Gene Therapy Using Hepatocyte Growth Factor Expressing Adenovirus Improves Skin Flap Survival in a Rat Model

Hepatocyte growth factor (HGF) is a potent angiogenic factor that can stimulate the production of blood vessels in ischemic tissue. We investigated whether gene therapy using HGF-expressing adenovirus could enhance skin flap survival. Sprague-Dawley rats were randomly divided into three groups. Rats were subdermally injected with HGF-expressing adenovirus (HGF virus group), recombinant HGF (rhHGF group), or phosphate buffered saline (PBS group) 2 days before and immediately after 3 x 9 cm caudal flap elevation. The survival area of the skin flap, the ratio of blood flow, CD31-positive vessels and, VEGF expression were examined. Skin flap viability was significantly increased in the HGF virus group compared to the rhHGF and PBS groups (71.4% +/- 5.9%, 63.8%+/- 6.4%, and 39.2% +/- 13.0%, respectively) (P = 0.025). Furthermore, the blood flow ratio was significantly increased in the HGF virus group. In the HGF virus group, the number of CD31-positive vessels and vascular endothelial growth factor (VEGF) expression were significantly increased. Gene therapy using HGF-expressing adenovirus increase VEGF expression, the number of viable capillaries, and blood flow to the flap, thereby improving skin flap survival.

Microarray Analysis for Genes Associated with Angiogenesis in Diabetic OLETF Keratocytes

The purpose of this study was to identify the differences in angiogenesis gene expression between normal and diabetic keratocytes stimulated with interleukin-1alpha (IL-1alpha) and tumor necrosis factor-alpha (TNF-alpha). Primarily cultured normal and diabetic keratocytes were treated with 20 ng/mL of IL-1a and TNF-alpha for 6 hr. cDNA was hybridized to an oligonucleotide microarray. Microarray analysis was used to identify differentially expressed genes that were further evaluated by real-time polymerase chain reaction (RT-PCR). Diabetes keratocytes overexpressed vital components of angiogenesis including Agtr1, and under-expressed components related to the blood vessel maturation, including Dcn. Cytokine-treated diabetic keratocytes differentially expressed components of angiogenesis. OLETF keratocytes after treatment with IL-1alpha and TNF-alpha showed the newly expressed 15 and 14 genes, respectively. Newly and commonly under-expressed five genes followed by treatment with both IL-1alpha and TNF-alpha were also evident. RT-PCR showed results similar to the microarray results. Agtr1 and Itga1 showed an increased expression in diabetic keratocytes compared with normal corneal keratocytes, especially after TNF-alpha treatment. Il6 appeared strong expression after interleukin-1alpha treatment, but showed down expression after TNF-alpha treatment. Further studies to analyze and confirm the significance of the identified angiogenetic genes of diabetes are needed.

Terapia gênica com fator de crescimento endotelial vascular 165 para pacientes com angina refratária: mobilização de células progenitoras endoteliais / VEGF 165 gene therapy for patients with refractory angina: mobilization of endothelial progenitor cells

FUNDAMENTO: O fator de crescimento endotelial vascular (VEGF - vascular endothelial growth factor) induz a mobilização de células progenitoras endoteliais (CPEs) com capacidade de proliferação e diferenciação em células endoteliais, contribuindo, dessa forma, para o processo angiogênico. OBJETIVO: Buscamos avaliar o comportamento de CPEs em pacientes com doença cardíaca isquêmica e angina refratária que receberam injeções intramiocardicas de 2000 µg de VEGF165 como terapia única. MÉTODOS: O estudo foi uma subanálise de um ensaio clínico. Pacientes com doença cardíaca isquêmica avançada e angina refratária foram avaliados para inclusão no estudo. Os critérios de inclusão foram: sinais e sintomas de angina e/ou insuficiência cardíaca apesar de tratamento medicamentoso máximo e área de isquemia miocárdica de, no mínimo, 5% conforme avaliado por uma tomografia computadorizada por emissão de fóton único (TCEFU). Os critérios de exclusão foram: idade > 65 anos, fração de ejeção do ventrículo esquerdo < 25% e cancer diagnosticado. Os pacientes cujos níveis de CPE foram avaliados foram incluídos. A intervenção consistiu na administração de 2000 µg de VEGF 165 de plasmídeo injetado no miocárdio isquêmico. A frequência de células CD34+/KDR+ foi analisada por citometria de fluxo antes e 3, 9, e 27 dias após a intervenção. RESULTADOS: Um total de 9 pacientes foram incluídos, 8 homens, média de idade de 59,4 anos, fração de ejeção ventricular esquerda de 59,3%, e classe de angina predominante III. Observou-se um aumento significativo dos níveis de CPEs no terceiro dia após a intervenção. Todavia, 9 e 27 dias após a intervenção, os níveis de CPEs foram similares aos basais. CONCLUSÃO: Identificamos uma mobilização transitória de CPE, com pico no terceiro dia após a intervenção com VEGF 165 em pacientes com angina refratária. Todavia, os níveis de CPEs apresentaram-se semelhantes aos basais 9 e 27 dias após a intervenção.

