Gene therapy for ischemic heart disease: therapeutic potential

Nuclear accumulation of plasmid DNA can be enhanced by non-selective gating of the nuclear pore

One of the major obstacles in non-viral gene transfer is the nuclear membrane. Attempts to improve the transport of DNA to the nucleus through the use of nuclear localization signals or importin-β have achieved limited success. It has been proposed that the nuclear pore complexes (NPCs) through which nucleocytoplasmic transport occurs are filled with a hydrophobic phase through which hydrophobic importins can dissolve. Therefore, considering the hydrophobic nature of the NPC channel, we evaluated whether a non-selective gating of nuclear pores by trans-cyclohexane-1,2-diol (TCHD), an amphipathic alcohol that reversibly collapses the permeability barrier of the NPCs, could be obtained and used as an alternative method to facilitate nuclear entry of plasmid DNA. Our data demonstrate for the first time that TCHD makes the nucleus permeable for both high molecular weight dextrans and plasmid DNA (pDNA) at non-toxic concentrations. Furthermore, in line with these observations, TCHD enhanced the transfection efficacy of both naked DNA and lipoplexes. In conclusion, based on the proposed structure of NPCs we succeeded to temporarily open the NPCs for macromolecules as large as pDNAs and demonstrated that this can significantly enhance non-viral gene delivery.

Poly(glycoamidoamine)s for gene delivery: stability of polyplexes and efficacy with cardiomyoblast cells

Polymeric vectors have potential as nucleic acid delivery vehicles for novel gene therapy and oligonucleotide treatments for cardiovascular disease. In this report, poly(glycoamidoamine)s that contain four secondary amines and either two or four hydroxyl units in the repeat unit with D-glucarate (D4), meso-galactarate (G4), D-mannarate (M4), and l-tartarate (T4) stereochemistry have been investigated for their pDNA-binding affinity, DNase protection effect, and polyplex stability in the presence of salt and serum. Also, the luciferase gene delivery and cellular internalization of polyplexes formed with these polymers have been investigated with rat cardiomyoblast [H9c2(2-1)] cells. The results demonstrate that the number of hydroxyl groups and the stereochemistry affect the biological properties. Polymers T4 and G4 have higher pDNA binding affinity, protect pDNA from nuclease degradation, and do not release pDNA in the presence of serum. Polymers D4 and M4 bind pDNA with lower affinity, which allows for some pDNA degradation and release in the presence of serum. Although T4 forms the most stable polyplexes, vector G4 reveals the highest luciferase gene expression in serum-free media and the greatest cellular internalization of fluorescein-labeled pDNA both in serum-free and serum-supplemented media. The results of these studies indicate that the polymer-DNA binding affinity, nuclease protection capability, and polyplex stability are important parameters to facilitate effective pDNA delivery with poly(glycoamidoamine)s in cultured cardiomyoblast cells. The carbohydrate type also plays an important role to increase cellular uptake and gene expression where the polymer with the galactarate stereochemistry (in G4) is found to be the most effective vector for pDNA delivery to cardiomyoblast cells in vitro.

Molecular aspects of ischemic heart disease: ischemia/reperfusion-induced genetic changes and potential applications of gene and RNA interference therapy

Molecular biologic techniques have a variety of applications in the study of ischemic heart disease, including roles in elucidating cardiac genetic changes resulting from ischemia as well as in developing therapeutic interventions to treat ischemic heart disease. This review describes recent studies documenting genetic changes associated with myocardial ischemia and infarction as well as those investigating the safety and effectiveness of gene therapy for stimulating angiogenesis, protecting the heart against reperfusion injury, and treating heart failure. Also discussed are future research directions, including the potential use of RNA interference and combined stem cell therapy and gene therapy for the treatment of cardiovascular disease.

Stimulation of Paracrine Pathways With Growth Factors Enhances Embryonic Stem Cell Engraftment and Host-Specific Differentiation in the Heart After Ischemic Myocardial Injury

Background— Growth factors play an essential role in organogenesis. We examine the potential of growth factors to enhance cell engraftment and differentiation and to promote functional improvement after transfer of undifferentiated embryonic stem cells into the injured heart.

Methods and Results— Green fluorescent protein (GFP)–positive embryonic stem cells derived from 129sv mice were injected into the ischemic area after left anterior descending artery ligation in allogenic (BALB/c) mice. Fifty nanograms of recombinant mouse vascular endothelial growth factor, fibroblast growth factor (FGF), and transforming growth factor (TGF) was added to the cell suspension. Separate control groups were formed in which only the growth factors were given. Echocardiography was performed 2 weeks later to evaluate heart function (fractional shortening [FS]), end-diastolic diameter, and left ventricular wall thickness). Hearts were harvested for histology (connexin 43, α-sarcomeric actin, CD3, CD11c, major histocompatability complex class I, hematoxylin-eosin). Degree of restoration (GFP-positive graft/infarct area ratio), expression of cardiac markers, host response, and tumorigenicity were evaluated. Cell transfer resulted in improved cardiac function. TGF-β led to better restorative effect and a stronger expression of connexin 43, α-sarcomeric actin, and major histocompatability complex class I. TGF-β and FGF retained left ventricular diameter. FS was better in the TGF-β, FGF, and embryonic stem cells-only group compared with left anterior descending artery-ligated controls. Growth factors with cells (TGF-β, FGF) resulted in higher FS and smaller end-diastolic diameter than growth factors alone.

Conclusions— Growth factors can promote in vivo organ-specific differentiation of early embryonic stem cells and improve myocardial function after cell transfer into an area of ischemic lesion. TGF-β should be considered as an adjuvant for myocardial restoration with the use of embryonic stem cells.