Safety of direct myocardial administration of an adenovirus vector encoding vascular endothelial growth factor 121

Shailen R. Patel, Leonard Y. Lee, Charles A. Mack, Dean R. Polce, Tarek El-Sawy, Neil R. Hackett, Arzu Ilercil, Erica C. Jones, Rebecca T. Hahn, O. Wayne Isom, Todd K. Rosengart, Ronald Crystal

Research output: Contribution to journalArticle

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Abstract

A gene therapy strategy involving direct myocardial administration of an adenovirus (Ad) vector encoding the vascular endothelial growth factor 121 cDNA (Ad(GV)VEGF121.10) has been shown to be capable of 'biological revascularization' of ischemic myocardium in an established porcine model. The present study evaluates the local and systemic safety of this therapy in this porcine ischemia model and in normal mice. Myocardial ischemia was induced in Yorkshire swine with an ameroid constrictor 21 days prior to vector administration. Ad(GV)VEGF121.10 (109 or 1010 PFU), Ad5 wild type (109 PFU), AdNull (control vector with no transgene; 109 PFU), saline, or no injection (naive) was administered in 10 sites in the ischemic, circumflex distribution of the myocardium. Toxicity was assessed by survival, serial echocardiography, blood analyses, and myocardial and liver histology at 3 and 28 days after vector administration. All pigs survived to sacrifice, except for one animal in the Ad(GV)VEGF121.10 (1010 PFU) group, which died as a result of oversedation. Echocardiograms of Ad(GV)VEGF121.10-treated pigs demonstrated no differences in pericardial effusion, mitral valve regurgitation, or regional wall motion compared with control pigs. Intramyocardial administration of Ad(GV)VEGF121.10 included only minimal myocardial inflammation and necrosis, and no hepatic inflammation or necrosis. Only a mild elevation of the white blood cell count was encountered on day 3, which was transient and self-limited in the Ad(GV)VEGF121.10 group as compared with the saline-treated animals. As a measure of inadvertent intravascular administration of vector, normal C57/BL6 mice received intravenous Ad(GV)VEGF121.10 (104, 106, 5 x 107, or 109 PFU), AdNull (5 x 107 or 109 PFU), or saline. Toxicity was assessed by survival, blood analyses, and organ histology at 3 and 7 days after vector administration. A separate group of C57/BL6 mice received intravenous AdmVEGF164 (Ad vector encoding the murine VEGF164 cDNA), Ad(GV)VEGF121.10, AdNull (108 PFU each group), or saline to assess duration of expression and safety of a homologous transgene. All mice survived to sacrifice except for 40% of the mice in the highest (109 PFU; a dose more than 103-fold higher by body weight than the efficacious dose in pigs) Ad(GV)VEGF121.10 dose group, which died on days 5-6 after vector administration. The only differences seen in the blood analyses between treated and control mice were in the very high Ad(GV)VEGF121.10 dose group (109 PFU), which demonstrated an anemia as well as an increase in alkaline phosphatase when compared with all other treatment groups. Hepatic VEGF levels by ELISA in AdmVEGF164-treated mice did not persist beyond 14 days after vector administration, suggesting that persistent expression of a homologous VEGF gene transferred with an Ad vector is not a significant safety risk. Although this is not a chronic toxicity study, these data demonstrate the safety of direct myocardial administration of Ad(GV)VEGF121.10, and support the potential use of this strategy to treat human myocardial ischemia.

Original languageEnglish
Pages (from-to)1331-1348
Number of pages18
JournalHuman Gene Therapy
Volume10
Issue number8
DOIs
Publication statusPublished - 20 May 1999
Externally publishedYes

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Adenoviridae
Vascular Endothelial Growth Factor A
Safety
Swine
Transgenes
Myocardial Ischemia
Liver
Myocardium
Histology
Necrosis
Complementary DNA
Inflammation
Pericardial Effusion
Mitral Valve Insufficiency
Survival Analysis
Leukocyte Count
Genetic Therapy
Alkaline Phosphatase
Echocardiography
Anemia

ASJC Scopus subject areas

  • Genetics

Cite this

Safety of direct myocardial administration of an adenovirus vector encoding vascular endothelial growth factor 121. / Patel, Shailen R.; Lee, Leonard Y.; Mack, Charles A.; Polce, Dean R.; El-Sawy, Tarek; Hackett, Neil R.; Ilercil, Arzu; Jones, Erica C.; Hahn, Rebecca T.; Isom, O. Wayne; Rosengart, Todd K.; Crystal, Ronald.

In: Human Gene Therapy, Vol. 10, No. 8, 20.05.1999, p. 1331-1348.

