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Gao MH, Giamouridis D, Lai NC, Guo T, Hammond HK. Effects of Urocortin 2 Gene Transfer on Glucose Disposal in Insulin-Resistant db/db Mice on Metformin. Hum Gene Ther 2023; 34:732-741. [PMID: 37433214 PMCID: PMC10457654 DOI: 10.1089/hum.2023.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/30/2023] [Indexed: 07/13/2023] Open
Abstract
The study was designed to determine whether urocortin 2 (Ucn2) gene transfer is as safe and effective as metformin in insulin-resistant mice. Four groups of insulin-resistant db/db mice and a nondiabetic group were studied: (1) metformin; (2) Ucn2 gene transfer; (3) metformin + Ucn2 gene transfer; (4) saline; and (5) nondiabetic mice. After completion of the 15-week protocol, glucose disposal was quantified, safety assessed, and gene expression documented. Ucn2 gene transfer was superior to metformin, providing reductions in fasting glucose and glycated hemoglobin and enhanced glucose tolerance. The combination of metformin + Ucn2 gene transfer provided no better glucose control than Ucn2 gene transfer alone and was not associated with hypoglycemia. Metformin alone, Ucn2 gene transfer alone, and metformin + Ucn2 gene transfer together reduced fatty infiltration of the liver. Serum alanine transaminase concentration was elevated in all db/db groups (vs. nondiabetic controls), but the metformin + Ucn2 gene transfer combined group had the lowest alanine transaminase levels. No group differences in fibrosis were detected. In a hepatoma cell line, activation of AMP kinase showed a rank order of combined metformin + Ucn2 peptide > Ucn2 peptide > metformin. We conclude (1) The combination of metformin + Ucn2 gene transfer does not result in hypoglycemia. (2) Ucn2 gene transfer alone provides superior glucose disposal versus metformin alone. (3) The combination of Ucn2 gene transfer and metformin is safe and has additive effects in reducing serum alanine transaminase concentration, activating AMP kinase activity, and increasing Ucn2 expression, but is no more efficacious than Ucn2 gene transfer alone in reducing hyperglycemia. These data indicate that Ucn2 gene transfer is more effective than metformin in the db/db model of insulin resistance and combined treatment with metformin + Ucn2 gene transfer appears to have favorable effects on liver function and Ucn2 expression.
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Affiliation(s)
- Mei Hua Gao
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Dimosthenis Giamouridis
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - N. Chin Lai
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Tracy Guo
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - H. Kirk Hammond
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
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Lai NC, Tan Z, Giamouridis D, Gao MH, Hammond HK. Urocortin 2 Gene Transfer for Systolic and Diastolic Dysfunction Due to Chronically Increased Left Ventricular Pressure. Hum Gene Ther 2022; 33:1091-1100. [PMID: 36053712 PMCID: PMC9595638 DOI: 10.1089/hum.2022.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/28/2022] [Indexed: 11/13/2022] Open
Abstract
We used transverse aortic constriction (TAC) in mice to test the hypothesis that urocortin 2 (Ucn2) gene transfer would increase left ventricular (LV) systolic and diastolic function in the pressure-stressed LV. Three groups were studied: (1) control mice (no TAC); (2) mice that received saline 6 weeks after TAC; and (3) mice that received Ucn2 gene transfer 6 weeks after TAC, using adeno-associated virus 8 encoding murine Ucn2 (AAV8.mUcn2; 2 × 1013 genome copies (gc)/kg, i.v. per mouse). Echocardiography was performed 6 and 12 weeks after TAC. In terminal studies 12 weeks after TAC, rates of LV pressure development and decay and Tau were measured, and LV cardiac myocytes (CMs) were isolated and cytosolic Ca2+ transients and sarcomere shortening rates recorded. Reverse transcription polymerase chain reaction and immunoblotting were used to measure key proteins in LV samples. A CM cell line (HL-1) was used to explore mechanisms. Concentric LV hypertrophy was evident on echocardiography 6 weeks after TAC. Twelve weeks after TAC, LV ejection fraction (EF) was higher in mice that received Ucn2 gene transfer (TAC-saline: 65% ± 3%; TAC-Ucn2: 75% ± 2%; p = 0.01), as was LV peak +dP/dt (1.9-fold increase; p = 0.001) and LV peak -dP/dt (1.7-fold increase; p = 0.017). Tau was more rapid (23% reduction, p = 0.02), indicating improved diastolic function. The peak rates of sarcomere shortening (p = 0.002) and lengthening (p = 0.002) were higher in CMs from TAC-Ucn2 mice, and Tau was reduced (p = 0.001). LV (Ser-16) phosphorylation of phospholamban (PLB) was increased in TAC-Ucn2 mice (p = 0.025), and also was increased in HL-1 cells treated with angiotensin II to induce hypertrophy and incubated with Ucn2 peptide (p = 0.001). Ucn2 gene transfer in TAC-induced heart failure with preserved ejection fraction increased cardiac function in the intact LV and provided corresponding benefits in CMs isolated from study animals, including increased myofilament Ca2+ sensitivity during contraction. The mechanism includes enhanced CM Ca2+ handling associated with increased (Ser-16)-PLB.
