title: Nuclear factor-kappaB transcription factor decoy treatment inhibits graft coronary artery disease after cardiac transplantation in rodents.
abstract: BACKGROUND
  Nuclear factor-kappaB (NF-kappaB) is a transcription factor that upregulates adhesion molecules ICAM-1, VCAM-1, and ELAM-1. We hypothesized the use of ex vivo pressure-mediated delivery of transcription factor decoys (TFD) to NF-kappaB binding sites would decrease expression of adhesion molecules, and decrease reperfusion injury, acute rejection, and graft coronary artery disease (GCAD) in rat cardiac allografts.
  
  
  METHODS
  Heterotopic heart transplants were performed on donor hearts treated with saline, 10 mg/kg LPS, 160 micromol/L NF-kappaB TFD, or 160 micromol/L scrambled sequence (NF-SC) TFD for 45 min at 78 psi (6 atm). Transfection efficiency was determined with FITC-labeled TFD. Reverse transcription-PCR and immunohistochemistry was used to analyze adhesion molecule mRNA and protein expression, respectively. Apoptosis was measured with DNA fragmentation analysis. Reperfusion injury was assessed with cardiac edema, neutrophil infiltration, and histology. Acute rejection was determined by daily palpation. Allografts were assessed at POD 90 for the development of GCAD by computer-assisted image analysis to determine intimal:medial ratio and myointimal proliferation.
  
  
  RESULTS
  Hyperbaric pressure was an effective method of NF-kappaB TFD delivery (P<0.001 vs. controls). NF-kappaB TFD treatment led to decreased mRNA and protein expression of adhesion molecules. Treatment with NF-kappaB TFD led to a significant decrease in all reperfusion injury parameters compared to saline and NF-SC controls (P<0.01 vs. controls). Higher levels of apoptosis were seen in allografts treated with NF-kappaB TFD compared to control allografts. NF-kappaB TFD treatment prolonged allograft survival over saline and NF-SC controls (P<0.05). Myointimal proliferation and intimal:medial ratios in NF-kappaB TFD-treated allografts were significantly decreased compared to saline and NF-SC treatment (P<0.00001).
  
  
  CONCLUSIONS
  Ex vivo pressure-mediated delivery of NF-kappaB TFD is an effective method to block adhesion molcule expression and reperfusion injury in the immediate posttransplant period. Further, NF-kappaB TFD treatment prolongs allograft survival and decreases GCAD.
authors.affiliation: Department of Cardiothoracic Surgery, Stanford University School of Medicine, California 94305-5407, USA.
authors.forename: B T
authors.initials: BT
authors.lastname: Feeley
authors.forename: D N
authors.initials: DN
authors.lastname: Miniati
authors.forename: A K
authors.initials: AK
authors.lastname: Park
authors.forename: E G
authors.initials: EG
authors.lastname: Hoyt
authors.forename: R C
authors.initials: RC
authors.lastname: Robbins
mesh_terms: D000818:Animals; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects; D016027:Heart Transplantation / Q000009:adverse effects / Q000276:immunology; D007150:Immunohistochemistry; D008297:Male; D016328:NF-kappa B / Q000627:therapeutic use*; D020320:Oligoribonucleotides, Antisense / Q000494:pharmacology; D051381:Rats; D011912:Rats, Inbred ACI; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000517:prevention & control; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014157:Transcription Factors / Q000627:therapeutic use*
chemical_list: D016328:NF-kappa B; D020320:Oligoribonucleotides, Antisense; D014157:Transcription Factors