Cardiac Myosin Activation with Gene Therapy Produces Sustained Inotropic Effects and May Treat Heart Failure with Reduced Ejection Fraction.
Handb Exp Pharmacol
; 243: 447-464, 2017.
Article
en En
| MEDLINE
| ID: mdl-27590227
ABSTRACT
Chronic inotropic therapy is effective for the treatment of heart failure with reduced ejection fraction, but has been limited by adverse long-term safety profiles, development of tolerance, and the need for chronic parenteral administration. A safe and convenient therapeutic agent that produces sustained inotropic effects could improve symptoms, functional capacity, and quality of life. Small amounts of 2-deoxy-adenosine triphosphate (dATP) activate cardiac myosin leading to enhanced contractility in normal and failing heart muscle. Cardiac myosin activation triggers faster myosin crossbridge cycling with greater force generation during each contraction. This paper describes the rationale and results of a translational medicine effort to increase dATP levels using a gene therapy strategy to deliver and upregulate ribonucleotide reductase (R1R2), the enzyme responsible for dATP synthesis, selectively in cardiomyocytes. In small and large animal models of heart failure, a single dose of this gene therapy has led to sustained inotropic effects with a benign safety profile. Further animal studies are appropriate with the goal of testing this agent in patients with heart failure.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Volumen Sistólico
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Terapia Genética
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Miosinas Cardíacas
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Insuficiencia Cardíaca
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Contracción Miocárdica
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Miocardio
Límite:
Animals
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Humans
Idioma:
En
Revista:
Handb Exp Pharmacol
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos