title: Beta-adrenoceptor blockade markedly attenuates transgene expression from cytomegalovirus promoters within the cardiovascular system.
abstract: OBJECTIVE
  The major immediate-early cytomegalovirus enhancer/promoter (MIECMV), widely used in cardiovascular gene therapy, contains several positively regulatory cAMP response elements (CRE). Catecholamine signaling via beta-adrenoceptors might increase transgene expression from MIECMV, and if so, beta-blockers may have a detrimental effect on the efficacy of clinical cardiovascular gene therapy strategies.
  
  
  RESULTS
  Cultured smooth muscle cells were exposed to isoprenaline, atenolol, or propranolol, alone and in combination before infection with adenoviruses expressing beta-galactosidase. beta-galactosidase expression was assayed 72 hours later. Isoprenaline increased transgene expression from MIECMV up to 8-fold (P<0.001), but had no effect on a promoter containing no CRE. The effect of isoprenaline was inhibited by beta-blockade and by specific CRE-decoy oligonucleotides. Beta-blockers did not reduce transgene expression below basal levels. After adenovirus-mediated porcine intracoronary gene transfer, however, beta-blockade reduced beta-galactosidase expression by up to 250-fold compared with non-beta-blocked animals (P<0.01).
  
  
  CONCLUSIONS
  Enhancement of promoter activity by endogenous catecholamines is essential for high-level transgene expression from MIECMV within the vasculature. Beta-blocker-mediated suppression of transgene expression from MIECMV in vascular tissues has a significant bearing on clinical studies of cardiovascular gene transfer. This is the first described interaction to our knowledge between widely prescribed pharmaceuticals and a commonly used promoter of clinical transgene expression.
authors.affiliation: Vascular Gene Therapy Unit, University of Manchester, Manchester, UK.
authors.forename: Husein K
authors.initials: HK
authors.lastname: Salem
authors.forename: Parisa
authors.initials: P
authors.lastname: Ranjzad
authors.forename: Anita
authors.initials: A
authors.lastname: Driessen
authors.forename: Clare E
authors.initials: CE
authors.lastname: Appleby
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Heagerty
authors.forename: Paul A
authors.initials: PA
authors.lastname: Kingston
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000818:Animals; D002478:Cells, Cultured; D003331:Coronary Vessels / Q000166:cytology / Q000378:metabolism*; D017362:Cyclic AMP Response Element-Binding Protein / Q000502:physiology; D015870:Gene Expression / Q000187:drug effects*; D018014:Gene Transfer Techniques; D005822:Genetic Vectors; D006801:Humans; D007545:Isoproterenol / Q000494:pharmacology; D018146:Muromegalovirus / Q000235:genetics*; D032389:Myocytes, Smooth Muscle / Q000378:metabolism*; D011401:Promoter Regions, Genetic; D013552:Swine; D019076:Transgenes
chemical_list: D000319:Adrenergic beta-Antagonists; D017362:Cyclic AMP Response Element-Binding Protein; D007545:Isoproterenol