Abstract
Coronary heart disease is still the leading cause of death in industrialized nations. Even though revascularization strategies such as coronary artery bypass graft surgery, percutaneous coronary intervention and enhanced drug therapy significantly improved the outcome, about 30 % of patients develop chronic heart failure. Ischemic heart disease and heart failure are characterized by an adverse remodeling of the heart, featuring cardiomyocyte hypertrophy, increased fibrosis and capillary rarefaction. Therefore, gene therapeutic approaches for the treatment of heart failure, such as the modulating contractile function or therapeutic neovascularization, seem to be promising. To achieve an efficient transduction of the gene therapeutic agent, the time point and the application route seem to be important for the therapeutic success. In contrast to the classical systemic application regional intra-coronary application offers the possibility of higher transduction efficacy in the target area accompanied by a reduced off-target contamination. Antegrade delivery however, may be impaired by coronary heart disease, such as stenosis or occlusion of a coronary artery. Coronary veins appear not to be affected and might therefore be the preferable application route for gene therapy. For an effective and safe retrograde application in gene therapy, selective catheterization of the coronary vein draining the target area is necessary. In addition, to avoid coronary vein injury, a pressure regulated infusion enhances safety. Therefore, a selective pressure regulation of retroinfusion (SSR) seems to be a favorable approach for gene therapy transduction in combination with reduced systemic contamination.
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Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De SG, Ferguson TB, Ford E, Furie K, Gillespie C, Go A, Greenlund K, Haase N, Hailpern S, Ho PM, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott MM, Meigs J, Mozaffarian D, Mussolino M, Nichol G, Roger VL, Rosamond W, Sacco R, Sorlie P, Roger VL, Thom T, Wasserthiel-Smoller S, Wong ND, Wylie-Rosett J (2010) Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation 121(7):e46–e215
Suero JA, Marso SP, Jones PG, Laster SB, Huber KC, Giorgi LV, Johnson WL, Rutherford BD (2001) Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience. J Am Coll Cardiol 38(2):409–414
White HD, Chew DP (2008) Acute myocardial infarction. Lancet 372(9638):570–584
Roger VL, Weston SA, Redfield MM, Hellermann-Homan JP, Killian J, Yawn BP, Jacobsen SJ (2004) Trends in heart failure incidence and survival in a community-based population. JAMA 292(3):344–350
Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, Murabito JM, Vasan RS (2002) Long-term trends in the incidence of and survival with heart failure. N Engl J Med 347(18):1397–1402
Pedrazzini G, Santoro E, Latini R, Fromm L, Franzosi MG, Mocetti T, Staszewsky L, Barlera S, Tognoni G, Maggioni AP (2008) Causes of death in patients with acute myocardial infarction treated with angiotensin-converting enzyme inhibitors: findings from the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto (GISSI)-3 trial. Am Heart J 155(2):388–394
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Ikonomidis JS, Khavjou O, Konstam MA, Maddox TM, Nichol G, Pham M, Pina IL, Trogdon JG (2013) Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail 6(3):606–619
