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on December 31, 2001

Circulation. 2001
Published online before print December 31, 2001, doi: 10.1161/hc0602.103673
A more recent version of this article appeared on February 12, 2002
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Submitted on October 12, 2001
Revised on November 29, 2001
Accepted on December 14, 2001

Endothelial Progenitor Cell Vascular Endothelial Growth Factor Gene Transfer for Vascular Regeneration

Hideki Iwaguro MD, Jun-ichi Yamaguchi MD, PhD, Christoph Kalka MD, Satoshi Murasawa MD, PhD, Haruchika Masuda MD, PhD, Shin-ichiro Hayashi MD, PhD, Marcy Silver BS, Tong Li MD, Jeffrey M. Isner MD, and Takayuki Asahara MD, PhD*

From the Division of Cardiovascular Research and Medicine (H.I., J.Y., C.K., S.M., H.M., S.H., M.S., T.L., J.M.I., T.A.), St Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Mass; and the Department of Physiology (H.I.) and Institute of Medical Science (T.A.), Tokai University School of Medicine, Japan.

* To whom correspondence should be addressed. E-mail: asa777{at}aol.com.

Background—Previous studies have established that bone marrow--derived endothelial progenitor cells (EPCs) are present in the systemic circulation. In the current study, we investigated the hypothesis that gene transfer can be used to achieve phenotypic modulation of EPCs.

Methods and Results—In vitro, ex vivo murine vascular endothelial growth factor (VEGF) 164 gene transfer augmented EPC proliferative activity and enhanced adhesion and incorporation of EPCs into quiescent as well as activated endothelial cell monolayers. To determine if such phenotypic modulation may facilitate therapeutic neovascularization, heterologous EPCs transduced with adenovirus encoding VEGF were administered to athymic nude mice with hindlimb ischemia; neovascularization and blood flow recovery were both improved, and limb necrosis/autoamputation were reduced by 63.7% in comparison with control animals. The dose of EPCs used for the in vivo experiments was 30 times less than that required in previous trials of EPC transplantation to improve ischemic limb salvage. Necropsy analysis of animals that received DiI-labeled VEGF-transduced EPCs confirmed that enhanced EPC incorporation demonstrated in vitro contributed to in vivo neovascularization as well.

Conclusions—In vitro, VEGF EPC gene transfer enhances EPC proliferation, adhesion, and incorporation into endothelial cell monolayers. In vivo, gene-modified EPCs facilitate the strategy of cell transplantation to augment naturally impaired neovascularization in an animal model of experimentally induced limb ischemia.


Key words: gene therapy • endothelium • angiogenesis • ischemia




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K.-i. Hiasa, M. Ishibashi, K. Ohtani, S. Inoue, Q. Zhao, S. Kitamoto, M. Sata, T. Ichiki, A. Takeshita, and K. Egashira
Gene Transfer of Stromal Cell-Derived Factor-1{alpha} Enhances Ischemic Vasculogenesis and Angiogenesis via Vascular Endothelial Growth Factor/Endothelial Nitric Oxide Synthase-Related Pathway: Next-Generation Chemokine Therapy for Therapeutic Neovascularization
Circulation, May 25, 2004; 109(20): 2454 - 2461.
[Abstract] [Full Text] [PDF]


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FASEB J.Home page
L. G. MELO, A. S. PACHORI, D. KONG, M. GNECCHI, K. WANG, R. E. PRATT, and V. J. DZAU
Gene and cell-based therapies for heart disease
FASEB J, April 1, 2004; 18(6): 648 - 663.
[Abstract] [Full Text] [PDF]


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CirculationHome page
J. Rehman, D. Traktuev, J. Li, S. Merfeld-Clauss, C. J. Temm-Grove, J. E. Bovenkerk, C. L. Pell, B. H. Johnstone, R. V. Considine, and K. L. March
Secretion of Angiogenic and Antiapoptotic Factors by Human Adipose Stromal Cells
Circulation, March 16, 2004; 109(10): 1292 - 1298.
[Abstract] [Full Text] [PDF]


