(Circulation. 2000;102:1308.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
From the Department of Geriatric Medicine (K.Y., R.M., N.T., H.N., M.A., J.H., T.O.) and the Division of Gene Therapy Science (R.M., Y.K.), Osaka University Medical School, Suita; BILIS (T.S.), Shiga; and Toyohashi Technology University (A.K.), Toyohashi, Japan.
Correspondence to Ryuichi Morishita, MD, PhD, Associate Professor, Division of Gene Therapy Science, Osaka University Medical School, Suita 565, Japan. E-mail morishit{at}geriat.med.osaka-u.ac.jp
| Abstract |
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Methods and ResultsWe constructed ribozyme oligonucleotides (ONs) targeted to the sequence of the TGF-ß gene that shows 100% homology among the human, rat, and mouse species. The specificity of ribozyme against TGF-ß gene was confirmed by selective inhibition of TGF-ß mRNA in cultured vascular smooth muscle cells as well as balloon-injured blood vessels in vivo. Importantly, the marked decrease in TGF-ß resulted in significant inhibition of neointimal formation after vascular injury in a rat carotid artery model (P<0.01), whereas DNA-based control ONs and mismatched ribozyme ONs did not have any inhibitory effect on neointimal formation. Inhibition of neointimal formation was accompanied by (1) a reduction in collagen synthesis and mRNA expression of collagen I and III and (2) a significant decrease in DNA synthesis as assessed by proliferating cell nuclear antigen staining. Moreover, we modified ribozyme ONs containing phosphorothioate DNA and RNA targeted to the TGF-ß gene. Of importance, modified ribozyme ONs showed a further reduction in TGF-ß expression.
ConclusionsOverall, this study provides the first evidence that selective blockade of TGF-ß resulted in inhibition of neointimal formation, accompanied by a reduction in collagen synthesis and DNA synthesis in a rat model. We anticipate that modification of ribozyme ON pharmacokinetics will facilitate the potential clinical utility of the ribozyme strategy.
Key Words: atherosclerosis growth substances gene therapy enzymes
| Introduction |
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| Methods |
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In Vivo Gene Transfer
A 2F Fogarty catheter was used to induce vascular injury in male
Sprague-Dawley rats (400 to 500 g; Charles River Breeding
Laboratories, Shizuoka, Japan).12 13 In vivo gene
transfer was performed under the following conditions: vascular injury
of the common carotid artery was induced by the passage and inflation
of a balloon catheter through an arteriotomy in the external carotid
artery 3 times. The injured segment was transiently isolated with
temporary ligatures. Then, 200 µL hemagglutinating virus of Japan
(HVJ)liposome complex containing either ribozyme ONs, DNA-control
ONs, or mismatched ONs (each at 1 µmol/L contained in liposome)
was incubated within the lumen for 10 minutes at room temperature. At 2
weeks after transfection, each carotid artery was processed for
morphological study.12 13 For histological
analyses, a segment of each artery was perfusion-fixed with 4%
paraformaldehyde at physiological
pressure (110 mm Hg) and subsequently processed. Areas of media
and lumen were measured on a digitizing tablet (Power Laboratory) after
staining with hematoxylin. At least 3 individual sections from the
middle of the transfected arterial segments were
analyzed. Animals were coded so that in the analysis,
the researcher did not know which treatment each individual animal had
received.
Preparation of HVJ-Liposome
We used HVJ-coated liposome, which is reported to provide highly
efficient transfection of cells in culture.12 13 14 15 16 Briefly,
phosphatidylserine, phosphatidylcholine, and
cholesterol were mixed in a weight ratio of 1:4.8:2 to
create a lipid mixture. Purified HVJ (Z strain) was
inactivated by UV irradiation before use. The liposome
suspension was mixed with HVJ, and then free HVJ was removed by sucrose
density gradient centrifugation. This preparation
method has been optimized to achieve maximal transfection efficiency as
reported previously.15
In Vivo Transfection of FITC-Labeled Ribozyme ONs
FITC-labeled ribozyme ONs on the 3' and 5' ends were provided by
Nihon Seifun Inc. Transfer of FITC-labeled ribozyme ONs was performed
according to the following protocol; HVJ complex with FITC-labeled
ribozyme ONs (1 µmol/L) was incubated for 10 minutes. The
vessels were harvested 2 weeks after transfection and perfusion-fixed
with 4% paraformaldehyde. Sections were examined by
fluorescence microscopy after staining in Erichrome black T
solution. Elastic fibers stained dark red and were readily
distinguishable from the specific FITC-labeled ribozyme ONs by
treatment with Erichrome black T solution.17
Northern Blot Analysis
RNA was extracted from injured vessels transfected with ribozyme
ONs (1 µmol/L wrapped in liposome) treated with RNAzol (Tel-Test
Inc) at 1 and 7 days after transfection. Contralateral arteries in
ribozyme ONtransfected animals were also used as intact arteries.