BACKGROUND: Vascular endothelial growth factor (VEGF) induces mobilization of endothelial progenitor cells (EPCs) with the capacity for proliferation and differentiation into mature endothelial cells, thus contributing to the angiogenic process. OBJECTIVE: We sought to assess the behavior of EPCs in patients with ischemic heart disease and refractory angina who received an intramyocardial injections of 2000 µg of VEGF 165 as the sole therapy. METHODS: The study was a subanalysis of a clinical trial. Patients with advanced ischemic heart disease and refractory angina were assessed for eligibility. Inclusion criteria were as follows: signs and symptoms of angina and/or heart failure despite maximum medical treatment and a myocardial ischemic area of at least 5% as assessed by single-photon emission computed tomography (SPECT). Exclusion criteria were as follows: age > 65 years, left ventricular ejection fraction < 25%, and a diagnosis of cancer. Patients whose EPC levels were assessed were included. The intervention was 2000 µg of VEGF 165 plasmid injected into the ischemic myocardium. The frequency of CD34+/KDR+ cells was analyzed by flow cytometry before and 3, 9, and 27 days after the intervention. RESULTS: A total of 9 patients were included, 8 males, mean age 59.4 years, mean left ventricular ejection fraction of 59.3% and predominant class III angina. The number of EPCs on day 3 was significantly higher than that at baseline (p = 0.03); however, that on days 9 and 27 was comparable to that at baseline. CONCLUSION: We identified a transient mobilization of EPCs, which peaked on the 3th day after VEGF 165 gene therapy in patients with refractory angina and returned to near baseline levels on days 9 and 27.

Polimorfismos genéticos e endometriose: a contribuição dos genes que regulam a função vascular e o remodelamento de tecidos / Genetic polymorphisms and endometriosis: contribution of genes that regulate vascular function and tissue remodeling

A endometriose é uma doença ginecológica benigna caracterizada pela presença e crescimento de células endometriais fora do útero. Fatores genéticos, endócrinos, imunológicos e ambientais têm sido sugeridos em sua patogênese. Um grande número de estudos tem relacionado polimorfismos genéticos como um fator que contribui para o desenvolvimento da endometriose. Nesta revisão, apresentamos uma descrição detalhada da contribuição de polimorfismos genéticos nos genes que regulam a função vascular e o remodelamento do tecido em endometriose (AHSG, EGFR, EGF, VEGF, endostatina, PAI-1, ACE e MMPs). Alguns polimorfismos dos genes VEGF (-460 C/T, +405 G/C, +936 C/T), PAI, MMP-1, 2 e 3 foram amplamente estudados, enquanto outros dos genes AHSG, EGF, endostatina e VEGF (-1154 G/A, -2578 A/C), não. Nesse último caso, estudos adicionais tornam-se necessários para confirmar os achados encontrados pelos poucos trabalhos que analisaram esses polimorfismos de único nucleotídeo (SNP). Além disso, os estudos que encontraram associação positiva ou negativa do SNP com endometriose enfatizam a importância de estudos com grande número de casos-controles para confirmar os achados por eles publicados. A análise por haplótipo foi realizada apenas para os genes VEGF (-460, +405, -1154 e -2578), ACE (-240/2350) e MMP-1, 2, 3 e 9, e, na maioria deles, não houve associação com endometriose. Dos oito trabalhos que analisaram haplótipos do gene VEGF, cinco deles não os associaram à endometriose. Os haplótipos dos genes ACE e MMP-2 não foram associados à endometriose, enquanto aqueles dos genes MMP-1, 3 e 9 foram relacionados a risco elevado da doença.

