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Del Bauzá MR, López AE, Simonin JA, Cimbaro FS, Scharn A, Castro A, Silvestro CV, Cuniberti LA, Crottogini AJ, Belaich MN, Locatelli P, Olea FD. Effect of Intramyocardial Administration of Baculovirus Encoding the Transcription Factor Tbx20 in Sheep With Experimental Acute Myocardial Infarction. J Am Heart Assoc 2024; 13:e031515. [PMID: 39028008 DOI: 10.1161/jaha.123.031515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/13/2023] [Indexed: 07/20/2024]
Abstract
BACKGROUND Gene therapy has been proposed as a strategy to induce cardiac regeneration following acute myocardial infarction (AMI). Given that Tbx20, a transcription factor of the T-box subfamily, stimulates cell proliferation and angiogenesis, we designed a baculovirus overexpressing Tbx20 (Bv-Tbx20) and evaluated its effects in cultured cardiomyocytes and in an ovine model of AMI. METHODS AND RESULTS Cell proliferation and angiogenesis were measured in cardiomyocytes transduced with Bv-Tbx20 or Bv-Null (control). Subsequently, in sheep with AMI, Bv-Tbx20 or Bv-Null was injected in the infarct border. Cardiomyocyte cell cycle activity, angioarteriogenesis, left ventricular function, and infarct size were assessed. Cardiomyocytes transduced with BvTbx20 increased cell proliferation, cell cycle regulatory and angiogenic gene expression, and tubulogenesis. At 7 days posttreatment, sheep treated with Bv-Tbx20 showed increased Tbx20, promitotic and angiogenic gene expression, decreased levels of P21, increased Ki67- (17.09±5.73 versus 7.77±7.24 cardiomyocytes/mm2, P<0.05) and PHH3 (phospho-histone H3)-labeled cardiomyocytes (10.10±3.51 versus 5.23±2.87 cardiomyocytes/mm2, P<0.05), and increased capillary (2302.68±353.58 versus 1694.52±211.36 capillaries/mm2, P<0.001) and arteriolar (146.95±53.14 versus 84.06±16.84 arterioles/mm2, P<0.05) densities. At 30 days, Bv-Tbx20 decreased infarct size (9.89±1.92% versus 12.62±1.33%, P<0.05) and slightly improved left ventricular function. Baculoviral gene transfer-mediated Tbx20 overexpression exerted angiogenic and cardiomyogenic effects in vitro. CONCLUSIONS In sheep with AMI, Bv-Tbx20 induced angioarteriogenesis, cardiomyocyte cell cycle activity, infarct size limitation, and a slight recovery of left ventricular function, suggesting that Bv-Tbx20 gene therapy may contribute to cardiac regeneration following AMI.
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Affiliation(s)
- María Rosario Del Bauzá
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Ayelén Emilce López
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Jorge Alejandro Simonin
- Laboratorio de Ingeniería Genética y Biología Celular y Molecular, Departamento de Ciencia y Tecnología Instituto de Microbiología Básica y Aplicada, Universidad Nacional de Quilmes Bernal Provincia de Buenos Aires Argentina
| | - Francisco Stefano Cimbaro
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Agustina Scharn
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Araceli Castro
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Cintia Virginia Silvestro
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Luis Alberto Cuniberti
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Alberto José Crottogini
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Mariano Nicolás Belaich
- Laboratorio de Ingeniería Genética y Biología Celular y Molecular, Departamento de Ciencia y Tecnología Instituto de Microbiología Básica y Aplicada, Universidad Nacional de Quilmes Bernal Provincia de Buenos Aires Argentina
| | - Paola Locatelli
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
| | - Fernanda Daniela Olea
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB)-Universidad Favaloro- CONICET Buenos Aires Argentina
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Goswami AG, Basu S, Huda F, Pant J, Ghosh Kar A, Banerjee T, Shukla VK. An appraisal of vascular endothelial growth factor (VEGF): the dynamic molecule of wound healing and its current clinical applications. Growth Factors 2022; 40:73-88. [PMID: 35584274 DOI: 10.1080/08977194.2022.2074843] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Angiogenesis is a critical step of wound healing, and its failure leads to chronic wounds. The idea of restoring blood flow to the damaged tissues by promoting neo-angiogenesis is lucrative and has been researched extensively. Vascular endothelial growth factor (VEGF), a key dynamic molecule of angiogenesis has been investigated for its functions. In this review, we aim to appraise its biology, the comprehensive role of this dynamic molecule in the wound healing process, and how this knowledge has been translated in clinical application in various types of wounds. Although, most laboratory research on the use of VEGF is promising, its clinical applications have not met great expectations. We discuss various lacunae that might exist in making its clinical application unsuccessful for commercial use, and provide insight to the foundation for future research.
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Affiliation(s)
- Aakansha Giri Goswami
- Department of General surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Somprakas Basu
- Department of General surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Farhanul Huda
- Department of General surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Jayanti Pant
- Department of Physiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Amrita Ghosh Kar
- Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Tuhina Banerjee
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Vijay Kumar Shukla
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Benington L, Rajan G, Locher C, Lim LY. Fibroblast Growth Factor 2-A Review of Stabilisation Approaches for Clinical Applications. Pharmaceutics 2020; 12:E508. [PMID: 32498439 PMCID: PMC7356611 DOI: 10.3390/pharmaceutics12060508] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 02/07/2023] Open
Abstract
Basic fibroblast growth factor (FGF)-2 has been shown to regulate many cellular functions including cell proliferation, migration, and differentiation, as well as angiogenesis in a variety of tissues, including skin, blood vessel, muscle, adipose, tendon/ligament, cartilage, bone, tooth, and nerve. These multiple functions make FGF-2 an attractive component for wound healing and tissue engineering constructs; however, the stability of FGF-2 is widely accepted to be a major concern for the development of useful medicinal products. Many approaches have been reported in the literature for preserving the biological activity of FGF-2 in aqueous solutions. Most of these efforts were directed at sustaining FGF-2 activity for cell culture research, with a smaller number of studies seeking to develop sustained release formulations of FGF-2 for tissue engineering applications. The stabilisation approaches may be classified into the broad classes of ionic interaction modification with excipients, chemical modification, and physical adsorption and encapsulation with carrier materials. This review discusses the underlying causes of FGF-2 instability and provides an overview of the approaches reported in the literature for stabilising FGF-2 that may be relevant for clinical applications. Although efforts have been made to stabilise FGF-2 for both in vitro and in vivo applications with varying degrees of success, the lack of comprehensive published stability data for the final FGF-2 products represents a substantial gap in the current knowledge, which has to be addressed before viable products for wider tissue engineering applications can be developed to meet regulatory authorisation.
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Affiliation(s)
- Leah Benington
- Division of Pharmacy, School of Allied Health, University of Western Australia, Crawley 6009, Australia; (L.B.); (C.L.)
| | - Gunesh Rajan
- Division of Surgery, School of Medicine, University of Western Australia, Crawley 6009, Australia;
- Department of Otolaryngology, Head & Neck Surgery, Luzerner Kantonsspital, 6000 Luzern, Switzerland
| | - Cornelia Locher
- Division of Pharmacy, School of Allied Health, University of Western Australia, Crawley 6009, Australia; (L.B.); (C.L.)
| | - Lee Yong Lim
- Division of Pharmacy, School of Allied Health, University of Western Australia, Crawley 6009, Australia; (L.B.); (C.L.)
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N-acetylcysteine differentially regulates the populations of bone marrow and circulating endothelial progenitor cells in mice with limb ischemia. Eur J Pharmacol 2020; 881:173233. [PMID: 32492379 DOI: 10.1016/j.ejphar.2020.173233] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 05/21/2020] [Accepted: 05/29/2020] [Indexed: 12/20/2022]
Abstract
Endothelial progenitor cells (EPCs) are important to tissue repair and regeneration especially after ischemic injury, and very heterogeneous in phenotypes and biological features. Reactive oxygen species are involved in regulating EPC number and function. N-acetylcysteine (NAC) inhibits ischemia-induced reactive oxygen species formation and promotes ischemic limb recovery. This study was to evaluate the effect of NAC on EPC subpopulations in bone marrow (BM) and blood in mice with limb ischemia. Limb ischemia was induced by femoral artery ligation in male C57BL/6 mice with or without NAC treatment. EPC subpopulations, intracellular reactive oxygen species production, cell proliferation and apoptosis in BM and blood cells were analyzed at baseline, day 3 (acute ischemia) and 21 (chronic) after ligation. c-Kit+/CD31+, Sca-1+/Flk-1+, CD34+/CD133+, and CD34+/Flk-1+ were used to define EPC subpopulations. Limb blood flow, function, muscle structure, and capillary density were evaluated with laser Doppler perfusion imaging, treadmill test, and immunohistochemistry, respectively, at day 3, 7, 14 and 21 post ischemia. Reactive oxygen species production in circulating and BM mononuclear cells and EPCs populations were significantly increased in BM and blood in mice with acute and chronic ischemia. NAC treatment effectively blocked ischemia-induced reactive oxygen species production in circulating and BM mononuclear cells, and selectively increased EPC population in circulation, not BM, with preserved proliferation in mice with chronic ischemia, and enhanced limb blood flow and function recovery, while preventing acute ischemia-induced increase in BM and circulating EPCs. These data demonstrated that NAC selectively enhanced circulating EPC population in mice with chronic limb ischemia.
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Machado MJC, Boardman R, Riu F, Emanueli C, Benest AV, Bates DO. Enhanced notch signaling modulates unproductive revascularization in response to nitric oxide-angiopoietin signaling in a mouse model of peripheral ischemia. Microcirculation 2019; 26:e12549. [PMID: 30974486 PMCID: PMC6899699 DOI: 10.1111/micc.12549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/28/2019] [Accepted: 04/08/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Arteriolargenesis can be induced by concomitant stimulation of nitric Oxide (NO)-Angiopoietin receptor (Tie)-Vascular Endothelial Growth Factor (VEGF) signaling in the rat mesentery angiogenesis assay. We hypothesized that the same combination of exogenously added growth factors would also have a positive impact on arteriolargenesis and, consequently, the recovery of blood flow in a model of unilateral hindlimb ischemia. RESULTS AND METHODS NO-Tie mice had faster blood flow recovery compared to control mice, as assessed by laser speckle imaging. There was no change in capillary density within the ischemic muscles, but arteriole density was higher in NO-Tie mice. Given the previously documented beneficial effect of VEGF signaling, we tested whether NO-Tie-VEGF mice would show further improvement. Surprisingly, these mice recovered no differently from control, arteriole density was similar and capillary density was lower. Dll4 is a driver of arterial specification, so we hypothesized that Notch1 expression would be involved in arteriolargenesis. There was a significant upregulation of Notch1 transcripts in NO-Tie-VEGF compared with NO-Tie mice. Using soluble Dll4 (sDll4), we stimulated Notch signaling in the ischemic muscles of mice. NO-Tie-sDll4 mice had significantly increased capillary and arteriole densities, but impaired blood flow recovery. CONCLUSION These results suggest that Dll4 activation early on in revascularization can lead to unproductive angiogenesis and arteriolargenesis, despite increased vascular densities. These results suggest spatial and temporal balance of growth factors needs to be perfected for ideal functional and anatomical revascularisation.
