86 research outputs found

    Gene transfer into vascular cells

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    AbstractThe goal of gene therapy is to introduce foreign deoxyribonucleic acid (DNA) into somatic cells to correct or prevent disorders caused by the malfunction of genes within a diseased individual. Overexpression of recombinant genes at specific sites within the vasculature can provide insights into vascular biology and potential treatments for various cardiovascular disorders such as restenosis. Methods for the introduction of foreign DNA into endothelial and vascular smooth muscle cells have been developed recently. These include the genetic modification of endothelium in vitro and implantation in vivo on arterial segments, direct infection of the arterial wall in vivo with a replication-defective retroviral vector expressing a recombinant gene and direct transfer of genes into vascular cells in vivo with use of liposomes. Although still in its formative stages, gene transfer into the vasculature holds promise as a potential treatment for vascular diseases, including atherosclerosis and restenosis. This approach may also provide insight into the role of specific gene products in the development of pathologic lesions

    Gene transfer and cardiovascular disease

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    Through the introduction of foreign DNA into somatic cells, the aim of gene therapy is to correct or prevent disorders caused by the absence or malfunction of genes within a diseased individual. Expression of recombinant genes at specific sites within the vasculature can provide insights into vascular biology and potential treatments for various cardiovascular disorders. In our studies, we have developed methods for the transfer of recombinant genes into the endothelium and vascular smooth muscle cells by using retroviral vectors and liposomal transfection. Although these techniques are still in the formative stages, gene transfer into the endothelium and other vascular cells is a new approach to the treatment of vascular diseases, including atherosclerosis and restenosis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29517/1/0000604.pd

    Biology of the impaired endothelium

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    The endothelium is a regulatory organ that mediates hemostasis, contractility, cellular proliferation, and inflammatory mechanisms in the vessel wall. Injury to the endothelium from hypertension, smoking, hyperlipidemia, and diabetes mellitus disrupts normal regulatory properties and results in abnormal endothelial cell function. Clinically, endothelial cell dysfunction can be manifested as vasospasm, thrombus formation, atherosclerosis, or restenosis. The normal hemostatic properties of the endothelium include the maintenance of a nonadhesive luminal surface, antithrombotic properties, anticoagulant properties, and fibrinolytic properties. The endothelial cell regulates smooth muscle cell contractility by the production of relaxing and constricting factors in response to physiologic stimuli. Endothelial cell injury is also an initial event in the development of atherosclerosis and restenosis by facilitating platelet adhesion and aggregation and by signaling the release of mitogens from platelets, macrophages, and endothelial cells, which stimulate smooth muscle cell proliferation. In addition, endothelial cells undergo morphologic and functional alterations in response to cytokine signals, which may contribute to the pathogenesis of vasculitis and atherosclerosis. In sum, the normal endothelium performs many regulatory functions which become altered when the endothelium is injured.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29035/1/0000068.pd

    Large coronary arteries in humans are responsive to changing blood flow: An endothelium-dependent mechanism that fails in patients with atherosclerosis

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    AbstractChanges in blood flow can alter vasomotion of conduit arteries. This study examined vasomotor responses to incremental blood flow induced by papaverine in the epicardial arteries of 10 patients with angiographically normal coronary arteries (group 1) and in 14 patients with arterial irregularities (group 2) using quantitative angiography and Doppler ultrasound flow velocity measurements. An increase in coronary blood flow of 384.3 ± 32.8% (p < 0.001) in group 1 patients was associated with dilation of the proximal coronary artery segment and a 23.2 ± 4.6% increase in cross-sectional area (p < 0.001). In contrast, in group 2 patients a similar increase in coronary blood flow of 339.3 ± 18.7% (p < 0.001) was associated with mixed responses and a Modest net constriction in cross-sectional area of -7.4 ± 2.8% (p < 0.05). The dilation response to nitroglycerin was intact in group 1 (31.7 ± 4.2%, p < 0.001) and in group 2 (26.4 ± 3.2%, p < 0.001).In five patients from group 1 acetylcholine, an endothelium-dependent dilator, produced an increase in cross-sectional area of 20.7 ± 4.6% (p < 0.05) that paralleled the response to an increase in flow in the same segment (a 24.3 ± 6.1% increase in cross-sectional area, p < 0.05). Five group 21 patients demonstrated a vasoconstrictor response to acetylcholine (a − 22.8 ± 3.4% decrease in cross-sectional area, p < 0.05) together with an impaired dilation response to incremental flow (a − 6.4 ± 3.2% decrease in cross-sectional area). Thus, the normal flow-mediated dilation of coronary arteries is lost in atherosclerosis and this impairment may be due to endothelial cell vasodilator dysfunction