Endometriosis is a benign gynecological disease characterized by the presence and growth of endometrial cells outside the uterus. Genetic, endocrine, immunological, and environmental factors have been suggested in its pathogenesis. A great number of studies have related genetic polymorphisms as a factor that contributes to the development of endometriosis. This review presents a detailed description of the contribution of genetic polymorphisms in genes that regulate vascular function and tissue remodeling in endometriosis (alpha 2-HS glycoprotein [AHSG], epidermal growth factor receptor [EGFR], vascular endothelial growth factor [VEGF], endostatin, plasminogen activator inhibitor 1 [PAI-1], angiotensin I-converting enzyme [ACE], and matrix metalloproteinases [MMPs]). Some polymorphisms of the VEGF (-460 C/T, +405 G/C, +936 C/T), PAI, MMP-1, 2, and 3 genes were widely studied, while polymorphisms of the AHSG, EGF, endostatin, and VEGF (-1154 G/A, -2578 A/C) genes were not. In this latter case, additional studies are required to confirm the findings of the few studies that have analyzed these single nucleotide polymorphisms (SNPs). Additionally, studies that found a positive or negative association of SNP with endometriosis emphasize the relevance of studies with a large number of control cases to confirm their findings. The haplotype analysis was performed only for the VEGF (-460, +405, -1154 and -2578), ACE (-240/2350) and MMP-1, 2, 3, and 9 genes, and in most of them, there was no association with endometriosis. Of the eight works that analyzed haplotypes of the VEGF gene, five did not associate them with endometriosis. Haplotypes of ACE and MMP-2 genes were not associated with endometriosis, while those of MMP-1, 3, and 9 genes were related to a high risk for the disease.

The discovery of placenta growth factor and its biological activity

Angiogenesis is a complex biological phenomenon crucial for a correct embryonic development and for post-natal growth. In adult life, it is a tightly regulated process confined to the uterus and ovary during the different phases of the menstrual cycle and to the heart and skeletal muscles after prolonged and sustained physical exercise. Conversly, angiogenesis is one of the major pathological changes associated with several complex diseases like cancer, atherosclerosis, arthritis, diabetic retinopathy and age-related macular degeneration. Among the several molecular players involved in angiogenesis, some members of VEGF family, VEGF-A, VEGF-B and placenta growth factor (PlGF), and the related receptors VEGF receptor 1 (VEGFR-1, also known as Flt-1) and VEGF receptor 2 (VEGFR-2, also known as Flk-1 in mice and KDR in human) have a decisive role. In this review, we describe the discovery and molecular characteristics of PlGF, and discuss the biological role of this growth factor in physiological and pathological conditions.

Early growth response protein 1 acts as an activator of SOX18 promoter

Sex-determining region Y box 18 (Sox18/SOX18) gene is an important regulator of vascular development playing a role in endothelial cell specification or differentiation, angiogenesis and atherogenesis. The aim of this study was to perform comprehensive functional characterization of the human SOX18 promoter, including determination of transcription start point (tsp) and identification of control elements involved in the regulation of SOX18 gene expression, with an emphasis on angiogenesis-related transcription factors. Analyses were performed in HeLa cells, representing a tumor cell line, and in EA.hy926 cells used as an endothelial model system. We have determined unique tsp of SOX18 gene, located 172 nucleotides upstream from ATG codon. Further, we have shown that SOX18 promoter region, -726 to -89 bp relative to tsp, contains positive cis-regulatory element(s) that stimulates SOX18 promoter activity, while region -89 to + 166 represents the minimal promoter. Within this region we have recognized the presence of essential element(s), positioned from -89 to +29, which harbors cluster of three putative early growth response 1 (EGR1) binding sites. By in vitro binding assays and functional analyses we have shown that these three putative binding sites are functionally relevant and sufficient for EGR1-induced SOX18 transcription. Mutations of these binding sites significantly impaired activity of the SOX18 promoter, particularly in EA.hy926 cells, indicating the importance of these regulatory elements for SOX18 promoter activity in endothelial setting. By data presented in this study, we have established SOX18 as a novel target gene regulated by EGR1 transcription factor, thus providing the first functional link between two transcription factors previously shown to be involved in the control of angiogenesis.