Research output: Contribution to journalArticle

Patel, SR, Lee, LY, Mack, CA, Polce, DR, El-Sawy, T, Hackett, NR, Ilercil, A, Jones, EC, Hahn, RT, Isom, OW, Rosengart, TK & Crystal, R 1999, 'Safety of direct myocardial administration of an adenovirus vector encoding vascular endothelial growth factor 121', Human Gene Therapy, vol. 10, no. 8, pp. 1331-1348. https://doi.org/10.1089/10430349950018012
Patel, Shailen R. ; Lee, Leonard Y. ; Mack, Charles A. ; Polce, Dean R. ; El-Sawy, Tarek ; Hackett, Neil R. ; Ilercil, Arzu ; Jones, Erica C. ; Hahn, Rebecca T. ; Isom, O. Wayne ; Rosengart, Todd K. ; Crystal, Ronald. / Safety of direct myocardial administration of an adenovirus vector encoding vascular endothelial growth factor 121. In: Human Gene Therapy. 1999 ; Vol. 10, No. 8. pp. 1331-1348.
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T1 - Safety of direct myocardial administration of an adenovirus vector encoding vascular endothelial growth factor 121

AU - Patel, Shailen R.

AU - Lee, Leonard Y.

AU - Mack, Charles A.

AU - Polce, Dean R.

AU - El-Sawy, Tarek

AU - Hackett, Neil R.

AU - Ilercil, Arzu

AU - Jones, Erica C.

AU - Hahn, Rebecca T.

AU - Isom, O. Wayne

AU - Rosengart, Todd K.

AU - Crystal, Ronald

PY - 1999/5/20

Y1 - 1999/5/20

N2 - A gene therapy strategy involving direct myocardial administration of an adenovirus (Ad) vector encoding the vascular endothelial growth factor 121 cDNA (Ad(GV)VEGF121.10) has been shown to be capable of 'biological revascularization' of ischemic myocardium in an established porcine model. The present study evaluates the local and systemic safety of this therapy in this porcine ischemia model and in normal mice. Myocardial ischemia was induced in Yorkshire swine with an ameroid constrictor 21 days prior to vector administration. Ad(GV)VEGF121.10 (109 or 1010 PFU), Ad5 wild type (109 PFU), AdNull (control vector with no transgene; 109 PFU), saline, or no injection (naive) was administered in 10 sites in the ischemic, circumflex distribution of the myocardium. Toxicity was assessed by survival, serial echocardiography, blood analyses, and myocardial and liver histology at 3 and 28 days after vector administration. All pigs survived to sacrifice, except for one animal in the Ad(GV)VEGF121.10 (1010 PFU) group, which died as a result of oversedation. Echocardiograms of Ad(GV)VEGF121.10-treated pigs demonstrated no differences in pericardial effusion, mitral valve regurgitation, or regional wall motion compared with control pigs. Intramyocardial administration of Ad(GV)VEGF121.10 included only minimal myocardial inflammation and necrosis, and no hepatic inflammation or necrosis. Only a mild elevation of the white blood cell count was encountered on day 3, which was transient and self-limited in the Ad(GV)VEGF121.10 group as compared with the saline-treated animals. As a measure of inadvertent intravascular administration of vector, normal C57/BL6 mice received intravenous Ad(GV)VEGF121.10 (104, 106, 5 x 107, or 109 PFU), AdNull (5 x 107 or 109 PFU), or saline. Toxicity was assessed by survival, blood analyses, and organ histology at 3 and 7 days after vector administration. A separate group of C57/BL6 mice received intravenous AdmVEGF164 (Ad vector encoding the murine VEGF164 cDNA), Ad(GV)VEGF121.10, AdNull (108 PFU each group), or saline to assess duration of expression and safety of a homologous transgene. All mice survived to sacrifice except for 40% of the mice in the highest (109 PFU; a dose more than 103-fold higher by body weight than the efficacious dose in pigs) Ad(GV)VEGF121.10 dose group, which died on days 5-6 after vector administration. The only differences seen in the blood analyses between treated and control mice were in the very high Ad(GV)VEGF121.10 dose group (109 PFU), which demonstrated an anemia as well as an increase in alkaline phosphatase when compared with all other treatment groups. Hepatic VEGF levels by ELISA in AdmVEGF164-treated mice did not persist beyond 14 days after vector administration, suggesting that persistent expression of a homologous VEGF gene transferred with an Ad vector is not a significant safety risk. Although this is not a chronic toxicity study, these data demonstrate the safety of direct myocardial administration of Ad(GV)VEGF121.10, and support the potential use of this strategy to treat human myocardial ischemia.

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