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Affiliation(s)
- N. Chin Lai
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Zhen Tan
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Dimosthenis Giamouridis
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Mei Hua Gao
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - H. Kirk Hammond
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
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Gao MH, Giamouridis D, Lai NC, Guo T, Xia B, Kim YC, Huu VAN, Skowronska-Krawczyk D, Lantier L, Bhargava R, Hammond HK. Urocortin 2 Gene Transfer Improves Glycemic Control and Reduces Retinopathy and Mortality in Murine Insulin Deficiency. Mol Ther Methods Clin Dev 2020; 17:220-233. [PMID: 31970200 PMCID: PMC6965520 DOI: 10.1016/j.omtm.2019.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/07/2019] [Indexed: 11/20/2022]
Abstract
Type 1 diabetes affects 20 million patients worldwide. Insulin is the primary and commonly the sole therapy for type 1 diabetes. However, only a minority of patients attain the targeted glucose control and reduced adverse events. We tested urocortin 2 gene transfer as single-agent therapy for insulin deficiency using two mouse models. Urocortin 2 gene transfer reduced blood glucose for months after a single intravenous injection, through increased skeletal muscle insulin sensitivity, increased insulin release in response to glucose stimulation, and increased plasma insulin levels before and during euglycemic clamp. The combined increases in both insulin availability and sensitivity resulted in improved glycemic indices-events that were not anticipated in these insulin-deficient models. In addition, urocortin 2 gene transfer reduced ocular manifestations of long-standing insulin deficiency such as vascular leak and improved retinal function. Finally, mortality was reduced by urocortin 2 gene transfer. The mechanisms for these beneficial effects included increased activities of AMP-activated protein kinase and Akt (protein kinase B) in skeletal muscle, increased skeletal muscle glucose uptake, and increased insulin release. These data suggest that urocortin 2 gene transfer may be a viable therapy for new onset type 1 diabetes and might reduce insulin needs in later stage disease.
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Affiliation(s)
- Mei Hua Gao
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Dimosthenis Giamouridis
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - N. Chin Lai
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Tracy Guo
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Bing Xia
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Young Chul Kim
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - Viet Anh Nguyen Huu
- Department of Ophthalmology, University of California, San Diego, San Diego, CA 92103, USA
| | | | - Louise Lantier
- Vanderbilt University, Department of Molecular Physiology and Biophysics, Nashville, TN 37232-0615, USA
| | - Raag Bhargava
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
| | - H. Kirk Hammond
- Department of Medicine, University of California, San Diego, La Jolla, CA 92037, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
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Giamouridis D, Gao MH, Lai NC, Guo T, Miyanohara A, Blankesteijn WM, Biessen EAL, Hammond HK. Urocortin 2 Gene Transfer Improves Heart Function in Aged Mice. Mol Ther 2020; 28:180-188. [PMID: 31676153 DOI: 10.1016/j.ymthe.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022] Open
Abstract
Prevalence of left ventricular (LV) systolic and diastolic dysfunction increases with aging. We previously reported that urocortin 2 (Ucn2) gene transfer increases heart function in mice with heart failure with reduced ejection fraction. Here, we test the hypotheses that (1) Ucn2 gene transfer will increase LV function in aged mice and that (2) Ucn2 gene transfer given in early life will prevent age-related LV dysfunction. Nineteen-month-old (treatment study) and 3-month-old (prevention study) mice received Ucn2 gene transfer or saline. LV function was examined 3-4 months (treatment study) or 20 months (prevention study) after Ucn2 gene transfer or saline injection. In both the treatment and prevention strategies, Ucn2 gene transfer increased ejection fraction, reduced LV volume, increased LV peak -dP/dt and peak +dP/dt, and reduced global longitudinal strain. Ucn2 gene transfer-in both treatment and prevention strategies-was associated with higher levels of LV SERCA2a protein, reduced phosphorylation of LV CaMKIIa, and reduced LV α-skeletal actin mRNA expression (reflecting reduced cardiac stress). In conclusion, Ucn2 gene transfer restores normal cardiac function in mice with age-related LV dysfunction and prevents development of LV dysfunction.
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Affiliation(s)
- Dimosthenis Giamouridis
- Department of Medicine, University of California, San Diego, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; Department of Medicine, University of California San Diego, San Diego, CA, USA; Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands; Department of Pathology, Cardiovascular Research Institute, Maastricht University, the Netherlands
| | - Mei Hua Gao
- Department of Medicine, University of California, San Diego, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - N Chin Lai
- Department of Medicine, University of California, San Diego, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Tracy Guo
- Department of Medicine, University of California, San Diego, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Atsushi Miyanohara
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - W Matthijs Blankesteijn
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands
| | - Erik A L Biessen
- Department of Pathology, Cardiovascular Research Institute, Maastricht University, the Netherlands; Institute for Molecular Cardiovascular Research, RWTH Aachen University, Aachen, Germany
| | - H Kirk Hammond
- Department of Medicine, University of California, San Diego, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; Department of Medicine, University of California San Diego, San Diego, CA, USA.