    Safety and Toxicity of Catheter Gene Delivery to the Pulmonary Vasculature in a Patient with Metastatic Melanoma

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    Overview summary Transcatheter delivery of HLA-B7 DNA and cationic liposomes into a segment of a pulmonary artery was safely performed in 1 patient with tumor nodules in the lung. No immunologic or organ toxicities were observed. Percutaneous catheter gene delivery has been performed in humans. Further refinements of this approach may lead to useful treatments for a variety of human diseases.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63196/1/hum.1994.5.9-1089.pd

    A New Cationic Liposome DNA Complex Enhances the Efficiency of Arterial Gene Transfer In Vivo

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    Overview summary GAP-DLRIE/DOPE, a new cationic liposome preparation, is an efficient liposomal vector that increases gene expression in arteries compared to naked DNA or previously described cationic DNA–liposome complexes by more than 15-fold. Although less efficient than adenoviral gene transfer, these levels of gene expression represent a significant improvement in liposome transfection in vivo and approach levels observed with clinically acceptable doses of adenoviral vectors. The improvement in gene expression, together with the relative safety associated with liposomal gene transfer, suggests that such nonviral vectors may be appropriate for human gene therapy protocols which utilize catheter-based gene delivery.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63105/1/hum.1996.7.15-1803.pd

    Safety and Short-Term Toxicity of a Novel Cationic Lipid Formulation for Human Gene Therapy

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    Overview summary Although several viral vectors have been widely applied to the treatment of human disease, the development of nonviral vectors is still in their infancy. In this report, a novel cationic lipid, DMRIE/DOPE, has been incorporated into the DNA–liposome formulation that improves transfection efficiencies and allows up to 1,000-fold higher concentrations of DNA to be administered in vivo. In this paper, the safety and toxicity of this formulation is described in two species, mice and pigs, suggesting that it may prove useful for human gene therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63224/1/hum.1993.4.6-781.pd

    Time course analysis of gene expression identifies multiple genes with differential expression in patients with in-stent restenosis

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    Abstract Background The vascular disease in-stent restenosis (ISR) is characterized by formation of neointima and adverse inward remodeling of the artery after injury by coronary stent implantation. We hypothesized that the analysis of gene expression in peripheral blood mononuclear cells (PBMCs) would demonstrate differences in transcript expression between individuals who develop ISR and those who do not. Methods and Results We determined and investigated PBMC gene expression of 358 patients undergoing an index procedure to treat in de novo coronary artery lesions with bare metallic stents, using a novel time-varying intercept model to optimally assess the time course of gene expression across a time course of blood samples. Validation analyses were conducted in an independent sample of 97 patients with similar time-course blood sampling and gene expression data. We identified 47 probesets with differential expression, of which 36 were validated upon independent replication testing. The genes identified have varied functions, including some related to cellular growth and metabolism, such as the NAB2 and LAMP genes. Conclusions In a study of patients undergoing bare metallic stent implantation, we have identified and replicated differential gene expression in peripheral blood mononuclear cells, studied across a time series of blood samples. The genes identified suggest alterations in cellular growth and metabolism pathways, and these results provide the basis for further specific functional hypothesis generation and testing of the mechanisms of ISR.http://deepblue.lib.umich.edu/bitstream/2027.42/112500/1/12920_2010_Article_214.pd
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