Pulmonary surfactant has been used as a carrier to deliver a therapeutic virus to dysfunctional lung cells that reside within an intricate lung structure. To investigate whether
pulmonary surfactant enhances the efficacy of intratracheal instillation of a therapeutic virus to target KRAS mutation-bearing
lung cancer in vivo, we developed a recombinant adenovirus that induces cell death only in
lung cancer cells and injected the adenovirus into a mouse model of KRAS mutation-positive
lung cancer intratracheally with and without
surfactant. A therapeutic adenovirus that induces cell death only in
lung cancer cells was constructed by combining a
cancer-specific human
telomerase reverse transcriptase (hTERT) promoter fused to
CCAAT/enhancer-binding protein alpha (CEBPα) with a modified lung-specific Clara cell-specific 10-kDa
protein (CC10) promoter fused to cytotoxic adenovirus type 5 early region 1A (E1A). CEBPα is induced only in
cancer cells and activates the CC10 promoter, which in turn induces cytotoxic E1A, and causes cell death only in
lung cancer cells in vitro. This adenovirus was intratracheally administered to the model mice (CCSP-rtTA/Tet-op-K-Ras4bG12D bitransgenic mice) in the presence and absence of
pulmonary surfactant. Intratracheally administered therapeutic adenovirus with
pulmonary surfactant spread to airways, as well as to the alveolar region of the lung, and caused a reduction of lung
tumors developed. The therapeutic adenovirus without
pulmonary surfactant spread only to airways and was ten-fold less effective in
tumor reduction. Here, we demonstrate that
pulmonary surfactant is an efficient tool to intratracheally deliver a therapeutic virus to treat KRAS mutation-positive
lung cancer in vivo.