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Kim YC, Truax AD, Giamouridis D, Lai NC, Guo T, Hammond HK, Gao MH. Significant alteration of liver metabolites by AAV8.Urocortin 2 gene transfer in mice with insulin resistance. PLoS One 2019; 14:e0224428. [PMID: 31790421 PMCID: PMC6886859 DOI: 10.1371/journal.pone.0224428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/14/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Urocortin 2 (Ucn2) is a 38-amino acid peptide of the corticotropin-releasing factor family. Intravenous (IV) delivery of an adeno-associated virus vector serotype 8 encoding Ucn2 (AAV8.Ucn2) increases insulin sensitivity and glucose disposal in mice with insulin resistance. OBJECTIVE To determine the effects of Ucn2 on liver metabolome. METHODS Six-week-old C57BL6 mice were divided into normal chow (CHOW)-fed and high fat diet (HFD)-fed groups. The animals received saline, AAV8 encoding no gene (AAV8.Empt) or AAV8.Ucn2 (2x1013 genome copy/kg, IV injection). Livers were isolated from CHOW-fed and HFD-fed mice and analyzed by untargeted metabolomics. Group differences were statistically analyzed. RESULTS In CHOW-fed mice, AAV8.Ucn2 gene transfer (vs. saline) altered the metabolites in glycolysis, pentose phosphate, glycogen synthesis, glycogenolysis, and choline-folate-methionine signaling pathways. In addition, AAV8.Ucn2 gene transfer increased amino acids and peptides, which were associated with reduced protein synthesis. In insulin resistant (HFD-induced) mice, HFD (vs CHOW) altered 448 (112 increased and 336 decreased) metabolites and AAV8.Ucn2 altered 239 metabolites (124 increased and 115 reduced) in multiple pathways. There are 61 metabolites in 5 super pathways showed interactions between diet and AAV8.Ucn2 treatment. Among them, AAV8.Ucn2 gene transfer reversed HFD effects on 13 metabolites. Finally, plasma Ucn2 effects were determined using a 3-group comparison of HFD-fed mice that received AAV8.Ucn2, AAV.Empt or saline, where 18 metabolites that altered by HFD (15 increased and 3 decreased), but restored levels to that seen in CHOW-fed mice by increased plasma Ucn2. CONCLUSIONS Metabolomics study revealed that AAV8.Ucn2 gene transfer, through increased plasma Ucn2, provided counter-HFD effects in restoring hepatic metabolites to normal levels, which could be the underlying mechanisms for Ucn2 effects on increasing glucose disposal and reducing insulin assistance.
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Affiliation(s)
- Young Chul Kim
- Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Agnieszka D. Truax
- Metabolon, Inc, Research Triangle Park, Morrisville, North Carolina, United States of America
| | - Dimosthenis Giamouridis
- Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - N. Chin Lai
- Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Tracy Guo
- Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - H. Kirk Hammond
- Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Mei Hua Gao
- Veterans Affairs San Diego Healthcare System, San Diego, California, United States of America
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
- * E-mail:
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6
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Cardiovascular Effects of Urocortin-2: Pathophysiological Mechanisms and Therapeutic Potential. Cardiovasc Drugs Ther 2019; 33:599-613. [DOI: 10.1007/s10557-019-06895-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kim YC, Giamouridis D, Lai NC, Guo T, Xia B, Fu Z, Gao MH, Hammond HK. Urocortin 2 Gene Transfer Reduces the Adverse Effects of a Western Diet on Cardiac Function in Mice. Hum Gene Ther 2019; 30:693-701. [PMID: 30648430 DOI: 10.1089/hum.2018.150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Diabetes mellitus is associated with increased risk of heart failure. It has been previously demonstrated in mice that a single injection of adeno-associated virus 8 encoding urocortin 2 (AAV8.UCn2) increases glucose disposal in models of insulin resistance and improves the function of the failing heart. The present study tested the hypothesis that UCn2 gene transfer would reduce diabetes-related left ventricular (LV) dysfunction. Eight-week-old C57BL6 male mice were fed a Western diet (WD; 45% fat, 35% carbohydrate) for 40 weeks. At week 30, they received saline or AAV8.UCn2 (2 × 1013 genome copies/kg) via intravenous injection. Ten weeks after gene transfer, fasting blood glucose, glucose tolerance, and cardiac function were measured via echocardiography and in vivo measurement of LV contractile function, and the results were compared to those of mice fed normal chow (NC; 10% fat; 70% carbohydrate). The contents of key LV signaling proteins were also measured to probe mechanisms. WD increased 12 h fasting glucose (WD: 190 ± 11 mg/dL, n = 8; NC: 105 ± 12 mg/dL, n = 7; p = 0.0004). WD tended to reduce LV peak +dP/dt (p = 0.08) and LV peak -dP/dt (p = 0.05). LV ejection fraction was unchanged. Among WD-fed mice, UCn2 gene transfer reduced 12 h fasting glucose (WD-UCn2: 149 ± 6 mg/dL, n = 8; WD-Saline: 190 ± 11 mg/dL, n = 8; p = 0.012), increased LV peak +dP/dt (p < 0.001) and LV peak -dP/dt (p = 0.013), and reduced Tau (p < 0.02), indicating beneficial effects on systolic and diastolic LV function. In addition, among WD-fed mice, UCn2 gene transfer increased LV ejection fraction (p < 0.005) and the velocity of circumferential fiber shortening (p = 0.0005). Finally, a reduction was seen in fatty infiltration of the liver in WD-fed mice that had received UCn2 gene transfer. LV samples from WD-UCn2 mice showed increased phosphorylation of the protein kinase A catalytic domain (p = 0.03). In conclusion, UCn2 gene transfer increased LV systolic and diastolic function and reduced blood glucose in mice with diabetes-related LV dysfunction, indicating that UCn2 gene transfer may be of potential therapeutic benefit.
