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Martinez EC, Li J, Ataam JA, Tokarski K, Thakur H, Karakikes I, Dodge-Kafka K, Kapiloff MS. Targeting mAKAPβ expression as a therapeutic approach for ischemic cardiomyopathy. Gene Ther 2023; 30:543-551. [PMID: 35102273 PMCID: PMC9339585 DOI: 10.1038/s41434-022-00321-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 01/02/2023]
Abstract
Ischemic cardiomyopathy is a leading cause of death and an unmet clinical need. Adeno-associated virus (AAV) gene-based therapies hold great promise for treating and preventing heart failure. Previously we showed that muscle A-kinase Anchoring Protein β (mAKAPβ, AKAP6β), a scaffold protein that organizes perinuclear signalosomes in the cardiomyocyte, is a critical regulator of pathological cardiac hypertrophy. Here, we show that inhibition of mAKAPβ expression in stressed adult cardiomyocytes in vitro was cardioprotective, while conditional cardiomyocyte-specific mAKAP gene deletion in mice prevented pathological cardiac remodeling due to myocardial infarction. We developed a new self-complementary serotype 9 AAV gene therapy vector expressing a short hairpin RNA for mAKAPβ under the control of a cardiomyocyte-specific promoter (AAV9sc.shmAKAP). This vector efficiently downregulated mAKAPβ expression in the mouse heart in vivo. Expression of the shRNA also inhibited mAKAPβ expression in human induced cardiomyocytes in vitro. Following myocardial infarction, systemic administration of AAV9sc.shmAKAP prevented the development of pathological cardiac remodeling and heart failure, providing long-term restoration of left ventricular ejection fraction. Our findings provide proof-of-concept for mAKAPβ as a therapeutic target for ischemic cardiomyopathy and support the development of a translational pipeline for AAV9sc.shmAKAP for the treatment of heart failure.
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Affiliation(s)
- Eliana C Martinez
- Interdisciplinary Stem Cell Institute, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, 33101, USA
| | - Jinliang Li
- Interdisciplinary Stem Cell Institute, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, 33101, USA
- Departments of Ophthalmology and Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, CA, 94304, USA
| | - Jennifer Arthur Ataam
- Department of Cardiothoracic Surgery and Stanford Cardiovascular Institute, Stanford University, Stanford, CA, 94305, USA
| | - Kristin Tokarski
- Calhoun Center for Cardiology, University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Hrishikesh Thakur
- Interdisciplinary Stem Cell Institute, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, 33101, USA
- Departments of Ophthalmology and Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, CA, 94304, USA
| | - Ioannis Karakikes
- Department of Cardiothoracic Surgery and Stanford Cardiovascular Institute, Stanford University, Stanford, CA, 94305, USA
| | - Kimberly Dodge-Kafka
- Calhoun Center for Cardiology, University of Connecticut Health Center, Farmington, CT, 06030, USA
| | - Michael S Kapiloff
- Interdisciplinary Stem Cell Institute, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, 33101, USA.
- Departments of Ophthalmology and Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, CA, 94304, USA.
