title: Optimization of ex vivo inducible nitric oxide synthase gene transfer to vein grafts.
abstract: BACKGROUND
  Vein graft failure as the result of intimal hyperplasia (IH) remains a significant clinical problem. Ex vivo modification of vein grafts using gene therapy is an attractive approach to attenuate IH. Gene transfer of the inducible nitric oxide synthase (iNOS) gene effectively reduces IH. However, iNOS activity after gene transfer may be impaired by the availability of cofactor, such as tetrahydrobiopterin (BH4). The purpose of this study is to determine the optimal conditions for ex vivo adenoviral-mediated iNOS gene transfer into arterial and venous vessels.
  
  
  METHODS
  Porcine internal jugular veins and carotid arteries were infected ex vivo with the adenoviral iNOS vector (AdiNOS) and with an adenovirus carrying the cDNA encoding guanosine triphosphate cyclohydrolase I (AdGTPCH), the rate-limiting enzyme for BH4 synthesis. The production of nitrite, cyclic guanosine monophosphate (cGMP), and biopterin were assessed daily.
  
  
  RESULTS
  Nitric oxide (NO) production after iNOS gene transfer was maximal when vessels were cotransduced with AdGTPCH. NO production in these vessels persisted for more than 10 days. Vein segments generated approximately 2-fold more nitrite, cGMP, and biopterin than arterial segments infected with AdiNOS/AdGTPCH. Submerging vein segments into adenoviral solution resulted in improved gene transfer with greater nitrite and cGMP release compared with infections carried out under pressure intraluminally. Similarly, injury to the vein segments before infection with AdiNOS resulted in less nitrite production.
  
  
  CONCLUSIONS
  These data demonstrate that AdiNOS can efficiently transduce vein segments ex vivo and that the cotransfer of GTPCH can optimize iNOS enzymatic activity. This cotransfer technique may be used to engineer vein grafts before coronary artery bypass to prevent IH.
authors.affiliation: Department of Surgery, University of Pittsburgh, Pa. 15261, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Kibbe
authors.forename: S
authors.initials: S
authors.lastname: Nie
authors.forename: T
authors.initials: T
authors.lastname: Yoneyama
authors.forename: K
authors.initials: K
authors.lastname: Hatakeyama
authors.forename: A
authors.initials: A
authors.lastname: Lizonova
authors.forename: I
authors.initials: I
authors.lastname: Kovesdi
authors.forename: T R
authors.initials: TR
authors.lastname: Billiar
authors.forename: E
authors.initials: E
authors.lastname: Tzeng
mesh_terms: D000256:Adenoviridae / Q000235:genetics; D000818:Animals; D001708:Biopterins / Q000096:biosynthesis; D006152:Cyclic GMP / Q000096:biosynthesis; D006136:GTP Cyclohydrolase / Q000235:genetics; D018014:Gene Transfer Techniques; D008297:Male; D009569:Nitric Oxide / Q000096:biosynthesis; D019001:Nitric Oxide Synthase / Q000235:genetics*; D052247:Nitric Oxide Synthase Type II; D009924:Organ Culture Techniques; D013552:Swine; D014680:Veins / Q000378:metabolism* / Q000637:transplantation*
chemical_list: D001708:Biopterins; D009569:Nitric Oxide; D019001:Nitric Oxide Synthase; D052247:Nitric Oxide Synthase Type II; D006136:GTP Cyclohydrolase; D006152:Cyclic GMP