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Affiliation(s)
- Young Chul Kim
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Dimosthenis Giamouridis
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - N Chin Lai
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Tracy Guo
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Bing Xia
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Zhenxing Fu
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Mei Hua Gao
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - H Kirk Hammond
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
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Tan Z, Giamouridis D, Lai NC, Kim YC, Guo T, Xia B, Gao MH, Hammond HK. Cardiac-Directed Expression of Adenylyl Cyclase Catalytic Domain ( C1C2) Attenuates Deleterious Effects of Pressure Overload. Hum Gene Ther 2019; 30:682-692. [PMID: 30638074 DOI: 10.1089/hum.2018.176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A fusion protein (C1C2) constructed by fusing the intracellular C1 and C2 segments of adenylyl cyclase type 6 (AC6) retains beneficial effects of AC6 expression, without increasing cyclic adenosine monophosphate generation. The effects of cardiac-directed C1C2 expression in pressure overload is unknown. Left ventricular (LV) pressure overload was induced by transverse aortic constriction (TAC) in C1C2 mice and in transgene negative (TG-) mice. Four weeks after TAC, LV systolic function and diastolic function were measured, and Ca2+ handling was assessed. Four weeks after TAC, TG- animals showed reduced LV peak +dP/dt. LV peak +dP/dt in C1C2 mice was statistically indistinguishable from that of normal mice and was higher than that seen in TG- mice 4 weeks after TAC (p = 0.02), despite similar and substantial cardiac hypertrophy. In addition to higher LV peak +dP/dt in vivo, cardiac myocytes from C1C2 mice showed shorter time-to-peak Ca2+ transient amplitude (p = 0.002) and a reduced time constant of cytosolic Ca2+ decline (Tau; p = 0.003). Sarcomere shortening fraction (p < 0.03) and the rate of sarcomere shortening (p < 0.02) increased in C1C2 cardiac myocytes. Myofilament sensitivity to Ca2+ was increased in systole (p = 0.02) and diastole (p = 0.04) in C1C2 myocytes. These findings indicate enhanced Ca2+ handling associated with C1C2 expression. Favorable effects on Ca2+ handling and LV function were associated with increased LV SERCA2a protein content (p = 0.015) and reduced LV fibrosis (p = 0.008). Cardiac-directed C1C2 expression improves Ca2+ handling and increases LV contractile function in pressure overload. These data provide a rationale for further exploration of C1C2 gene transfer as a potential treatment for heart failure.
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Affiliation(s)
- Zhen Tan
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Dimosthenis Giamouridis
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - N Chin Lai
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Young Chul Kim
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Tracy Guo
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Bing Xia
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - Mei Hua Gao
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
| | - H Kirk Hammond
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California, and University of California San Diego, San Diego, California.,2 Department of Medicine, University of California San Diego, San Diego, California
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Abstract
The identification of corticotropin-releasing hormone (CRH) has led to the discovery of a growing family of ligands and receptors. CRH receptor 1 (CRHR1) and CRHR2 are mammalian G-protein coupled receptors (GPCRs) with high affinity for CRH and the CRH family of peptides. CRHR1 is predominantly expressed in the brain and plays a vital role in the hypothalamic-pituitary-adrenal (HPA) axis stress responses by secreting adrenal corticotropic hormone (ACTH). CRHR2 is predominantly expressed in the heart, and a CRHR2-specific ligand, urocortin 2 (UCN2), shows positive cardiac chronotropic and inotropic effects through 3´,5´-cyclic adenosine monophosphate (cAMP) signaling in response to CRHR2-mediated Gαs activation in mice and humans. Central administration of the CRH family of peptides increases mean arterial pressure through CRHR1 activation, whereas peripheral administration of the peptides decreases mean arterial pressure through CRHR2 activation. These observations have led to further investigations of CRHR2 as an important and unique GPCR in the physiological and pathological functioning of the cardiovascular (CV) system. Moreover, recent clinical trials demonstrate CRHR2 as a potentially therapeutic target in the treatment of heart failure. We present recent reviews of the role of CRHRs in basic CV physiology and in the pathophysiology of CV diseases.
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Affiliation(s)
- Mikito Takefuji
- Department of Cardiology, Nagoya University School of Medicine
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Giamouridis D, Gao MH, Lai NC, Tan Z, Kim YC, Guo T, Miyanohara A, Blankesteijn MW, Biessen EAL, Hammond HK. Urocortin 3 Gene Transfer Increases Function of the Failing Murine Heart. Hum Gene Ther 2018; 30:10-20. [PMID: 30003813 DOI: 10.1089/hum.2018.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Peptide infusions of peptides the corticotropin releasing factor family, including urocortin 2, stresscopin, and urocortin 3 (UCn3), have favorable acute effects in clinical heart failure (HF), but their short half-lives make them unsuitable for chronic therapy. This study asked whether UCn3 gene transfer, which provides sustained elevation of plasma UCn3 levels, increases the function of the failing heart. HF was induced by transmural left ventricular (LV) cryoinjury in mice. LV function was assessed 3 weeks later by echocardiography. Those with ejection fractions (EF) <40% received intravenous saline or intravenous adeno-associated virus type-8 encoding murine UCn3 (AAV8.mUCn3; 1.9 × 1013 genome copies/kg). Five weeks after randomization, repeat echocardiography, assessment of LV function (+dP/dt, -dP/dt), and quantification of Ca2+ transients and sarcomere shortening in isolated cardiac myocytes were conducted, and assessment of LV Ca2+ handling and stress proteins was performed. Three weeks after myocardial infarction, prior to treatment, EFs were reduced (mean 31%, from 63% in sham-operated animals). Mice randomized to receive UCn3 gene transfer showed increased plasma UCn3 (from 0.1 ± 0.01 ng/mL in the saline group to 5.6 ± 1.1 ng/mL; n = 12 each group; p < 0.0001). Compared to mice that received saline, UCn3 gene transfer was associated with higher values for EF (p = 0.0006); LV +dP/dt (p < 0.0001), and LV -dP/dt (p < 0.0001). Cardiac myocytes from mice that received UCn3 gene transfer showed higher peak Ca2+ transients (p = 0.0005), lower time constant of cytosolic Ca2+ decline (tau, p < 0.0001), and higher rates of sarcomere shortening (+dL/dt, p = 0.03) and lengthening (-dL/dt, p = 0.04). LV samples from mice that received UCn3 gene transfer contained higher levels of SERCA2a (p = 0.0004 vs. HF) and increased amounts of phosphorylated troponin I (p = 0.04 vs. HF). UCn3 gene transfer is associated with improved Ca2+ handling and LV function in mice with HF and reduced EF.