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JEMHome page
M. Xaymardan, J. Zheng, I. Duignan, A. Chin, J. M. Holm, V. L.T. Ballard, and J. M. Edelberg
Senescent Impairment in Synergistic Cytokine Pathways That Provide Rapid Cardioprotection in the Rat Heart
J. Exp. Med., March 15, 2004; 199(6): 797 - 804.
[Abstract] [Full Text] [PDF]


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StrokeHome page
E. Ribourtout and J. Raymond
Gene Therapy and Endovascular Treatment of Intracranial Aneurysms
Stroke, March 1, 2004; 35(3): 786 - 793.
[Abstract] [Full Text] [PDF]


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DevelopmentHome page
K. M. Downs, E. R. Hellman, J. McHugh, K. Barrickman, and K. E. Inman
Investigation into a role for the primitive streak in development of the murine allantois
Development, January 1, 2004; 131(1): 37 - 55.
[Abstract] [Full Text] [PDF]


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CirculationHome page
H.-J. Cho, H.-S. Kim, M.-M. Lee, D.-H. Kim, H.-J. Yang, J. Hur, K.-K. Hwang, S. Oh, Y.-J. Choi, I.-H. Chae, et al.
Mobilized Endothelial Progenitor Cells by Granulocyte-Macrophage Colony-Stimulating Factor Accelerate Reendothelialization and Reduce Vascular Inflammation After Intravascular Radiation
Circulation, December 9, 2003; 108(23): 2918 - 2925.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
C. Herder, T. Tonn, R. Oostendorp, S. Becker, U. Keller, C. Peschel, M. Grez, and E. Seifried
Sustained Expansion and Transgene Expression of Coagulation Factor VIII-Transduced Cord Blood-Derived Endothelial Progenitor Cells
Arterioscler Thromb Vasc Biol, December 1, 2003; 23(12): 2266 - 2272.
[Abstract] [Full Text] [PDF]


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CirculationHome page
P. E. Szmitko, C.-H. Wang, R. D. Weisel, G. A. Jeffries, T. J. Anderson, and S. Verma
Biomarkers of Vascular Disease Linking Inflammation to Endothelial Activation: Part II
Circulation, October 28, 2003; 108(17): 2041 - 2048.
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BloodHome page
B. R. Stoll, C. Migliorini, A. Kadambi, L. L. Munn, and R. K. Jain
A mathematical model of the contribution of endothelial progenitor cells to angiogenesis in tumors: implications for antiangiogenic therapy
Blood, October 1, 2003; 102(7): 2555 - 2561.
[Abstract] [Full Text] [PDF]


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CirculationHome page
J. S. Forrester, M. J. Price, and R. R. Makkar
Stem Cell Repair of Infarcted Myocardium: An Overview for Clinicians
Circulation, September 2, 2003; 108(9): 1139 - 1145.
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BloodHome page
C. Heeschen, A. Aicher, R. Lehmann, S. Fichtlscherer, M. Vasa, C. Urbich, C. Mildner-Rihm, H. Martin, A. M. Zeiher, and S. Dimmeler
Erythropoietin is a potent physiologic stimulus for endothelial progenitor cell mobilization
Blood, August 15, 2003; 102(4): 1340 - 1346.
[Abstract] [Full Text] [PDF]


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Am. J. Physiol. Heart Circ. Physiol.Home page
T.-S. Li, K. Hamano, M. Nishida, M. Hayashi, H. Ito, A. Mikamo, and M. Matsuzaki
CD117+ stem cells play a key role in therapeutic angiogenesis induced by bone marrow cell implantation
Am J Physiol Heart Circ Physiol, August 7, 2003; 285(3): H931 - H937.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
M. Hristov, W. Erl, and P. C. Weber
Endothelial Progenitor Cells: Mobilization, Differentiation, and Homing
Arterioscler Thromb Vasc Biol, July 1, 2003; 23(7): 1185 - 1189.
[Abstract] [Full Text] [PDF]