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2
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Park F. The heart is where AAV9 lies. Physiol Genomics 2022; 54:316-318. [PMID: 35816650 DOI: 10.1152/physiolgenomics.00102.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Frank Park
- The University of Tennessee Health Science Center, Department of Pharmaceutical Sciences, Memphis, TN, United States
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3
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Li J, Kelly SC, Ivey JR, Thorne PK, Yamada KP, Aikawa T, Mazurek R, Turk JR, Silva KAS, Amin AR, Tharp DL, Mueller CM, Thakur H, Leary EV, Domeier TL, Rector RS, Fish K, Cividini F, Ishikawa K, Emter CA, Kapiloff MS. Distribution of cardiomyocyte-selective adeno-associated virus serotype 9 vectors in swine following intracoronary and intravenous infusion. Physiol Genomics 2022; 54:261-272. [PMID: 35648460 PMCID: PMC9236866 DOI: 10.1152/physiolgenomics.00032.2022] [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] [Indexed: 11/22/2022] Open
Abstract
Limited reports exist regarding adeno-associated virus (AAV) biodistribution in swine. This study assessed biodistribution following antegrade intracoronary and intravenous delivery of two self-complementary serotype 9 AAV (AAV9sc) biologics designed to target signaling in the cardiomyocyte considered important for the development of heart failure. Under the control of a cardiomyocyte-specific promoter, AAV9sc.shmAKAP and AAV9sc.RBD express a small hairpin RNA for the perinuclear scaffold protein muscle A-kinase anchoring protein β (mAKAPβ) and an anchoring disruptor peptide for p90 ribosomal S6 kinase type 3 (RSK3), respectively. Quantitative PCR was used to assess viral genome (vg) delivery and transcript expression in Ossabaw and Yorkshire swine tissues. Myocardial viral delivery was 2-5 × 105 vg/µg genomic DNA (gDNA) for both infusion techniques at a dose ∼1013 vg/kg body wt, demonstrating delivery of ∼1-3 viral particles per cardiac diploid genome. Myocardial RNA levels for each expressed transgene were generally proportional to dose and genomic delivery, and comparable with levels for moderately expressed endogenous genes. Despite significant AAV9sc delivery to other tissues, including the liver, neither biologic induced toxic effects as assessed using functional, structural, and circulating cardiac and systemic markers. These results indicate successful targeted delivery of cardiomyocyte-selective viral vectors in swine without negative side effects, an important step in establishing efficacy in a preclinical experimental setting.
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Affiliation(s)
- Jinliang Li
- Department of Ophthalmology, Stanford University, Palo Alto, California
- Department of Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, California
| | - Shannon C Kelly
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Jan R Ivey
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Pamela K Thorne
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Kelly P Yamada
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Tadao Aikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Renata Mazurek
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - James R Turk
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | | | - Amira R Amin
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Darla L Tharp
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Christina M Mueller
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Hrishikesh Thakur
- Department of Ophthalmology, Stanford University, Palo Alto, California
- Department of Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, California
| | - Emily V Leary
- Department of Orthopedic Surgery, University of Missouri, Columbia, Missouri
| | - Timothy L Domeier
- Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri
| | - R Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Missouri, Columbia, Missouri
- Research Service, Harry S. Truman Memorial VA Hospital, University of Missouri, Columbia, Missouri
| | - Kenneth Fish
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | | | - Kiyotake Ishikawa
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Craig A Emter
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
| | - Michael S Kapiloff
- Department of Ophthalmology, Stanford University, Palo Alto, California
- Department of Medicine, Stanford Cardiovascular Institute, Stanford University, Palo Alto, California
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4
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Tao Z, Loo S, Su L, Tan S, Tee G, Gan SU, Zhang J, Chen X, Ye L. Angiopoietin-1 enhanced myocyte mitosis, engraftment, and the reparability of hiPSC-CMs for treatment of myocardial infarction. Cardiovasc Res 2021; 117:1578-1591. [PMID: 32666104 DOI: 10.1093/cvr/cvaa215] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/23/2020] [Accepted: 07/07/2020] [Indexed: 01/11/2023] Open
Abstract
AIMS To examine whether transient over-expression of angiopoietin-1 (Ang-1) increases the potency of hiPSC-CMs for treatment of heart failure. METHODS AND RESULTS Atrial hiPSC-CMs (hiPSC-aCMs) were differentiated from hiPSCs and purified by lactic acid and were transfected with Ang-1 (Ang-1-hiPSC-aCMs) plasmid using lipoSTEM. Ang-1 gene transfection efficiency was characterized in vitro. Gene transfected CMs (1×106) were seeded into a fibrin/thrombin patch and implanted on the rat-infarcted left ventricular (LV) anterior wall after myocardial infarction (MI). Echo function was determined at 1- and 6 weeks post-MI. Immunohistochemistry study was performed at 6 weeks post-MI. Ang-1 (20 and 40 ng/mL) protected hiPSC-aCMs from hypoxia through up-regulating pERK1/2 and inhibiting Bax protein expressions. Ang-1-hiPSC-aCMs transiently secreted Ang-1 protein up to 14 days, with peak level on day-2 post-transfection (24.39 ± 13.02 ng/mL) in vitro. Animal study showed that transplantation of Ang-1-hiPSC-aCM seeded patch more effectively limited rat heart apoptosis at 1 day post-MI as compared with LipoSTEM-Ang-1 or hiPSC-aCMs transplantation. Ang-1-hiPSC-aCMs transplantation induced host (rat) and donor (human) CM mitosis and arteriole formation, improved cell engraftment rate, more effectively limited LV dilation (EDV = 460.7 ± 96.1 μL and ESV = 219.8 ± 72.9 μL) and improved LV global pump function (EF = 53.1 ± 9%) as compared with the MI (EDV = 570.9 ± 91.8 μL, P = 0.033; ESV = 331.6 ± 71.2 μL, P = 0.011; EF = 42.3 ± 4.1%, P = 0.02) or the LipoSTEM-Ang-1 injected (EDV = 491.4 ± 100.4 μL, P = 0.854; ESV = 280.9 ± 71.5 μL, P = 0.287; EF = 43.2 ± 4.6, P = 0.039) or hiPSC-CM transplanted (EDV = 547.9 ± 55.5 μL, P = 0.095; ESV = 300.2 ± 88.4 μL, P = 0.075; EF = 46 ± 10.9%, P = 0.166) animal groups at 6 weeks post-MI and treatment. CONCLUSION Transient over-expression of Ang-1 enhanced hiPSC-aCM mitosis and engraftment and increased the reparability potency of hiPSC-aCMs for treatment of MI.
