
—
—
100 ml PBS-








10% glycerol








on Day 1


2
8-10
Ad-βgal
Intravesical
—
1.3 × 1011
Ad-βgal on Day 1


3
8-10
Ad-βgal
Intravesical
 5% ethanol
1.3 × 1011
 5% ethanol








pretreatment








followed by








virus








administration








on Day 1


4
8-10
Ad-βgal
Intravesical
10% ethanol
1.3 × 1011
10% ethanol








pretreatment








followed by








virus








administration








on Day 1


5
8-10
Ad-βgal
Intravesical
15% ethanol
1.3 × 1011
15% ethanol








pretreatment








followed by








virus








administration








on Day 1


6
8-10
Ad-βgal
Intravesical
20% ethanol
1.3 × 1011
20% ethanol








pretreatment








followed by








virus








administration








on Day 1


7
8-10
Ad-βgal
Intravesical
25% ethanol
1.3 × 1011
25% ethanol








pretreatment








followed by








virus








administration








on Day 1


8
8-10
Ad-βgal
Intravesical
30% ethanol
1.3 × 1011
30% ethanol








pretreatment








followed by








virus








administration








on Day 1









For the data in Table 1, the concentration of Ad-βgal virus was 1.3×1012 vp/ml as determined by optical density measurements.

Treatment Procedure

1. Animals were anesthetized with isoflurane and a 24 g catheter introduced through the urethra into the bladder.
2. Residual urine was emptied and the bladder was flushed 3 times with 100-150 μl each of PBS.
3. In test animals, bladders were pretreated for 20 minutes with 0.1 ml of 5, 10, 15, 20, 25 or 30% ethanol solution, respectively, and then rinsed 3 times with 100-150 μl of PBS.
4. Ad-βgal viruses diluted in 0.1 ml of PBS-10% glycerol were administered intravesically into the bladder and retained in the bladder for 45 minutes. A knot was placed around the urethral orifice to prevent leakage of the virus and to prevent the catheter from dislodging.
5. Treatment was stopped by withdrawing the virus and flushing the bladders 3 times with 100-150 μl of PBS. If the catheter became clogged, the washing step was avoided so that the virus was flushed out in the urine. However, the use of this procedure may prevent determination of the viral resident time in the bladder.
Measurement/Determinations
The clinical condition of the animals was observed before dosing on the day of treatment and the animals were observed daily during the experimental period.
Assessment of β-Galactosidase Activity
Animals were killed 48 hours after treatment. Bladders were filled with 0.1 ml whole organ fixative: 2% Neutral buffered formalin, 2% glutaraldehyde, 2 mM MgCl2, 10 mM PBS, pH 7.4. Bladders were then removed and immersed in whole organ fixative for 1 hr. Thereafter, the bladders were cut open longitudinally, rinsed (2 mM MgCl2, 0.1% deoxycholate, 0.2% Triton) for 24 hours at 4° C., and submerged into X-gal staining solution. Transgene expression in the luminal epithelium of the longitudinally opened bladders was empirically determined.
Histopathology
Bladders fixed in whole organ fixative were sectioned and stained with hematoxylin-eosin for histologic examination.
Results
Pretreatment of the luminal bladder surface with various concentrations of ethanol (i.e., 15%, 20%, 25%, and 30 wt. %) for 20 minutes resulted in 10-20% transduction. FIGS. 1-4 show transduction of murine bladders after pretreatment with ethanol. FIGS. 1A and 1B are photographs showing a murine bladder after pretreatment with a 15% ethanol solution followed by infection with Ad-LacZ. FIG. 1A shows the outside surface of the bladder and FIG. 1B shows the luminal bladder surface. FIGS. 1C and 1D are photographs showing a murine bladder after pretreatment with a 20% ethanol solution followed by infection with Ad-LacZ. FIG. 1C shows the outside surface of the bladder and FIG. 1D shows the luminal bladder surface. FIGS. 1E and 1F are photographs showing a murine bladder after pretreatment with a 25% ethanol solution followed by infection with Ad-LacZ. FIG. 1E shows the outside surface of the bladder and FIG. 1F shows the luminal bladder surface. FIGS. 1G and 1H are photographs showing a murine bladder after pretreatment with a 30% ethanol solution followed by infection with Ad-LacZ. FIG. 1G shows the outside surface of the bladder and FIG. 1H shows the luminal bladder surface. As can be seen from FIG. 1, higher concentrations of ethanol resulted in greater levels of transduction as measured by staining.
FIG. 2A is a photograph showing a cross section of a murine bladder control (i.e., no pretreatment). FIGS. 2B and 2C are photographs showing the cross section of a murine bladder after pretreatment with a 30% ethanol solution followed by infection with Ad-LacZ.
FIGS. 3A-3F are photographs showing the cross section of three murine bladders after pretreatment with a 25% ethanol solution followed by infection with Ad-LacZ. FIGS. 3A and 3B are photographs showing the cross-section of the first murine bladder, FIGS. 3C and 3D are photographs showing the cross-section of the second murine bladder, and FIGS. 3E and 3F are photographs showing the cross-section of the third murine bladder. FIGS. 3A, 3C and 3E were taken at 40× and FIGS. 3B, 3D and 3F were taken at 100× magnification.
FIGS. 4A-4F are photographs showing the cross section of three murine bladders after pretreatment with a 30% ethanol solution followed by infection with Ad-LacZ. FIGS. 4A and 4B are photographs showing the cross-section of the first murine bladder, FIGS. 4C and 4D are photographs showing the cross-section of the second murine bladder, and FIGS. 4E and 4F are photographs showing the cross-section of the third murine bladder. FIGS. 4A, 4C and 4E were taken at 40× and FIGS. 4B, 4D and 4F were taken at 100× magnification.
Effect of Chemical Agent Pretreatment on Adenovirus-Mediated Gene Transfer and Expression in The Bladder Epithelium of Rodent
A study was conducted to evaluate the effect of chemical agent pretreatment on adenovirus-mediated gene transfer and expression in the bladder epithelium of rodents.
Test Materials
Ad-βgal virus was made at CGI, as a frozen formulation using standard conditions known in the art for freezing and formulation of adenovirus. The vehicle for the virus arm was PBS plus 10% glycerol.
Animals
152 female BALB/c mice were used this study. Female animals were chosen because of the ease of urethral cannulation and vesicle instillation. The mice were approximately 10 to 12 weeks on the day of the start of the experiment.
Treatment Regimen
Animals were assigned to each group shown in the following table. The route of administration of the chemical agent and virus was intravesical.