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Affiliation(s)
- Maria J. C. Machado
- Division of Cancer and Stem CellsTumour and Vascular Biology Laboratories, Cancer BiologySchool of MedicineQueen's Medical CentreUniversity of NottinghamNottinghamUK
| | - Rachel Boardman
- Division of Cancer and Stem CellsTumour and Vascular Biology Laboratories, Cancer BiologySchool of MedicineQueen's Medical CentreUniversity of NottinghamNottinghamUK
| | - Federica Riu
- Division of Cancer and Stem CellsTumour and Vascular Biology Laboratories, Cancer BiologySchool of MedicineQueen's Medical CentreUniversity of NottinghamNottinghamUK
| | | | - Andrew V. Benest
- Division of Cancer and Stem CellsTumour and Vascular Biology Laboratories, Cancer BiologySchool of MedicineQueen's Medical CentreUniversity of NottinghamNottinghamUK
- COMPARE University of Birmingham and University of NottinghamNottinghamUK
| | - David O. Bates
- Division of Cancer and Stem CellsTumour and Vascular Biology Laboratories, Cancer BiologySchool of MedicineQueen's Medical CentreUniversity of NottinghamNottinghamUK
- COMPARE University of Birmingham and University of NottinghamNottinghamUK
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Bauzá MDR, Giménez CS, Locatelli P, De Lorenzi A, Hnatiuk A, Capogrossi MC, Crottogini A, Cuniberti L, Olea FD. High-dose intramyocardial HMGB1 induces long-term cardioprotection in sheep with myocardial infarction. Drug Deliv Transl Res 2019; 9:935-944. [DOI: 10.1007/s13346-019-00628-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sanada F, Taniyama Y, Muratsu J, Otsu R, Shimizu H, Rakugi H, Morishita R. Gene-Therapeutic Strategies Targeting Angiogenesis in Peripheral Artery Disease. MEDICINES (BASEL, SWITZERLAND) 2018; 5:E31. [PMID: 29601487 PMCID: PMC6024305 DOI: 10.3390/medicines5020031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/21/2018] [Accepted: 03/28/2018] [Indexed: 11/24/2022]
Abstract
The World Health Organization announced that cardiovascular disease is the number one cause of death globally, representing 31% of all global deaths. Coronary artery disease (CAD) affects approximately 5% of the US population aged 40 years and older. With an age-adjusted prevalence of approximately 12%, peripheral artery disease (PAD) affects at least 8 to 12 million Americans. Both CAD and PAD are caused by mainly atherosclerosis, the hardening and narrowing of arteries over the years by lipid deposition in the vascular bed. Despite the significant advances in interventions for revascularization and intensive medical care, patients with CAD or PAD who undergo percutaneous transluminal angioplasty have a persistent high rate of myocardial infarction, amputation, and death. Therefore, new therapeutic strategies are urgently needed for these patients. To overcome this unmet need, therapeutic angiogenesis using angiogenic growth factors has evolved in an attempt to stimulate the growth of new vasculature to compensate for tissue ischemia. After nearly 20 years of investigation, there is growing evidence of successful or unsuccessful gene therapy for ischemic heart and limb disease. This review will discuss basic and clinical data of therapeutic angiogenesis studies employing angiogenic growth factors for PAD patients and will draw conclusions on the basis of our current understanding of the biological processes of new vascularization.
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Affiliation(s)
- Fumihiro Sanada
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Yoshiaki Taniyama
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Jun Muratsu
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Rei Otsu
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Hideo Shimizu
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Ryuichi Morishita
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
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Bao H, Lv F, Liu T. A pro-angiogenic degradable Mg-poly(lactic-co-glycolic acid) implant combined with rhbFGF in a rat limb ischemia model. Acta Biomater 2017; 64:279-289. [PMID: 28951330 DOI: 10.1016/j.actbio.2017.09.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 09/15/2017] [Accepted: 09/22/2017] [Indexed: 12/25/2022]
Abstract
Site-specific controlled release of exogenous angiogenic growth factors, such as recombinant human basic fibroblast growth factor (rhbFGF), has become a promising approach to improve peripheral vascular disease. Here, we have developed an implant composed of spiral magnesium (Mg) and a coating made using poly(lactic-co-glycolic acid) (PLGA) with encapsulated rhbFGF (Mg-PLGA-rhbFGF). The encapsulated protein could release continually for 4weeks with well preserved bioactivity. We compared the angiogenic effect produced by Mg-PLGA-rhbFGF with that of a PLGA implant loaded with rhbFGF (PLGA-rhbFGF). The incorporation of Mg in the implant raised the microclimate pH in the polymer, which preserved the stability of rhbFGF. Mg-PLGA-rhbFGF exhibited advantages over PLGA-rhbFGF implant in terms of a cytocompatibility evaluation. An in vivo angiogenesis test further confirmed the efficacy of released rhbFGF. HE, CD31 and α-SMA staining revealed that the controlled release of rhbFGF from the Mg-PLGA-rhbFGF implant was superior in promoting angiogenesis compared with that of the PLGA-rhbFGF implant. Four weeks post-implantation, the capillary density of the Mg-PLGA-rhbFGF group was significantly higher than that of the PLGA-rhbFGF, control and the normal group (p<0.05, p<0.01 and p<0.01, respectively). Furthermore, the limb blood perfusion ratios of the Mg-PLGA-rhbFGF and PLGA-rhbFGF groups were dramatically increased, at 99.1±2.9% and 80.7±3.2%, respectively, whereas the ischemic limb did not recover in the control group. The biocompatibility of the implants was also evaluated. In conclusion, Mg-PLGA-based, sustained local delivery of rhbFGF promotes post-ischemic angiogenesis and blood flow recovery. The results suggest potential therapeutic usefulness of Mg-PLGA-rhbFGF for tissue ischemia. STATEMENT OF SIGNIFICANCE Magnesium (Mg)-based implant has been already used in patients with critical limb ischemia. Site-specific controlled release of recombinant human basic fibroblast growth factor (rhbFGF), has become a promising approach to improve peripheral vascular disease. We report here on a novel combination implant composed of spiral magnesium and a coating made using poly(lactic-co-glycolic acid) (PLGA) with encapsulated rhbFGF (Mg-PLGA-rhbFGF). The preparation method does not involve any complex processes and results in a high encapsulation efficiency (approximately 100%). The degradation of metal Mg raise the microclimate pH in the PLGA polymer, which could well preserve the bioactivity of rhbFGF incorporated in the implant. Mg-PLGA-based, sustained local delivery of rhbFGF promotes post-ischemic angiogenesis and blood flow recovery in rat limb ischemic model. This work marks the first report for controlled release of rhbFGF in combination with metal Mg, and suggests potential therapeutic usefulness of Mg-PLGA-rhbFGF for tissue ischemia.
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Affiliation(s)
- Hanmei Bao
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Biomedical Materials, Tianjin 300192, China; Department of Clinical Pharmacology, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Feng Lv
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Biomedical Materials, Tianjin 300192, China.
| | - Tianjun Liu
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin Key Laboratory of Biomedical Materials, Tianjin 300192, China.
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Hadjizadeh A, Ghasemkhah F, Ghasemzaie N. Polymeric Scaffold Based Gene Delivery Strategies to Improve Angiogenesis in Tissue Engineering: A Review. POLYM REV 2017. [DOI: 10.1080/15583724.2017.1292402] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Afra Hadjizadeh
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Farzaneh Ghasemkhah
- Institute of Nanotechnology, Amirkabir University of Technology, Tehran, Iran
| | - Niloofar Ghasemzaie
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
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10
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Gong H, Liu M, Klomp J, Merrill BJ, Rehman J, Malik AB. Method for Dual Viral Vector Mediated CRISPR-Cas9 Gene Disruption in Primary Human Endothelial Cells. Sci Rep 2017; 7:42127. [PMID: 28198371 PMCID: PMC5309830 DOI: 10.1038/srep42127] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/03/2017] [Indexed: 01/13/2023] Open
Abstract
Human endothelial cells (ECs) are widely used to study mechanisms of angiogenesis, inflammation, and endothelial permeability. Targeted gene disruption induced by Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-CRISPR-Associated Protein 9 (Cas9) nuclease gene editing is potentially an important tool for definitively establishing the functional roles of individual genes in ECs. We showed that co-delivery of adenovirus encoding EGFP-tagged Cas9 and lentivirus encoding a single guide RNA (sgRNA) in primary human lung microvascular ECs (HLMVECs) disrupted the expression of the Tie2 gene and protein. Tie2 disruption increased basal endothelial permeability and prevented permeability recovery following injury induced by the inflammatory stimulus thrombin. Thus, gene deletion via viral co-delivery of CRISPR-Cas9 in primary human ECs provides a novel platform to investigate signaling mechanisms of normal and perturbed EC function without the need for clonal expansion.
