title: Adenoviral-mediated transfer of vascular endothelial growth factor 121 cDNA enhances myocardial perfusion and exercise performance in the nonischemic state.
abstract: BACKGROUND
  Angiogenic gene therapy has been demonstrated to enhance perfusion to ischemic tissues, but it is unknown whether the administration of angiogenic growth factors will increase blood flow to nonischemic tissues. This study investigates whether enhanced myocardial perfusion can be mediated by adenovirus-mediated transfer of vascular endothelial growth factor 121 cDNA to nonischemic myocardium.
  
  
  METHODS
  New Zealand White rabbits received adenovirus (5 x 10(10) particle units) encoding for vascular endothelial growth factor 121 (n = 14) or a control vector without a transgene (n = 13) or saline solution (n = 9) via direct myocardial injection. Fluorescent microsphere perfusion studies and histologic analyses were performed 4 weeks later. In a parallel study, exercise treadmill testing was performed to assess the functional effects of this therapy in Sprague-Dawley rats.
  
  
  RESULTS
  Microsphere assessment of myocardial perfusion in rabbits 4 weeks after adenovirus-encoding vascular endothelial growth factor administration was greater than that for rats injected with control vector without a transgene or saline solution (3.2 +/- 0.5 vs 2.7 +/- 0.7 and 2.4 +/- 0.4, respectively; P <.03). The endothelial cell count per high power field was increased in animals injected with adenovirus-encoding vascular endothelial growth factor versus animals injected with control vector without a transgene or saline solution (147 +/- 27 vs 123 +/- 14 and 125 +/- 16 cells, respectively), although this did not reach statistical significance (P =.12). Rats treated with adenovirus-encoding vascular endothelial growth factor also demonstrated prolonged exercise tolerance compared with rats injected with control vector without a transgene or saline solution (exhaustion time: 26 +/- 5 minutes vs 19 +/- 2 minutes and 20 +/- 3 minutes, respectively; P =.006).
  
  
  CONCLUSIONS
  Adenovirus encoding-mediated transfer of vascular endothelial growth factor 121 induces an enhancement in regional perfusion in nonischemic myocardium that corresponds to changes in exercise tolerance. Adenovirus-encoding vascular endothelial growth factor therapy may be useful for inducing angiogenesis in the nonischemic state, such as for prophylactic therapy of early coronary artery disease.
authors.affiliation: Evanston Northwestern Healthcare, Evanston, IL, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Schalch
authors.forename: G Farah
authors.initials: GF
authors.lastname: Rahman
authors.forename: Gerald
authors.initials: G
authors.lastname: Patejunas
authors.forename: Robert A
authors.initials: RA
authors.lastname: Goldschmidt
authors.forename: JoAnn
authors.initials: J
authors.lastname: Carbray
authors.forename: Mauricio A
authors.initials: MA
authors.lastname: Retuerto
authors.forename: David
authors.initials: D
authors.lastname: Kim
authors.forename: Karyn
authors.initials: K
authors.lastname: Esser
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Crystal
authors.forename: Todd K
authors.initials: TK
authors.lastname: Rosengart
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000818:Animals; D003326:Coronary Circulation / Q000187:drug effects; D018076:DNA, Complementary / Q000235:genetics*; D042783:Endothelial Cells / Q000187:drug effects; D004730:Endothelium, Vascular / Q000166:cytology / Q000187:drug effects / Q000378:metabolism; D017079:Exercise Tolerance / Q000187:drug effects* / Q000235:genetics*; D018014:Gene Transfer Techniques; D015316:Genetic Therapy; D005822:Genetic Vectors / Q000235:genetics; D006346:Heart Septum / Q000187:drug effects; D006352:Heart Ventricles / Q000187:drug effects; D008297:Male; D023421:Models, Animal; D008955:Models, Cardiovascular; D017202:Myocardial Ischemia / Q000235:genetics* / Q000628:therapy*; D015425:Myocardial Reperfusion; D011817:Rabbits; D051381:Rats; D017207:Rats, Sprague-Dawley; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A / Q000008:administration & dosage / Q000235:genetics*
chemical_list: D018076:DNA, Complementary; D042461:Vascular Endothelial Growth Factor A