TABLE 2







Effect of Chemical Agent Pretreatment













Animals


Virus dose



Group
per
Test

(particles/


No.
group
Article
Chemical agent
animal)
Dose Regimen















1
2
Vehicle
4% Poloxamer 407
—
100 ml of 4%





(Pluronic 127)

Poloxamer 407







(Pluronic 127) in







PBS-10% glycerol on







Day 1


2
6-8
Ad-βgal
4% Poloxamer 407
1.3 × 1011
4% Poloxomer 407





(Pluronic 127)

(Pluronic 127)







pretreatment followed







by virus







administration on Day 1


3
2
Vehicle
4% Poloxamer 188

100 ml of 4%





(Pluronic F68)

Poloxamer 188







(Plluronic F68) in







PBS-10% glycerol on







Day 1


4
6-8
Ad-βgal
4% Poloxamer 188
1.3 × 1011
4% Poloxomer 188





(Pluronic F68)

(Pluronic F68)







pretreatment following







by virus







administration on Day 1


5
2
Vehicle
Lipofectamine

100 ml of





2000

Lipofectamine 2000







(20 mg/ml) in PBS







10% glycerol.


6
6-8
Ad-βgal
Lipofectamine
0.65 × 1011 
1.25 mg of





2000

Lipofectamine 2000







mixed with virus







administration on







Day 1


7
2
Vehicle
3% Benzyl

100 μl of 3% Benzyl





Alcohol

Alcohol in PBS-10%







glycerol on Day 1


8
6-8
Ad-βgal
3% Benzyl
  1 × 1011
3% Benzyl Alcohol





Alcohol

pretreatment followed







by virus







administration on Day 1


9
2
Vehicle
0.2%

0.2% Oxychlorosene





Oxychlorosene

in PBS-10% glycerol







on Day 1


10
6-8
Ad-βgal
0.2%
1.3 × 1011
0.2% Oxychlorosene





Oxychlorosene

pretreatment (only







wash) followed by







virus administration







on Day 1


11
6-8
Ad-βgal
0.2%
1.3 × 1011
0.2% Oxychlorosene





Oxychlorosene

pretreatment (5 min)







followed by virus







administration on Day 1


12
6-8
Ad-βgal
0.2%
1.3 × 1011
0.2% Oxychlorosene





Oxychlorosene

pretreatment (15 min)







followed by virus







administration on Day 1


13
2
Vehicle
0.05% Polidocanol

0.05% Polidocanol in







PBS-10% glycerol on







Day 1


14
6-8
Ad-βgal
0.05% Polidocanol
1.3 × 1011
0.05% Polidocanol







pretreatment followed







by virus







administration on Day 1


15
2
Vehicle
0.1% DC-Chol

0.1% DC-Chol in







PBS-10% glycerol on







Day 1


16
6-8
Ad-βgal
0.1% DC-Chol
1.3 × 1011
0.1% DC-Chol







pretreatment followed







by virus







administration on Day 1


17
2
Vehicle
In vivo Gene

4 mM solution in PBS





Shuttle (DOTAP +





Cholesterol)


18
6-8
Ad-βgal
In vivo Gene
0.65 × 1011 
4 mM of In vivo Gene





Shuttle (DOTAP +

Shuttle mixed with





Cholesterol)

virus. Administration







on Day 1. (Dilute







60 ml of Lipid with







90 ml of water. Then







add 150 ul of Ad-bgal)


19
2
Vehicle
0.5% Polidocanol

0.5% Polidocanol in







PBS-10% glycerol on







Day 1


20
6-8
Ad-βgal
0.5% Polidocanol
1.3 × 1011
0.5% Polidocanol







pretreatment followed







by virus







administration on Day 1


21
2
Vehicle
0.4% HPMC 2910

0.4% HPMC 2910 in







PBS-10% glycerol on







Day 1


22
6-8
Ad-βgal
0.4% HPMC 2910
0.5 × 1011
0.8% HPMC 2910







mixed with an equal







volume of the virus







and then administered







on Day 1


23
2
Vehicle
100 mg/ml Poly-

100 ug/ml Poly-Lysine





Lysine

in PBS-10% glycerol







on Day 1


24
6-8
Ad-βgal
100 mg/ml Poly-
0.5 × 1011
200 ug/ml Poly-Lysine





Lysine

mixed with an equal







volume of the virus







and then administered







on Day 1


25
2
Vehicle
0.1% n-dodecyl-b-

0.1% n-dodecyl-b-D





D glucopyranoside

glucopyranoside in







PBS-10% glycerol on







Day 1


26
6-8
Ad-βgal
0.1% n-dodecyl-b-
  1 × 1011
0.1% n-dodecyl-b-D





D glucopyranoside

glucopyranoside







pretreatment followed







by virus







administration on Day 1


27
2
Vehicle
0.4% PVA

0.4% PVA in PBS-







10% glycerol on Day 1


28
6-8
Ad-βgal
0.4% PVA
0.5 × 1011
0.8% PVA mixed with







an equal volume of the







virus and then







administered on Day 1


29
2
Vehicle
0.4% PVP

0.4% PVP in PBS-







10% glycerol on Day 1


30
6-8
Ad-βgal
0.4% PVP
0.5 × 1011
0.8% PVP mixed with







an equal volume of the







virus and then







administered on Day 1


31
2
Vehicle
0.1% Cholesterol-

0.1% Cholesterol-





Cyclodextrin

Cyclodextrin reagent





reagent

in PBS-10% glycerol







on Day 1


32
6-8
Ad-βgal
0.1% Cholesterol-
0.5 × 1011
0.2% Cholesterol-





Cyclodextrin

Cyclodextrin reagent





reagent

mixed with an equal







volume of the virus







and then administered







on Day 1


33
2
Vehicle
0.05% n-Dodecyl

0.05% n-Dodecyl b-D-





b-D-Maltoside

Maltoside in PBS-







10% glycerol on Day 1


34
6-8
Ad-βgal
0.05% n-Dodecyl
  1 × 1011
0.05% n-Dodecyl b-D-





b-D-Maltoside

Maltoside







pretreatment followed







by virus







administration on







Day 1


35
2
Vehicle
0.3% Benzyl

100 μl of 0.3% Benzyl





Alcohol

Alcohol in PBS-10%







glycerol on Day 1


36
6-8
Ad-βgal
0.3% Benzyl
  1 × 1011
0.3% Benzyl Alcohol





Alcohol

pretreatment followed







by virus







administration on Day 1


37
2
Vehicle
0.1% Benzyl

100 μl of 0.1% Benzyl





Alcohol

Alcohol in PBS-10%







glycerol on Day 1


38
6-8
Ad-βgal
0.1% Benzyl
  1 × 1011
0.1% Benzyl Alcohol





Alcohol

pretreatment followed







by virus







administration on Day 1


39
2
Vehicle
0.1%

0.1% Oxychlorosene





Oxychlorosene

in PBS-10% glycerol







on Day 1


40
6-8
Ad-βgal
0.1%
  1 × 1011
0.1% Oxychlorosene





Oxychlorosene

pretreatment (5 min)