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Affiliation(s)
- Dimosthenis Giamouridis
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California; RWTH Aachen, Aachen, Germany.,2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany.,3 Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands; and RWTH Aachen, Aachen, Germany
| | - Mei Hua Gao
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California; RWTH Aachen, Aachen, Germany.,2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany
| | - N Chin Lai
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California; RWTH Aachen, Aachen, Germany.,2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany
| | - Zhen Tan
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California; RWTH Aachen, Aachen, Germany.,2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany
| | - Young Chul Kim
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California; RWTH Aachen, Aachen, Germany.,2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany
| | - Tracy Guo
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California; RWTH Aachen, Aachen, Germany.,2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany
| | - Atsushi Miyanohara
- 2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany
| | - Matthijs W Blankesteijn
- 3 Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands; and RWTH Aachen, Aachen, Germany
| | - Erik A L Biessen
- 3 Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht University, Maastricht, The Netherlands; and RWTH Aachen, Aachen, Germany.,4 Institute for Molecular Cardiovascular Research, RWTH Aachen, Aachen, Germany
| | - H Kirk Hammond
- 1 Veterans Affairs San Diego Healthcare System, San Diego, California; RWTH Aachen, Aachen, Germany.,2 Department of Medicine, University of California San Diego, San Diego, California; RWTH Aachen, Aachen, Germany
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11
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Giamouridis D, Gao MH, Lai NC, Tan Z, Kim YC, Guo T, Miyanohara A, Blankesteijn WM, Biessen E, Hammond HK. Effects of Urocortin 2 Versus Urocortin 3 Gene Transfer on Left Ventricular Function and Glucose Disposal. JACC Basic Transl Sci 2018; 3:249-264. [PMID: 30062211 PMCID: PMC6059348 DOI: 10.1016/j.jacbts.2017.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/13/2017] [Accepted: 12/21/2017] [Indexed: 12/20/2022]
Abstract
UCn2 and UCn3 peptides have recently been infused to treat patients with heart failure (HF) but are limited by their short half-lives. A 1-time intravenous injection of virus vectors encoding UCn2 or UCn3 provided sustained increases in plasma concentrations of the peptides. This was associated with increases in both systolic and diastolic left ventricular (LV) function, mediated by increased LV SERCA2a expression and Ca2+ handling. UCn2, but not UCn3, gene transfer reduced fasting glucose and increased glucose disposal. These findings support UCn2 and UCn3 gene transfer as potential treatments for HF and indicate that UCn2 may be an optimal selection in patients with diabetes and HF.
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Key Words
- AAV, adeno-associated virus
- CO, cardiac output
- CRF, corticotropin-releasing factor
- CRHR, corticotropin-releasing hormone receptor
- CaMKII, Ca2+/calmodulin-dependent protein kinase II
- EDD, end-diastolic diameter
- EF, ejection fraction
- ESD, end-systolic diameter
- ESPVR, end-systolic pressure-volume relationship
- HF, heart failure
- IP, intraperitoneal
- IV, intravenous
- LV, left ventricle/ventricular
- PKA, protein kinase A
- RYR2, ryanodine receptor 2
- SERCA2a, sarco/endoplasmic reticulum Ca2+-ATPase
- Tau, time constant of left ventricular pressure decline
- UCn2, urocortin 2
- UCn3, urocortin 3
- VCFc, velocity of circumferential fiber shortening corrected for heart rate
- adeno-associated virus
- cAMP, 3′,5′-cyclic adenosine monophosphate
- contractile function
- diastolic function
- gc, genome copies
- gene therapy
- insulin sensitivity
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Affiliation(s)
- Dimosthenis Giamouridis
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California San Diego, San Diego, California
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht University, Maastricht, the Netherlands
| | - Mei Hua Gao
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California San Diego, San Diego, California
| | - N. Chin Lai
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California San Diego, San Diego, California
| | - Zhen Tan
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California San Diego, San Diego, California
| | - Young Chul Kim
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California San Diego, San Diego, California
| | - Tracy Guo
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California San Diego, San Diego, California
| | - Atsushi Miyanohara
- Department of Medicine, University of California San Diego, San Diego, California
| | - W. Matthijs Blankesteijn
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht University, Maastricht, the Netherlands
| | - Erik Biessen
- Department of Pharmacology and Toxicology, Cardiovascular Research Institute Maastricht University, Maastricht, the Netherlands
| | - H. Kirk Hammond
- Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Medicine, University of California San Diego, San Diego, California
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12
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Tsuda T, Takefuji M, Wettschureck N, Kotani K, Morimoto R, Okumura T, Kaur H, Eguchi S, Sakaguchi T, Ishihama S, Kikuchi R, Unno K, Matsushita K, Ishikawa S, Offermanns S, Murohara T. Corticotropin releasing hormone receptor 2 exacerbates chronic cardiac dysfunction. J Exp Med 2017; 214:1877-1888. [PMID: 28550160 PMCID: PMC5502432 DOI: 10.1084/jem.20161924] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/09/2017] [Accepted: 04/12/2017] [Indexed: 12/20/2022] Open
Abstract
Prognosis of patients with chronic heart failure remains poor, emphasizing the need to identify additional pathophysiological factors. Tsuda et al. show that Crhr2 activation causes cardiac dysfunction and suggest Crhr2 blockade is a promising therapeutic strategy for chronic heart failure. Heart failure occurs when the heart is unable to effectively pump blood and maintain tissue perfusion. Despite numerous therapeutic advancements over previous decades, the prognosis of patients with chronic heart failure remains poor, emphasizing the need to identify additional pathophysiological factors. Here, we show that corticotropin releasing hormone receptor 2 (Crhr2) is a G protein–coupled receptor highly expressed in cardiomyocytes and continuous infusion of the Crhr2 agonist, urocortin 2 (Ucn2), reduced left ventricular ejection fraction in mice. Moreover, plasma Ucn2 levels were 7.5-fold higher in patients with heart failure compared to those in healthy controls. Additionally, cardiomyocyte-specific deletion of Crhr2 protected mice from pressure overload-induced cardiac dysfunction. Mice treated with a Crhr2 antagonist lost maladaptive 3′-5′-cyclic adenosine monophosphate (cAMP)–dependent signaling and did not develop heart failure in response to overload. Collectively, our results indicate that constitutive Crhr2 activation causes cardiac dysfunction and suggests that Crhr2 blockade is a promising therapeutic strategy for patients with chronic heart failure.