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Affiliation(s)
- Haixia Gong
- Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612, USA
- The Center for Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Menglin Liu
- Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612, USA
- The Center for Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Jeff Klomp
- Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612, USA
- The Center for Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Bradley J. Merrill
- Department of Biochemistry and Molecular Genetics, University of Illinois College of Medicine, Chicago, IL 60612, USA
- Genome Editing Core, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Jalees Rehman
- Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612, USA
- The Center for Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, IL 60612, USA
- Division of Cardiology, Department of Medicine, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Asrar B. Malik
- Department of Pharmacology, University of Illinois College of Medicine, Chicago, IL 60612, USA
- The Center for Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, IL 60612, USA
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11
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Henning RJ. Therapeutic angiogenesis: angiogenic growth factors for ischemic heart disease. Future Cardiol 2016; 12:585-99. [PMID: 27420190 DOI: 10.2217/fca-2016-0006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Stem cells encode vascular endothelial growth factors (VEGFs), fibroblastic growth factors (FGFs), stem cell factor, stromal cell-derived factor, platelet growth factor and angiopoietin that can contribute to myocardial vascularization. VEGFs and FGFs are the most investigated growth factors. VEGFs regulate angiogenesis and vasculogenesis. FGFs stimulate vessel cell proliferation and differentiation and are regulators of endothelial cell migration, proliferation and survival. Clinical trials of VEGF or FGF for myocardial angiogenesis have produced disparate results. The efficacy of therapeutic angiogenesis can be improved by: (1) identifying the most optimal patients; (2) increased knowledge of angiogenic factor pharmacokinetics and proper dose; (3) prolonging contact of angiogenic factors with the myocardium; (4) increasing the efficiency of VEGF or FGF gene transduction; and (5) utilizing PET or MRI to measure myocardial perfusion and perfusion reserve.
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Affiliation(s)
- Robert J Henning
- The University of South Florida and the James A. Haley Hospital, Tampa, FL 33612 USA
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12
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Boden J, Lassance-Soares RM, Wang H, Wei Y, Spiga MG, Adi J, Layman H, Yu H, Vazquez-Padron RI, Andreopoulos F, Webster KA. Vascular Regeneration in Ischemic Hindlimb by Adeno-Associated Virus Expressing Conditionally Silenced Vascular Endothelial Growth Factor. J Am Heart Assoc 2016; 5:e001815. [PMID: 27231018 PMCID: PMC4937238 DOI: 10.1161/jaha.115.001815] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 04/19/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Critical limb ischemia (CLI) is the extreme manifestation of peripheral artery disease, a major unmet clinical need for which lower limb amputation is the only option for many patients. After 2 decades in development, therapeutic angiogenesis has been tested clinically via intramuscular delivery of proangiogenic proteins, genes, and stem cells. Efficacy has been modest to absent, and the largest phase 3 trial of gene therapy for CLI reported a worsening trend of plasmid fibroblast growth factor. In all clinical trials to date, gene therapy has used unregulated vectors with limited duration of expression. Only unregulated extended expression vectors such as adeno-associated virus (AAV) and lentivirus have been tested in preclinical models. METHODS AND RESULTS We present preclinical results of ischemia (hypoxia)-regulated conditionally silenced (CS) AAV-human vascular endothelial growth factor (hVEGF) gene delivery that shows efficacy and safety in a setting where other strategies fail. In a BALB/c mouse model of CLI, we show that gene therapy with AAV-CS-hVEGF, but not unregulated AAV or plasmid, vectors conferred limb salvage, protection from necrosis, and vascular regeneration when delivered via intramuscular or intra-arterial routes. All vector treatments conferred increased capillary density, but organized longitudinal arteries were selectively generated by AAV-CS-hVEGF. AAV-CS-hVEGF therapy reversibly activated angiogenic and vasculogenic genes, including Notch, SDF1, Angiopoietin, and Ephrin-B2. Reoxygenation extinguished VEGF expression and inactivated the program with no apparent adverse side effects. CONCLUSIONS Restriction of angiogenic growth factor expression to regions of ischemia supports the safe and stable reperfusion of hindlimbs in a clinically relevant murine model of CLI.
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Affiliation(s)
- Jeffrey Boden
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL Vascular Biology Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Roberta Marques Lassance-Soares
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL Vascular Biology Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Huilan Wang
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL Vascular Biology Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Yuntao Wei
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - Maria-Grazia Spiga
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL
| | - Jennipher Adi
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL
| | - Hans Layman
- Department of Bioengineering, University of Miami Miller School of Medicine, Miami, FL
| | - Hong Yu
- Vascular Biology Institute, University of Miami Miller School of Medicine, Miami, FL Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Roberto I Vazquez-Padron
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL Vascular Biology Institute, University of Miami Miller School of Medicine, Miami, FL
| | - Fotios Andreopoulos
- Department of Bioengineering, University of Miami Miller School of Medicine, Miami, FL
| | - Keith A Webster
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL Vascular Biology Institute, University of Miami Miller School of Medicine, Miami, FL Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Sanada F, Taniyama Y, Kanbara Y, Otsu R, Ikeda-Iwabu Y, Carracedo M, Rakugi H, Morishita R. Gene therapy in peripheral artery disease. Expert Opin Biol Ther 2015; 15:381-90. [PMID: 25633211 DOI: 10.1517/14712598.2015.1007039] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Despite the remarkable progress of medicine and endovascular procedures for revascularization, patients with critical limb ischemia (CLI) remain at high risk for amputation and often have a low quality of life due to pain and ulcers in the ischemic leg. Thus, a novel strategy for generating new blood vessels in CLI patients without treatment options is vital. Pre-clinical studies and Phase I clinical trials using VEGF and fibroblast growth factor (FGF) demonstrated promising results; however, more rigorous Phase II and III clinical trials failed to demonstrate benefits for CLI patients. Recently, two multicenter, double-blind, placebo-controlled clinical trials in Japan (Phase III) and the USA (Phase II) showed the benefits of hepatocyte growth factor (HGF) gene therapy for CLI patients. Although the number of patients included in these trials was relatively small, these results imply a distinct beneficial function for HGF over other angiogenic growth factors in a clinical setting. AREAS COVERED In this review, data from Phase I-III clinical trials of gene therapy for patients with peripheral artery disease (PAD) are examined. In addition, the potential mechanisms behind the success or failure of clinical trials are discussed. EXPERT OPINION Compared with VEGF and FGF, HGF has a unique molecular effect on inflammation, fibrosis and cell senescence under pathological conditions. These features may explain the clinical benefits of HGF in PAD patients.
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Affiliation(s)
- Fumihiro Sanada
- Osaka University Graduate School of Medicine, Department of Clinical Gene Therapy , Suita, Osaka 565-0871 , Japan
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14
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Olea FD, Locatelli P, Hnatiuk A, De Lorenzi A, Valdivieso L, Rocha E, Ramírez R, Laguens R, Crottogini A. Vascular endothelial growth factor overexpression does not enhance adipose stromal cell-induced protection on muscle damage in critical limb ischemia. Arterioscler Thromb Vasc Biol 2014; 35:184-8. [PMID: 25414254 DOI: 10.1161/atvbaha.114.304348] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Critical limb ischemia complicates peripheral artery disease leading to tissue damage and amputation. We hypothesized that modifying adipose stromal cells (ASCs) to overexpress human vascular endothelial growth factor 165 (VEGF) would limit ischemic muscle damage to a larger extent than nonmodified ASCs. APPROACH AND RESULTS Rabbits with critical hindlimb ischemia were injected with allogeneic abdominal fat-derived ASCs transfected with plasmid-VEGF165 (ASCs-VEGF; n=10). Additional rabbits received nontransfected ASCs (ASCs; n=10) or vehicle (placebo; n=10). One month later, ASCs-VEGF rabbits exhibited significantly higher density of angiographically visible collaterals and capillaries versus placebo (both P<0.05) but not versus ASCs (both P=NS). Arteriolar density, however, was increased in both ASCs and ASCs-VEGF groups (both P<0.05 versus placebo). ASCs-VEGF and ASCs showed comparable post-treatment improvements in Doppler-assessed peak systolic velocity, blood pressure ratio, and resistance index. Ischemic lesions were found in 40% of the muscle samples in the placebo group, 19% in the ASCs-VEGF group, and 17% in the ASCs groups (both P<0.05 versus placebo, Fisher test). CONCLUSIONS In a rabbit model of critical limb ischemia, intramuscular injection of ASCs genetically modified to overexpress VEGF increase angiographically visible collaterals and capillary density. However, both modified and nonmodified ASCs increase arteriolar density to a similar extent and afford equal protection against ischemia-induced muscle lesions. These results indicate that modifying ASCs to overexpress VEGF does not enhance the protective effect of ASCs, and that arteriolar proliferation plays a pivotal role in limiting the irreversible tissue damage of critical limb ischemia.
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Affiliation(s)
- Fernanda Daniela Olea
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - Paola Locatelli
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - Anna Hnatiuk
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - Andrea De Lorenzi
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - León Valdivieso
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - Estefanía Rocha
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - Rodrigo Ramírez
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - Rubén Laguens
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.)
| | - Alberto Crottogini
- From the Departments of Physiology (F.D.O., P.L., A.H., E.R., R.R., A.C.) and Pathology (R.L.), Favaloro University, Buenos Aires, Argentina; and Favaloro Foundation University Hospital, Buenos Aires, Argentina (A.D.L., L.V.).
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15
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Hong G, Lee JC, Jha A, Diao S, Nakayama KH, Hou L, Doyle TC, Robinson JT, Antaris AL, Dai H, Cooke JP, Huang NF. Near-infrared II fluorescence for imaging hindlimb vessel regeneration with dynamic tissue perfusion measurement. Circ Cardiovasc Imaging 2014; 7:517-25. [PMID: 24657826 PMCID: PMC4079035 DOI: 10.1161/circimaging.113.000305] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Real-time vascular imaging that provides both anatomic and hemodynamic information could greatly facilitate the diagnosis of vascular diseases and provide accurate assessment of therapeutic effects. Here, we have developed a novel fluorescence-based all-optical method, named near-infrared II (NIR-II) fluorescence imaging, to image murine hindlimb vasculature and blood flow in an experimental model of peripheral arterial disease, by exploiting fluorescence in the NIR-II region (1000-1400 nm) of photon wavelengths. METHODS AND RESULTS Because of the reduced photon scattering of NIR-II fluorescence compared with traditional NIR fluorescence imaging and thus much deeper penetration depth into the body, we demonstrated that the mouse hindlimb vasculature could be imaged with higher spatial resolution than in vivo microscopic computed tomography. Furthermore, imaging during 26 days revealed a significant increase in hindlimb microvascular density in response to experimentally induced ischemia within the first 8 days of the surgery (P<0.005), which was confirmed by histological analysis of microvascular density. Moreover, the tissue perfusion in the ischemic hindlimb could be quantitatively measured by the dynamic NIR-II method, revealing the temporal kinetics of blood flow recovery that resembled microbead-based blood flowmetry and laser Doppler blood spectroscopy. CONCLUSIONS The penetration depth of millimeters, high spatial resolution, and fast acquisition rate of NIR-II imaging make it a useful imaging tool for murine models of vascular disease.