followed by virus







administration on







Day 1


41
2
Vehicle
0.4%

0.4% Oxychlorosene





Oxychlorosene

in PBS-10% glycerol







on Day 1


42
6-8
Ad-βgal
0.4%
  1 × 1011
0.4% Oxychlorosene





Oxychlorosene

pretreatment (5 min)







followed by virus







administration on







Day 1


43
2
Vehicle
0.02% Polidocanol

0.02% Polidocanol in







PBS-10% glycerol on







Day 1


44
6-8
Ad-βgal
0.02% Polidocanol
  1 × 1011
0.02% Polidocanol







pretreatment followed







by virus







administration on Day 1


45
2
Vehicle
0.2% Polidocanol

0.2% Polidocanol in







PBS-10% glycerol on







Day 1


46
6-8
Ad-βgal
0.2% Polidocanol
  1 × 1011
0.2% Polidocanol







pretreatment followed







by virus







administration on Day 1


47
2
Vehicle
0.02% n-Dodecyl

0.02% n-Dodecyl b-D-





b-D-Maltoside

Maltoside in PBS-







10% glycerol on Day 1


48
6-8
Ad-βgal
0.02% n-Dodecyl
  1 × 1011
0.02% n-Dodecyl b-D-





b-D-Maltoside

Maltoside







pretreatment followed







by virus







administration on







Day 1


49
2
Vehicle
0.2% n-Dodecyl b-

0.2% n-Dodecyl b-D-





D-Maltoside

Maltoside in PBS-







10% glycerol on Day 1


50
6-8
Ad-βgal
0.2% n-Dodecyl b-
  1 × 1011
0.2% n-Dodecyl b-D





D-Maltoside

Maltoside







pretreatment followed







by virus







administration on







Day 1


51
2
Vehicle
0.2% sodium salt

0.2% sodium salt of





of Dodecyl

Dodecyl





benzenesulfonic

benzenesulfonic acid





acid

in PBS-10% glycerol







on Day 1


52
6-8
Ad-βgal
0.2% sodium salt
  1 × 1011
0.2% sodium salt of





of Dodecyl

Dodecyl





benzenesulfonic

benzenesulfonic acid





acid

pretreatment followed







by virus







administration on Day 1


53
2
Vehicle
0.1% sodium

0.1% sodium dodecyl





dodecyl sulphate

sulphate in PBS-10%







glycerol on Day 1


54
6-8
Ad-βgal
0.1% sodium
  1 × 1011
0.1% sodium dodecyl





dodecyl sulphate

sulphate pretreatment







followed by virus







administration on







Day 1


55
2
Vehicle
0.1% Tween 20

0.1% Tween 20 in







PBS-10% glycerol on







Day 1


56
6-8
Ad-βgal
0.1% Tween 20
  1 × 1011
0.1% Tween 20







pretreatment followed







by virus







administration on Day 1


57
2
Vehicle
0.1% Triton X-100

0.1% Triton X-100 in







PBS-10% glycerol on







Day 1


58
6-8
Ad-βgal
0.1% Triton X-100
  1 × 1011
0.1% Triton X-100







pretreatment followed







by virus







administration on Day 1


59
2
Vehicle
0.1% Forlan C-24

0.1% Forlan C-24 in





(PEG Cholesterol)

PBS-10% glycerol on







Day 1


60
6-8
Ad-βgal
0.1% Forlan C-24
  1 × 1011
0.1% Forlan C-24





(PEG Cholesterol)

pretreatment followed







by virus







administration on Day 1


61
2
Vehicle
0.1% Decyl-b-D-

0.1% Decyl-b-D-





Maltoside

Maltoside in PBS-







10% glycerol on Day 1


62
6-8
Ad-βgal
0.1% Decyl-b-D-
  1 × 1011
0.1% Decyl-b-D-





Maltoside

Maltoside







pretreatment followed







by virus







administration on







Day 1


63
2
Vehicle
0.1% 6-

0.1% 6-





Cyclohexylhexyl-

Cyclohexylhexyl-b-D-





b-D-Maltoside

Maltoside in PBS-







10% glycerol on Day 1


64
6-8
Ad-βgal
01% 6-
  1 × 1011
0.1% 6-





Cyclohexylhexyl-

Cyclohexylhexyl-b-D-





b-D-Maltoside

Maltoside







pretreatment followed







by virus







administration on







Day 1


65
2
Vehicle
0.1% Tromboject

0.1% Tromboject in





(Sodium

PBS-10% glycerol on





Tetradecyl Sulfate)

Day 1


66
6-8
Ad-βgal
0.1% Tromboject
  1 × 1011
0.1% Tromboject





(Sodium

pretreatment followed





Tetradecyl Sulfate)

by virus







administration on Day 1


67
2
Vehicle
0.1% Phenyl B-D-

0.1% Phenyl B-D-





Glucopyranoside

Glucopyranoside in







PBS-10% glycerol on







Day 1


68
6-8
Ad-βgal
0.1% Phenyl B-D-
  1 × 1011
0.1% Phenyl B-D-





Glucopyranoside

Glucopyranoside







pretreatment followed







by virus







administration on Day 1


69
2
Vehicle
0.1% Sucrose

0.1% Sucrose





Monolaurate

Monolaurate in PBS-







10% glycerol on Day 1


70
6-8
Adβgal
0.1% Sucrose
  1 × 1011
0.1% Sucrose





Monolaurate

Monolaurate







pretreatment followed







by virus







administration on Day 1


71
2
Vehicle
0.1% 1-O-dodecyl-

0.1% 1-O-dodecyl-





rac-glycerol

rac-glycerol in PBS-







10% glycerol on Day 1


72
6-8
Ad-βgal
0.1% 1-O-dodecyl-
  1 × 1011
0.1% 1-O-dodecyl-





rac-glycerol

rac-glycerol







pretreatment followed







by virus







administration on Day 1









The concentration of Ad-βgal virus for the data in Table 2 was 1.3×1012 vp/ml (1st preparation, particle: PFU: 30) and 1×1012 vp/ml (2nd preparation, particle: PFU: 30) as determined by optical density measurements.

