Magovern C J, Mack C A, Zhang J, Hahn R T, Ko W, Isom O W, Crystal R G, Rosengart T K
Department of Cardiothoracic Surgery, New York Hospital, Cornell Medical Center, NY 10021, USA.
Ann Thorac Surg. 1996 Aug;62(2):425-33; discussion 433-4.
Direct myocardial gene transfer is a mordality that involves the introduction of genetic information into myocardial tissue to achieve a therapeutic effect. This study was designed to characterize the temporal and spatial limits of gene expression and to determine the safety of direct myocardial gene transfer in a large animal model using replication-deficient adenovirus vectors.
Mongrel dogs underwent left thoracotomy and direct myocardial injections (100 microL/injection) of adenovirus vectors (10(9) pfu) carrying the DNA for the reporter enzyme chloramphenicol acetyl transferase or the angiogenic protein vascular endothelial growth factor. Two to 14 days after vector administration, regional protein expression was evaluated in myocardium and distant organs. Left ventricular function, assessed by echocardiography, and routine hematologic and biochemical indices were evaluated before and after vector administration.
Peak levels of chloramphenicol acetyl transferase activity were detected 2 days after vector administration, and levels above baseline persisted for at least 14 days. Local chloramphenicol acetyl transferase activity was detected at distances at least as far as 1.5 cm from the site of injection. Chloramphenicol acetyl transferase activity in distant organs was less than 0.1% of that in injected myocardium 7 days after vector administration. Localized expression of vascular endothelial growth factor was achieved for up to 7 days after a single vector administration. Cardiac function and laboratory values were unchanged during the study.
Adenovirus-mediated direct myocardial gene transfer can be accomplished safely in a large animal model, providing high levels of protein expression in a greater spatial distribution than previously reported, with minimal transfection of distant organs. Sustained and localized expression of a potent angiogenic mediator has been accomplished, which may provide an innovative strategy to stimulate angiogenesis in ischemic myocardium.
直接心肌基因转移是一种将遗传信息导入心肌组织以达到治疗效果的方式。本研究旨在描述基因表达的时空限度,并使用复制缺陷型腺病毒载体在大型动物模型中确定直接心肌基因转移的安全性。
杂种犬接受左胸切开术,并将携带报告酶氯霉素乙酰转移酶或血管生成蛋白血管内皮生长因子DNA的腺病毒载体(10⁹ pfu)直接注入心肌(100 μL/注射)。在给予载体后2至14天,评估心肌和远处器官中的局部蛋白表达。在给予载体前后,通过超声心动图评估左心室功能,并评估常规血液学和生化指标。
在给予载体后2天检测到氯霉素乙酰转移酶活性的峰值水平,且高于基线的水平持续至少14天。在距注射部位至少1.5 cm处检测到局部氯霉素乙酰转移酶活性。在给予载体7天后,远处器官中的氯霉素乙酰转移酶活性低于注射心肌中的0.1%。单次给予载体后,血管内皮生长因子的局部表达可持续长达7天。在研究期间,心脏功能和实验室值未发生变化。
腺病毒介导的直接心肌基因转移可以在大型动物模型中安全完成,与先前报道相比,能在更大的空间分布中提供高水平的蛋白表达,远处器官的转染极少。已实现了一种强效血管生成介质的持续局部表达,这可能为刺激缺血心肌中的血管生成提供一种创新策略。