Levels of TGF-ß (1 day after transfection) and collagen I and III (7
days after transfection) mRNA were measured by Northern blot
analysis. The filter was baked, prehybridized, and hybridized
with mouse TGF-ß probe (pMTGFbeta, American Type Culture Collection),
collagen I and III probes (donated by Dr S. Kim, Osaka City
University), and G3PDH probe (Clontech Laboratories, Inc).
Immunohistochemistry
Sections were dewaxed, rehydrated, and incubated with PBS
containing 0.3% hydrogen peroxide to reduce endogenous
peroxidase activity. The sections were then incubated with primary
antibodies or lectin diluted in PBS with 10% horse serum at room
temperature for 60 minutes. After 3 washings in Tris-buffered saline
containing 2% horse serum, species-appropriate biotinylated secondary
antibodies were applied, followed by avidin-biotin peroxidase complex
(Vectastain ABC kit, PK 6100, Vector Laboratories). Omission of primary
antibodies and staining with type- and class-matched irrelevant
immunoglobulin served as a negative control for each antibody. A
monoclonal antibody for collagen I and III (mouse IgG, Chemicon)
recognizes collagen I and III.
Sirius Red Method for Collagen Staining
Sirius red microscopy detects interstitial collagen,
including types I and III.18 19 The stained
sections were observed under polarized light and photographed with the
same exposure time for each section. Analysis of Sirius red
staining was performed with a computer-based quantitative color image
analysis system. Photographs were scanned into a
1000x1000 image buffer of the Optimas 5.2 image
analysis system (Optimas Co). A color threshold mask for
immunostaining was defined to detect the red color by
sampling, and the same threshold was applied to all specimens. The
percentage of the total area with positive color was recorded for
each section.
Quantification of Cell Proliferation in Medial
Lesions
Paraffin-embedded sections of carotid artery harvested 4 days
after transfection were used for quantification of cell
proliferation.7 8 Four sections of each vessel spaced at
0.4-mm intervals were measured by a computerized image analyzer
system (Image Command 5098, Olympus). Monoclonal antibody against
proliferating cell nuclear antigen (PCNA; PC-10; 1:500; DAKO) was used
as a specific marker for proliferating cells. The number of
PCNA-positive nuclei was counted in the medium by the image
analysis system at x400 magnification. Frequency of cell
proliferation was expressed as PCNA index, defined as the ratio of the
number of PCNA-positive nuclei to the total number of nuclei in the
media. Samples were coded so that the analysis was performed
without knowledge of which treatment each individual vessel had
received.
Statistical Analysis
All values are expressed as mean±SEM. ANOVA with subsequent
Bonferronis test was used to determine the significance of
differences in multiple comparisons. A value of P<0.05 was
considered statistically significant.
| Results |
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Given the successful transfection of ribozyme ONs into balloon-injured
vessels, we next examined the in vivo inhibitory effect of
ribozyme TGF-ß ONs on TGF-ß expression induced by vascular injury.
As shown in Figure 1
, ribozyme ONs can cleave the mRNA of
TGF-ß at +817, based on the reported sequence,9 10 11
whereas other genes theoretically cannot be cleaved by ribozyme ONs. In
the present study, we used DNA-based control ONs and mismatched
ribozyme ONs as negative controls, because both control ONs have no
catalytic activity. Neither DNA-ribozyme nor mismatched ribozyme ONs
inhibited TGF-ß expression induced by vascular injury (Figure 3
). No change in TGF-ß expression was
observed in untransfected blood vessels. In contrast, transfection of
ribozyme TGF-ß ONs significantly decreased TGF-ß expression
(P<0.01, Figure 3
). Thus, we examined the effect of
ribozyme TGF-ß ONs on neointimal formation after vascular
injury in the rat carotid artery. As shown in Figure 4
, untreated, DNA-based control
ONtransfected, and mismatched ribozyme ONtransfected (1
µmol/L) vessels exhibited neointimal formation at 2 weeks
after transfection. In contrast, a single administration of ribozyme
TGF-ß ONs (1 µmol/L) resulted in a significant reduction in
neointimal formation (P<0.01; Figure
4B). Ribozyme ON treatment did not alter the medial area
(Table
). The reduction in
neointimal formation was limited to transfected regions
(data not shown). In addition, treatment with antisense thrombomodulin
oligodeoxynucleotide had no effect on the ratio of
neointimal to medial area as an additional negative control
(data not shown).
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It is noteworthy how inhibition of TGF-ß resulted in the blockade of
neointimal formation. Given the previous reports that
TGF-ß stimulated extracellular matrix through the induction of
collagen expression,6 7 8 we postulated that inhibition of
TGF-ß would interfere with the matrix structure. Indeed, we have
observed that mRNAs of collagen I and III were also reduced by ribozyme
TGF-ß ONs, whereas they were induced after vascular injury (Figures 5
and 6
).