Treatment Procedure

1. The animals were anesthetized with isoflurane and a 24 g catheter was introduced through the urethra into the bladder.
2. Residual urine was emptied and the bladder was flushed 3 times with 100 μl each of PBS.
3. Based on the reagent being tested, bladder pretreatment was performed as follows:
Poloxomer 407 procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
Poloxomer 188 procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 minutes and gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
Lipofectamine 2000 procedure: Added 5 μl of stock Lipofectamine (1 mg/ml) to 195 μl of PBS-10% glycerol. Mixed with an equal volume of Ad-βgal virus and incubated for 15 minutes. Administered 100 μl of the mixture intravesically and retained in the bladder for 30 minutes.
Benzyl Alcohol procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 15 minutes and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
Oxychlorosene procedure: Washing performed as mentioned in the dose regimen (i.e., 3 washes of 100 μl each, one wash but retained for 5 min., one wash but retained for 15 min). Performed 3 times PBS wash prior to virus instillation.
Polidocanol procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
DC-Cho procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.4% HPMC 2910 procedure: No pretreatment. An equal volume of the virus was mixed with 0.8% solution of HPMC2910 and the mixture was instilled into the bladder for 30 minutes.
100 mg/ml Poly-Lysine procedure: No pretreatment. An equal volume of the virus was mixed with 100 mg/ml solution of Poly-Lysine and the mixture was instilled into the bladder for 30 minutes.
0.4% polyvinyl alcohol (PVA) procedure: No pretreatment. An equal volume of the virus was mixed with 0.8% solution of PVA and the mixture was instilled into the bladder for 30 minutes.
n-dodecyl-p-D glucopyranoside procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.4% PVP procedure: No pretreatment. An equal volume of the virus was mixed with 0.8% solution of PVP and the mixture was instilled into the bladder for 30 min.
0.1% cholesterol-cyclodextrin reagent procedure: No pretreatment. An equal volume of the virus was mixed with 0.2% solution of Cholesterol-Cyclodextrin and the mixture was instilled into the bladder for 30 minutes.
n-dodecyl-β-D-maltoside procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
Sodium salt of dodecyl benzenesulfonic acid procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% sodium dodecyl sulphate procedure: Wash 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% Tween 20 procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% Triton® X-100 procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Perform 3 times PBS wash prior to virus instillation.
0.1% Forlan C-24 procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% decyl-b-D-maltoside procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% 6-cyclohexylhexyl-b-D-maltoside procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% sodium tetradecyl sulfate (Tromboject®, Omega Laboratories Ltd.) procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% phenyl-β-D-glucopyranoside procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation. 0.1% sucrose monolaurate procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
0.1% 1-O-dodecyl-rac-glycerol procedure: Washed 2 times with 100 μl each. Retained the 3rd wash for 5 min and then gave one additional wash. Performed 3 times PBS wash prior to virus instillation.
In vivo geneSHUTTLETM procedure. Mixed 4 mM of In vivo geneSHUTTLETM with virus. Administration on Day 1. Diluted 60 ml of Lipid with 90 ml of water. Then added 150 μl of Ad-βgal.
4. Virus treatment (45 min) stopped by withdrawing the virus and flushing the bladders 3 times with 100 μl of PBS.
Measurement/Determinations
The clinical condition of the animals were observed before dosing on the day of treatment, and animals were observed daily during the experimental period.
Assessment of β-galactosidase Activity
Animals were killed 48 hours after treatment. The bladders were filled with 0.1-ml whole organ fixative: 2% Neutral buffered formalin, 2% glutaraldehyde, 2 mM MgCl2, 10 mM PBS, pH 7.4. The bladders were then removed and immersed in whole organ fixative for 1 hour. Thereafter, each bladder was cut open longitudinally, rinsed (in 2 mM MgCl2, 0.1% deoxycholate, 0.2% Triton) for 24 hours at 4° C., and submerged into X-gal staining solution. Transgene expression in the luminal epithelium of the longitudinally opened bladders was empirically determined.
Histopathology
Bladders fixed in whole organ fixative were sectioned and stained with hematoxylin-eosin for histologic examination.
Results
The results of the above experiments can be summarized as follows:
Pre-treatment of the bladder with 4% Poloxamer 407 (Pluronic 127) for 5 minutes resulted in <5% transduction.
Treatment of the bladder with a lipofectamine and virus mixture (no pretreatment) resulted in <5% transduction.
Treatment of the bladder with an In vivo geneSHUTTLETM and virus mix (no bladder pretreatment) resulted in <5% transduction.
A pre-treatment of the bladder with 0.1% oxychlorosene for 5 minutes resulted in >90% transduction of the urothelium. The pathologists report indicated mild submucosal edema with intact epithelial layer.
A pre-treatment of the bladder with 0.2% oxychlorosene for 5 minutes resulted in >90% transduction of the urothelium. The pathologists report indicated minimal submucosal edema and perivascular lymphocytes.
A pre-treatment of the bladder with 0.2% oxychlorosene for 15 minutes resulted in >90% transduction of Urothelium. The pathologists report indicated focal severe ulceration with suppurtative exudate, hemorrhage and edema in the submucosa.
A pre-treatment of the bladder with 0.4% oxychlorosene for 5 minutes resulted in >90% transduction of Urothelium. The pathologists report indicated moderate submucosal edema with focal large ulcer.