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Affiliation(s)
- Takuma Tsuda
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Mikito Takefuji
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Nina Wettschureck
- Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Kazuhiko Kotani
- Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Ryota Morimoto
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Takahiro Okumura
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Harmandeep Kaur
- Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Shunsuke Eguchi
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Teruhiro Sakaguchi
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Sohta Ishihama
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Ryosuke Kikuchi
- Department of Medical Technique, Nagoya University Hospital, Nagoya, Japan
| | - Kazumasa Unno
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Shizukiyo Ishikawa
- Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Stefan Offermanns
- Department of Pharmacology, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
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13
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Gao MH, Lai NC, Giamouridis D, Kim YC, Tan Z, Guo T, Dillmann WH, Suarez J, Hammond HK. Cardiac-Directed Expression of Adenylyl Cyclase Catalytic Domain Reverses Cardiac Dysfunction Caused by Sustained Beta-Adrenergic Receptor Stimulation. ACTA ACUST UNITED AC 2016; 1:617-629. [PMID: 28670631 PMCID: PMC5490496 DOI: 10.1016/j.jacbts.2016.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Cardiac-targeted expression of C1C2 reduces cAMP production yet mice maintain normal cardiac function through increased Ca2+ handling. Sustained isoproterenol infusion reduces heart function in normal mice, but improves heart function in mice with increased cardiac C1C2 expression. Reduced cardiac cAMP generation and resistance to catecholamine cardiomyopathy are attractive features of this potential heart failure therapeutic. Removing the large transmembrane domains of AC6 and fusing the two intracellular domains provides a small molecule, C1C2, that replicates many of the beneficial effects of AC6, but is sufficiently small to be expressed in an AAV vector for gene transfer.
Transgenic mice with cardiac-directed C1C2, a fusion protein of the intracellular C1 and C2 segments of adenylyl cyclase type 6, had normal left ventricular (LV) function, but diminished cAMP generation. Cardiac myocytes from C1C2 mice showed increased Ca2+ release. Mice underwent continuous isoproterenol infusion to stress the heart. In C1C2 mice, sustained isoproterenol infusion increased rather than decreased LV function. LV SERCA2a and Ca2+ release were increased. Reduced cAMP generation and resistance to catecholamine cardiomyopathy are attractive features of this potential heart failure therapeutic.
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Affiliation(s)
- Mei Hua Gao
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - N Chin Lai
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - Dimosthenis Giamouridis
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - Young Chul Kim
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - Zhen Tan
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - Tracy Guo
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - Wolfgang H Dillmann
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - Jorge Suarez
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
| | - H Kirk Hammond
- VA San Diego Healthcare System and Department of Medicine, University of California San Diego
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14
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Gao MH, Giamouridis D, Lai NC, Walenta E, Paschoal VA, Kim YC, Miyanohara A, Guo T, Liao M, Liu L, Tan Z, Ciaraldi TP, Schenk S, Bhargava A, Oh DY, Hammond HK. One-time injection of AAV8 encoding urocortin 2 provides long-term resolution of insulin resistance. JCI Insight 2016; 1:e88322. [PMID: 27699250 PMCID: PMC5033760 DOI: 10.1172/jci.insight.88322] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/23/2016] [Indexed: 12/17/2022] Open
Abstract
Using mice rendered insulin resistant with high fat diets (HFD), we examined blood glucose levels and insulin resistance after i.v. delivery of an adeno-associated virus type 8 encoding murine urocortin 2 (AAV8.UCn2). A single i.v. injection of AAV8.UCn2-normalized blood glucose and glucose disposal within weeks, an effect that lasted for months. Hyperinsulinemic-euglycemic clamps showed reduced plasma insulin, increased glucose disposal rates, and increased insulin sensitivity following UCn2 gene transfer. Mice with corticotropin-releasing hormone type 2-receptor deletion that were rendered insulin resistant by HFD showed no improvement in glucose disposal after UCn2 gene transfer, indicating that the effect requires UCn2's cognate receptor. We also demonstrated increased glucose disposal after UCn2 gene transfer in db/db mice, a second model of insulin resistance. UCn2 gene transfer reduced fatty infiltration of the liver in both models of insulin resistance. UCn2 increases Glut4 translocation to the plasma membrane in skeletal myotubes in a manner quantitatively similar to insulin, indicating a mechanism through which UCn2 operates to increase insulin sensitivity. UCn2 gene transfer, in a dose-dependent manner, is insulin sensitizing and effective for months after a single injection. These findings suggest a potential long-term therapy for clinical type-2 diabetes.
