title: Electroporation-mediated gene transfer of the Na+,K+ -ATPase rescues endotoxin-induced lung injury.
abstract: BACKGROUND
  Acute lung injury and acute respiratory distress syndrome are common clinical syndromes resulting largely from the accumulation of and inability to clear pulmonary edema, due to injury to the alveolar epithelium. Gene therapy may represent an important alternative for the treatment and prevention of these diseases by restoring alveolar epithelial function. We have recently developed an electroporation strategy to transfer genes to the lungs of mice, with high efficiency and low inflammation.
  
  
  OBJECTIVE
  We asked whether electroporation-mediated transfer of genes encoding subunits of the Na+,K+ -ATPase could protect from LPS-induced lung injury or be used to treat already injured lungs by up-regulating mechanisms of pulmonary edema clearance.
  
  
  METHODS
  Plasmids were delivered to the lungs of mice using transthoracic electroporation. Lung injury was induced by intratracheal administration of LPS (4 mg/kg body weight). Biochemical, cellular, and physiologic measurements were taken to assess gene transfer and lung injury.
  
  
  RESULTS
  Improvements in wet-to-dry ratios, pulmonary effusions, bronchoalveolar lavage protein levels and cellularity, alveolar fluid clearance, and respiratory mechanics were seen after delivery of plasmids expressing Na+,K+ -ATPase subunits, but not control plasmids, in LPS-injured lungs. Delivery of plasmids expressing Na+,K+ -ATPase subunits both protected from subsequent lung injury and partially reversed existing lung injury by these measures.
  
  
  CONCLUSIONS
  These results demonstrate that electroporation can be used effectively in healthy and injured lungs to facilitate gene delivery and expression. To our knowledge, this is the first successful use of gene delivery to treat existing lung injury, and may have future clinical potential.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: Gökhan M
authors.initials: GM
authors.lastname: Mutlu
authors.forename: David
authors.initials: D
authors.lastname: Machado-Aranda
authors.forename: James E
authors.initials: JE
authors.lastname: Norton
authors.forename: Amy
authors.initials: A
authors.lastname: Bellmeyer
authors.forename: Daniela
authors.initials: D
authors.lastname: Urich
authors.forename: Rui
authors.initials: R
authors.lastname: Zhou
authors.forename: David A
authors.initials: DA
authors.lastname: Dean
mesh_terms: D000818:Animals; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D004195:Disease Models, Animal; D053672:Electrochemotherapy / Q000379:methods*; D005260:Female; D015870:Gene Expression; D018014:Gene Transfer Techniques; D007150:Immunohistochemistry; D008070:Lipopolysaccharides / Q000633:toxicity; D051379:Mice; D008807:Mice, Inbred BALB C; D010957:Plasmids; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D000254:Sodium-Potassium-Exchanging ATPase / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D008070:Lipopolysaccharides; D000254:Sodium-Potassium-Exchanging ATPase