(Circulation. 2000;101:178.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
From the UCSD-Salk Program in Molecular Genetics, Department of Medicine and Center for Molecular Genetics, University of California San Diego, La Jolla (G.C., S.M., P.J.G., Y.W., K.R.C.); the Institute for Experimental Medical Research, University of Oslo, Ullevaal Hospital, Oslo, Norway (G.C.); the Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Md (P.J.G.); and the Department of Physiology, University of Maryland School of Medicine, Baltimore (Y.W.).
Correspondence to Dr Geir Christensen, Institute for Experimental Medical Research, University of Oslo, Ullevaal Hospital, N-0407 Oslo, Norway. E-mail geir.christensen{at}ioks.uio.no
| Abstract |
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Methods and ResultsFor embryonic gene transfer, an adenovirus vector expressing ß-galactosidase was injected in utero into the ventricular cavity of living embryos via microsurgical approaches. The injected embryos were developed to term, and efficient expression of the transgene was detected in all cell types in the heart. For postnatal cardiac gene transfer, adenovirus was injected into the cardiac ventricle of neonatal mice, resulting in efficient expression of the transgene in the outer layer of the myocardium as well as cardiomyocytes in the middle and inner layers of the cardiac wall. Mice examined after 3 weeks displayed a pattern of expression that completely mimicked the pattern seen after 3 days, and gene expression was also found after 6 months. The infected myocytes can be identified by coinfection of an adenovirus expressing green fluorescent protein without affecting their normal physiological function.
ConclusionsWe have developed a new strategy to achieve efficient and long-term foreign gene expression in both embryonic and postnatal mouse myocardium via direct intracardiac injection of recombinant adenovirus. The strategy should allow the functional assessment of the expression of dominantly acting exogenous genes, overexpression of wild-type genes, and Cre recombinasemediated gene ablations at the single-cell level in the context of the intact adult mouse myocardium.
Key Words: myocytes viruses proteins myocardium
| Introduction |
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In the present study, we describe an in utero microsurgical approach for direct injection of recombinant adenoviruses into the ventricular cavity of living mouse embryos and a protocol for reproducible and efficient transfection to the postnatal mouse myocardium with long-term gene expression and absence of inflammatory reaction. Our results document the potential to examine the function of any given gene in mouse cardiomyocytes through in vivo gene transfer.
| Methods |
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Adenovirus-Mediated Gene Transfer to the Postnatal Mouse Heart
In Vivo
The animals were anesthetized by cooling in ice water at
4°C for 2 minutes.7 A flame-stretched capillary tube
mounted on a micromanipulator system (Figure 1
) was filled with 10 µL of suspension
containing virus. Injections were carried out by direct punctuation of
the cardiac cavity through the chest wall on the left border of the
sternum at the axillary level. Flashback of light-colored pulsatile
blood into the barrel of the glass tube indicated positioning in the
left chamber. Fewer than 1 of 10 injected animals died immediately or
within 1 day after intracardiac injection.
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Examination of Whole Embryos With ß-Gal Assay
Assays for ß-gal of embryonic tissue were performed by a
variation of standard techniques.8 Briefly, whole embryos
were dissected such that communications were made throughout multiple
body cavities, including the pleural, pericardial,
intraventricular, and peritoneal spaces. The
embryos were quickly rinsed twice in ice-cold PBS,
permeabilized, and stained with X-gal. Paraffin
sections were photographed under dark-field microscopy with a Nikon
Optiphot-2.
Examination of Postnatal Cardiac Tissue
For staining of tissue sections, the hearts were perfused
through the left ventricle with PBS containing 40 mmol/L KCl
before fixation and incubation overnight in 30% sucrose. The hearts
were snap-frozen in OCT (Miles Inc) and sectioned on a Leica cryostat
(Frigocut 2800, Leica Instruments GmbH) before being stained with X-gal
solution and counterstained with eosin and hematoxylin.
Examination of Isolated Neonatal Cardiomyocytes After In Vivo
Cotransfection With ß-Gal and GFP
The cells were plated overnight on laminated glass coverslips
with etched grids and lettering (Bellco Glass Inc). Localization of the
cardiomyocytes expressing GFP was recorded.
Subsequently, the cardiomyocytes were fixed and incubated
in X-gal solution. The percentage of cardiomyocytes
previously noted as green, which also expressed ß-gal, was
calculated.