A pre-treatment of the bladder with 0.02% polidocanol for 5 minutes resulted in 10-20% transduction of the urothelium. The pathologists report indicated an intact mucosa.
A pre-treatment of the bladder with 0.05% polidocanol for 5 minutes resulted in 30-40% transduction of the urothelium. The pathologists report indicated minimal submucosal edema.
A pre-treatment of the bladder with 0.2% polidocanol for 5 minutes resulted in 50-80% transduction of Urothelium. The pathologists report indicated erosions and focal ulcer as well as mucosal compromise.
A pre-treatment of the bladder with 0.02% n-dodecyl β-D-maltoside for 5 minutes resulted in 50-80% transduction of the urothelium. The pathologists report indicated no significant lesions.
A pre-treatment of the bladder with 0.05% n-dodecyl β-D-maltoside for 5 minutes resulted in >90% transduction of the urothelium. The pathologists report indicated no significant lesions.
A pre-treatment of the bladder with 0.2% n-dodecyl β-D-maltoside for 5 minutes resulted in >90% transduction of the urothelium. The pathologists report indicated erosions, focal ulcer, moderate submucosal edema with mucosal compromise.
A pre-treatment of the bladder with 0.2% dodecyl benzenesulfonic acid for 5 minutes resulted in 20-40% transduction of the urothelium.
As can be seen from the above results, several single compounds and one mixed reagent showed significantly increased transduction as measured by the levels of final blue stain (LacZ). Several other single compounds resulted in enhanced but smaller levels of transduction. An ethanol pre-treatment was used as a reference to validate each chemical tested. Even with an ethanol percentage as high as 30%, only 10-20% transduction was observed. The “strong responders” were those transduction enhancing agents which exhibited significantly better (i.e., 70-90% staining) than the ethanol pre-treatment controls, which exhibited 10-20% staining. The weak responders had significantly less stained area compared to the ethanol control group.
The strongest response (i.e., highest level of transduction) was observed following pretreatment of the bladder surface with: 0.02%-0.5% polidocanol; 0.02 -0.5% n-dodecyl-b-D-maltoside; 0.1% 6-cyclohexylhexyl-b-D-maltoside; 0. %-0.4% oxychlorosene; 0.2% sodium salt of dodecyl benzenesulfonic acid; and 0.1% sodium dodecyl sulphate.
The “weak responders” included 0.1% decyl-b-D-maltoside and 0.1% Triton® X-100.
Although not wishing to be bound by theory, the mechanism of action can be hypothesized by analyzing the physical and chemical properties of successful transduction enhancing reagents. The transduction enhancing reagent in general is a surfactant. The surfactant can be ionic or non-ionic. The surfactant preferably has both hydrophilic and lipophilic sections. The hydrophilic portion of the molecule contributes to water solubility while the lipophilic (i.e., hydrophobic) portion helps molecular interactions with lipids. The hydrophilic/lipophilic balance or HLB ratio is an indication of the relative size of each part of the molecule.
Sugar Based Surfactants (Saccharides)
The transduction enhancing agent according to the invention can be a sugar (e.g., a mono-, di-, or poly-saccharide) having a lipophilic substituent. The transduction enhancing agent can be any mono-, di-, or poly-saccharide having a lipophilic substituent. According to a preferred embodiment of the invention, the transduction enhancing agent is a di-saccharide having a lipophilic substituent. Exemplary di-saccharides include maltose or sucrose. Other di-saccharides having lipophilic substituents, however, can also be used including lactose, isomaltose, trehalose or cellobiose.
The lipophilic substituent can be linear (e.g., a straight chain n-alkane or alkene) or non-linear (e.g., cyclic or branched chain alkanes or alkenes). The lipophilic substituent can also be an alkanoic acid residue. The length of the lipophilic substituent can be varied to achieve the desired hydrophilic-lipophilic balance. Tests on various maltoside substituted compounds indicated that a sufficient lipophilic length resulted in improved transduction efficacy. For example, both n-dodecyl-β-D-maltoside and 6-cyclohexylhexyl-β-D-maltoside increased transduction significantly. In contrast, n-decyl-β-D-maltoside had only a slight effect on transduction.
Results for bladder pretreatment with n-dodecyl-β-D-maltoside are shown in FIGS. 25-29. FIG. 25A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.02% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ. FIGS. 25B and 25C are photographs showing the cross section of the murine bladder of FIG. 25A. FIG. 25B was taken at 40× and FIG. 25C was taken at 100× magnification. FIG. 26A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.02% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ. FIGS. 26B and 26C are photographs showing the cross section of the murine bladder of FIG. 26A. FIG. 26B was taken at 40× and FIG. 26C was taken at 100× magnification. FIG. 27A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.05% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ. FIGS. 27B and 27C are photographs showing the cross section of the murine bladder of FIG. 27A. FIG. 27B was taken at 40× and FIG. 27C was taken at 100× magnification. FIG. 28A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.05% n-dodecyl P-D-maltoside solution followed by infection with Ad-LacZ. FIGS. 28B and 28C are photographs showing the cross section of the murine bladder of FIG. 28A. FIG. 28B was taken at 40× and FIG. 28C was taken at 100× magnification. FIG. 29A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% n-dodecyl β-D-maltoside solution followed by infection with Ad-LacZ. FIGS. 29B and 29C are photographs showing the cross section of the murine bladder of FIG. 29A. FIG. 29B was taken at 40× and FIG. 29C was taken at 100× magnification.
The chemical formula for n-dodecyl-β-D-maltoside and n-decyl-β-D-maltoside is given below:




where n is 11 and 9, respectively. The chemical formula for 6-cyclohexylhexyl-β-D-maltoside is:





where n is 6.

The transduction experiments demonstrated that a small reduction in the size of the lipophilic side chain (i.e., CH2—CH2) can limit the efficacy of the molecule for transduction enhancement to a great degree. It is important to note that all of the above compounds had good solubility in both water and PBS buffer.
Compounds in this class of surfactants having a shorter hydrophilic moiety were also evaluated. The results for n-dodecyl-β-D-glucopyranoside showed little or no enhancement of transduction. The chemical formula for n-dodecyl-β-D-glucopyranoside is:




where n is 11. While not wishing to be bound by theory, the relative sizes of the hydrophilic and lipophilic portions of the molecule appear to influence transduction enhancement. Therefore, shorter chain n-alkyl-β-D-glucopyranosides (e.g., n-hexyl-β-D-glucopyranoside) may exhibit improved transduction.

Any mono-, di-, or poly-saccharide having a lipophilic substituent can be used as a transduction enhancing agent according to the invention. Exemplary di-saccharide compounds include sucrose, lactose, maltose, isomaltose, trehalose, and cellobiose. The lipophilic substituent preferably comprises an alkyl or alkenyl group. According to a preferred embodiment of the invention, the lipophilic substituent is an alkanoic acid residue.
Although the β-forms of the mono- and di-saccharides are described above, the α-forms of these and other mono-, di-, or poly-saccharide compounds can also be used according to the invention. Exemplary α-saccharide transduction enhancing agents according to the invention include n-dodecyl-α-D-maltoside, n-hexyl-α-D-glucopyranoside and 6-cyclohexylhexyl-α-D-maltoside. Additionally, either the D- or L-forms of the mono-, di-, or poly-saccharides may be used as transduction enhancing agents according to the invention.
Ionic Alkyl Surfactants
Ionic alkyl surfactants can also be used as a transduction enhancing compounds according to the invention. Exemplary ionic alkyl surfactants include sodium dodecyl sulfate which has a formula represented by:




Another exemplary ionic surfactant is the sodium salt of dodecyl-benzenesulfonic acid which has a chemical formula represented by:




Surfactants of the above type were evaluated and were found to exhibit enhanced transduction comparable to the non-ionic reagents set forth above. These results are shown in FIG. 30 for dodecyl benzenesulfonic acid sodium salt. As can be seen by FIGS. 30A-30C, dodecyl benzenesulfonic acid sodium salt, enhanced the transduction of Ad-LacZ in murine bladders. FIG. 30A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% sodium salt of dedecyl benzenesulfonic acid solution followed by infection with Ad-LacZ. FIGS. 30B and 30C are photographs showing the cross section of the murine bladder of FIG. 30A. FIG. 30B was taken at 40× and FIG. 30C was taken at 100× magnification.
The ionic alkyl surfactants consist of two portions, a hydrophilic portion and a lipophilic portion. The arrangement of these portions of the molecule is similar to the sugar-based enhancing agents described above. According to the invention, compounds similar to those set forth above and having variations in alkyl substitution can also be used.
Alkyl(ether) Alcohols
Also according to the invention, an alkyl ether compound can be used as a transduction enhancing compound. Polidocanol, an alkyl ether having the following chemical formula:

C12H26—O—(CH2—CH2—O) ̃9 

and a total formula of  ̃C30H62O10, was evaluated. The polidocanol used in the evaluation was sold under the name Thesit®, which is a registered trademark of Desitin-Werk, Carl Klinke GmbH, Hamburg, Germany). There are several other chemical names for polidocanol such as polyethyleneglycoldodecyl ether [9002-92-0], lauryl alcohol, and macrogol lauryl ether.

Results for pretreatment of the bladder surface with various concentrations of polidocanol are shown in FIGS. 19-24. Results for pretreatment of the bladder surface with 0.02% polidocanol are shown in FIGS. 19 and 20. FIG. 19A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.02% polidocanol solution followed by infection with Ad-LacZ. FIGS. 19B and 19C are photographs showing the cross section of the murine bladder of FIG. 19A. FIG. 19B was taken at 40× and FIG. 19C was taken at 100× magnification. FIG. 20A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.02% polidocanol solution followed by infection with Ad-LacZ. FIGS. 20B and 20C are photographs showing the cross section of the murine bladder of FIG. 20A. FIG. 20B was taken at 40× and FIG. 20C was taken at 100× magnification.
Results for pretreatment of the bladder surface with 0.05% polidocanol are shown in FIGS. 21 and 22. FIGS. 21A and 21B are photographs showing the outside and luminal surfaces, respectively, of a first murine bladder after pretreatment with a 0.05% polidocanol solution followed by infection with Ad-LacZ. FIGS. 21C and 21D are photographs showing the cross section of the murine bladder of FIG. 21A. FIG. 21B was taken at 40× and FIG. 21C was taken at 100× magnification. FIGS. 22A and 22B are photographs showing the outside and luminal surfaces, respectively, of a second murine bladder after pretreatment with a 0.05% polidocanol solution followed by infection with Ad-LacZ. FIGS. 22C and 22D are photographs showing the cross section of the murine bladder of FIG. 22A. FIG. 22B was taken at 40× and FIG. 22C was taken at 100× magnification;
Results for pretreatment of the bladder surface with 0.2% polidocanol are shown in FIGS. 23 and 24. FIG. 23A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% polidocanol solution followed by infection with Ad-LacZ. FIGS. 23B and 23C are photographs showing the cross section of the murine bladder of FIG. 23A. FIG. 23B was taken at 40× and FIG. 23C was taken at 100× magnification. FIG. 24A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.2% polidocanol solution followed by infection with Ad-LacZ. FIGS. 24B and 24C are photographs showing the cross section of the murine bladder of FIG. 24A. FIG. 24B was taken at 40× and FIG. 24C was taken at 100× magnification.
Triton® X-100, having a general formula of:




wherein x=10 was also evaluated and was also found to enhance transduction. A similar compound having a cyclohexane ring rather than a benzene ring can also be used as a transduction enhancing agent according to the invention. This compound has the following chemical structure:





wherein x=10. Compounds of the above type wherein x is any positive integer can also be used according to the invention.

Similar alkyl(ether) compounds having the general structure of:




are also commercially available. The trade name for these compounds is “Brij”. The compound shown above is designated “Brij 56”. Brij 56 has the chemical formula C20H42O5. Another commercially available compound, “Brij 58”, has the chemical formula C16H114O21.