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Affiliation(s)
- Guosong Hong
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Jerry C Lee
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Arshi Jha
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Shuo Diao
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Karina H Nakayama
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Luqia Hou
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Timothy C Doyle
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Joshua T Robinson
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Alexander L Antaris
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Hongjie Dai
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - John P Cooke
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.)
| | - Ngan F Huang
- From the School of Medicine, Division of Cardiovascular Medicine (J.C.L., A.J., J.P.C., N.F.H.), Department of Pediatrics (T.C.D.), Department of Chemistry (G.H., S.D., J.T.R., A.L.A., H.D.), and Cardiovascular Institute (K.H.N., L.H., H.D., J.P.C., N.F.H.), Stanford University, CA; and Veteran Affairs Palo Alto Health Care System, Palo Alto, CA (K.H.N., L.H., N.F.H.).
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Sanada F, Taniyama Y, Azuma J, Yuka II, Kanbara Y, Iwabayashi M, Rakugi H, Morishita R. Therapeutic Angiogenesis by Gene Therapy for Critical Limb Ischemia: Choice of Biological Agent. IMMUNOLOGY, ENDOCRINE & METABOLIC AGENTS IN MEDICINAL CHEMISTRY 2014; 14:32-39. [PMID: 26005508 PMCID: PMC4435566 DOI: 10.2174/1871522213999131231105139] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 11/27/2013] [Accepted: 11/27/2013] [Indexed: 11/22/2022]
Abstract
Peripheral artery disease (PAD) is caused by atherosclerosis, hardening and narrowing arteries over time due to buildup of fatty deposit in vascular bed called plaque. Severe blockage of an artery of the lower extremity markedly reduce blood flow, resulting in critical limb ischemia (CLI) manifested by a variety of clinical syndromes including rest pain in the feet or toes, ulcer and gangrene with infection. Despite significant advances in clinical care and interventions for revascularization, patients with CLI remain at high risk for amputation and cardiovascular death. To overcome this unmet need, therapeutic angiogenesis using angiogenic growth factors has evolved in an attempt to increase blood flow in ischemic limb. Initial animal studies and phase I clinical trials with vascular endothelial growth factor (VEGF) or fibroblast growth factor (FGF) demonstrated promising results, inspiring scientists to progress forward. However, more rigorous phase II and III clinical trials have failed to demonstrate beneficial effects of these angiogenic growth factors to date. Recently, two multicenter, double-blind, placebo-controlled clinical trials in Japan (phase III) and US (phase II) demonstrated that hepatocyte growth factor (HGF) gene therapy for CLI significant improved primary end points and tissue oxygenation up to two years in comparison to placebo. These clinical results implicate a distinct action of HGF on cellular processes involved in vascular remodeling under pathological condition. This review presents data from phase I-III clinical trials of therapeutic angiogenesis by gene therapy in patients with PAD. Further, we discuss the potential explanation for the success or failure of clinical trials in the context of the biological mechanisms underlying angiogenesis and vascular remodeling, including cellular senescence, inflammation, and tissue fibrosis.
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Affiliation(s)
| | - Yoshiaki Taniyama
- Department of Clinical Gene Therapy
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Junya Azuma
- Department of Clinical Gene Therapy
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | | | | | | | - Hiromi Rakugi
- Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
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Vasita R, Katti DS. Growth factor-delivery systems for tissue engineering: a materials perspective. Expert Rev Med Devices 2014; 3:29-47. [PMID: 16359251 DOI: 10.1586/17434440.3.1.29] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The transplantation of organs, their surgical reconstruction or implantation of synthetic devices that can perform the function of organs, are the currently available methods for treating loss of tissue/organs in humans. However, the limitations associated with these techniques have led to the development of tissue engineering. One of the primary goals of tissue engineering is to provide growth factor delivery systems that can induce desired cell responses both in vitro and in vivo, in order to cause accelerated tissue regeneration. To make growth factors a more therapeutically viable alternative for the treatment of chronic degenerative diseases, a wide range of natural and synthetic materials have been employed as vehicles for their controlled delivery. The choice of material and design of the carrier device influence the mode of immobilization of growth factors on the scaffolds and their local/systemic administration. From a tissue engineer's perspective, materials could be used for designing scaffolds as well as for delivering single or multiple growth factors. Therefore, this review discusses growth factor delivery systems, with particular reference to carrier-based growth factor delivery systems with a focus on materials.
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Affiliation(s)
- Rajesh Vasita
- Indian Institute of Technology - Kanpur, Department of Biological Sciences and Bioengineering, Kanpur-208016, Uttar-Pradesh, India.
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18
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Lijkwan MA, Hellingman AA, Bos EJ, van der Bogt KEA, Huang M, Kooreman NG, de Vries MR, Peters HAB, Robbins RC, Hamming JF, Quax PHA, Wu JC. Short hairpin RNA gene silencing of prolyl hydroxylase-2 with a minicircle vector improves neovascularization of hindlimb ischemia. Hum Gene Ther 2014; 25:41-9. [PMID: 24090375 DOI: 10.1089/hum.2013.110] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
In this study, we target the hypoxia inducible factor-1 alpha (HIF-1-alpha) pathway by short hairpin RNA interference therapy targeting prolyl hydroxylase-2 (shPHD2). We use the minicircle (MC) vector technology as an alternative for conventional nonviral plasmid (PL) vectors in order to improve neovascularization after unilateral hindlimb ischemia in a murine model. Gene expression and transfection efficiency of MC and PL, both in vitro and in vivo, were assessed using bioluminescence imaging (BLI) and firefly luciferase (Luc) reporter gene. C57Bl6 mice underwent unilateral electrocoagulation of the femoral artery and gastrocnemic muscle injection with MC-shPHD2, PL-shPHD2, or phosphate-buffered saline (PBS) as control. Blood flow recovery was monitored using laser Doppler perfusion imaging, and collaterals were visualized by immunohistochemistry and angiography. MC-Luc showed a 4.6-fold higher in vitro BLI signal compared with PL-Luc. BLI signals in vivo were 4.3×10(5)±3.3×10(5) (MC-Luc) versus 0.4×10(5)±0.3×10(5) (PL-Luc) at day 28 (p=0.016). Compared with PL-shPHD2 or PBS, MC-shPHD2 significantly improved blood flow recovery, up to 50% from day 3 until day 14 after ischemia induction. MC-shPHD2 significantly increased collateral density and capillary density, as monitored by alpha-smooth muscle actin expression and CD31(+) expression, respectively. Angiography data confirmed the histological findings. Significant downregulation of PHD2 mRNA levels by MC-shPHD2 was confirmed by quantitative polymerase chain reaction. Finally, Western blot analysis confirmed significantly higher levels of HIF-1-alpha protein by MC-shPHD2, compared with PL-shPHD2 and PBS. This study provides initial evidence of a new potential therapeutic approach for peripheral artery disease. The combination of HIF-1-alpha pathway targeting by shPHD2 with the robust nonviral MC plasmid improved postischemic neovascularization, making this approach a promising potential treatment option for critical limb ischemia.
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Affiliation(s)
- Maarten A Lijkwan
- 1 Department of Medicine and Radiology, Stanford University School of Medicine , Stanford, CA 94305
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19
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Poole KM, Tucker-Schwartz JM, Sit WW, Walsh AJ, Duvall CL, Skala MC. Quantitative optical imaging of vascular response in vivo in a model of peripheral arterial disease. Am J Physiol Heart Circ Physiol 2013; 305:H1168-80. [PMID: 23955718 PMCID: PMC3798791 DOI: 10.1152/ajpheart.00362.2013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 08/13/2013] [Indexed: 12/20/2022]
Abstract
The mouse hind limb ischemia (HLI) model is well established for studying collateral vessel formation and testing therapies for peripheral arterial disease, but there is a lack of quantitative techniques for intravitally analyzing blood vessel structure and function. To address this need, non-invasive, quantitative optical imaging techniques were developed to assess the time-course of recovery in the mouse HLI model. Hyperspectral imaging and optical coherence tomography (OCT) were used to non-invasively image hemoglobin oxygen saturation and microvessel morphology plus blood flow, respectively, in the anesthetized mouse after induction of HLI. Hyperspectral imaging detected significant increases in hemoglobin saturation in the ischemic paw as early as 3 days after femoral artery ligation (P < 0.01), and significant increases in distal blood flow were first detected with OCT 14 days postsurgery (P < 0.01). Intravital OCT images of the adductor muscle vasculature revealed corkscrew collateral vessels characteristic of the arteriogenic response to HLI. The hyperspectral imaging and OCT data significantly correlated with each other and with laser Doppler perfusion imaging (LDPI) and tissue oxygenation sensor data (P < 0.01). However, OCT measurements acquired depth-resolved information and revealed more sustained flow deficits following surgery that may be masked by more superficial measurements (LDPI, hyperspectral imaging). Therefore, intravital OCT may provide a robust biomarker for the late stages of ischemic limb recovery. This work validates non-invasive acquisition of both functional and morphological data with hyperspectral imaging and OCT. Together, these techniques provide cardiovascular researchers an unprecedented and comprehensive view of the temporal dynamics of HLI recovery in living mice.
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Affiliation(s)
- Kristin M Poole
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
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20
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Locatelli P, Olea FD, Hnatiuk A, Sepúlveda D, Pérez Sáez JM, Argüello R, Crottogini A. Efficient plasmid-mediated gene transfection of ovine bone marrow mesenchymal stromal cells. Cytotherapy 2013; 15:163-70. [PMID: 23321328 DOI: 10.1016/j.jcyt.2012.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/28/2012] [Accepted: 11/02/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND AIMS Given the close similarity between ovine and human cardiomyocytes, sheep models of myocardial infarction and heart failure are increasingly used in studies of stem cell-mediated heart regeneration. In these studies, mesenchymal stromal cells (MSCs) are frequently employed. To enhance the paracrine effects of these MSCs, ex vivo transfection with genes encoding growth factors has been proposed. Although viral vectors exhibit higher transfection efficiency than plasmids, they entail the risks of uncontrolled transgene expression and immune reactions that preclude repeated administration. Our aim was to optimize the efficiency of plasmid-mediated transfection of ovine MSCs, while preserving cell viability. METHODS Varying amounts of diverse cationic lipids were used to obtain the reagent-to-DNA mass ratio showing highest luciferase activity. Transfection efficiency (flow cytometry) was tested on plasmid-green fluorescent protein-transfected MSCs at increasing DNA mass. RESULTS Lipofectamine LTX 5 μL and Plus reagent 4 μL with 2 μg of DNA yielded 42.3 ± 4.7% transfection efficiency, while preserving cell viability. Using these transfection conditions, we transfected MSCs with a plasmid encoding human vascular endothelial growth factor (VEGF) and found high VEGF protein concentrations in the culture supernatant from day 2 (1968 ± 324 pg/mL per μg DNA) through at least day 12 (888 ± 386 pg/mL per μg DNA) after transfection. CONCLUSIONS Plasmid-mediated transfection of ovine MSCs to over-express paracrine heart-regenerative growth factors is feasible and efficient and overcomes the risks and limitations associated with the use of viral vectors.
