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J Thorac Cardiovasc Surg 1997;114:783-792
© 1997 Mosby, Inc.
CARDIAC AND PULMONARY REPLACEMENT |
Supported by the National Institutes of Health grants 1 R01 HL-41281 and HL-29594 and Alan A. and Edith Wolff Charitable Trust.
Received for publication March 25, 1997 revisions requested May 15, 1997; revisions received June 18, 1997 accepted for publication June 19, 1997. Address for reprints: G. Alexander Patterson, MD, 3108 Queeny Tower, One Barnes Hospital Plaza, St. Louis, MO 63110.
Abstract
Objectives: Our objectives were to determine the feasibility, efficacy, and safety of in vivo and ex vivo liposome-mediated gene transfer to lung isografts.Methods: Fischer rats were divided into three main groups: (1) Nontransplant setting: Liposomechloramphenicol acetyl transferase cDNA was intravenously injected, and lungs were harvested at different time points: 2, 6, 12, and 24 hours; 2, 5, 8, and 21 days (n = 3). Chloramphenicol acetyl transferase activity was determined in lungs, hearts, livers, and kidneys. The distribution and type of transfected cells were evaluated by in situ hybridization. Lung toxicity was assessed by arterial oxygen tension, histology, and tumor necrosis factor
levels.(2) In vivo graft transfection: Left lungs were transplanted 6 hours, 4 hours, and 15 minutes after intravenous injection and were assessed for chloramphenicol acetyl transferase activity and arterial oxygen tension on postoperative day 2. (3) Ex vivo graft transfection: Grafts were infused ex vivo with either 660 µg (n = 3) or 330 µg (n = 3) of DNA complexed to liposomes and stored at 10° C for 4 hours. Chloramphenicol acetyl transferase activity was assessed 44 hours after transplantation. Results: Transgene expression was detected in endothelial cells, macrophages, and interstitial cells. Chloramphenicol acetyl transferase activity was present as early as 2 hours, increased significantly between 6 hours and 8 days, and then decreased to minimal levels by 21 days. Chloramphenicol acetyl transferase activity was greatest in donor lungs and hearts and minimal in livers and kidneys. Arterial oxygen tension was normal in treated animals. Inflammation was minimal, and tumor necrosis factor
levels increased only sevenfold in treated animals. Conclusion: In vivo and ex vivo liposome-mediated gene transfer to lung isografts allows significant transgene expression with minimal effects on graft function.
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