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Pastore CJ, Isner JM, Bacha PA, Kearney M, Pickering JG. Epidermal growth factor receptor-targeted cytotoxin inhibits neointimal hyperplasia in vivo. Results of local versus systemic administration. Circ Res 1995; 77:519-29. [PMID: 7641322 DOI: 10.1161/01.res.77.3.519] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Smooth muscle cell accumulation is a key feature of restenosis that may be inhibited by the delivery of receptor-targeted cytotoxins. DAB389EGF is a recombinant fusion protein in which the receptor-binding domain of diphtheria toxin has been replaced by human epidermal growth factor (EGF). We investigated the effectiveness of DAB389EGF to inhibit neointimal hyperplasia in the balloon-injured rat carotid artery. Incubation of rat carotid arteries with 125I-labeled EGF revealed extensive EGF binding sites in the neointima of balloon-injured arteries. Sixty rats subsequently received either saline or DAB389EGF (total dose, 0.15 mg) delivered immediately following balloon injury either systemically, via 14-day continuous osmotic pump infusion, or locally, via 30-minute intraluminal incubation. The effect of both treatment strategies was measured 2 weeks after injury by cross-sectional morphometric analysis of intimal area, the ratio of intimal/medial area (I/M), and the percent luminal narrowing (%LN). In addition, proliferative activity was assessed by immunostaining for the presence of the proliferating cell nuclear antigen (PCNA). Compared with controls, systemic delivery of fusion toxin significantly reduced intimal area, I/M, and %LN by 40%, 40%, and 29%, respectively. However, these rats exhibited 2% weight loss, indicating mild systemic toxicity. Local, intraluminal administration of DAB389EGF yielded a more pronounced reduction in intimal area, I/M, and %LN by 74%, 79%, and 72%, respectively. This inhibitory effect was preserved at 3 weeks postinjury, and PCNA immunostaining of locally treated arteries revealed a virtual absence of proliferative activity in the neointima and media at this timepoint. In contrast to systemically treated rats, rats receiving fusion toxin locally gained weight at a rate similar to controls, indicating avoidance of systemic toxicity. We conclude that DAB389EGF is a potent inhibitor of neointimal hyperplasia in vivo and that whereas an inhibitory effect may be achieved by systemic delivery, local delivery appears to be more potent, avoids systemic toxicity, and thus represents a feasible strategy to preempt restenosis.
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Affiliation(s)
- C J Pastore
- Department of Medicine (Cardiology), St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Mass 02135, USA
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Pastore CJ, Isner JM, Bacha PA, Kearney M, Pickering JG. Epidermal Growth Factor Receptor–Targeted Cytotoxin Inhibits Neointimal Hyperplasia In Vivo. Circ Res 1995. [DOI: 10.1161/res.77.1.1/a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Smooth muscle cell accumulation is a key feature of restenosis that may be inhibited by the delivery of receptor-targeted cytotoxins. DAB
389
EGF is a recombinant fusion protein in which the receptor-binding domain of diphtheria toxin has been replaced by human epidermal growth factor (EGF). We investigated the effectiveness of DAB
389
EGF to inhibit neointimal hyperplasia in the balloon-injured rat carotid artery. Incubation of rat carotid arteries with
125
I-labeled EGF revealed extensive EGF binding sites in the neointima of balloon-injured arteries. Sixty rats subsequently received either saline or DAB
389
EGF (total dose, 0.15 mg) delivered immediately following balloon injury either systemically, via 14-day continuous osmotic pump infusion, or locally, via 30-minute intraluminal incubation. The effect of both treatment strategies was measured 2 weeks after injury by cross-sectional morphometric analysis of intimal area, the ratio of intimal/medial area (I/M), and the percent luminal narrowing (%LN). In addition, proliferative activity was assessed by immunostaining for the presence of the proliferating cell nuclear antigen (PCNA). Compared with controls, systemic delivery of fusion toxin significantly reduced intimal area, I/M, and %LN by 40%, 40%, and 29%, respectively. However, these rats exhibited 2% weight loss, indicating mild systemic toxicity. Local, intraluminal administration of DAB
389
EGF yielded a more pronounced reduction in intimal area, I/M, and %LN by 74%, 79%, and 72%, respectively. This inhibitory effect was preserved at 3 weeks postinjury, and PCNA immunostaining of locally treated arteries revealed a virtual absence of proliferative activity in the neointima and media at this timepoint. In contrast to systemically treated rats, rats receiving fusion toxin locally gained weight at a rate similar to controls, indicating avoidance of systemic toxicity. We conclude that DAB
389
EGF is a potent inhibitor of neointimal hyperplasia in vivo and that whereas an inhibitory effect may be achieved by systemic delivery, local delivery appears to be more potent, avoids systemic toxicity, and thus represents a feasible strategy to preempt restenosis.