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Affiliation(s)
- Paola Locatelli
- Department of Physiology, Favaloro University, Buenos Aires, Argentina
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21
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Shevchenko EK, Makarevich PI, Tsokolaeva ZI, Boldyreva MA, Sysoeva VY, Tkachuk VA, Parfyonova YV. Transplantation of modified human adipose derived stromal cells expressing VEGF165 results in more efficient angiogenic response in ischemic skeletal muscle. J Transl Med 2013; 11:138. [PMID: 23742074 PMCID: PMC3680170 DOI: 10.1186/1479-5876-11-138] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 05/29/2013] [Indexed: 01/21/2023] Open
Abstract
Background Modified cell-based angiogenic therapy has become a promising novel strategy for ischemic heart and limb diseases. Most studies focused on myoblast, endothelial cell progenitors or bone marrow mesenchymal stromal cells transplantation. Yet adipose-derived stromal cells (in contrast to bone marrow) are abundantly available and can be easily harvested during surgery or liposuction. Due to high paracrine activity and availability ADSCs appear to be a preferable cell type for cardiovascular therapy. Still neither genetic modification of human ADSC nor in vivo therapeutic potential of modified ADSC have been thoroughly studied. Presented work is sought to evaluate angiogenic efficacy of modified ADSCs transplantation to ischemic tissue. Materials and methods Human ADSCs were transduced using recombinant adeno-associated virus (rAAV) serotype 2 encoding human VEGF165. The influence of genetic modification on functional properties of ADSCs and their angiogenic potential in animal models were studied. Results We obtained AAV-modified ADSC with substantially increased secretion of VEGF (VEGF-ADSCs). Transduced ADSCs retained their adipogenic and osteogenic differentiation capacities and adhesion properties. The level of angiopoetin-1 mRNA was significantly increased in VEGF-ADSC compared to unmodified cells yet expression of FGF-2, HGF and urokinase did not change. Using matrigel implant model in mice it was shown that VEGF-ADSC substantially stimulated implant vascularization with paralleling increase of capillaries and arterioles. In murine hind limb ischemia test we found significant reperfusion and revascularization after intramuscular transplantation of VEGF-ADSC compared to controls with no evidence of angioma formation. Conclusions Transplantation of AAV-VEGF- gene modified hADSC resulted in stronger therapeutic effects in the ischemic skeletal muscle and may be a promising clinical treatment for therapeutic angiogenesis.
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Affiliation(s)
- Evgeny K Shevchenko
- Laboratory of angiogenesis, Russian Cardiology Research and Production Complex, 3rd Cherepkovskaya 15A, Moscow, 121552, Russia.
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22
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Raval Z, Losordo DW. Cell therapy of peripheral arterial disease: from experimental findings to clinical trials. Circ Res 2013; 112:1288-302. [PMID: 23620237 PMCID: PMC3838995 DOI: 10.1161/circresaha.113.300565] [Citation(s) in RCA: 165] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/28/2013] [Indexed: 12/19/2022]
Abstract
The age-adjusted prevalence of peripheral arterial disease in the US population was estimated to approach 12% in 1985, and as the population ages, the overall population having peripheral arterial disease is predicted to rise. The clinical consequences of occlusive peripheral arterial disease include intermittent claudication, that is, pain with walking, and critical limb ischemia (CLI), which includes pain at rest and loss of tissue integrity in the distal limbs, which may ultimately lead to amputation of a portion of the lower extremity. The risk factors for CLI are similar to those linked to coronary artery disease and include advanced age, smoking, diabetes mellitus, hyperlipidemia, and hypertension. The worldwide incidence of CLI was estimated to be 500 to 1000 cases per million people per year in 1991. The prognosis is poor for CLI subjects with advanced limb disease. One study of >400 such subjects in the United Kingdom found that 25% required amputation and 20% (including some subjects who had required amputation) died within 1 year. In the United States, ≈280 lower-limb amputations for ischemic disease are performed per million people each year. The first objective in treating CLI is to increase blood circulation to the affected limb. Theoretically, increased blood flow could be achieved by increasing the number of vessels that supply the ischemic tissue with blood. The use of pharmacological agents to induce new blood vessel growth for the treatment or prevention of pathological clinical conditions has been called therapeutic angiogenesis. Since the identification of the endothelial progenitor cell in 1997 by Asahara and Isner, the field of cell-based therapies for peripheral arterial disease has been in a state of continuous evolution. Here, we review the current state of that field.
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Affiliation(s)
- Zankhana Raval
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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23
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Whole-mount imaging of the mouse hindlimb vasculature using the lipophilic carbocyanine dye DiI. Biotechniques 2012; 53:000113907. [PMID: 26307258 DOI: 10.2144/000113907] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/10/2012] [Indexed: 11/23/2022] Open
Abstract
The availability of transgenic disease backgrounds and the accessibility of molecular research reagents have contributed to make the mouse ischemic hindlimb the model of choice for many studies of angiogenesis, and to investigate new treatments for peripheral artery disease. A limitation of these models involves our inability to easily visualize the regenerated vascular architecture. Approaches such as micro-computed tomography and micro-angiography are expensive, technically demanding and not available to many laboratories. Here we describe a rapid and inexpensive adaptation of a vascular staining procedure for precise imaging of the mouse hindlimb vasculature. We introduced two technical modifications and an analytical extension to the original method including (i) pre-skinning of the muscle prior to fixation that preserves tissue integrity, (ii) mild pressure-desiccation subsequent to fixing that enhances resolution and image penetration, and (iii) reconstruction of confocal data into 3D images. The procedure provides resolution that is equivalent or superior to other approaches at a fraction of the cost, time and technology required.
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24
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Stromal-Cell-Derived Factor-1 (SDF-1)/CXCL12 as Potential Target of Therapeutic Angiogenesis in Critical Leg Ischaemia. Cardiol Res Pract 2012; 2012:143209. [PMID: 22462026 PMCID: PMC3296148 DOI: 10.1155/2012/143209] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 12/16/2011] [Indexed: 12/14/2022] Open
Abstract
In the Western world, peripheral vascular disease (PVD) has a high prevalence with high morbidity and mortality. In a large percentage of these patients, lower limb amputation is still required. Studies of ischaemic skeletal muscle disclosed evidence of endogenous angiogenesis and adaptive skeletal muscle metabolic changes in response to hypoxia. Chemokines are potent chemoattractant cytokines that regulate leukocyte trafficking in homeostatic and inflammatory processes. More than 50 different chemokines and 20 different chemokine receptors have been cloned. The chemokine stromal-cell-derived factor-1 (SDF-1 aka CXCL12) is a constitutively expressed and inducible chemokine that regulates multiple physiological processes, including embryonic development and organ homeostasis. The biologic effects of SDF-1 are mediated by chemokine receptor CXCR4, a 352 amino acid rhodopsin-like transmembrane-specific G protein-coupled receptor (GPCR). There is evidence that the administration of SDF-1 increases blood flow and perfusion via recruitment of endothelial progenitor cells (EPCs). This review will focus on the role of the SDF-1/CXCR4 system in the pathophysiology of PVD and discuss their potential as therapeutic targets for PVD.
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25
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Nonviral delivery of genetic medicine for therapeutic angiogenesis. Adv Drug Deliv Rev 2012; 64:40-52. [PMID: 21971337 DOI: 10.1016/j.addr.2011.09.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 06/29/2011] [Accepted: 09/18/2011] [Indexed: 01/08/2023]
Abstract
Genetic medicines that induce angiogenesis represent a promising strategy for the treatment of ischemic diseases. Many types of nonviral delivery systems have been tested as therapeutic angiogenesis agents. However, their delivery efficiency, and consequently therapeutic efficacy, remains to be further improved, as few of these technologies are being used in clinical applications. This article reviews the diverse nonviral gene delivery approaches that have been applied to the field of therapeutic angiogenesis, including plasmids, cationic polymers/lipids, scaffolds, and stem cells. This article also reviews clinical trials employing nonviral gene therapy and discusses the limitations of current technologies. Finally, this article proposes a future strategy to efficiently develop delivery vehicles that might be feasible for clinically relevant nonviral gene therapy, such as high-throughput screening of combinatorial libraries of biomaterials.
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26
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Long-term effects of hepatocyte growth factor gene therapy in rat myocardial infarct model. Gene Ther 2011; 19:836-43. [DOI: 10.1038/gt.2011.128] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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27
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Frangogiannis NG. Stromal cell-derived factor-1-mediated angiogenesis for peripheral arterial disease: ready for prime time? Circulation 2011; 123:1267-9. [PMID: 21403099 DOI: 10.1161/circulationaha.111.021204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Layman H, Li X, Nagar E, Vial X, Pham SM, Andreopoulos FM. Enhanced angiogenic efficacy through controlled and sustained delivery of FGF-2 and G-CSF from fibrin hydrogels containing ionic-albumin microspheres. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2010; 23:185-206. [PMID: 21192837 DOI: 10.1163/092050610x546417] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neo-vessel formation in ischemic tissues relies on numerous growth factors and cell fractions for the formation of mature, stable, functional vasculature. However, the efforts to regenerate tissues typically rely on the administration of a single growth factor or cells alone. Conversely, polymeric matrices have been investigated extensively to deliver multiple growth factors at pre-determined rates to form stable blood vessels in ischemic tissues. We report on a novel sequential delivery system of a fibrin hydrogel containing ionic-albumin microspheres that allows for the controlled release of two growth factors. The use of this system was investigated in the context of therapeutic angiogenesis. Material properties were determined based on degree of swelling measurements and degradation characteristics. Release kinetics of model angiogenic polypeptides FGF-2 and G-CSF were determined using ELISA and the bioactivity of released protein was evaluated in human endothelial cell cultures. The release of growth factors from ionic-albumin microspheres was significantly delayed compared to the growth factor released from fibrin matrices in the absence of spheres. The scaffolds were implanted in a murine critical limb ischemia model at two concentrations, 40 ng (low) and 400 ng (high), restoring 92% of the blood flow in a normally perfused limb using a fibrin hydrogel releasing FGF-2 containing albumin-PLL microspheres releasing G-CSF (measured by LDPI at the high concentration), a 3.2-fold increase compared to untreated limbs. The extent of neo-vessel formation was delineated by immunohistochemical staining for capillary density (CD-31+) and mature vessel formation (α-SMA+). In conclusion, our study demonstrated that the release kinetics from our scaffold have distinct kinetics previously unpublished and the delivery of these factors resulted in hindlimb reperfusion, and robust capillary and mature vessel formation after 8 weeks compared to either growth factor alone or bolus administration of growth factor.
