title: Use of p53-Silenced Endothelial Progenitor Cells to Treat Ischemia in Diabetic Peripheral Vascular Disease.
abstract: BACKGROUND
  Peripheral vascular disease is a major diabetes mellitus-related complication. In this study, we noted that expressions of proapoptotic p53 gene and its downstream cascade gene such as p21 are upregulated in hyperglycemia. Therefore, we investigated whether p53- and p21-silenced endothelial progenitor cells (EPCs) were able to survive in hyperglycemic milieu, and whether transplantation of either p53 knockout (KO) or p21KO or p53- and p21-silenced EPCs could improve collateral vessel formation and blood flow in diabetic vaso-occlusive peripheral vascular disease mouse models.
  
  
  RESULTS
  We transplanted p53 and p21KO mouse EPCs (mEPCs) into streptozotocin-induced diabetic (type 1 diabetes mellitus model) C57BL/6J and db/db (B6.BKS(D)-Leprdb/J) (type 2 model) post-femoral artery occlusion. Similarly, Ad-p53-silenced and Ad-p21-silenced human EPCs (CD34+) cells were transplanted into streptozotocin-induced diabetic NOD.CB17-Prkdcscid/J mice. We measured blood flow at 3, 7, and 10 days and hindlimb muscles were obtained postsacrifice for mRNA estimation and CD31 staining. Enhanced blood flow was noted with delivery of p53 and p21KO mEPCs in streptozotocin-induced diabetic C57BL/6J mice. Similar results were obtained when human Ad-p53shEPCs(CD34+) and Ad-p21shEPCs(CD34+) were transplanted into streptozotocin-induced nonobese diabetic severe combined immunodeficiency mice. Gene expression analysis of p53 and p21KO EPCs transplanted hindlimb muscles showed increased expression of endothelial markers such as endothelial nitric oxide synthase, vascular endothelial growth factor A, and platelet endothelial cell adhesion molecule 1. Similarly, quantitative reverse transcriptase polymerase chain reaction of human Ad-p53shEPCs (CD34+)- and Ad-p21shEPCs (CD34+)-transplanted hindlimb muscles also showed increased expression of endothelial markers such as vascular endothelial growth factor A, noted primarily in the p53-silenced EPCs group. However, such beneficial effect was not noted in the db/db type 2 diabetic mouse models.
  
  
  CONCLUSIONS
  Transient silencing of p53 using adenoviral vector in EPCs may have a therapeutic role in diabetic peripheral vascular disease.
authors.affiliation: Department of Medicine, The George Washington University, Washington, DC.
authors.forename: Nabanita
authors.initials: N
authors.lastname: Kundu
authors.affiliation: Department of Medicine, The George Washington University, Washington, DC.
authors.forename: Cleyton C
authors.initials: CC
authors.lastname: Domingues
authors.affiliation: Pioneer Valley Life Science Institute, Baystate Medical Center, Springfield, MA.
authors.forename: Cyril
authors.initials: C
authors.lastname: Chou
authors.affiliation: Department of Medicine, The George Washington University, Washington, DC.
authors.forename: Neeki
authors.initials: N
authors.lastname: Ahmadi
authors.affiliation: Department of Medicine, The George Washington University, Washington, DC.
authors.forename: Sara
authors.initials: S
authors.lastname: Houston
authors.affiliation: Pioneer Valley Life Science Institute, Baystate Medical Center, Springfield, MA.
authors.forename: D Joseph
authors.initials: DJ
authors.lastname: Jerry
authors.affiliation: Department of Medicine, The George Washington University, Washington, DC ssen1@gwu.edu.|Pioneer Valley Life Science Institute, Baystate Medical Center, Springfield, MA.
authors.forename: Sabyasachi
authors.initials: S
authors.lastname: Sen
mesh_terms: D000818:Animals; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000235:genetics; D003921:Diabetes Mellitus, Experimental / Q000150:complications; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003925:Diabetic Angiopathies / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D004195:Disease Models, Animal; D066026:Endothelial Progenitor Cells / Q000378:metabolism / Q000637:transplantation*; D020868:Gene Silencing; D006614:Hindlimb / Q000098:blood supply; D007511:Ischemia / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D051379:Mice; D008810:Mice, Inbred C57BL; D016688:Mice, Inbred NOD; D018345:Mice, Knockout; D018482:Muscle, Skeletal / Q000098:blood supply / Q000378:metabolism; D018919:Neovascularization, Physiologic; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D016491:Peripheral Vascular Diseases / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D012039:Regional Blood Flow; D016159:Tumor Suppressor Protein p53 / Q000235:genetics; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: C493957:Cdkn1a protein, mouse; D050759:Cyclin-Dependent Kinase Inhibitor p21; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D016159:Tumor Suppressor Protein p53; D042461:Vascular Endothelial Growth Factor A; C467480:vascular endothelial growth factor A, mouse; D052250:Nitric Oxide Synthase Type III; C496315:Nos3 protein, mouse
keywords: adenovirus vector; apoptosis; diabetes mellitus; endothelial progenitor cells; gene therapy