Percutaneous Intramyocardial Septal Radiofrequency Ablation for Interventricular Septal Reduction: An Ovine Model with 1-Year Outcomes

Cardiology ◽  
2019 ◽  
Vol 145 (1) ◽  
pp. 53-62
Author(s):  
Fang Liu ◽  
Jianli Fu ◽  
David Hsi ◽  
Chao Sun ◽  
Guangbin He ◽  
...  

Background: Percutaneous intramyocardial (PIM) septal radiofrequency ablation (SRA) is a novel treatment approach for hypertrophic obstructive cardiomyopathy patients, but there has been lack of a large animal model to study PIM-SRA. We aimed to validate the long-term safety and efficacy of PIM-SRA and to observe pathological changes of the ablated interventricular septum (IVS) in a healthy sheep model. Methods and Results: Twelve sheep were randomized to the PIM-SRA group (n = 6) and the sham group (n = 6). In the PIM-SRA group, a radiofrequency (RF) electrode was inserted into the IVS with a maximum power of 80 W for 5 min. In the sham group, the RF electrode tip was positioned in the IVS segment but without RF power delivery. Septal hypokinesis was seen in all PIM-SRA group animals immediately after the procedure; the systolic wall thickening rate and motion amplitude of the ablated region decreased (p < 0.01), and the diastolic IVS thickness also decreased significantly over time (p < 0.01). ECG showed that all the sheep had normal sinus rhythm during the follow-up. Pathological examinations revealed scar tissue in the ablated region as expected. Conclusions: PIM-SRA produced precisely ablated myocardial tissue, reduced the IVS thickness significantly, preserved the global LV function, and avoided the incidence of conduction system damage in the long term. PIM-SRA was found to be a safe and effective minimally invasive septal reduction therapy.

Blood ◽  
1992 ◽  
Vol 79 (2) ◽  
pp. 356-364 ◽  
Author(s):  
RF Carter ◽  
AC Abrams-Ogg ◽  
JE Dick ◽  
SA Kruth ◽  
VE Valli ◽  
...  

Abstract Retroviral infection of bone marrow cells in long-term marrow cultures (LTMCs) offers several theoretical advantages over other methods for gene transfer into hematopoietic stem cells. To investigate the feasibility of this approach in a large animal model system, we subjected LTMCs from nine dogs to multiple infections with retrovirus containing the neomycin phosphotransferase gene (neo) during 21 days of culture. Feeder layers, cocultivation, polycations, and selection were not used. The in vitro gene transfer efficiency was 70% as determined by polymerase chain reaction amplification of neo sequences in colony- forming unit granulocyte-macrophage (CFU-GM) obtained from day-21 LTMCs. Day-21 LTMC cells were infused into autologous recipients with (four dogs) and without (three dogs) marrow-ablative conditioning. At 3 months posttransplant, up to 10% of marrow cells contained the neo gene. This percentage declined to 0.1% to 1% at 10 to 21 months posttransplant. Neo was also detected in individual CFU-GM, burst- forming unit-erythroid (BFU-E), and CFU-Mix progenitors derived from marrow up to 21 months postinfusion and in cultures of peripheral blood- derived T cells up to 19 months postinfusion. There was no difference in the percentage of neo-marked cells present when dogs that received marrow ablative conditioning were compared with dogs receiving no conditioning. Detection of neo-marked marrow cells almost 2 years after autologous transplantation in a large mammalian species shows that retroviral infection of marrow cells in LTMCs is a potentially nontoxic and efficient protocol for gene transfer. Further, our results suggest that marrow conditioning and in vivo selection pressure to retain transplanted cells may not be absolute requirements for the retention of genetically marked cells in vivo.


2014 ◽  
Vol 85 (6) ◽  
pp. 1026-1032 ◽  
Author(s):  
Anthony Venbrux ◽  
Philippe Gailloud ◽  
Martin G. Radvany ◽  
Leon Rudakov ◽  
Maximilian Y. Emmert ◽  
...  

2003 ◽  
Vol 14 (8) ◽  
pp. 1037-1043 ◽  
Author(s):  
Kamran Ahrar ◽  
Roger E. Price ◽  
Michael J. Wallace ◽  
David C. Madoff ◽  
Sanjay Gupta ◽  
...  