Yla-Herttuala S, Rissanen TT, Vajanto I, Hartikainen J (2007) Vascular endothelial growth factors: biology and current status of clinical applications in cardiovascular medicine. J Am Coll Cardiol 49(10):1015–1026
Kupatt C, Hinkel R, Pfosser A, El-Aouni C, Wuchrer A, Fritz A, Globisch F, Thormann M, Horstkotte J, Lebherz C, Thein E, Banfi A, Boekstegers P (2010) Cotransfection of vascular endothelial growth factor-A and platelet-derived growth factor-B via recombinant adeno-associated virus resolves chronic ischemic malperfusion role of vessel maturation. J Am Coll Cardiol 56(5):414–422
Anisimov A, Tvorogov D, Alitalo A, Leppanen VM, An Y, Han EC, Orsenigo F, Gaal EI, Holopainen T, Koh YJ, Tammela T, Korpisalo P, Keskitalo S, Jeltsch M, Yla-Herttuala S, Dejana E, Koh GY, Choi C, Saharinen P, Alitalo K (2013) Vascular endothelial growth factor-angiopoietin chimera with improved properties for therapeutic angiogenesis. Circulation 127(4):424–434
Hinkel R, Boekstegers P, Kupatt C (2012) Adjuvant early and late cardioprotective therapy: access to the heart. Cardiovasc Res 94(2):226–236
Hinkel R, Trenkwalder T, Kupatt C (2011) Gene therapy for ischemic heart disease. Expert Opin Biol Ther 11(6):723–737
Boekstegers P, Giehrl W, Gv D, Steinbeck G (1998) Selective suction and pressure-regulated retroinfusion: an effective and safe approach to retrograde protection against myocardial ischemia in patients undergoing normal and high risk percutaneous transluminal angioplasty. J Am Coll Cardiol 31:1525–1533
von Degenfeld G, Raake P, Kupatt C, Lebherz C, Hinkel R, Gildehaus FJ, Munzing W, Kranz A, Waltenberger J, Simoes M, Schwaiger M, Thein E, Boekstegers P (2003) Selective pressure-regulated retroinfusion of fibroblast growth factor-2 into the coronary vein enhances regional myocardial blood flow and function in pigs with chronic myocardial ischemia. J Am Coll Cardiol 42(6):1120–1128
Hinkel R, Trenkwalder T, Petersen B, Husada W, Gesenhues F, Lee S, Hannappel E, Bock-Marquette I, Theisen D, Leitner L, Boekstegers P, Cierniewski C, Mueller OJ, le Noble F, Adams RH, Weinl C, Nordheim A, Reichart B, Weber C, Olson E, Posern G, Deindl E, Niemann H, Kupatt C (2014) MRTF-A controls vessel growth and maturation by increasing the expression of CCN1 and CCN2. Nat Commun 5:3970
Kupatt C, Hinkel R, von Bruhl ML, Pohl T, Horstkotte J, Raake P, El AC, Thein E, Dimmeler S, Feron O, Boekstegers P (2007) Endothelial nitric oxide synthase overexpression provides a functionally relevant angiogenic switch in hibernating pig myocardium. J Am Coll Cardiol 49(14):1575–1584
Pleger ST, Shan C, Ksienzyk J, Bekeredjian R, Boekstegers P, Hinkel R, Schinkel S, Leuchs B, Ludwig J, Qiu G, Weber C, Raake P, Koch WJ, Katus HA, Muller OJ, Most P (2011) Cardiac AAV9-S100A1 gene therapy rescues post-ischemic heart failure in a preclinical large animal model. Sci Transl Med 3(92):92ra64
Raake PW, Schlegel P, Ksienzyk J, Reinkober J, Barthelmes J, Schinkel S, Pleger S, Mier W, Haberkorn U, Koch WJ, Katus HA, Most P, Muller OJ (2013) AAV6.betaARKct cardiac gene therapy ameliorates cardiac function and normalizes the catecholaminergic axis in a clinically relevant large animal heart failure model. Eur Heart J 34(19):1437–1447
Weber C, Neacsu I, Krautz B, Schlegel P, Sauer S, Raake P, Ritterhoff J, Jungmann A, Remppis AB, Stangassinger M, Koch WJ, Katus HA, Muller OJ, Most P, Pleger ST (2014) Therapeutic safety of high myocardial expression levels of the molecular inotrope S100A1 in a preclinical heart failure model. Gene Ther 21(2):131–138