Isolation and Functional Analysis of Infected Adult
Cardiomyocytes
For isolation of rod-shaped cardiomyocytes, the
heart was excised 3 weeks after infection. The aorta was cannulated
under a microscope while submerged and was mounted in a modified
Langendorff perfusion system fitted with heating coils. The heart was
perfused at 37°C for 5 minutes at 2 mL/min with a modified Jokliks
minimum essential medium. Subsequently, 150 U/mL of type II
collagenase (Worthington) was added, and perfusion
continued for 20 minutes. The ventricles were cut and gently
triturated. After filtration, cells were resuspended in modified
Jokliks medium, and calcium concentration was increased to 1
mmol/L.
For functional measurements, isolated myocytes were transferred to a temperature-controlled perfusion chamber (HCB-101, Crescent Electronics) located on the stage of an inverted microscope (Nikon Diaphot TMD). Cells expressing GFP were identified by use of a fluorescent light source mounted on the microscope. Images of contracting myocytes were obtained with a CCD camera (FTM 800 NH/PH, Philips). Shortening and relaxation were measured in GFP-negative (n=12) and GFP-positive (n=8) cells with a video edge-detection system (Crescent Electronics).
Statistics
Data are presented as mean±SEM. Unpaired 2-tailed
t test was performed to assess differences between 2 groups.
A value of P<0.05 was considered statistically
significant.
| Results |
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Crafted pulled-glass micropipettes (World Precision Instruments) were
developed with a model 730 pipette puller (David Kopf) and a model
MF-79 microforge (Narishige). A needle with a 10x20-µm side hole
(Figure 3a
) was found to give the best results. Under
submersion, a loosely placed 10-0 monofilament purse-string suture was
placed through the membranes incorporating both the yolk sac and
amnion. Through a small tear in the membranes (Figure 2c
), the
needle containing the viral solution could be introduced into the
ventricular cavity of the embryo. A retrograde flash of
blood in the barrel of the needle confirmed the right position before
the viral solution was injected. The preplaced purse-string suture was
gently approximated (Figure 2d
). Hemostasis was a critical
portion of the procedure. The abdomen was closed with a running suture,
and the mother was allowed to recover. Embryos were delivered either by
cesarean section or by maternal euthanasia and use of a foster
mother.
Efficient Transduction of the Embryonic Murine
Myocardium With Adenovirus
A recombinant adenovirus encoding ß-gal was injected into the
ventricular cavity of midgestational embryos. Embryos were
allowed to develop for 24 hours before death. When
106 to 108 pfu of viral
particles were used, we were able to effectively transduce the full
thickness of the myocardium (Figure 4a
). All cell types in the heart could be
effectively transduced (Figure 4b
), as determined by light
microscopy. The success of the in utero viral transduction approach was
confirmed in a series of 54 consecutive embryonic manipulations,
resulting in an overall survival of 73%.
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Efficient Gene Transfer of the Day 1 Neonatal Mouse
Myocardium
A viral solution containing 109 particles of
adenovirus encoding ß-gal was injected into cardiac ventricles of
mouse neonates from the first (n=6), third (n=6), and fifth days (n=6)
after birth. The entire outer layer of the myocardium
expressed the transduced gene when the viral solution was injected the
first day after birth (Figure 5a
).
Injection at a later postnatal period (day 3 to 5) resulted in a much
less efficient expression of the transgene (Figure 5b
).
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Sections of hearts injected the first day after birth (n=6) were
examined 3 days after administration of virus, documenting transgene
expression in the nuclei of the cardiomyocytes (Figure 6a
). The infection was most efficient in
the outer layer of the myocardium, but Figure 6a
shows that cardiomyocytes in the trabecular
network and the middle and inner layers of the myocardium
were also infected. The myocytes in all parts of the atrial
myocardium were efficiently infected, as demonstrated in
Figure 6b
. No inflammatory cells were found in any of the
sections from the atria or ventricles examined after staining with
hematoxylin and eosin (Figure 7
). The
regions of myocardial sections used to examine any inflammatory
response were those with highest efficiency of ß-gal expression.
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The percentage of cardiomyocytes expressing ß-gal was
estimated by counting positively stained cardiomyocytes
isolated from hearts of 6 animals. In some animals, 27% of the
cardiomyocytes expressed ß-gal. The average percentage of
cells expressing the gene was 10.9±3.5%. Little expression of ß-gal
was found in other organs, with the exception of the liver, because
staining with X-gal showed numerous cells positive for ß-gal in the
liver (Figure 8
).
