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Author: Armen Henderson, Meharry Medical
College, Class of 2013
Introduction: Vector mediated cardiac gene
therapy is a translatable platform for treating many cardiovascular
diseases. However, in spite of development of adeno-associated
viral (AAV) vector serotypes with significant trophism for the
heart, these results have not yet been confirmed using an
intravenous delivery route in small or large animals in situ.
The quest for more efficient, cardiac gene delivery methods is
currently a critically important, rate-limiting challenge in
cardiac gene therapy. MCARD is proven to serve as a solution to
this problem and the efficacy of a probable gene is explored.
Methods: Six ovine subjects underwent MCARDTM
with delivery of 1014 vg scAAV6-CMV-ßARKct. After a 3 week
recovery, the obtuse marginal artery (OM1) was ligated proximally.
The control infarct group (n=3, no ßARKct) underwent OM1
ligation only. All nine animals survived to euthanasia at 8-12
weeks. LV function [Dp/dtmax, End diastolic volume (EDV), End
systolic volume (ESV), Ejection Fraction (EF), Cardiac Output (CO)]
was assessed via MRI pre-infarct and 8-12 Weeks post-infarct.
Isoproterenol (Iso) was infused [0.5 mcg/min] to evaluate ßAR
responsiveness following baseline assessment.
Results: At 8-12 Weeks, (Iso) stimulated LV
contractility (dP/dt) increased in the MCARD/ßARKct group
only. In this group, LV (EDV) decreased significantly post
isoproterenol infusion resulting in an acute reverse remodeling.
Western blot analysis confirmed robust ßARKct expression
globally in the LV and there results are confirmed with RT-qPCR. No
statistically significant improvement was found in EF, Baseline EDV
or CO compared to the control infarct group. In comparing control
infarct sheep with the creation of infarct followed by subsequent
MCARD treatment using BARKct sheep, there was no significant
difference between the two groups.
Conclusion: Robust ßARKct gene expression
increases inotropic reserve post infarction. However, it did not
prevent progressive left ventricular dilatation and the reduction
in LV function associated with ovine ischemic cardiomyopathy.
December 2012 Issue of IMpact