Hoshino K, Kimura T, De Grand AM, Yoneyama R, Kawase Y, Houser S, Ly HQ, Kushibiki T, Furukawa Y, Ono K, Tabata Y, Frangioni JV, Kita T, Hajjar RJ, Hayase M (2006) Three catheter-based strategies for cardiac delivery of therapeutic gelatin microspheres. Gene Ther 13(18):1320–1327
Kupatt C, Hinkel R, Horstkotte J, Deiss M, von Bruhl ML, Bilzer M, Boekstegers P (2004) Selective retroinfusion of GSH and cariporide attenuates myocardial ischemia-reperfusion injury in a preclinical pig model. Cardiovasc Res 61(3):530–537
Hinkel R, El-Aouni C, Olson T, Horstkotte J, Mayer S, Muller S, Willhauck M, Spitzweg C, Gildehaus FJ, Munzing W, Hannappel E, Bock-Marquette I, DiMaio JM, Hatzopoulos AK, Boekstegers P, Kupatt C (2008) Thymosin ß 4 Is an essential paracrine factor of embryonic endothelial progenitor cell-mediated cardioprotection. Circulation 117(17):2232–2240
Kupatt C, Dessy C, Hinkel R, Raake P, Daneau G, Bouzin C, Boekstegers P, Feron O (2004) Heat shock protein 90 transfection reduces ischemia-reperfusion-induced myocardial dysfunction via reciprocal endothelial NO synthase serine 1177 phosphorylation and threonine 495 dephosphorylation. Arterioscler Thromb Vasc Biol 24(8):1435–1441
Kupatt C, Hinkel R, Vachenauer R, Horstkotte J, Raake P, Sandner T, Kreuzpointner R, Muller F, Dimmeler S, Feron O, Boekstegers P (2003) VEGF165 transfection decreases postischemic NF-kappa B-dependent myocardial reperfusion injury in vivo: role of eNOS phosphorylation. FASEB J 17(6):705–707
Hinkel R, Penzkofer D, Zuhlke S, Fischer A, Husada W, Xu QF, Baloch E, van Rooij E, Zeiher AM, Kupatt C, Dimmeler S (2013) Inhibition of MicroRNA-92a protects against ischemia/reperfusion injury in a large-animal model. Circulation 128(10):1066–1075
Hinkel R, Lebherz C, Fydanaki M, Wuchrer A, El-Aouni C, Thormann M, Thein E, Kupatt C, Boekstegers P (2013) Angiogenetic potential of ad2/hif-1alpha/vp16 after regional application in a preclinical pig model of chronic ischemia. Curr Vasc Pharmacol 11(1):29–37
Hinkel R, Lange P, Petersen B, Gottlieb E, Ng JK, Finger S, Horstkotte J, Lee S, Thormann M, Knorr M, El-Aouni C, Boekstegers P, Reichart B, Wenzel P, Niemann H, Kupatt C (2015) Heme oxygenase-1 gene therapy provides cardioprotection via control of post-ischemic inflammation: an experimental study in a pre-clinical pig model. J Am Coll Cardiol 66(2):154–165
Pohl T, Giehrl W, Reichart B, Kupatt C, Raake P, Paul S, Reichenspurner H, Steinbeck G, Boekstegers P (2004) Retroinfusion-supported stenting in high-risk patients for percutaneous intervention and bypass surgery: results of the prospective randomized myoprotect I study. Catheter Cardiovasc Interv 62(3):323–330
Raake P, von Degenfeld G, Hinkel R, Vachenauer R, Sandner T, Beller S, Andrees M, Kupatt C, Schuler G, Boekstegers P (2004) Myocardial gene transfer by selective pressure-regulated retroinfusion of coronary veins: comparison with surgical and percutaneous intramyocardial gene delivery. J Am Coll Cardiol 44(5):1124–1129
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Hinkel, R., Kupatt, C. (2017). Selective Pressure-Regulated Retroinfusion for Gene Therapy Application in Ischemic Heart Disease. In: Ishikawa, K. (eds) Cardiac Gene Therapy. Methods in Molecular Biology, vol 1521. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-6588-5_18
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DOI: https://doi.org/10.1007/978-1-4939-6588-5_18
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