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Affiliation(s)
- Zhonghao Tao
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, 210006 Nanjing, Jiangsu, PR China
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609 Singapore
| | - Szejie Loo
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609 Singapore
| | - Liping Su
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609 Singapore
| | - Shihua Tan
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609 Singapore
| | - Guizhen Tee
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609 Singapore
| | - Shu Uin Gan
- Department of Surgery, National University of Singapore, 1E Kent Ridge Road, 119228 Singapore
| | - Jianyi Zhang
- Department of Biomedical Engineering, University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35294-2182, USA
| | - Xin Chen
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, 210006 Nanjing, Jiangsu, PR China
| | - Lei Ye
- National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, 169609 Singapore
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5
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Tan S, Tao Z, Loo S, Su L, Chen X, Ye L. Non-viral vector based gene transfection with human induced pluripotent stem cells derived cardiomyocytes. Sci Rep 2019; 9:14404. [PMID: 31591436 PMCID: PMC6779884 DOI: 10.1038/s41598-019-50980-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/23/2019] [Indexed: 01/06/2023] Open
Abstract
Non-viral transfection of mammalian cardiomyocytes (CMs) is challenging. The current study aims to characterize and determine the non-viral vector based gene transfection efficiency with human induced pluripotent stem cells (hiPSCs) derived cardiomyocytes (hiPSC-CMs). hiPSC-CMs differentiated from PCBC hiPSCs were used as a cell model to be transfected with plasmids carrying green fluorescence protein (pGFP) using polyethylenimine (PEI), including Transporter 5 Transfection Reagent (TR5) and PEI25, and liposome, including lipofectamine-2000 (Lipo2K), lipofectamine-3000 (Lipo3K), and Lipofectamine STEM (LipoSTEM). The gene transfection efficiency and cell viability were quantified by flow cytometry. We found that the highest gene transfection efficiency in hiPSC-CMs on day 14 of contraction can be achieved by LipoSTEM which was about 32.5 ± 6.7%. However, it also cuased poor cell viability (60.1 ± 4.5%). Furthermore, a prolonged culture of (transfection on day 23 of contraction) hiPSC-CMs not only improved gene transfection (54.5 ± 8.9%), but also enhanced cell viability (74 ± 4.9%) by LipoSTEM. Based on this optimized gene transfection condition, the highest gene transfection efficiency was 55.6 ± 7.8% or 34.1 ± 4%, respectively, for P1C1 or DP3 hiPSC line that was derived from healthy donor (P1C1) or patient with diabetes (DP3). The cell viability was 80.8 ± 5.2% or 92.9 ± 2.24%, respectively, for P1C1 or DP3. LipoSTEM is a better non-viral vector for gene transfection of hiPSC-CMs. The highest pGFP gene transfection efficiency can reach >50% for normal hiPSC-CMs or >30% for diabetic hiPSC-CMs.
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Affiliation(s)
- Shihua Tan
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Zhonghao Tao
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Szejie Loo
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Liping Su
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore
| | - Xin Chen
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Lei Ye
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore.