Any of the above mentioned alkyl(ether) compounds can be used as transduction enhancing agents according to the invention.
Sodium Oxychlorosene
A composition comprising a sodium salt of dodecylbenzenesulfonic acid and hypochlorous acid (i.e., sodium oxychlorosene) at a pH of about 6.5 to 6.9 was evaluated. The sodium oxychlorosene used in these evaluations was sold under the name Clorpactin WCS-90 (manufactured by Guardian Labs and sold by Cardinal Health). Sodium oxychlorosene has been used to treat urinary tract infections and in abdominal and plastic surgery.
Results for pretreatment of the bladder surface with sodium oxychlorosene are shown in FIGS. 8-18. FIGS. 8A-8N are photographs showing seven murine bladders after pretreatment with a 0.2% oxychlorosene solution for 5 minutes followed by infection with Ad-LacZ. FIGS. 8A and 8B show the outside and luminal surfaces, respectively, of the first bladder, FIGS. 8C and 8D show the outside and luminal surfaces, respectively, of the second bladder, FIGS. 8E and 8F show the outside and luminal surfaces, respectively, of the third bladder, FIGS. 8G and 8H show the outside and luminal surfaces, respectively, of the fourth bladder, FIGS. 8I and 8J show the outside and luminal surfaces, respectively, of the fifth bladder, FIGS. 8K and 8L show the outside and luminal surfaces, respectively, of the sixth bladder, and FIGS. 8M and 8N show the outside and luminal surfaces, respectively, of the seventh bladder.
FIGS. 9A-9N are photographs showing seven murine bladders after pretreatment with a 0.2% oxychlorosene solution for 15 minutes followed by infection with Ad-LacZ. FIGS. 9A and 9B show the outside and luminal surfaces, respectively, of the first bladder, FIGS. 9C and 9D show the outside and luminal surfaces, respectively, of the second bladder, FIGS. 9E and 9F show the outside and luminal surfaces, respectively, of the third bladder, FIGS. 9G and 9H show the outside and luminal surfaces, respectively, of the fourth bladder, FIGS. 9I and 9J show the outside and luminal surfaces, respectively, of the fifth bladder, FIGS. 9K and 9L show the outside and luminal surfaces, respectively, of the sixth bladder, and FIGS. 9M and 9N show the outside and luminal surfaces, respectively, of the seventh bladder.
FIGS. 10A and 10B are photographs showing the cross section of the murine bladders of FIGS. 8C and 8I, respectively. FIGS. 11A and 11B are photographs showing the cross section of the murine bladders of FIGS. 9C and 9I, respectively.
FIGS. 12A-12F are photographs showing the cross section of three murine bladders after pretreatment with a 0.2% oxychlorosene solution for 5 minutes followed by infection with Ad-LacZ. FIGS. 12A and 12B are photographs showing the cross-section of the first murine bladder, FIGS. 12C and 12D are photographs showing the cross-section of the second murine bladder, and FIGS. 12E and 12F are photographs showing the cross-section of the third murine bladder. FIGS. 12A, 12C and 12E were taken at 40× and FIGS. 12B, 12D and 12F were taken at 100× magnification.
FIGS. 13A-13F are photographs showing the cross section of three murine bladders after pretreatment with a 0.2% oxychlorosene solution for 15 minutes followed by infection with Ad-LacZ. FIGS. 13A and 13B are photographs showing the cross-section of the first murine bladder, FIGS. 13C and 13D are photographs showing the cross-section of the second murine bladder, and FIGS. 13E and 13F are photographs showing the cross-section of the third murine bladder. FIGS. 13A, 13C and 13E were taken at 40× and FIGS. 13B, 13D and 13F were taken at 100× magnification.
FIG. 14A is a photograph showing the luminal surface of a murine bladder after pretreatment with a 0.1% oxychlorosene solution followed by infection with Ad-LacZ. FIGS. 14B and 14C are photographs showing the cross section of the murine bladder of FIG. 14A. FIG. 14B was taken at 40× and FIG. 14C was taken at 100× magnification;
FIG. 15A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.2% oxychlorosene solution followed by infection with Ad-LacZ. FIGS. 15B and 15C are photographs showing the cross section of the murine bladder of FIG. 15A. FIG. 15B was taken at 40× and FIG. 15C was taken at 100× magnification.
FIG. 16A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.2% oxychlorosene solution followed by infection with Ad-LacZ. FIGS. 16B and 16C are photographs showing the cross section of the murine bladder of FIG. 16A. FIG. 16B was taken at 40× and FIG. 16C was taken at 100× magnification.
FIG. 17A is a photograph showing the luminal surface of a first murine bladder after pretreatment with a 0.4% oxychlorosene solution followed by infection with Ad-LacZ. FIGS. 17B and 17C are photographs showing the cross section of the murine bladder of FIG. 17A. FIG. 17B was taken at 40× and FIG. 17C was taken at 100× magnification.
FIG. 18A is a photograph showing the luminal surface of a second murine bladder after pretreatment with a 0.4% oxychlorosene solution followed by infection with Ad-LacZ. FIGS. 18B and 18C are photographs showing the cross section of the murine bladder of FIG. 18A. FIG. 18B was taken at 40× and FIG. 18C was taken at 100× magnification.
Polymers with Alternating Hydrophilic and Lipophilic Units
Polymeric compounds comprising repeating sequences of alternating or identical monomers were also tested. One such compound tested was Poloxamer 407 (Pluronic 127) having a structure represented by the following formula:




Poloxamers polymers come in a wide range of HLB values. Both of the compounds tested, however, had only a minimal effect on the transduction of adenovirus. While not wishing to be bound by theory, it is believed that compounds having separated, longer hydrophilic and lipophilic chains are more effective at enhancing transduction of the bladder epithelium.
Additional Transduction Enhancing Compounds
Additional compounds can also be used as transduction enhancing agents according to the invention.
These compounds include ω-undecylenyl-β-D-maltopyranoside, which has a structure represented by:




Sugar based thiolic compounds such as alkyl-β-D-thioglucopyranosides having a general structure represented by:





may also be employed.

Additionally, alkyl-β-D-thiomaltopyranosides having a general structure represented by:




may also be used as transduction enhancing compounds according to the invention.

Further, compounds having a positive charge such as




can also be used.

Additionally, compounds wherein the lipophilic and hydrophilic parts are connected via a carboxylic bond can also be employed. An exemplary compound of this type is 6-O-methyl-n-heptylcarboxyl-α-D-glucopyranoside:




Sugar based compounds having alkyl groups with side groups or other modifications may also be used. Exemplary compounds of this type include 2-propyl-1-pentyl-β-D-maltopyranoside having a structure represented by:




Sarcosine compounds may also be used as transduction enhancing agents according to the invention. Exemplary sarcosine compounds include sodium alkyl sarcosine having a structure represented by:




Various substituted sugars can also be used as transduction enhancing compounds. An exemplary substituted sugar which can be used as a transduction enhancing compound is a sucrose mono alkyl ester having a chemical structure represented by:




Exemplary compounds of this type include compounds wherein n=10 (i.e., sucrose monolaurate).