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Long-Term Gene Expression Is Achieved When Adenovirus Is
Administered in 1-Day-Old Neonatal Mice
To examine the persistence of gene expression, hearts from groups
of animals were examined 3 days, 3 weeks, 6 weeks, and 6 months after
injection of adenoviral constructs the first day after birth. Figure 6c
shows highly efficient gene expression in atrial
cardiomyocytes 3 weeks after injection. The pattern of
ß-gal expression was virtually identical to that found in animals
examined after 3 days (Figure 6b
). A similar pattern of
expression was also found 6 weeks after injection of the virus. When
examined after 6 months, the ß-gal was still expressed in the
infected regions, and there was no evidence of an inflammatory
reaction.
Cotransfection and Identification of Viable Infected Cardiac
Myocytes
The ability to coinfect cardiomyocytes in vivo
with a second virus was examined by intracavitary injection of a
mixture of adenovirus encoding GFP and adenovirus encoding ß-gal in a
group of 6 neonatal mice. In Figure 9a
, the bright-field image shows a cardiomyocyte isolated 3
days after adenovirus injection. A cell located on an F on the
coverslip expresses GFP, as shown in the dark field under a
fluorescent source (Figure 9b
). After fixation and
staining with X-gal solution, the same cell is blue (Figure 9c
),
indicating that the expression of ß-gal resulted from successful in
vivo cotransfection. When cardiomyocytes from all 6 hearts
in the group were examined, 93% of the cells expressing GFP also
expressed ß-gal, suggesting a high fidelity of cotransfection.
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Isolation, Identification, and Physiological
Assessment of Viable Rod-Shaped Mouse Cardiomyocytes Infected by
Adenovirus Expressing GFP
Successfully infected cells were identified by the
fluorescent signal at 450 nm (Figure 10
). Shortening and relaxation were
measured in GFP-negative (n=12) and GFP-positive (n=8) cells. In the
adult noninfected mouse myocytes, a shortening of 9.35±0.94% and a
shortening duration of 469±29 ms were found. These functional
parameters were not different from data obtained in
infected cells, which were 9.84±1.46% and 467±34 ms,
respectively.
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| Discussion |
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Although previous attempts have been made to transduce the whole embryonic heart in nonmammalian models,10 high-efficiency and spatially restricted transduction of the mammalian heart has not been established. In mammals,11 adenoviral vectors have been delivered via intra-amnionic injection to target the pulmonary epithelium for therapy of cystic fibrosis. Transgene expression was found in the proximal airways, but no expression was observed in cardiac tissue. A recent study12 used intraplacental delivery of recombinant adenoviruses in mice and found that a little less than 20% of the ventricular cardiomyocytes expressed the transgene. However, intraplacental delivery leads to substantial expression of the marker gene in noncardiovascular tissue. In our study, in which the virus was delivered directly to the heart, little expression of the marker gene was observed in other organs. No inflammatory reaction was observed.
It is intriguing that in vivo administration of adenoviral constructs
the first day after birth has significant advantages compared with
later delivery. Efficiency, reproducibility, and duration of gene
expression all were substantially improved when 1-day-old neonatal mice
were used. The virus was most likely trapped in the highly developed
neonatal trabecular network of the ventricles and atria as
well as within the pericardium. The cells in the
midmyocardium, however, were most likely infected through
the coronary arteries. In one previous study,13
neonatal mice were injected intravenously with
109 pfu recombinant virus encoding ß-gal.
However, only
0.2% of cardiac cells had undergone gene transfer. In
another study performed in neonatal rats,14 adenovirus was
injected into the thoracic cavity. Expression of the reporter gene
choramphenicol acetyltransferase was found in the heart, but the
highest levels were in the lungs and diaphragm, with a substantial
degree of variation between animals. The authors explain their findings
by the relatively imprecise nature of the thoracic injection. In
comparison, the percentage of cardiomyocytes expressing
ß-gal from the injected neonatal heart averaged
11% but could be
up to 27% of the cardiomyocytes. Intrathoracic injection
performed in neonatal mice in our laboratory gave much lower efficiency
and higher lethality than intraventricular
injection (G.C., Y.W., and K.R.C., unpublished observation,
1997). Using the cytomegalovirus promoter, we were able to
compare the expression of ß-gal in several organs after injection
into the left ventricle. Very little expression of ß-gal was found in
the lungs and other remote organs, except the liver. It should be
noted, however, that our approach for gene transfer into the embryonic
and postnatal heart will be even more powerful when cardiac-specific
promoters are used. In adult mice,15 direct
intramyocardial injection has been performed. However, the limited
spatial extent of transfection and possible damage of cells surrounding
the needle track makes that approach, in our opinion, much less
appealing than successfully performed intracavitary injection.