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6
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Yadav S, Yuan CC, Kazmierczak K, Liang J, Huang W, Takeuchi LM, Kanashiro-Takeuchi RM, Szczesna-Cordary D. Therapeutic potential of AAV9-S15D-RLC gene delivery in humanized MYL2 mouse model of HCM. J Mol Med (Berl) 2019; 97:1033-1047. [PMID: 31101927 DOI: 10.1007/s00109-019-01791-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/24/2019] [Accepted: 05/01/2019] [Indexed: 12/15/2022]
Abstract
Familial hypertrophic cardiomyopathy (HCM) is an autosomal dominant disorder characterized by ventricular hypertrophy, myofibrillar disarray, and fibrosis, and is primarily caused by mutations in sarcomeric genes. With no definitive cure for HCM, there is an urgent need for the development of novel preventive and reparative therapies. This study is focused on aspartic acid-to-valine (D166V) mutation in the myosin regulatory light chain, RLC (MYL2 gene), associated with a malignant form of HCM. Since myosin RLC phosphorylation is critical for normal cardiac function, we aimed to exploit this post-translational modification via phosphomimetic-RLC gene therapy. We hypothesized that mimicking/modulating cardiac RLC phosphorylation in non-phosphorylatable D166V myocardium would improve heart function of HCM-D166V mice. Adeno-associated virus, serotype-9 (AAV9) was used to deliver phosphomimetic human RLC variant with serine-to-aspartic acid substitution at Ser15-RLC phosphorylation site (S15D-RLC) into the hearts of humanized HCM-D166V mice. Improvement of heart function was monitored by echocardiography, invasive hemodynamics (PV-loops) and muscle contractile mechanics. A significant increase in cardiac output and stroke work and a decrease in relaxation constant, Tau, shown to be prolonged in HCM mice, were observed in AAV- vs. PBS-injected HCM mice. Strain analysis showed enhanced myocardial longitudinal shortening in AAV-treated vs. control mice. In addition, increased maximal contractile force was observed in skinned papillary muscles from AAV-injected HCM hearts. Our data suggest that myosin RLC phosphorylation may have important translational implications for the treatment of RLC mutations-induced HCM and possibly play a role in other disease settings accompanied by depressed Ser15-RLC phosphorylation. KEY MESSAGES: HCM-D166V mice show decreased RLC phosphorylation and decompensated function. AAV9-S15D-RLC gene therapy in HCM-D166V mice, but not in WT-RLC, results in improved heart performance. Global longitudinal strain analysis shows enhanced contractility in AAV vs controls. Increased systolic and diastolic function is paralleled by higher contractile force. Phosphomimic S15D-RLC has a therapeutic potential for HCM.
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Affiliation(s)
- Sunil Yadav
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Chen-Ching Yuan
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Katarzyna Kazmierczak
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Jingsheng Liang
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Wenrui Huang
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Lauro M Takeuchi
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Rosemeire M Kanashiro-Takeuchi
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.,Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Danuta Szczesna-Cordary
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
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7
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French BA, Holmes JW. Implications of scar structure and mechanics for post-infarction cardiac repair and regeneration. Exp Cell Res 2019; 376:98-103. [PMID: 30610848 DOI: 10.1016/j.yexcr.2019.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/21/2018] [Accepted: 01/01/2019] [Indexed: 01/14/2023]
Abstract
Regenerating cardiac muscle lost during a heart attack is a topic of broad interest and enormous potential impact. One promising approach is to regenerate or re-engineer new myocardium in situ, at the site of damage, by injecting cells, growth factors, and other materials, or by reprogramming aspects of the normal wound healing process. A wide variety of strategies have been explored, from promoting angiogenesis to injection of a variety of different progenitor cell types, to re-engineering resident cells to produce key growth factors or even transdifferentiate into myocytes. Despite substantial progress and continued promise, clinical impact of this work has fallen short of expectations. One contributing factor may be that many efforts focus primarily on generating cardiomyocytes, with less attention to re-engineering the extracellular matrix (ECM). Yet the role of the ECM is particularly crucial to consider following myocardial infarction, which leads to rapid formation of a collagen-rich scar. This review combines a brief summary of current efforts to regenerate cardiomyocytes with what is currently known about the structure and mechanics of post-infarction scar, with the goal of identifying principles that can guide efforts to produce new myocytes embedded in an extracellular environment that facilitates their differentiation, maintenance, and function.
