RESUMO
AIMS: The aim of this study was to prove that an intramyocardial injection of a mixture of low-dose human growth factor (HGF) plasmid and microbubbles (MB) in combination with insonation was an effective therapy for myocardial infarction. MAIN METHODS: Twenty dogs with myocardial infarction were divided into 4 groups: (1) HGF, MB and ultrasound (HGF-US/MB), (2) HGF and US (HGF-US), (3) HGF alone and (4) surgery alone (control). In the HGF-US/MB group, HGF plasmid DNA (500 µg) mixed with 0.5 ml of MB solution was injected 5 min after coronary occlusion followed by insonation. With the exception of the control group, the other dogs were divided into two groups, one treated with the HGF gene and insonation and the other with the HGF gene only. KEY FINDINGS: Compared to the HGF group, infarct size decreased from 32%±7% (control) to 23%±5% in the HGF-US/MB group 28 d later (P<0.05). Capillary density increased from 21.7±4.2/mm(2) (control) to 114.3±28.9/mm(2) in the HGF-US/MB group (P<0.01). Compared to the HGF group, there was a 14% decrease in the ratio of left ventricle weight/body weight and a 25% decrease in hydroxyproline content. We also observed a 29% and 20% decrease in collagen volume fraction of type I and type III collagen, respectively in the HGF-US/MB group. SIGNIFICANCE: Intramyocardial injection of HGF and MB in combination with insonation enhances neovascularization and reduces ventricular remodeling and infarct size.
Assuntos
Hormônio do Crescimento Humano/administração & dosagem , Microbolhas/uso terapêutico , Infarto do Miocárdio/patologia , Infarto do Miocárdio/terapia , Miocárdio/patologia , Neovascularização Fisiológica , Animais , Vasos Coronários/fisiologia , Cães , Terapia Genética , Hormônio do Crescimento Humano/genética , Humanos , Hidroxiprolina/metabolismo , Masculino , Infarto do Miocárdio/genética , Infarto do Miocárdio/cirurgia , Miocárdio/metabolismo , Plasmídeos/genética , Fluxo Sanguíneo Regional , Terapia por Ultrassom , Fator A de Crescimento do Endotélio Vascular/sangue , Remodelação Ventricular/genéticaRESUMO
BACKGROUND: To enhance myocardial angiogenic gene expression, a novel gene delivery strategy was tested. Direct intramyocardial injection of an angiogenic gene with microbubbles and insonation were applied in a dog animal model. Dogs received one of the four different treatments in conjunction with either the enhanced green fluorescence protein (EGFP) gene or the hepatocyte growth factor (HGF) gene: gene with microbubbles (MB) and ultrasound (US); gene with US; gene with MB; or the gene alone. RESULTS: Distribution of MB and the gene in the myocardium was visualized during the experiment. Compared with the EGFP gene group, an average 14.7-fold enhancement in gene expression was achieved in the EGFP+MB/US group (P < 0.01). Compared with the HGF gene group, an average 10.7-fold enhancement in gene expression was achieved in the HGF+MB/US group (P < 0.01). In addition, capillary density increased from 20.8 ± 3.4/mm2 in the HGF gene group to 146.7 ± 31.4/mm2 in HGF+MB/US group (P < 0.01). CONCLUSIONS: Thus, direct intramyocardial injection of an angiogenic gene in conjunction with microbubbles plus insonation synergistically enhances angiogenesis. This method offers an observable gene delivery procedure with enhanced expression efficiency of the delivered gene.
