Figure 1.

Obstacles to overcome in adenovirus-mediated virotherapy. In blood the Ad capsid binds to erythrocytes, platetes, monocytes, neutrophils, antibodies, complement, and clotting factors. In liver, the capsid binds to Kupffer cells and hepatocytes. In tumors, the diffusion of the virus is blocked by the stroma formed by an extracellular matrix and cells such as cancer-associated fibroblasts. An innate inflammatory response calls antigen presenting cells to the tumor site to capture and transport antigens to lymph nodes to elicit an adaptive responses dominated by the virus.