Our protocol for delivery of adenovirus to neonates is highly reproducible with regard to gene transfer efficiency, and a high number of animals can be injected within a relatively short time period. For anesthesia, we used rapid cooling,7 which is possible because of the small body mass in neonates and the lack of thermoregulatory capabilities. By lowering the body temperature, we were able to temporarily arrest the heart, which prolonged the exposure of the heart to the virus. Injection into the minute cardiac chambers of the neonatal hearts required crafted pulled-glass micropipettes mounted on a micromanipulator system. Successful placement of the pipette within the ventricular cavity was achieved in >90% of the animals. Each animal could be anesthetized and injected in <10 minutes.
We found that the expression of the transfected gene was stable for several months after administration of adenovirus to the neonatal mice. Previous studies in adult rats and rabbits16 17 have shown only transient expression, and in most studies, adenovirus injection was accompanied by substantial inflammatory reaction. The mechanism for the reduction in gene expression in those studies is not known, but it has been attributed to intracellular degradation of the viral genome, a direct lytic effect of the virus on the cells, inactivation of gene transcription, or immune response against the transduced cells. We speculate that absence of immune response in neonatal mice is the main reason for the long-term expression in these animals. It has been shown that in neonatal mice, B-cell and T-cell responses are impoverished compared with those in adults.18 These reduced responses are the result of deficient accessory cell numbers and function. Adenovirus-mediated gene expression can be greatly prolonged in nude mice compared with that in immune-competent mice.19 The long-term stability of the transgene expression and the absence of inflammatory reaction allow physiological studies on cardiac myocytes from adult mice.
Identification of viable, infected cardiomyocytes was easy and reliable with coinjection of adenovirus expressing GFP and adenovirus expressing ß-gal. Successful cotransfection of cardiomyocytes in vivo has not been reported previously but has been shown in vitro.20 By coinjecting virus encoding GFP and a gene of interest, the transfected cardiomyocytes can therefore be identified and single-cell physiology can be examined. In our study, we showed the feasibility of this approach by measuring physiological function in adult mouse cardiomyocytes isolated 3 weeks after administration of virus encoding GFP. No functional changes were found in GFP-infected cells, which is important for future use of this approach.
Recently, mouse models of cardiac developmental defects,21 cardiac hypertrophy,22 23 24 and dilated cardiomyopathy25 have been developed by overexpression or deletion of specific genes. Our in vivo strategy for gene transfer into the mouse myocardium will allow examination of the ability to rescue such cardiac phenotypes by introduction of genes with subsequent assessment of function at the single-cell level. Because several of these mouse models develop the disordered phenotype around birth25 or after overload,26 and associated increase in wall stress,26B gene delivery in the late embryonic or early postnatal phase would be expected to rescue the cellular phenotype. Gene transfer by use of our protocols may also partly rescue global function of a disordered phenotype, because a recent study in adult rats27 showed altered cardiac function, although only patchy expression of phospholamban was found and inflammatory reaction occurred. Our strategy also allows genetic targeting of the heart prenatally (P.J.G.; Ross, MD; OGorman, PhD; and K.R.C., unpublished observations, 1996) and postnatally (Chen and K.R.C., unpublished observations, 1997) with temporal and spatial control by adenovirus-mediated delivery of Cre recombinase to mouse engineered floxed alleles.5 15 28 29
In conclusion, we have shown temporally and spatially restricted efficient in utero gene transfer to living mouse embryonic and postnatal hearts. Viable myocytes can be detected from coinfection with adenoviral constructs expressing GFP and analyzed for physiological function at the single-cell level. Our approaches provide a useful strategy to couple somatic and germline gene transfer and modification to explore the functional role of calcium cycling genes in cardiac development and diseases.30
| Acknowledgments |
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Received March 22, 1999; revision received July 16, 1999; accepted July 20, 1999.
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