Also according to the present invention, methods of treating the luminal surface of the bladder are provided. According to a preferred embodiment of the invention, the bladder is treated by instillation using bladder catheterization. According to this embodiment, any urine in the bladder is first removed and the bladder is optionally washed with a buffer (e.g., PBS). A composition comprising the transduction enhancing agent is then applied to the luminal surface of the bladder (e.g., by instillation). The transduction enhancing solution may be incubated for some specified time or drained immediately. Multiple treatments with the composition comprising the transduction enhancing agent can be performed. After treatment with the transduction enhancing agent, the luminal surface of the bladder may be washed with a buffer (e.g., PBS). A solution comprising the adenovirus can then be introduced into the bladder (e.g., by instillation). The solution comprising the adenovirus can be removed immediately or, alternatively, the solution can be allowed to incubate for a certain amount of time. After treatment with the adenovirus, the bladder surface can again be washed with a buffer solution (e.g., PBS). According to a preferred embodiment of the invention, about 50 to about 500 ml of the transduction enhancing composition is delivered to the bladder by instillation for each treatment.
Alternatively, a composition comprising the transduction enhancing agent and the adenovirus can be used to treat the luminal bladder surface. According to this embodiment of the invention, any urine in the bladder is first removed and the bladder is then optionally washed with a buffer (e.g., PBS). A composition comprising the transduction enhancing agent and the adenovirus is then applied to the luminal surface of the bladder. The solution may be incubated for some specified time or drained immediately. After treatment, the luminal surface of the bladder may again be washed with a buffer (e.g., PBS).
Although phosphate buffered saline (PBS) is the preferred buffer, any other pharmaceutical buffer can be used according to the invention. Exemplary buffers include sodium phosphate/sodium sulfate, Tris buffer, glycine buffer, sterile water and other buffers known in the art, including those described by Good, et al., Biochemistry 5, 467 (1966). The pH of the buffer can be in the range of 6.4 to 8.4, preferably 7 to 7.5, and most preferably 7.2 to 7.4.
The composition comprising the transduction enhancing agent according to the invention preferably also comprises an oxidizing agent. Exemplary oxidizing agents include, but are not limited to, chlorite compounds, hypochlorous acid, hydrogen peroxide, and peroxyacetic acid. According to a preferred embodiment of the invention, any of the single compound transduction enhancing agents can be combined with an oxidizing agent and used as a transduction enhancing agent.
As set forth above, the viral gene therapy vehicle can be an oncolytic virus, for example an oncolytic adenovirus exemplified herein by CG8840. The adenovirus composition can further comprise a chemotherapeutic agent such as Docetaxel. The adenovirus composition preferably comprises from about 1×1011 to about 1×1014 viral particles.
While the foregoing specification teaches the principles of the present invention, with examples provided for the purpose of illustration, it will be appreciated by one skilled in the art from reading this disclosure that various changes in form and detail can be made without departing from the true scope of the invention.
All publications cited herein are hereby incorporated by reference in their entirety.

## Claims

1. A method for treating superficial cancer of the bladder comprising:
contacting a luminal surface of the bladder with a pretreatment composition comprising a transduction enhancing agent; and
further contacting the luminal surface of the bladder with a composition comprising a replication competent oncolytic adenovirus,
wherein the transduction enhancing agent is a disaccharide having a lipophilic side chain consisting of 12 carbons;
wherein said oncolytic adenovirus exhibits preferential expression in bladder epithelium;
and wherein said cancer is derived from the bladder epithelium.

2. The method of claim 1, wherein the transduction enhancing agent has the following general formula (I):




wherein X is a sulfur or oxygen atom, each R2 is independently hydrogen or a moiety represented by:




and R1 represents an alkyl or alkenyl group of 12 carbons.

3. The method of claim 2, wherein the transduction enhancing agent has the chemical formula:




wherein n is 11.

4. The method of claim 1, wherein the transduction enhancing agent has the chemical formula:




wherein n is 6.

5. The method of claim 4, wherein the pretreatment composition comprises about 0.1% by weight of the transduction enhancing agent.

6. The method of claim 1, wherein contacting the luminal surface of the bladder with the composition comprising the oncolytic adenovirus comprises delivering about 50 to about 500 ml of the composition comprising the oncolytic adenovirus to the bladder by instillation.

7. The method of claim 1, wherein the oncolytic adenovirus composition comprises from about 1×1011 to about 1×1014 viral particles.

8. The method of claim 1, wherein contacting the luminal surface of the bladder with a pretreatment composition comprises delivering the pretreatment composition to the bladder by instillation.

9. The method of claim 1, further comprising washing the luminal surface of the bladder after contact with the pretreatment composition and before contact with the composition comprising the oncolytic adenovirus.

10. The method of claim 1, wherein the pretreatment composition is contacted with the luminal surface of the bladder for about 5 minutes.

11. The method of claim 1, wherein the pretreatment composition further comprises an oxidizing agent.

12. The method of claim 11, wherein the oxidizing agent is selected from the group consisting of hypochlorous acid, hydrogen peroxide, and peroxyacetic acid.

13. A composition comprising:
a transduction enhancing agent; and
a replication competent oncolytic adenovirus;
wherein said replication competent oncolytic adenovirus is effective to transduce cells of a bladder epithelium and said transduction enhancing agent has the following general formula (I):





wherein X is a sulfur or oxygen atom, each R2 is independently hydrogen or a moiety represented by:




and R1 represents an alkyl or alkenyl group of 12 carbons.

14. The composition of claim 13 wherein the transduction enhancing agent has the chemical formula




wherein n is 11.

15. The composition of claim 13 wherein the transduction enhancing agent has the chemical formula




wherein n is 11.

16. A composition comprising:
a transduction enhancing agent; and
a replication competent oncolytic adenovirus;
wherein said replication competent oncolytic adenovirus is effective to transduce cells of a bladder epithclium and said transduction enhancing agent has the following formula





wherein n is 6.

17. A composition comprising:
a transduction enhancing agent; and
a replication competent oncolytic adenovirus;
wherein said replication competent oncolytic adenovirus is effective to transduce cells of a bladder epithelium and said transduction enhancing agent has the following formula





wherein n is 6.

18. The method of claim 2, wherein the transduction enhancing agent has the chemical formula:




wherein n is 11.

19. The method of claim 1, wherein the transduction enhancing agent has the chemical formula:




wherein n is 6.

20. The method of claim 1, wherein the composition comprising the transduction enhancing agent and the composition comprising the replication competent oncolytic adenovirus are co-administered.

21. The method of claim 1, wherein the composition comprising the transduction enhancing agent is administered prior to the composition comprising the replication competent oncolytic adenovirus.

22. The method of claim 4 or claim 19, wherein the pretreatment composition comprises about 0.1% by weight of the transduction enhancing agent.