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Affiliation(s)
- Brent A French
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA; Department of Radiology, University of Virginia, Charlottesville, VA, USA; Department of Medicine, University of Virginia, Charlottesville, VA, USA; Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, USA
| | - Jeffrey W Holmes
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA; Department of Medicine, University of Virginia, Charlottesville, VA, USA; Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, USA.
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8
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Martino F, Magenta A, Pannarale G, Martino E, Zanoni C, Perla FM, Puddu PE, Barillà F. Epigenetics and cardiovascular risk in childhood. J Cardiovasc Med (Hagerstown) 2017; 17:539-46. [PMID: 27367935 DOI: 10.2459/jcm.0000000000000334] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease (CVD) can arise at the early stages of development and growth. Genetic and environmental factors may interact resulting in epigenetic modifications with abnormal phenotypic expression of genetic information without any change in the nucleotide sequence of DNA. Maternal dietary imbalance, inadequate to meet the nutritional needs of the fetus can lead to intrauterine growth retardation, decreased gestational age, low birth weight, excessive post-natal growth and metabolic alterations, with subsequent appearance of CVD risk factors. Fetal exposure to high cholesterol, diabetes and maternal obesity is associated with increased risk and progression of atherosclerosis. Maternal smoking during pregnancy and exposure to various environmental pollutants induce epigenetic alterations of gene expression relevant to the onset or progression of CVD. In children with hypercholesterolemia and/or obesity, oxidative stress activates platelets and monocytes, which release proinflammatory and proatherogenic substances, inducing endothelial dysfunction, decreased Doppler flow-mediated dilation and increased carotid intima-media thickness. Primary prevention of atherosclerosis should be implemented early. It is necessary to identify, through screening, high-risk apparently healthy children and take care of them enforcing healthy lifestyle (mainly consisting of Mediterranean diet and physical activity), prescribing nutraceuticals and eventual medications, if required by a high-risk profile. The key issue is the restoration of endothelial function in the reversible stage of atherosclerosis. Epigenetics may provide new markers for an early identification of children at risk and thereby develop innovative therapies and specific nutritional interventions in critical times.
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Affiliation(s)
- Francesco Martino
- aDepartment of Pediatrics and Child Neuropsychiatry, Sapienza University of RomebVascular Pathology Laboratory, Fondazione Luigi Monti, Istituto Dermopatico dell'Immacolata-IRCCScDepartment of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, 'Sapienza' University of Rome, Rome, Italy*The authors contributed equally to this work
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9
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Systemic injection of AAV9 carrying a periostin promoter targets gene expression to a myofibroblast-like lineage in mouse hearts after reperfused myocardial infarction. Gene Ther 2016; 23:469-78. [PMID: 26926804 DOI: 10.1038/gt.2016.20] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 01/15/2016] [Accepted: 02/17/2016] [Indexed: 12/11/2022]
Abstract
Adeno-associated virus (AAV) has been used to direct gene transfer to a variety of tissues, including heart, liver, skeletal muscle, brain, kidney and lung, but it has not previously been shown to effectively target fibroblasts in vivo, including cardiac fibroblasts. We constructed expression cassettes using a modified periostin promoter to drive gene expression in a cardiac myofibroblast-like lineage, with only occasional spillover into cardiomyocyte-like cells. We compared AAV serotypes 6 and 9 and found robust gene expression when the vectors were delivered by systemic injection after myocardial infarction (MI), with little expression in healthy, non-infarcted mice. AAV9 provided expression in a greater number of cells than AAV6, with reporter gene expression visible in the cardiac infarct and border zones from 5 to 62 days post MI, as assessed by luciferase and Cre-activated green fluorescent protein expression. Although common myofibroblast markers were expressed in low abundance, most of the targeted cells expressed myosin IIb, an embryonic form of smooth muscle myosin heavy chain that has previously been associated with myofibroblasts after reperfused MI. This study is the first to demonstrate AAV-mediated expression in a potentially novel myofibroblast-like lineage in mouse hearts post MI and may open new avenues of gene therapy to treat patients surviving MI.