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Affiliation(s)
- Hans Layman
- Department of Surgery, University of California at San Francisco, San Francisco, CA, USA
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29
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Layman H, Rahnemai-Azar AA, Pham SM, Tsechpenakis G, Andreopoulos FM. Synergistic angiogenic effect of codelivering fibroblast growth factor 2 and granulocyte-colony stimulating factor from fibrin scaffolds and bone marrow transplantation in critical limb ischemia. Tissue Eng Part A 2010; 17:243-54. [PMID: 20712534 DOI: 10.1089/ten.tea.2010.0270] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Increasing evidence suggests that therapeutic angiogenesis strategies utilizing cytokines and stem cells are necessary to treat traumatic vascular events such as critical limb ischemia and peripheral artery disease. In this study, basic fibroblast growth factor 2 (FGF-2) and granulocyte-colony stimulating factor (G-CSF) were immobilized in fibrin matrices and codelivered in combination with unfractionated bone marrow cells. Hindlimb ischemia was induced on young (6-7 weeks) Balb/C mice, and fibrin gels containing 100 ng/mL of FGF-2 and G-CSF were implanted adjacent to the ligation points. In addition, 1×10(6) bone marrow (BM) cells were injected into five locations in the ischemic muscle immediately after ligation and artery excision. Hindlimb reperfusion was determined by Laser Doppler Perfusion Imaging and immunohistochemistry for CD31+ and smooth muscle actin-positive cells at 2, 4, and 8 weeks postsurgery to identify capillary formation and maturation. A fluorescent vessel painting technique was also utilized to determine the extent of angiogenesis and arteriogenesis in the hindlimb at 8 weeks postsurgery. The codelivery of FGF-2 and G-CSF in combination with BM cells led to enhanced therapeutic recovery in critical limb ischemia Balb/C mice after 8 weeks of treatment with 87.2% blood flow recovery and a significant increase (p<0.05) in capillary formation in comparison to growth factor delivery or BM cell administration alone.
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Affiliation(s)
- Hans Layman
- Department of Biomedical Engineering, University of Miami, Coral Gables, Florida 33124, USA
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30
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Li J, Wei Y, Liu K, Yuan C, Tang Y, Quan Q, Chen P, Wang W, Hu H, Yang L. Synergistic effects of FGF-2 and PDGF-BB on angiogenesis and muscle regeneration in rabbit hindlimb ischemia model. Microvasc Res 2010; 80:10-7. [DOI: 10.1016/j.mvr.2009.12.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Revised: 12/03/2009] [Accepted: 12/10/2009] [Indexed: 10/20/2022]
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31
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Diabetes impairs arteriogenesis in the peripheral circulation: review of molecular mechanisms. Clin Sci (Lond) 2010; 119:225-38. [PMID: 20545627 DOI: 10.1042/cs20100082] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Patients suffering from both diabetes and PAD (peripheral arterial disease) are at risk of developing critical limb ischaemia and ulceration, and potentially requiring limb amputation. In addition, diabetes complicates surgical treatment of PAD and impairs arteriogenesis. Arteriogenesis is defined as the remodelling of pre-existing arterioles into conductance vessels to restore the perfusion distal to the occluded artery. Several strategies to promote arteriogenesis in the peripheral circulation have been devised, but the mechanisms through which diabetes impairs arteriogenesis are poorly understood. The present review provides an overview of the current literature on the deteriorating effects of diabetes on the key players in the arteriogenesis process. Diabetes affects arteriogenesis at a number of levels. First, it elevates vasomotor tone and attenuates sensing of shear stress and the response to vasodilatory stimuli, reducing the recruitment and dilatation of collateral arteries. Secondly, diabetes impairs the downstream signalling of monocytes, without decreasing monocyte attraction. In addition, EPC (endothelial progenitor cell) function is attenuated in diabetes. There is ample evidence that growth factor signalling is impaired in diabetic arteriogenesis. Although these defects could be restored in animal experiments, clinical results have been disappointing. Furthermore, the diabetes-induced impairment of eNOS (endothelial NO synthase) strongly affects outward remodelling, as NO signalling plays a key role in several remodelling processes. Finally, in the structural phase of arteriogenesis, diabetes impairs matrix turnover, smooth muscle cell proliferation and fibroblast migration. The review concludes with suggestions for new and more sophisticated therapeutic approaches for the diabetic population.
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32
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Abstract
Despite significant advances in medical, interventional, and surgical therapy for coronary and peripheral arterial disease, the burden of these illnesses remains high. To address this unmet need, the science of therapeutic angiogenesis has been evolving for almost two decades. Early preclinical studies and phase I clinical trials achieved promising results with growth factors administered as recombinant proteins or as single-agent gene therapies, and data accumulated through 10 years of clinical trials indicate that gene therapy has an acceptable safety profile. However, more rigorous phase II and phase III clinical trials have failed to unequivocally demonstrate that angiogenic agents are beneficial under the conditions and in the patients studied to date. Investigators have worked to understand the biology of the vascular system and to incorporate their findings into new treatments for patients with ischemic disease. Recent gene- and cell-therapy trials have demonstrated the bioactivity of several new agents and treatment strategies. Collectively, these observations have renewed interest in the mechanisms of angiogenesis and deepened our understanding of the complexity of vascular regeneration. Gene therapy that incorporates multiple growth factors, approaches that combine cell and gene therapy, and the administration of "master switch" agents that activate numerous downstream pathways are among the credible and plausible steps forward. In this review, we examine the clinical development of angiogenic gene therapy, summarize several of the lessons learned during the conduct of these trials, and suggest how this prior experience may guide the conduct of future preclinical investigations and clinical trials.
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Affiliation(s)
- Rajesh Gupta
- Feinberg Cardiovascular Research Institute, Northwestern University School of Medicine and Northwestern Memorial Hospital, Chicago, IL 60611, USA
| | - Jörn Tongers
- Feinberg Cardiovascular Research Institute, Northwestern University School of Medicine and Northwestern Memorial Hospital, Chicago, IL 60611, USA
- Department of Cardiology and Angiology, Hannover Medical School, 30625 Hannover, Germany
| | - Douglas W. Losordo
- Feinberg Cardiovascular Research Institute, Northwestern University School of Medicine and Northwestern Memorial Hospital, Chicago, IL 60611, USA
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33
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Abstract
Critical limb ischemia (CLI) represents the most severe form of peripheral arterial disease. Manifestations of CLI include rest pain, ischemic ulcers, and/or gangrene. The presence of CLI frequently leads to amputation, and furthermore, patients with CLI are at an increased risk of cardiovascular events including death. Treatment options for CLI when revascularization is not possible are extremely limited. Therapeutic angiogenesis is a promising new tool in the management of CLI. There is a growing body of evidence demonstrating the safety and efficacy of therapeutic angiogenesis with gene and cell therapy. Many factors must be considered in formulating clinically efficacious gene and/or cell therapies. The dosing regimen, route of delivery, and choice of growth factor or cell population must be decided. Although the optimal regimen of therapeutic angiogenesis has yet to be identified, building on the knowledge gained from the early pioneering studies may help to identify the best combination.
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34
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Le KN, Hwang CW, Tzafriri AR, Lovich MA, Hayward A, Edelman ER. Vascular regeneration by local growth factor release is self-limited by microvascular clearance. Circulation 2009; 119:2928-35. [PMID: 19470891 DOI: 10.1161/circulationaha.108.823609] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The challenge of angiogenesis science is that stable sustained vascular regeneration in humans has not been realized despite promising preclinical findings. We hypothesized that angiogenic therapies powerfully self-regulate by dynamically altering tissue characteristics. Induced neocapillaries increase drug clearance and limit tissue retention and subsequent angiogenesis even in the face of sustained delivery. METHODS AND RESULTS We quantified how capillary flow clears fibroblast growth factor after local epicardial delivery. Fibroblast growth factor spatial loading was significantly reduced with intact coronary perfusion. Penetration and retention decreased with transendothelial permeability, a trend diametrically opposite to intravascular delivery, in which factor delivery depends on vascular leak, but consistent with a continuum model of drug transport in perfused tissues. Model predictions of fibroblast growth factor sensitivity to manipulations of its diffusivity and transendothelial permeability were validated by conjugation to sucrose octasulfate. Induction of neocapillaries adds pharmacokinetic complexity. Sustained local fibroblast growth factor delivery in vivo produced a burst of neovascularization in ischemic myocardium but was followed by drug washout and a 5-fold decrease in fibroblast growth factor penetration depth. CONCLUSIONS The very efficacy of proangiogenic compounds enhances their clearance and abrogates their pharmacological benefit. This self-limiting property of angiogenesis may explain the failures of promising proangiogenic therapies.
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Affiliation(s)
- Kha N Le
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Room E25-442, 77 Massachusetts Ave, Cambridge, MA 02139, USA.