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Affiliation(s)
- Christopher J. Pastore
- From the Departments of Medicine (Cardiology), Pathology, and Biomedical Research (C.J.P., J.M.I., M.K., J.G.P.), St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Mass; Seragen Inc (P.A.B.), Hopkinton, Mass; and the John P. Robarts Research Institute and Department of Medicine (Cardiology) (J.G.P.), University Hospital, University of Western Ontario, London, Canada
| | - Jeffrey M. Isner
- From the Departments of Medicine (Cardiology), Pathology, and Biomedical Research (C.J.P., J.M.I., M.K., J.G.P.), St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Mass; Seragen Inc (P.A.B.), Hopkinton, Mass; and the John P. Robarts Research Institute and Department of Medicine (Cardiology) (J.G.P.), University Hospital, University of Western Ontario, London, Canada
| | - Patricia A. Bacha
- From the Departments of Medicine (Cardiology), Pathology, and Biomedical Research (C.J.P., J.M.I., M.K., J.G.P.), St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Mass; Seragen Inc (P.A.B.), Hopkinton, Mass; and the John P. Robarts Research Institute and Department of Medicine (Cardiology) (J.G.P.), University Hospital, University of Western Ontario, London, Canada
| | - Marianne Kearney
- From the Departments of Medicine (Cardiology), Pathology, and Biomedical Research (C.J.P., J.M.I., M.K., J.G.P.), St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Mass; Seragen Inc (P.A.B.), Hopkinton, Mass; and the John P. Robarts Research Institute and Department of Medicine (Cardiology) (J.G.P.), University Hospital, University of Western Ontario, London, Canada
| | - J. Geoffrey Pickering
- From the Departments of Medicine (Cardiology), Pathology, and Biomedical Research (C.J.P., J.M.I., M.K., J.G.P.), St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, Mass; Seragen Inc (P.A.B.), Hopkinton, Mass; and the John P. Robarts Research Institute and Department of Medicine (Cardiology) (J.G.P.), University Hospital, University of Western Ontario, London, Canada
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Abstract
The protein toxins ricin, abrin, Shiga toxin, and diphtheria toxin were found to induce lysis of several cell lines in a manner characteristic for programmed cell death or apoptosis. The toxins induced DNA degradation, and light and electron microscopical studies revealed that lysis was preceded by reorganization of intracellular vacuoles, cell blebbing, and chromatin condensation both in Vero and in MDCK cells. Cell lysis was efficiently inhibited by cycloheximide and 3-methyladenine (3MA), a specific inhibitor of autophagy. Cycloheximide, which like 3MA inhibits autophagy, protected even when added at a time when the protein synthesis had been blocked by ricin, suggesting that the effect of cycloheximide on cell lysis is independent of its ability to inhibit protein synthesis. Also theophylline and dibutyryl-cGMP had some protective effect, whereas a number of compounds reported to protect against apoptosis in other systems were without protective effects. The data suggest that autophagy is important for the toxin-induced cell lysis.
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Affiliation(s)
- K Sandvig
- Institute for Cancer Research, Norwegian Radium Hospital, Montebello, Oslo
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