In contrast, treatment with DNA-based control ONs or mismatched
ribozyme ONs had no effect on collagen mRNA expression (Figures
5 and 6). The reduction of collagen I and III in blood vessels
transfected with ribozyme TGF-ß ONs was also confirmed by the
observation that positive immunohistochemical staining of collagen I
and III was markedly decreased by ribozyme TGF-ß ONs but not
mismatched ribozyme ONs (Figure 7A
and 7B
). In addition, we performed Sirius red staining for collagen,
because Sirius red staining under polarized light visualizes collagen,
including types I and III.19 Further evidence for the
inhibition of extracellular matrix deposition was provided by the
observation that treatment with ribozyme TGF-ß ONs decreased collagen
content, as assessed by quantitative color image analysis using
Sirius red staining (P<0.01, Figure 8
). Blood vessels transfected with
ribozyme TGF-ß ONs showed less positive Sirius red staining,
indicating a low content of interstitial collagen (Figure
8). In contrast, blood vessels transfected with mismatched
ribozyme ONs exhibited substantial accumulation of
interstitial collagen within the neointima
(Figure 8
). In addition, as shown in Figure 9A
, PCNA-stained nuclei were observed in
the neointimal and medial layers of blood vessels at 4 days
after vascular injury. Transfection of ribozyme ONs resulted in a
significant decrease in the ratio of PCNA-positive nuclei to total
cells at 4 days after transfection compared with blood vessels
transfected with mismatched ribozyme ONs (P<0.01, Figure
9B). In contrast, untransfected intact carotid arteries
exhibited few PCNA-stained nuclei.
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| Discussion |
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The present study demonstrated that ribozyme ONs against TGF-ß selectively inhibited TGF-ß production without affecting other genes. The specificity of the inhibitory effect of ribozyme ONs on TGF-ß production presented in this study is supported by several lines of evidence: (1) Ribozyme ONs inhibited TGF-ß expression in vivo, whereas DNA-control ONs and mismatched ONs did not. (2) Ribozyme TGF-ß ONs inhibited TGF-ß but not G3PDH expression, as assessed by Northern blotting in human cultured VSMCs. High transfection efficiency of the HVJ-liposome method into blood vessels has been reported in balloon-injury and vein graft models.12 13 15 16 23 30 31 32 With nucleus-targeted LacZ, transfection of the LacZ gene exhibited diffuse and frequent X-Galpositive signals in both medial and adventitial layers in vein grafts,30 consistent with a previous report.31 Similar results were also obtained with immunohistochemical staining against nitric oxide in vessels transfected with endothelial constitutive nitric oxide synthase.30 32 In addition, Yonemitsu et al15 documented that HVJ liposomes could achieve highly efficient gene transfection into the medial smooth muscle cells of intact arteries at 150 and 760 mm Hg of pressure (mean=85.3% and 93.5% of total smooth muscle cells, respectively). Moreover, the sufficient transfection efficiency of the HVJ-liposome method to inhibit neointimal formation was also supported by the previous publications.32 33 In contrast, the previous reports documented the expression of TGF-ß in balloon-injured arteries.26 34 35 By in situ hybridization, Smith et al26 reported that proliferating and quiescent smooth muscle cells in denuded vessels expressed high levels of mRNA for TGF-ß. A similar expression pattern of TGF-ß has also been reported.34 35 The localization of transfected cells seems to be identical to that of cells producing TGF-ß.
Using ribozyme ONs against TGF-ß, the present study demonstrated that inhibition of TGF-ß by ribozyme ONs resulted in a significant reduction in neointimal formation in a rat balloon-injury model. How do ribozyme TGF-ß ONs inhibit neointimal formation? As expected, the inhibition of neointimal formation was accompanied by a marked reduction in collagen synthesis and mRNA expression and protein content of collagen I and III, because TGF-ß stimulated extracellular matrix formation. Moreover, ribozyme TGF-ß ONs also significantly reduced DNA synthesis in VSMCs, as assessed by PCNA staining. Although previous reports documented an antiproliferative action of TGF-ß in cultured cells,27 28 29 the in vivo effects of TGF-ß might be mitogenic, consistent with previous reports.24 25 26 These results together suggest that TGF-ß contributes to the restenosis process through the accumulation of collagen synthesis and increase in DNA synthesis of VSMCs rather than antiproliferative actions in vivo. Moreover, this is the first report of successful in vivo application of ribozyme ON technology progressing toward human gene therapy in cardiovascular disease. The practical use of these ribozyme ONs as therapy for atherosclerosis induced by high TGF-ß is dependent on the development of a delivery system into blood vessels. Further studies are necessary to test the efficacy of ribozyme ONs in vivo to examine the therapeutic application. Here, we revealed the first evidence that TGF-ß expression can be selectively prevented by ribozyme ONs directed against the TGF-ß gene, suggesting a novel therapeutic strategy for the treatment of cardiovascular disease related to high TGF-ß. The selective blockade of TGF-ß is particularly attractive, because ribozyme TGF-ß ONs prevented neointimal formation, accompanied by a reduction in collagen synthesis and DNA synthesis in the rat model.
| Acknowledgments |
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Received January 7, 2000; revision received April 7, 2000; accepted April 13, 2000.
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