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35
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Inducible adeno-associated virus vectors promote functional angiogenesis in adult organisms via regulated vascular endothelial growth factor expression. Cardiovasc Res 2009; 83:663-71. [DOI: 10.1093/cvr/cvp152] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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36
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Baumgartner I, Chronos N, Comerota A, Henry T, Pasquet JP, Finiels F, Caron A, Dedieu JF, Pilsudski R, Delaère P. Local gene transfer and expression following intramuscular administration of FGF-1 plasmid DNA in patients with critical limb ischemia. Mol Ther 2009; 17:914-21. [PMID: 19240689 PMCID: PMC2835130 DOI: 10.1038/mt.2009.24] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 01/21/2009] [Indexed: 11/09/2022] Open
Abstract
NV1FGF is an expression plasmid encoding sp.FGF-1(21-154) currently under investigation for therapeutic angiogenesis in clinical trials. NV1FGF plasmid distribution and transgene expression following intramuscular (IM) injection in patients is unknown. The study involved six patients with chronic critical limb ischemia (CLI) planned to undergo amputation. A total dose of 0.5, 2, or 4 mg NV1FGF was administered as eight IM injections (0.006, 0.25, or 0.5 mg per injection) 3-5 days before amputation. Injected sites (30 cm(3)) were divided into equally sized smaller pieces to assess spatial distribution of NV1FGF sequences (PCR), NV1FGF mRNA (reverse transcriptase-PCR), and fibroblast growth factor-1 (FGF-1)-expressing cells (immunohistochemistry). Data indicated gene expression at all doses. The distribution area was within 5-12 cm for NV1FGF sequences containing the expression cassette, up to 5 cm for NV1FGF mRNA, and up to 3 cm for FGF-1-expressing myofibers. All FGF receptors were detected indicating robust potential for bioactivity after NV1FGF gene transfer. Circulating levels of NV1FGF sequences were shown to decrease within days after injection. Data support demonstration of plasmid-mediated gene transfer and expression in muscles from patients with CLI. FGF-1 expression was shown to be limited to injection sites, which supports the concept of multiple-site injection for therapeutic use.
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Affiliation(s)
- Iris Baumgartner
- Division of Cardiology, Swiss Cardiovascular Center, Division of Angiology, Bern University Hospital, University of Bern, Bern, Switzerland.
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37
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Repeated, but not single, VEGF gene transfer affords protection against ischemic muscle lesions in rabbits with hindlimb ischemia. Gene Ther 2009; 16:716-23. [DOI: 10.1038/gt.2009.30] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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38
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Abstract
The extracellular matrix (ECM) acts both as a physical scaffold for cells and as a repository for growth factors. Moreover, ECM structure and physical-chemical properties convey precise information to cells that profoundly influences their biology by interactions with cell surface receptors termed integrins. During angiogenesis, the perivascular ECM plays a critical role in determining the proliferative, invasive and survival responses of the local vascular cells to the angiogenic growth factors. Dynamic changes in both the ECM and the local vascular cells act in concert to regulate new blood vessel growth. The digestion of ECM components by proteolysis is critical for the invasive capacity of endothelial cells, but also creates ECM fragments, which antagonize the mechanosensory function of integrins, and can be apoptogenic. Here, we discuss the roles of integrins in modulating cellular responses to a changing ECM, in particular the regulation of survival and invasion among invasive endothelial cells.
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Modarai B, Humphries J, Gossage J, Waltham M, Burnand K, Kanaganayagam G, Afuwape A, Paleolog E, Smith A, Wadoodi A. Adenovirus-Mediated VEGF Gene Therapy Enhances Venous Thrombus Recanalization and Resolution. Arterioscler Thromb Vasc Biol 2008; 28:1753-9. [DOI: 10.1161/atvbaha.108.170571] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Rapid thrombus recanalization reduces the incidence of post–thrombotic complications. This study aimed to discover whether adenovirus-mediated transfection of the vascular endothelial growth factor gene (ad.VEGF) enhanced thrombus recanalization and resolution.
Methods and Results—
In rats, thrombi were directly injected with either ad.VEGF (n=40) or ad.GFP (n=37). Thrombi in SCID mice (n=12) were injected with human macrophages transfected with ad.VEGF or ad.GFP. Thrombi were analyzed at 1 to 14 days. GFP was found mainly in the vein wall and adventitia by 3 days, but was predominantly found in cells within the body of thrombus by day 7. VEGF levels peaked at 4 days (376±299 pg/mg protein). Ad.VEGF treatment reduced thrombus size by >50% (47.7±5.1 mm
2
to 22.0±4.0 mm
2
,
P
=0.0003) and increased recanalization by >3-fold (3.9±0.69% to 13.6±4.1%,
P
=0.024) compared with controls. Ad.VEGF treatment increased macrophage recruitment into the thrombus by more than 50% (
P
=0.002). Ad.VEGF-transfected macrophages reduced thrombus size by 30% compared with controls (12.3±0.89 mm
2
to 8.7±1.4 mm
2
,
P
=0.04) and enhanced vein lumen recanalization (3.39±0.34% to 5.07±0.57%,
P
=0.02).
Conclusion—
Treatment with ad.VEGF enhanced thrombus recanalization and resolution, probably as a consequence of an increase in macrophage recruitment.
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Affiliation(s)
- B. Modarai
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - J. Humphries
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - J.A. Gossage
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - M. Waltham
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - K.G. Burnand
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - G.S. Kanaganayagam
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - A. Afuwape
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - E. Paleolog
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - A. Smith
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
| | - A. Wadoodi
- From King’s College London, Academic Dept. of Surgery (B.M., J.H., J.A.G., M.W., K.G.B., A.W., A.S.) and Dept. of Cardiology (G.S.K.) Cardiovascular Division, st. Thomas’ Hospital, London, UK; and the Kennedy Institute of Rheumatology (A.A., E.P.), Imperial College London, UK
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40
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Pasqualoni E, Messas E, Fiessinger JN, Emmerich J. [Treatment perspectives for critical limb ischemia: gene and cell therapy]. Presse Med 2008; 37:1039-46. [PMID: 18450413 DOI: 10.1016/j.lpm.2008.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Accepted: 02/25/2008] [Indexed: 10/22/2022] Open
Abstract
Critical limb ischemia is associated with a high risk of amputation and death. Several medical options have been tested on patients who cannot be revascularized surgically, but none has shown any effect on the amputation rate at 6 months.Gene and cell therapy intended to stimulate angiogenesis have been tested in phase I and II clinical trials. These innovative approaches appear both feasible and safe. Large randomized clinical trials are necessary to demonstrate their benefits and long-term safety.
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Affiliation(s)
- Elisa Pasqualoni
- Service de médecine vasculaire - HTA, Hôpital européen Georges Pompidou, F75908 Paris Cedex 15, France
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41
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Ebos JML, Lee CR, Bogdanovic E, Alami J, Van Slyke P, Francia G, Xu P, Mutsaers AJ, Dumont DJ, Kerbel RS. Vascular endothelial growth factor-mediated decrease in plasma soluble vascular endothelial growth factor receptor-2 levels as a surrogate biomarker for tumor growth. Cancer Res 2008; 68:521-9. [PMID: 18199548 DOI: 10.1158/0008-5472.can-07-3217] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Vascular endothelial growth factor (VEGF) is a potent proangiogenic protein that activates VEGF receptor (VEGFR) tyrosine kinases expressed by vascular endothelial cells. We previously showed that one of these receptors, VEGFR-2, has a truncated soluble form (sVEGFR-2) that can be detected in mouse and human plasma. Because activation of VEGFR-2 plays an important role in tumor angiogenesis, clinical interest in monitoring plasma sVEGFR-2 levels in cancer patients has focused on its potential exploitation as a surrogate biomarker for disease progression as well as assessing efficacy/activity of antiangiogenic drugs, particularly those that target VEGF or VEGFR-2. However, no preclinical studies have been done to study sVEGFR-2 during tumor growth or the mechanisms involved in its modulation. Using spontaneously growing tumors and both localized and metastatic human tumor xenografts, we evaluated the relationship between sVEGFR-2 and tumor burden as well as underlying factors governing protein level modulation in vivo. Our results show an inverse relationship between the levels of sVEGFR-2 and tumor size. Furthermore, using various methods of VEGF overexpression in vivo, including cell transfection and adenoviral delivery, we found plasma sVEGFR-2 decreases to be mediated largely by tumor-derived VEGF. Finally, in vitro studies indicate VEGF-mediated sVEGFR-2 modulation is the result of ligand-induced down-regulation of the VEGFR-2 from the cell surface. Taken together, these findings may be pertinent to further clinical exploitation of plasma sVEGFR-2 levels as a surrogate biomarker of VEGF-dependent tumor growth as well as an activity indicator of antiangiogenic drugs that target the VEGFR system.
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Affiliation(s)
- John M L Ebos
- Sunnybrook Health Sciences Centre, Molecular and Cellular Biology Research, University of Toronto, Toronto, Ontario, Canada
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42
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Hwang GL, Patel TH, Hofmann LV. Role of image-guided vascular intervention in therapeutic angiogenesis translational research. Expert Rev Cardiovasc Ther 2007; 5:903-15. [PMID: 17867920 DOI: 10.1586/14779072.5.5.903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Therapeutic angiogenesis, the process of growing collateral blood vessels to better perfuse ischemic tissue, has been hailed as an up-and-coming treatment for symptomatic lower-extremity peripheral arterial occlusive disease. A minimally invasive durable treatment would be welcome since current treatment options for this disease carry high risk, limited efficacy or limited durability. Unfortunately, as evidenced by disappointing results in multiple clinical trials, therapeutic angiogenesis has yet to deliver in humans the success it has seen in animal models. In this review, we discuss the challenges of translating therapeutic angiogenesis into effective clinical treatments for lower-extremity peripheral arterial occlusive disease and we highlight the role that experts in image-guided vascular interventions can play in advancing the field.
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Affiliation(s)
- Gloria L Hwang
- Stanford University Medical Center, Department of Radiology, Room H3630, 300 Pasteur Drive, Stanford, CA 94305-5642, USA.
