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基于骨髓干细胞的SERCA2a基因疗法治疗急性心肌梗死后心力衰竭

[Bone marrow stem cells-based SERCA2a gene therapy for heart failure after acute myocardium infarction].

作者信息

Guo Yu-tao, Li Xiao-ying, Lu Xiao-chun, Wu Di, Yao Ke-qun, Chen Ping, Ma Kang-tao, Zhou Chun-yan

机构信息

Department of Geriatric Cardiology, General Hospital of The Chinese PLA, Beijing, 100853, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Mar 28;86(12):826-31.

Abstract

OBJECTIVE

Explore the possibility of MSC to be used to target delivery of therapeutic gene and evaluate the therapeutic effects among gene therapy, MSC transplantation and MSC-based gene therapy.

METHODS

MSC were infected with an adenoviral expression vector carrying SERCA2a. SD female rats were used to make animal model with heart failure after AMI and divided into 4 groups randomly. Group I (n = 7) received SERCA2a gene therapy, group II (n = 7) received MSC transplantation, group III (n = 8) received MSC infected with SERCA2a gene transplantation, and group IV (n = 7) received empty adenoviral vector. Cardiac function was evaluated by echocardiography and physiological recorder. SERCA2a gene and protein expression were evaluated by RT-PCR and Western blot respectively.

RESULTS

Compared to group IV, EF and FS of group I, group II and group III were elevated significantly on 14 days after therapy (EF: 67.7 +/- 3.9, 62.6 +/- 4.0, 67.9 +/- 3.7 versus 45.0 +/- 2.2; FS: 33.9 +/- 1.9, 31.1 +/- 2.0, 33.9 +/- 1.9 versus 22.5 +/- 1.1, P < 0.05). While the elevation values of EF and FS began to reduce in group I 14 days after, it continued to increase in both group II and group III. Absolute value of LVEDP at 21 days after treatment was increased in group I, group II and group III compared to group IV (5.3 mm Hg +/- 1.2 mm Hg, 6.0 +/- 1.3 mm Hg, 6.2 mm Hg +/- 1.2 mm Hg versus 1.5 mm Hg +/- 0.2 mm Hg, P < 0.05), as well as absolute value of DP/dtmin (4756 mm Hg/s +/- 270 mm Hg/s, 5028 mm Hg/s +/- 253 mm Hg/s, 5283 mm Hg/s +/- 363 mm Hg/s versus 3201 mm Hg/s +/- 211 mm Hg/s, P < 0.05). DP/dtmax at 21 days after treatment increased in group I, group II and group III compared to group IV (6026 mm Hg/s +/- 281 mm Hg/s, 6278 mm Hg/s +/- 319 mm Hg/s, 7057 mm Hg/s +/- 389 mm Hg/s versus 5293 mm Hg/s +/- 360 mm Hg/s, P < 0.05). SERCA2a expressions and enzyme activity were significantly stronger in group I and group III than in group II and group IV.

CONCLUSION

It showed that all MSC transplantation, SERCA2a gene therapy and MSC-based gene therapy could enhance cardiac function. The recovered heart function continued to improve in MSC transplantation group and MSC-based gene therapy group up to 21 days, however slowed down in single gene therapy group in 21 days. Such therapeutic tendency of MSC-based gene therapy was stronger than that of MSC transplantation. Thus, MSC proved an effective platform for the targeted delivery of therapeutic gene.

摘要

目的

探讨间充质干细胞(MSC)用于靶向递送治疗性基因的可能性,并评估基因治疗、MSC移植及基于MSC的基因治疗的疗效。

方法

用携带肌浆网Ca2+-ATP酶2a(SERCA2a)的腺病毒表达载体感染MSC。选用雌性SD大鼠制作急性心肌梗死后心力衰竭动物模型,并随机分为4组。Ⅰ组(n = 7)接受SERCA2a基因治疗,Ⅱ组(n = 7)接受MSC移植,Ⅲ组(n = 8)接受感染SERCA2a基因的MSC移植,Ⅳ组(n = 7)接受空腺病毒载体。通过超声心动图和生理记录仪评估心功能。分别采用逆转录-聚合酶链反应(RT-PCR)和蛋白质免疫印迹法评估SERCA2a基因和蛋白表达。

结果

与Ⅳ组相比,治疗后14天时,Ⅰ组、Ⅱ组和Ⅲ组的左室射血分数(EF)和左室短轴缩短率(FS)显著升高(EF:67.7±3.9、62.6±4.0、67.9±3.7比45.0±2.2;FS:33.9±1.9、31.1±2.0、33.9±1.9比22.5±1.1,P < 0.05)。Ⅰ组治疗后14天时EF和FS升高值开始降低,而Ⅱ组和Ⅲ组则持续升高。治疗后21天时,Ⅰ组、Ⅱ组和Ⅲ组的左室舒张末压(LVEDP)绝对值较Ⅳ组升高(5.3 mmHg±1.2 mmHg、6.0±1.3 mmHg、6.2 mmHg±1.2 mmHg比1.5 mmHg±0.2 mmHg,P < 0.05),左室内压最大下降速率(DP/dtmin)绝对值也升高(4756 mmHg/s±270 mmHg/s、5028 mmHg/s±253 mmHg/s、5283 mmHg/s±363 mmHg/s比3201 mmHg/s±211 mmHg/s,P < 0.05)。治疗后21天时,Ⅰ组、Ⅱ组和Ⅲ组的左室内压最大上升速率(DP/dtmax)较Ⅳ组升高(6026 mmHg/s±281 mmHg/s、6278 mmHg/s±319 mmHg/s、7057 mmHg/s±389 mmHg/s比5293 mmHg/s±360 mmHg/s,P < 0.05)。Ⅰ组和Ⅲ组的SERCA2a表达及酶活性显著强于Ⅱ组和Ⅳ组。

结论

结果显示,MSC移植、SERCA2a基因治疗及基于MSC的基因治疗均可增强心功能。MSC移植组和基于MSC的基因治疗组的心功能恢复在21天时持续改善,而单基因治疗组在21天时有所减缓。基于MSC的基因治疗的这种治疗趋势强于MSC移植。因此,MSC是治疗性基因靶向递送的有效平台。

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