Effects of therapeutic angiogenesis with plasmid VEGF165 on ventricular function in a canine model of chronic myocardial infarction / Efeito da angiogênese terapêutica com VEGF165 sobre a função ventricular em infarto do miocárdio crônico

OBJECTIVE: Therapeutic angiogenesis is currently under investigation in ischemic heart disease. We examined the effect on left ventricular function induced by therapeutic angiogenesis by intramyocardial injection of plasmid VEGF165, in a canine model of chronic myocardial infarction. METHODS: Left thoracotomy was performed in 10 mongrel dogs, and myocardial infarction induced by ligation of the major diagonal coronary artery. At 7 postoperative (p.o.) day (pre-treatment), left ventricular ejection fraction was assessed by echocardiogram, and a second procedure was done: saline or plasmid VEGF165 at 200 mg/mL was injected over 10 points of the ischemic areas of control or treated groups, respectively. Fourteen days later (post-treatment, day 21) a control echocardiogram was performed, the animals were sacrificed and histological examination was performed. RESULTS: Ejection fraction was maintained in the treated group: 52.45 + 15.1 percent on day 7 and 48.53 + 11.74 percent on day 21 (P=0.59), and tended to decrease in the control group, from 59.3 + 4 percent to 39.37 + 19.43 percent (P=0.04), although absolute values did not differ significantly between groups. Histological examination revealed a non significant increase in capillary vessels number in all areas in treated group. Paradoxically, arterioles were significantly less in number in all areas of treated dogs. CONCLUSION: Intramyocardial injection of plasmid VEGF165, in this canine model of chronic myocardial infarction, resulted in preservation of left ventricular ejection fraction, contrary to the control group where left ventricular ejection fraction showed continuous decline during the experiment. Histological examination, however, was unable to explain completely these results.

OBJETIVO: Angiogênese por terapia gênica é alternativa ainda experimental para revascularização miocárdica. Este estudo objetivou verificar a indução de angiogênese e melhora funcional miocárdica pela injeção transmural de plasmídeo contendo VEGF165 em áreas de infarto crônico do miocárdio. MÉTODOS: Em 10 cães anestesiados, por toracotomia lateral esquerda, foi induzido infarto agudo do miocárdio (IAM) por meio da ligadura do ramo diagonal principal da artéria coronária descendente anterior. Após 7 dias, realizado ecocardiograma para avaliação da fração de ejeção (FE) ventricular esquerda. Os animais foram divididos em dois grupos: Tratado (GT) e Controle (GC) e submetidos a segundo procedimento, para injeção intramiocárdica de solução contendo plasmídeo VEGF165 na concentração de 200mg/ml (GT) ou solução salina (GC), distribuída em 10 pontos da área infartada. Após 14 dias, novo ecocardiograma, sacrifício dos animais e retirada do coração para estudo histológico. RESULTADOS: Houve tendência à manutenção da FE no GT e de queda da FE no GC, conforme os valores: FE ao ecocardiograma pós-IAM inicial: GC 59,33 + 4,6 por cento e GT 52,45 + 15,1 por cento (P=0,359). FE após 14 dias: GC 39,37 + 19,43 por cento e GT 48,53 + 11,74 por cento (P=0,394). Comparação intra-grupo: Variação negativa da FEVE GC: 59,37 + 4 por cento para 39,37 + 19,43 por cento (P=0,04) e manutenção GT: 52,45 + 15,1 por cento para 48,53 + 11,74 por cento (P=0,59). No GT observou-se aumento do número de vasos capilares, mais intenso nas regiões injetadas, porém presente em todo miocárdio. Paradoxalmente, no GT houve redução do número de arteríolas. CONCLUSÃO: A injeção transmural de plasmídeo VEGF165 resultou em tendência para atenuar a perda de contratilidade consequente ao dano miocárdico, na fase crônica do IAM. O exame histológico da rede vascular, entretanto, não explica completamente os eventos funcionais.

Development of an angiogenesis-focused cDNA chip and validation of its functionality

DNA chip has been used as a powerful tool to study the genetic reprogramming of cells and its link to cellular phenotype such as angiogenesis. To evaluate the angiogenesis related genetic reprogramming more efficiently, we here developed an angiogenesis- focused cDNA chip containing 153 angiogenesis related genes arrayed in duplicate on a slide glass. In order to validate the functionality of the angiogenesis-focused cDNA chip, we examined gene expression profiles in HT1080 cells treated with either fetal bovine serum, a well known pro-angiogenic factor, or trichostatin A, a known angiogenesis inhibitor, using the cDNA chip. All duplicate data from the analysis are well matched with each other and gene expression profiles are well consistent with previously reported data. These results demonstrate that the angiogenesis-focused cDNA chip developed here can be a useful tool towards angiogenesisrelated researches.