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43
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Layman H, Spiga MG, Brooks T, Pham S, Webster KA, Andreopoulos FM. The effect of the controlled release of basic fibroblast growth factor from ionic gelatin-based hydrogels on angiogenesis in a murine critical limb ischemic model. Biomaterials 2007; 28:2646-54. [PMID: 17320947 PMCID: PMC1945227 DOI: 10.1016/j.biomaterials.2007.01.044] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Accepted: 01/30/2007] [Indexed: 12/26/2022]
Abstract
The localized delivery of exogenous, angiogenic growth factors has become a promising alternative treatment of peripheral artery disease (PAD) and critical limb ischemia. In the present study, we describe the development of a novel controlled release vehicle to promote angiogenesis in a murine critical limb ischemic model. Ionic, gelatin-based hydrogels were prepared by the carbodiimide-mediated amidation reaction between the carboxyl groups of gelatin or poly-L-glutamic acid molecules and the amine groups of poly-L-lysine or gelatin molecules, respectively. The degree of swelling of the synthesized hydrogels was assessed as a function of EDC/NHS ratios and the pH of the equilibrating medium, while the release kinetic profile of basic fibroblast growth factor (FGF-2) was evaluated in human fibroblast cultures. The degree of swelling (DS) decreased from 26.5+/-1.7 to 18.5+/-2.4 as the EDC concentration varied from 0.75 to 2.5 mg/ml. Eighty percent of the FGF-2 was released at controlled rates from gelatin-polylysine (gelatin-PLL) and gelatin-polyglutamic acid (gelatin-PLG) hydrogel scaffolds over a period of 28 days. Cell adhesion studies revealed that the negatively charged surface of the gelatin-PLG hydrogels exhibited superior adhesion capabilities in comparison to gelatin-PLL and control gelatin surfaces. Laser Doppler perfusion imaging as well as CD31(+) capillary immunostaining demonstrated that the controlled release of FGF-2 from ionic gelatin-based hydrogels is superior in promoting angiogenesis in comparison to the bolus administration of the growth factor. Over 4 weeks, FGF-2 releasing gelatin-PLG hydrogels exhibited marked reperfusion with a Doppler ratio of 0.889 (+/-0.04) which was 69.3% higher than in the control groups.
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Affiliation(s)
- Hans Layman
- Department of Biomedical Engineering, MCA 219 McArthur Engineering Building, University of Miami, Coral Gables, FL, USA
| | - Maria-Grazia Spiga
- Vascular Biology Institute, Rosenstiel Medical Science Building, Miller School of Medicine, Miami, FL, USA
| | - Toby Brooks
- Department of Biomedical Engineering, MCA 219 McArthur Engineering Building, University of Miami, Coral Gables, FL, USA
| | - Si Pham
- Daughtry Department of Surgery, Highland Professional Building, Miller School of Medicine, Miami, FL, USA
| | - Keith A. Webster
- Vascular Biology Institute, Rosenstiel Medical Science Building, Miller School of Medicine, Miami, FL, USA
| | - Fotios M. Andreopoulos
- Department of Biomedical Engineering, MCA 219 McArthur Engineering Building, University of Miami, Coral Gables, FL, USA
- Vascular Biology Institute, Rosenstiel Medical Science Building, Miller School of Medicine, Miami, FL, USA
- Daughtry Department of Surgery, Highland Professional Building, Miller School of Medicine, Miami, FL, USA
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44
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Vincent KA, Jiang C, Boltje I, Kelly RA. Gene therapy progress and prospects: therapeutic angiogenesis for ischemic cardiovascular disease. Gene Ther 2007; 14:781-9. [PMID: 17476300 DOI: 10.1038/sj.gt.3302953] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
During the past decade, both in vitro and in vivo studies have provided new insights into the cellular and molecular mechanisms that govern angiogenesis and arteriogenesis. However, therapeutic angiogenesis clinical trials using recombinant protein or gene therapy formulations of single angiogenic growth factors have yielded at best only modest success to date. Among the second generation of angiogenic agents are therapeutic transgenes that enhance expression of two or more proangiogenic cytokines. These include synthetic constructs that mimic that activity of endogenous transcriptional regulators and other upstream, regulatory factors that have the potential to induce formation of morphologically and physiologically functional vessels. These agents are now beginning to be evaluated in clinical trials for patients with advanced ischemic cardiac and peripheral vascular disease.
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Affiliation(s)
- K A Vincent
- Genzyme Corporation, Framingham, MA 01701-9322, USA
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45
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Gene Therapies and Stem Cell Therapies. Cardiovasc Ther 2007. [DOI: 10.1016/b978-1-4160-3358-5.50009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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46
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von Degenfeld G, Banfi A, Springer ML, Wagner RA, Jacobi J, Ozawa CR, Merchant MJ, Cooke JP, Blau HM. Microenvironmental VEGF distribution is critical for stable and functional vessel growth in ischemia. FASEB J 2006; 20:2657-9. [PMID: 17095533 DOI: 10.1096/fj.06-6568fje] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The critical role of vascular endothelial growth factor (VEGF) expression levels in developmental angiogenesis is well established. Nonetheless, the effects of different local (microenvironmental) VEGF concentrations in ischemia have not been studied in the adult organism, and VEGF delivery to patients has been disappointing. Here, we demonstrate the existence of both lower and upper threshold levels of microenvironmental VEGF concentrations for the induction of therapeutic vessel growth in ischemia. In the ischemic hind limb, implantation of myoblasts transduced to express VEGF164 at different levels per cell increased blood flow only moderately, and vascular leakage and aberrant preangiomatous vessels were always induced. When the same total dose was uniformly distributed by implanting a monoclonal population derived from a single VEGF-expressing myoblast, blood flow was fully restored to nonischemic levels, collateral growth was induced, and ischemic damage was prevented. Hemangiomas were avoided and only normal, pericyte-covered vessels were induced persisting over 15 mo. Surprisingly, clones uniformly expressing either lower or higher VEGF levels failed to provide any functional benefit. A biphasic effect of VEGF dose on vessel number and diameter was found. Blood flow was only improved if vessels were increased both in size and in number. Microenvironmental VEGF concentrations determine efficacy and safety in a therapeutic setting.
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Affiliation(s)
- Georges von Degenfeld
- Baxter Laboratory in Genetic Pharmacology, Department of Molecular Pharmacology, Stanford University School of Medicine, Stanford, CA 94305-5175, USA
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47
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Portlock JL, Keravala A, Bertoni C, Lee S, Rando TA, Calos MP. Long-term increase in mVEGF164 in mouse hindlimb muscle mediated by phage phiC31 integrase after nonviral DNA delivery. Hum Gene Ther 2006; 17:871-6. [PMID: 16942446 DOI: 10.1089/hum.2006.17.871] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Peripheral vascular disease (PVD), characterized by insufficient blood supply to extremities, can be a devastating illness. Although many gene therapy strategies for PVD using vascular endothelial growth factor (VEGF) have resulted in increased blood vessel formation, the vessels are often impermanent and regress after therapy, probably because of the short-lived VEGF expression mediated by gene therapy vectors (14 days or less). phiC31 integrase is a recombinase originally isolated from a bacteriophage of Streptomyces. This integrase performs efficient chromosomal integration of plasmid DNA into mammalian genomes that results in long-term transgene expression. In this study, gene transfer was achieved by intramuscular injection of VEGF and integrase plasmid DNAs into the tibialis anterior muscle in the mouse hindlimb, followed by electroporation of the muscle with needle electrodes. We observed VEGF levels significantly above background 40 days after injection in animals that received phiC31 integrase and the VEGF plasmid. Site-specific integration of plasmid DNA in the chromosomes of muscle tissue was verified by polymerase chain reaction at a common integration site. These results suggest the possible utility of the phiC31 integrase system to treat ischemic disease.
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Affiliation(s)
- Joylette L Portlock
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305, USA
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48
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Portlock JL, Keravala A, Bertoni C, Lee S, Rando TA, Calos MP. Long-Term Increase in mVEGF164 in Mouse Hindlimb Muscle Mediated by Phage oC31 Integrase After Nonviral DNA Delivery. Hum Gene Ther 2006. [DOI: 10.1089/hum.2006.17.ft-231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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49
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Emmerich J. Current state and perspective on medical treatment of critical leg ischemia: gene and cell therapy. INT J LOW EXTR WOUND 2006; 4:234-41. [PMID: 16286375 DOI: 10.1177/1534734605283538] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Critical limb ischemia (CLI) is a severe disease associated with a high risk of amputation and mortality. In patients who cannot be revascularized, several medical options have been tested, including the use of prostanoids, spinal cord stimulation, and lumbar sympathectomy. None of these treatments has demonstrated a benefit on the amputation rates after 6 months of follow-up; these treatments cannot therefore be recommended for CLI treatment in patients for whom surgery is not an option. In this setting, gene therapy and cell therapy to stimulate angiogenesis have been tested mainly in phase I and II clinical trials and are reviewed in this article. These studies demonstrated the short-term safety and feasibility of these new approaches, but larger randomized studies remain necessary to demonstrate their clinical benefits and longterm safety.
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Affiliation(s)
- Joseph Emmerich
- University Paris-Descartes, Department of Vascular Medicine and Hypertension, Hôpital Européen Georges Pompidou, Paris.
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50
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Wilhide ME, Jones WK. Potential therapeutic gene for the treatment of ischemic disease: Ad2/hypoxia-inducible factor-1alpha (HIF-1)/VP16 enhances B-type natriuretic peptide gene expression via a HIF-1-responsive element. Mol Pharmacol 2006; 69:1773-8. [PMID: 16567545 DOI: 10.1124/mol.106.024968] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
In this issue of Molecular Pharmacology, Luo et al. (p. 1953) present a study employing a HIF-1alpha/VP16 chimera to investigate the mechanism by which this constitutively active transcription factor activates expression of brain natriuretic peptide (BNP). The results define a functional hypoxia responsive element (HRE) in the promoter of the human BNP gene and demonstrate that this HRE is necessary for HIF-1alpha/VP16-induced gene expression in human cardiomyocytes grown under normoxic conditions. Luo et al. also show that a consensus E-box DNA binding sequence is necessary for appropriate BNP regulation. Because HIF-1 is known to elicit protective and beneficial gene expression programs in many scenarios and because BNP is known to be cardioprotective, this study provides support for the therapeutic use of the chimeric HIF-1alpha/VP16 protein in coronary heart disease. However, because HIF-1alpha is a key regulatory molecule that acts upon a large number of downstream gene networks, there remains a need for further investigation. Particularly useful would be comprehensive gene expression profiling coupled with functional analysis of HIF-1alpha/VP16-regulated genes. The results of such studies will elucidate the mechanism of beneficial effects and address concerns regarding potential adverse effects of activating specific HIF-1alpha/VP16-dependent gene programs.
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Affiliation(s)
- Michael E Wilhide
- Department of Pharmacology and Cell Biophysics, 231 Albert Sabin Way ML0575, University of Cincinnati, Cincinnati, OH 45267-0575, USA
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