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10
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O'Connor DM, Naresh NK, Piras BA, Xu Y, Smith RS, Epstein FH, Hossack JA, Ogle RC, French BA. A novel cardiac muscle-derived biomaterial reduces dyskinesia and postinfarct left ventricular remodeling in a mouse model of myocardial infarction. Physiol Rep 2015; 3:3/3/e12351. [PMID: 25825543 PMCID: PMC4393176 DOI: 10.14814/phy2.12351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Extracellular matrix (ECM) degradation after myocardial infarction (MI) leaves the myocardium structurally weakened and, as a result, susceptible to early infarct zone dyskinesia and left ventricular (LV) remodeling. While various cellular and biomaterial preparations have been transplanted into the infarct zone in hopes of improving post-MI LV remodeling, an allogeneic cardiac muscle-derived ECM extract has yet to be developed and tested in the setting of reperfused MI. We sought to determine the effects of injecting a novel cardiac muscle-derived ECM into the infarct zone on early dyskinesia and LV remodeling in a mouse model of MI. Cardiac muscle ECM was extracted from frozen mouse heart tissue by a protocol that enriches for basement membrane constituents. The extract was injected into the infarct zone immediately after ischemia/reperfusion injury (n = 6). Echocardiography was performed at baseline and at days 2, 7, 14, and 28 post-MI to assess 3D LV volumes and cardiac function, as compared to infarcted controls (n = 9). Early infarct zone dyskinesia was measured on day 2 post-MI using a novel metric, the dyskinesia index. End-systolic volume was significantly reduced in the ECM-treated group compared to controls by day 14. Ejection fraction and stroke volume were also significantly improved in the ECM-treated group. ECM-treated hearts showed a significant (P < 0.005) reduction in dyskinetic motion on day 2. Thus, using high-frequency ultrasound, it was shown that treatment with a cardiac-derived ECM preparation reduced early infarct zone dyskinesia and post-MI LV remodeling in a mouse model of reperfused MI.
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Affiliation(s)
- Daniel M O'Connor
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Nivedita K Naresh
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Bryan A Piras
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Yaqin Xu
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Robert S Smith
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Frederick H Epstein
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia Department of Radiology, University of Virginia, Charlottesville, Virginia
| | - John A Hossack
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia
| | - Roy C Ogle
- School of Medical Diagnostic and Translational Sciences, College of Health Sciences, Old Dominion University, Norfolk, Virginia
| | - Brent A French
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia Department of Radiology, University of Virginia, Charlottesville, Virginia
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12
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Call JA, Chain KH, Martin KS, Lira VA, Okutsu M, Zhang M, Yan Z. Enhanced skeletal muscle expression of extracellular superoxide dismutase mitigates streptozotocin-induced diabetic cardiomyopathy by reducing oxidative stress and aberrant cell signaling. Circ Heart Fail 2015; 8:188-97. [PMID: 25504759 PMCID: PMC4445759 DOI: 10.1161/circheartfailure.114.001540] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 12/04/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND Exercise training enhances extracellular superoxide dismutase (EcSOD) expression in skeletal muscle and elicits positive health outcomes in individuals with diabetes mellitus. The goal of this study was to determine if enhanced skeletal muscle expression of EcSOD is sufficient to mitigate streptozotocin-induced diabetic cardiomyopathy. METHODS AND RESULTS Exercise training promotes EcSOD expression in skeletal muscle and provides protection against diabetic cardiomyopathy; however, it is not known if enhanced expression of EcSOD in skeletal muscle plays a functional role in this protection. Here, we show that skeletal muscle-specific EcSOD transgenic mice are protected from cardiac hypertrophy, fibrosis, and dysfunction under the condition of type 1 diabetes mellitus induced by streptozotocin injection. We also show that both exercise training and muscle-specific transgenic expression of EcSOD result in elevated EcSOD protein in the blood and heart without increased transcription in the heart, suggesting that enhanced expression of EcSOD from skeletal muscle redistributes to the heart. Importantly, cardiac tissue in transgenic mice displayed significantly reduced oxidative stress, aberrant cell signaling, and inflammatory cytokine expression compared with wild-type mice under the same diabetic condition. CONCLUSIONS Enhanced expression of EcSOD in skeletal muscle is sufficient to mitigate streptozotocin-induced diabetic cardiomyopathy through attenuation of oxidative stress, aberrant cell signaling, and inflammation, suggesting a cross-organ mechanism by which exercise training improves cardiac function in diabetes mellitus.