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Affiliation(s)
- Mei Hua Gao
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
| | - Dimosthenis Giamouridis
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
| | - N. Chin Lai
- Department of Medicine, UCSD, San Diego, California, USA
| | - Evelyn Walenta
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
| | | | - Young Chul Kim
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
| | | | - Tracy Guo
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
| | - Min Liao
- Department of Ob-Gyn and The Osher Center for Integrative Medicine, UCSF, San Francisco, California, USA
| | - Li Liu
- Department of Ob-Gyn and The Osher Center for Integrative Medicine, UCSF, San Francisco, California, USA
- Department of Medicine, First Hospital of Qinhuangdao, Hebei Province, China
| | - Zhen Tan
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
| | - Theodore P. Ciaraldi
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
| | - Simon Schenk
- Department of Orthopedic Surgery, UCSD, San Diego, California, USA
| | - Aditi Bhargava
- Department of Ob-Gyn and The Osher Center for Integrative Medicine, UCSF, San Francisco, California, USA
| | - Da Young Oh
- Department of Medicine, UCSD, San Diego, California, USA
| | - H. Kirk Hammond
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Medicine, UCSD, San Diego, California, USA
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15
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Rincon MY, VandenDriessche T, Chuah MK. Gene therapy for cardiovascular disease: advances in vector development, targeting, and delivery for clinical translation. Cardiovasc Res 2015; 108:4-20. [PMID: 26239654 PMCID: PMC4571836 DOI: 10.1093/cvr/cvv205] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/22/2015] [Indexed: 01/06/2023] Open
Abstract
Gene therapy is a promising modality for the treatment of inherited and acquired cardiovascular diseases. The identification of the molecular pathways involved in the pathophysiology of heart failure and other associated cardiac diseases led to encouraging preclinical gene therapy studies in small and large animal models. However, the initial clinical results yielded only modest or no improvement in clinical endpoints. The presence of neutralizing antibodies and cellular immune responses directed against the viral vector and/or the gene-modified cells, the insufficient gene expression levels, and the limited gene transduction efficiencies accounted for the overall limited clinical improvements. Nevertheless, further improvements of the gene delivery technology and a better understanding of the underlying biology fostered renewed interest in gene therapy for heart failure. In particular, improved vectors based on emerging cardiotropic serotypes of the adeno-associated viral vector (AAV) are particularly well suited to coax expression of therapeutic genes in the heart. This led to new clinical trials based on the delivery of the sarcoplasmic reticulum Ca2+-ATPase protein (SERCA2a). Though the first clinical results were encouraging, a recent Phase IIb trial did not confirm the beneficial clinical outcomes that were initially reported. New approaches based on S100A1 and adenylate cyclase 6 are also being considered for clinical applications. Emerging paradigms based on the use of miRNA regulation or CRISPR/Cas9-based genome engineering open new therapeutic perspectives for treating cardiovascular diseases by gene therapy. Nevertheless, the continuous improvement of cardiac gene delivery is needed to allow the use of safer and more effective vector doses, ultimately bringing gene therapy for heart failure one step closer to reality.
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Affiliation(s)
- Melvin Y Rincon
- Department of Gene Therapy and Regenerative Medicine, Free University of Brussels (VUB), Building D, room D306, Laarbeeklaan 103, Brussels, Belgium Centro de Investigaciones, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia
| | - Thierry VandenDriessche
- Department of Gene Therapy and Regenerative Medicine, Free University of Brussels (VUB), Building D, room D306, Laarbeeklaan 103, Brussels, Belgium Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Marinee K Chuah
- Department of Gene Therapy and Regenerative Medicine, Free University of Brussels (VUB), Building D, room D306, Laarbeeklaan 103, Brussels, Belgium Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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16
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Makarewich CA, Troupes CD, Schumacher SM, Gross P, Koch WJ, Crandall DL, Houser SR. Comparative effects of urocortins and stresscopin on cardiac myocyte contractility. J Mol Cell Cardiol 2015; 86:179-86. [PMID: 26231084 DOI: 10.1016/j.yjmcc.2015.07.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 05/13/2015] [Accepted: 07/25/2015] [Indexed: 01/19/2023]
Abstract
RATIONALE There is a current need for the development of new therapies for patients with heart failure. OBJECTIVE We test the effects of members of the corticotropin-releasing factor (CRF) family of peptides on myocyte contractility to validate them as potential heart failure therapeutics. METHODS AND RESULTS Adult feline left ventricular myocytes (AFMs) were isolated and contractility was assessed in the presence and absence of CRF peptides Urocortin 2 (UCN2), Urocortin 3 (UCN3), Stresscopin (SCP), and the β-adrenergic agonist isoproterenol (Iso). An increase in fractional shortening and peak Ca(2+) transient amplitude was seen in the presence of all CRF peptides. A decrease in Ca(2+) decay rate (Tau) was also observed at all concentrations tested. cAMP generation was measured by ELISA in isolated AFMs in response to the CRF peptides and Iso and significant production was seen at all concentrations and time points tested. CONCLUSIONS The CRF family of peptides effectively increases cardiac contractility and should be evaluated as potential novel therapeutics for heart failure patients.
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Affiliation(s)
- Catherine A Makarewich
- Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA 19140, USA; Department of Physiology, Temple University School of Medicine, Philadelphia, PA 19140, USA
| | - Constantine D Troupes
- Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA 19140, USA; Department of Physiology, Temple University School of Medicine, Philadelphia, PA 19140, USA
| | - Sarah M Schumacher
- Center for Translational Research, Temple University School of Medicine, Philadelphia, PA 19140, USA; Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA 19140, USA
| | - Polina Gross
- Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA 19140, USA; Department of Physiology, Temple University School of Medicine, Philadelphia, PA 19140, USA
| | - Walter J Koch
- Center for Translational Research, Temple University School of Medicine, Philadelphia, PA 19140, USA; Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA 19140, USA
| | - David L Crandall
- Janssen Research & Development, LLC, Spring House, PA 19044, USA
| | - Steven R Houser
- Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA 19140, USA; Department of Physiology, Temple University School of Medicine, Philadelphia, PA 19140, USA.
