title: AAV6.βARKct cardiac gene therapy ameliorates cardiac function and normalizes the catecholaminergic axis in a clinically relevant large animal heart failure model.
abstract: OBJECTIVE
  G protein-coupled receptor kinase 2 (GRK2), which is markedly upregulated in failing human myocardium, has been implicated as a contributing factor or consequence of heart failure (HF). Importantly, cardiac-specific GRK2 knockout mice have recently proved the pathological nature of GRK2 in HF. Targeted inhibition of GRK2 is possible using a peptide inhibitor known as the βARKct, which has rescued several disparate small animal HF models. This study was designed to evaluate long-term βARKct expression in a clinically relevant large animal HF model, using stable myocardial gene delivery with adeno-associated virus serotype 6 (AAV6).
  
  
  RESULTS
  A porcine model of HF subsequent to left ventricular (LV) myocardial infarction (MI) was used to study the effects of retrograde injection into the anterior interventricular vein of either AAV6.βARKct or AAV6.luciferase as a control 2 weeks after MI. Echocardiography and LV hemodynamics were performed before and 6 weeks after gene transfer. Robust and long-term βARKct expression was found after AAV6-mediated delivery, leading to significant amelioration of LV haemodynamics and contractile function in HF pigs compared with AAV6.luciferase-treated control animals that showed a continued decline in cardiac function. Interestingly, the neurohormonal axis was virtually normalized in AVV6.βARKct-treated HF animals, represented by reductions in plasma norepinephrine levels, whereas AAV6.luciferase-treated pigs showed further increases in plasma catecholamine levels. As a result, LV remodelling and foetal gene expression was reversed by AVV6.βARKct gene therapy.
  
  
  CONCLUSIONS
  These data--showing sustained amelioration of cardiac function in a post-MI pig HF model--demonstrate the therapeutic potential of βARKct gene therapy for HF.
authors.affiliation: Department of Internal Medicine III, Cardiology, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg 69120, Germany. philip.raake@med.uni-heidelberg.de
authors.forename: Philip W J
authors.initials: PW
authors.lastname: Raake
authors.forename: Philipp
authors.initials: P
authors.lastname: Schlegel
authors.forename: Jan
authors.initials: J
authors.lastname: Ksienzyk
authors.forename: Julia
authors.initials: J
authors.lastname: Reinkober
authors.forename: Jens
authors.initials: J
authors.lastname: Barthelmes
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schinkel
authors.forename: Sven
authors.initials: S
authors.lastname: Pleger
authors.forename: Walter
authors.initials: W
authors.lastname: Mier
authors.forename: Uwe
authors.initials: U
authors.lastname: Haberkorn
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Koch
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: Patrick
authors.initials: P
authors.lastname: Most
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Müller
mesh_terms: D000256:Adenoviridae; D000818:Animals; D002395:Catecholamines / Q000378:metabolism; D003331:Coronary Vessels; D004452:Echocardiography; D018014:Gene Transfer Techniques; D015316:Genetic Therapy / Q000379:methods*; D005822:Genetic Vectors; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology; D008156:Luciferases / Q000235:genetics; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy; D010455:Peptides / Q000235:genetics / Q000378:metabolism / Q000627:therapeutic use*; D011897:Random Allocation; D054447:Receptors, CCR10 / Q000037:antagonists & inhibitors*; D011994:Recombinant Proteins / Q000235:genetics / Q000378:metabolism / Q000627:therapeutic use*; D034421:Sus scrofa; D019076:Transgenes / Q000235:genetics; D020257:Ventricular Remodeling / Q000502:physiology
chemical_list: D002395:Catecholamines; D010455:Peptides; D054447:Receptors, CCR10; D011994:Recombinant Proteins; C445259:beta-adrenergic receptor kinase inhibitory peptide; D008156:Luciferases