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Affiliation(s)
- Jarrod A Call
- From the Departments of Medicine (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), Pharmacology (Z.Y.), Molecular Physiology and Biological Physics (Z.Y.), Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), and Department of Biomedical Engineering (K.S.M.), University of Virginia, Charlottesville
| | - Kristopher H Chain
- From the Departments of Medicine (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), Pharmacology (Z.Y.), Molecular Physiology and Biological Physics (Z.Y.), Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), and Department of Biomedical Engineering (K.S.M.), University of Virginia, Charlottesville
| | - Kyle S Martin
- From the Departments of Medicine (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), Pharmacology (Z.Y.), Molecular Physiology and Biological Physics (Z.Y.), Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), and Department of Biomedical Engineering (K.S.M.), University of Virginia, Charlottesville
| | - Vitor A Lira
- From the Departments of Medicine (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), Pharmacology (Z.Y.), Molecular Physiology and Biological Physics (Z.Y.), Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), and Department of Biomedical Engineering (K.S.M.), University of Virginia, Charlottesville
| | - Mitsuharu Okutsu
- From the Departments of Medicine (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), Pharmacology (Z.Y.), Molecular Physiology and Biological Physics (Z.Y.), Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), and Department of Biomedical Engineering (K.S.M.), University of Virginia, Charlottesville
| | - Mei Zhang
- From the Departments of Medicine (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), Pharmacology (Z.Y.), Molecular Physiology and Biological Physics (Z.Y.), Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), and Department of Biomedical Engineering (K.S.M.), University of Virginia, Charlottesville
| | - Zhen Yan
- From the Departments of Medicine (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), Pharmacology (Z.Y.), Molecular Physiology and Biological Physics (Z.Y.), Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center (J.A.C., K.H.C., V.A.L., M.O., M.Z., Z.Y.), and Department of Biomedical Engineering (K.S.M.), University of Virginia, Charlottesville.
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Piras BA, O’Connor DM, French BA. Systemic delivery of shRNA by AAV9 provides highly efficient knockdown of ubiquitously expressed GFP in mouse heart, but not liver. PLoS One 2013; 8:e75894. [PMID: 24086659 PMCID: PMC3782464 DOI: 10.1371/journal.pone.0075894] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 08/17/2013] [Indexed: 01/09/2023] Open
Abstract
AAV9 is a powerful gene delivery vehicle capable of providing long-term gene expression in a variety of cell types, particularly cardiomyocytes. The use of AAV-delivery for RNA interference is an intense area of research, but a comprehensive analysis of knockdown in cardiac and liver tissues after systemic delivery of AAV9 has yet to be reported. We sought to address this question by using AAV9 to deliver a short-hairpin RNA targeting the enhanced green fluorescent protein (GFP) in transgenic mice that constitutively overexpress GFP in all tissues. The expression cassette was initially tested in vitro and we demonstrated a 61% reduction in mRNA and a 90% reduction in GFP protein in dual-transfected 293 cells. Next, the expression cassette was packaged as single-stranded genomes in AAV9 capsids to test cardiac GFP knockdown with several doses ranging from 1.8×10(10) to 1.8×10(11) viral genomes per mouse and a dose-dependent response was obtained. We then analyzed GFP expression in both heart and liver after delivery of 4.4×10(11) viral genomes per mouse. We found that while cardiac knockdown was highly efficient, with a 77% reduction in GFP mRNA and a 71% reduction in protein versus control-treated mice, there was no change in liver expression. This was despite a 4.5-fold greater number of viral genomes in the liver than in the heart. This study demonstrates that single-stranded AAV9 vectors expressing shRNA can be used to achieve highly efficient cardiac-selective knockdown of GFP expression that is sustained for at least 7 weeks after the systemic injection of 8 day old mice, with no change in liver expression and no evidence of liver damage despite high viral genome presence in the liver.
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Affiliation(s)
- Bryan A. Piras
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
| | - Daniel M. O’Connor
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
| | - Brent A. French
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Radiology, University of Virginia, Charlottesville, Virginia, United States of America
- Department of Medicine/Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia, United States of America
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