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17
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Lai NC, Gao MH, Giamouridis D, Suarez J, Miyanohara A, Parikh J, Hightower S, Guo T, Dillmann W, Kim YC, Diaz-Juarez J, Hammond HK. Intravenous AAV8 Encoding Urocortin-2 Increases Function of the Failing Heart in Mice. Hum Gene Ther 2015; 26:347-56. [PMID: 25760560 PMCID: PMC4492611 DOI: 10.1089/hum.2014.157] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Urocortin-2 (UCn2) peptide infusion increases cardiac function in patients with heart failure, but chronic peptide infusion is cumbersome, is costly, and provides only short-term benefits. Gene transfer would circumvent these shortcomings. We previously showed that a single intravenous (IV) injection of AAV8.UCn2 increases plasma UCn2 and left ventricular (LV) systolic and diastolic function for at least 7 months in normal mice. Here we test the hypothesis that IV delivery of AAV8.UCn2 increases function of the failing heart. Myocardial infarction (MI, by coronary ligation) was used to induce heart failure, which was assessed by echocardiography 3 weeks after MI. Mice with LV ejection fraction (EF) <25% received IV delivery of AAV8.UCn2 (5×1011 gc) or saline, and 5 weeks later echocardiography showed increased LV EF in mice that received UCn2 gene transfer (p=0.01). In vivo physiological studies showed a 2-fold increase in peak rate of LV pressure development (LV +dP/dt; p<0.0001) and a 1.6-fold increase in peak rate of LV pressure decay (LV −dP/dt; p=0.0007), indicating increased LV systolic and diastolic function in treated mice. UCn2 gene transfer was associated with increased peak systolic Ca2+ transient amplitude and rate of Ca2+ decline and increased SERCA2a expression. In addition, UCn2 gene transfer reduced Thr286 phosphorylation of Cam kinase II, and increased expression of cardiac myosin light chain kinase, findings that would be anticipated to increase function of the failing heart. We conclude that a single IV injection of AAV8.UCn2 increases function of the failing heart. The simplicity of IV injection of a vector encoding a gene with beneficial paracrine effects to increase cardiac function is an attractive potential clinical strategy.
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Affiliation(s)
- N Chin Lai
- 1 VA San Diego Healthcare System , San Diego, CA 92161.,2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Mei Hua Gao
- 1 VA San Diego Healthcare System , San Diego, CA 92161.,2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Dimosthenis Giamouridis
- 1 VA San Diego Healthcare System , San Diego, CA 92161.,2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Jorge Suarez
- 2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Atsushi Miyanohara
- 2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Jay Parikh
- 1 VA San Diego Healthcare System , San Diego, CA 92161.,2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Stephen Hightower
- 1 VA San Diego Healthcare System , San Diego, CA 92161.,2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Tracy Guo
- 2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Wolfgang Dillmann
- 2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Young-Chul Kim
- 2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - Julieta Diaz-Juarez
- 2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
| | - H Kirk Hammond
- 1 VA San Diego Healthcare System , San Diego, CA 92161.,2 Department of Medicine, University of California-San Diego , San Diego, CA 92161
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18
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Wang D, Zhong L, Nahid MA, Gao G. The potential of adeno-associated viral vectors for gene delivery to muscle tissue. Expert Opin Drug Deliv 2014; 11:345-364. [PMID: 24386892 PMCID: PMC4098646 DOI: 10.1517/17425247.2014.871258] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Muscle-directed gene therapy is rapidly gaining attention primarily because muscle is an easily accessible target tissue and is also associated with various severe genetic disorders. Localized and systemic delivery of recombinant adeno-associated virus (rAAV) vectors of several serotypes results in very efficient transduction of skeletal and cardiac muscles, which has been achieved in both small and large animals, as well as in humans. Muscle is the target tissue in gene therapy for many muscular dystrophy diseases, and may also be exploited as a biofactory to produce secretory factors for systemic disorders. Current limitations of using rAAVs for muscle gene transfer include vector size restriction, potential safety concerns such as off-target toxicity and the immunological barrier composing of pre-existing neutralizing antibodies and CD8(+) T-cell response against AAV capsid in humans. AREAS COVERED In this article, we will discuss basic AAV vector biology and its application in muscle-directed gene delivery, as well as potential strategies to overcome the aforementioned limitations of rAAV for further clinical application. EXPERT OPINION Delivering therapeutic genes to large muscle mass in humans is arguably the most urgent unmet demand in treating diseases affecting muscle tissues throughout the whole body. Muscle-directed, rAAV-mediated gene transfer for expressing antibodies is a promising strategy to combat deadly infectious diseases. Developing strategies to circumvent the immune response following rAAV administration in humans will facilitate clinical application.
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Affiliation(s)
- Dan Wang
- University of Massachusetts Medical School, Gene Therapy Center, 368 Plantation Street, AS6-2049, Worcester, MA 01605, USA
- University of Massachusetts Medical School, Department of Microbiology and Physiology Systems, Worcester, MA 01605, USA
| | - Li Zhong
- University of Massachusetts Medical School, Gene Therapy Center, 368 Plantation Street, AS6-2049, Worcester, MA 01605, USA
- University of Massachusetts Medical School, Division of Hematology/Oncology, Department of Pediatrics, Worcester, MA 01605, USA
| | - M Abu Nahid
- University of Massachusetts Medical School, Gene Therapy Center, 368 Plantation Street, AS6-2049, Worcester, MA 01605, USA
- University of Massachusetts Medical School, Department of Microbiology and Physiology Systems, Worcester, MA 01605, USA
| | - Guangping Gao
- University of Massachusetts Medical School, Gene Therapy Center, 368 Plantation Street, AS6-2049, Worcester, MA 01605, USA
- University of Massachusetts Medical School, Department of Microbiology and Physiology Systems, Worcester, MA 01605, USA
- Sichuan University, West China Hospital, State Key Laboratory of Biotherapy, Chengdu, Sichuan, People's Republic of China
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