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CirculationHome page
C. Patterson
The Ponzo Effect: Endothelial Progenitor Cells Appear on the Horizon
Circulation, June 24, 2003; 107(24): 2995 - 2997.
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CirculationHome page
P. E. Szmitko, P. W.M. Fedak, R. D. Weisel, D. J. Stewart, M. J.B. Kutryk, and S. Verma
Endothelial Progenitor Cells: New Hope for a Broken Heart
Circulation, June 24, 2003; 107(24): 3093 - 3100.
[Full Text] [PDF]


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Circ. Res.Home page
H. M. Nugent and E. R. Edelman
Tissue Engineering Therapy for Cardiovascular Disease
Circ. Res., May 30, 2003; 92(10): 1068 - 1078.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
A. Luttun and P. Carmeliet
De novo vasculogenesis in the heart
Cardiovasc Res, May 1, 2003; 58(2): 378 - 389.
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Cardiovasc ResHome page
H. Masuda and T. Asahara
Post-natal endothelial progenitor cells for neovascularization in tissue regeneration
Cardiovasc Res, May 1, 2003; 58(2): 390 - 398.
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Cardiovasc ResHome page
T. Suzuki, M. Nishida, S. Futami, K. Fukino, T. Amaki, K. Aizawa, S. Chiba, H. Hirai, K. Maekawa, and R. Nagai
Neoendothelialization after peripheral blood stem cell transplantation in humans: A case report of a Tokaimura nuclear accident victim
Cardiovasc Res, May 1, 2003; 58(2): 487 - 492.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. Aicher, W. Brenner, M. Zuhayra, C. Badorff, S. Massoudi, B. Assmus, T. Eckey, E. Henze, A. M. Zeiher, and S. Dimmeler
Assessment of the Tissue Distribution of Transplanted Human Endothelial Progenitor Cells by Radioactive Labeling
Circulation, April 29, 2003; 107(16): 2134 - 2139.
[Abstract] [Full Text] [PDF]


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FASEB J.Home page
T. M. DOHERTY, P. K. SHAH, and T. B. RAJAVASHISTH
Cellular origins of atherosclerosis: towards ontogenetic endgame?
FASEB J, April 1, 2003; 17(6): 592 - 597.
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CirculationHome page
J. Rehman, J. Li, C. M. Orschell, and K. L. March
Peripheral Blood "Endothelial Progenitor Cells" Are Derived From Monocyte/Macrophages and Secrete Angiogenic Growth Factors
Circulation, March 4, 2003; 107(8): 1164 - 1169.
[Abstract] [Full Text] [PDF]


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CirculationHome page
E. C. Perin, Y.-J. Geng, and J. T. Willerson
Adult Stem Cell Therapy in Perspective
Circulation, February 25, 2003; 107(7): 935 - 938.
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CirculationHome page
O. M. Tepper, R. D. Galiano, J. M. Capla, C. Kalka, P. J. Gagne, G. R. Jacobowitz, J. P. Levine, and G. C. Gurtner
Human Endothelial Progenitor Cells From Type II Diabetics Exhibit Impaired Proliferation, Adhesion, and Incorporation Into Vascular Structures
Circulation, November 26, 2002; 106(22): 2781 - 2786.
[Abstract] [Full Text] [PDF]


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J. Appl. Physiol.Home page
Y. Yang, J.-Y. Min, J. S. Rana, Q. Ke, J. Cai, Y. Chen, J. P. Morgan, and Y.-F. Xiao
VEGF enhances functional improvement of postinfarcted hearts by transplantation of ESC-differentiated cells
J Appl Physiol, September 1, 2002; 93(3): 1140 - 1151.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. Murasawa, J. Llevadot, M. Silver, J. M. Isner, D. W. Losordo, and T. Asahara
Constitutive Human Telomerase Reverse Transcriptase Expression Enhances Regenerative Properties of Endothelial Progenitor Cells
Circulation, August 27, 2002; 106(9): 1133 - 1139.
[Abstract] [Full Text] [PDF]


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CirculationHome page
E. G. Nabel
Stem Cells Combined With Gene Transfer for Therapeutic Vasculogenesis: Magic Bullets?
Circulation, February 12, 2002; 105(6): 672 - 674.
[Full Text] [PDF]