Angiogênese terapêutica obtida pela transferência gênica do 'VEGF IND 121' em tecido muscular esquelético: impacto sobre a perfusão tecidual após a indução de isquemia / Therapeutic angiogenesis achieved by gene transfer of vascular endothelial growth factor ('VEGF IND 121') in skeletal muscle: impact on tissue perfusion after the induction of ischemia

Testou-se a hipótese de que a injeção intramuscular de um vetor carreador do gene VEGF121 (AdCMV.VEGF121) estimula a angiogênese em músculo esquelético não-isquêmico e melhora a perfusão tecidual após a indução de isquemia. Coelhos e ratos receberam injeções de AdCMV.VEGF121, AdCMV.Null, ou salina, anteriormente à remoção da artéria femoral. No local da injeção de VEGF121, observou-se aumento de 96 por cento e 29 por cento em arteríolas e capilares, respectivamente. No grupo VEGF121, maior fluxo sangüíneo regional no músculo gastrocnêmio, maior número de vasos colaterais e melhora da reserva bioenergética muscular foram observados. Assim, a administração IM de AdCMV.VEGF121 estimula a angiogênese em tecido muscular esquelético normoperfundido e os vasos neoformados preservam a perfusão tecidual após a indução de isquemia.We tested the hypothesis that adenovirus-mediated intramuscular gene transfer of VEGF121 (AdCMV.VEGF121) could stimulate neovascularization in nonischemic skeletal muscle and improves tissue perfusion after the induction of ischemia. Rabbits and rats received injections of AdCMV.VEGF121, AdCMV.Null, or saline, before femoral artery removal. We found 96 per cent and 29 per cent increases in arterioles and capillaries, respectively. In the VEGF121 group, we also found improved blood flow to the ischemic gastrocnemius muscle, more collateral vessels, and improvement of the muscular bioenergetic reserve. Thus, IM administration of AdCMV.VEGF121 stimulates angiogenesis in normoperfused skeletal muscles, and the newly formed vessels preserve tissue perfusion after the induction of ischemia...

Biología molecular aplicada a la cirugía cardiaca / Molecular biology applied to cardiac surgery

La cirugía cardiaca plantea la alternativa terapéutica actualmente más efectiva para la resolución de numerosas cardiopatías; dicha circunstancia ocupa a los investigadores debido a que estas últimas constituyen las principales causas de mortalidad en el ámbito mundial. La aplicación de la biología molecular en la cirugía cardiaca hace posible una atmósfera de expectativas muy interesantes para la medicina y la cardiología contemporáneas, que se observa en el terreno de los trasplantes cardiacos, la aterosclerosis, y la angiogénesis. El presente trabajo constituye un sumario de las principales líneas de investigación actual sobre la aplicación de la biología molecular en la cirugía cardiaca; estas consideraciones podrían modificar la calidad de vida de los pacientes, de manera que su análisis racional es indispensable...

Cardiac surgery is the actual most effective treatment for cardiomyopathies, issue that makes the researchers more interested in this field, since it is the leading cause of death in the world. The application of molecular biology to the cardiac surgery has created an atmosphere of expectancy and interest for the contemporary medicine and cardiology, which has been released in the heart transplant, atheroesclerosis , and angiogenesis. The present paper makes a summary of the actual research lines , of this application of the molecular biology to the cardiac surgery, considerations that may change the quality of life of our patients, but in a rational way.

Angiogenesis: characterization of a cellular model

Endothelial cell proliferation and differentiation into blood capillaries (i.e., angiogenesis) are essential for growth and development, wound healing, osetogenesis, etc. But abnormal angiogenesis during tumor progression could lead to serious consequences. Angiogenesis is a complex biochemical process, and is often difficult to study the molecular mechanism in vivo due to interference by multitude of factors. Here, I present a non-transformed capillary endothelial cell line as a model which has been extensively characterized morphologically and biochemically to study the fundamentals of the angiogenic process. Studies completed in our laboratory also evidenced that expression of Glc3Man9GlcNAc2-PP-Dol is intricately connected with the balance between the cellular proliferation and apoptosis during angiogenesis.