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3265-3265
Author(s):  
Fanyi Zeng ◽  
Mei-Jue Chen ◽  
Zhi-Jian Gong ◽  
Don A. Baldwin ◽  
Hui Qian ◽  
...  

Abstract Abstract 3265 Poster Board III-1 In utero transplantation of large animals (sheep and goats) with human hematopoietic cells has proven valuable in distinguishing subsets of human cells with short- and long-term repopulating activity. Transplantation of secondary and tertiary fetal sheep with cells regenerated in primary sheep has also demonstrated the ability of human hematopoietic stem cells to retain and execute their self-renewal potential in a xenogeneic setting. We now describe the novel extension of this approach to the generation of a BCR-ABL gene transfer-based in vivo model of human myeloproliferative disease. Lin-CD34+ human cord blood (CB) cells were transduced with BCR-ABL retrovirus (MSCV-BCR-ABL-IRES-GFP) and the cells were then injected IP into pre-immune fetal goats at 45–55 days of gestation. This induced a high frequency of abortion among the injected fetuses: 79% (n=22) when >5×104BCR-ABL- transduced CB cells were injected as compared to 64% (n=9) when control (MIG)-transduced cells were injected. Six goats transplanted with 2×104 BCR-ABL-transduced cells were born alive and 3 weeks after birth, 3 of these were sacrificed so that their tissues could be analyzed. Interestingly, in the goats injected with BCR-ABL-transduced human cells, only GFP+(BCR-ABL+) human cells were detected and these were found in multiple hematopoietic and non-hematopoietic tissues, including peripheral blood, bone marrow (BM), liver, kidney, lung, heart, and skeletal and smooth muscle (1–49%) by fluorescence microscopy and confocal laser scanning microscopy, FISH and FACS. Immunohistochemical analysis allowed positive cells to also be detected in frozen sections of liver tissue. Continued follow-up of the other recipients of transduced cells showed that the 3 injected with BCR-ABL-transduced cells all developed features of early chronic phase human chronic myeloid leukemia (CML), as evidenced by a 3- to 5-fold elevation in their WBC count (up to 2.5×1010/L as compared to 5–8×109/L in the recipients of MIG-transduced cells, P<0.01). Changes in the WBC count were seen as early as 3 months after birth and up to 2.5 years post-transplant and were accompanied in all 3 of these goats by the presence of GFP+ cells, including human CD34+ stem/progenitor cells, in the blood and BM. Quantitative real-time PCR analysis of genomic DNA from multiple tissues demonstrated up to 8×104 copies of transgene per microgram of DNA. Microarray transcript profiling of blood and liver from BCR-ABL chimeric goats confirmed expression of many human genes, including 321 that were detected at >2.5-fold higher levels in the BCR-ABL chimeric goats as compared to both control chimeric goats and normal human CB. These over-expressed genes are from several functional categories, including tyrosine kinases and other proteins with phosphorylation activities, cell cycle control, cell adhesion, homing and differentiation, transcription, nucleotide binding and ion transport. Several were confirmed by quantitative RT-PCR. These results demonstrate long-term engraftment, but slow expansion of primitive human hematopoietic cells transduced with BCR-ABL fusion gene and transplanted in utero in a large animal model. This novel xenotransplant goat model should be useful for characterizing the early (pre-symptomatic) phase of human CML and for assessing new therapies with potential long-term benefits. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2002 ◽  
Vol 99 (8) ◽  
pp. 2670-2676 ◽  
Author(s):  
Jane D. Mount ◽  
Roland W. Herzog ◽  
D. Michael Tillson ◽  
Susan A. Goodman ◽  
Nancy Robinson ◽  
...  

Abstract Hemophilia B is an X-linked coagulopathy caused by absence of functional coagulation factor IX (FIX). Using adeno-associated virus (AAV)–mediated, liver-directed gene therapy, we achieved long-term (&gt; 17 months) substantial correction of canine hemophilia B in 3 of 4 animals, including 2 dogs with an FIX null mutation. This was accomplished with a comparatively low dose of 1 × 1012 vector genomes/kg. Canine FIX (cFIX) levels rose to 5% to 12% of normal, high enough to result in nearly complete phenotypic correction of the disease. Activated clotting times and whole blood clotting times were normalized, activated partial thromboplastin times were substantially reduced, and anti-cFIX was not detected. The fourth animal, also a null mutation dog, showed transient expression (4 weeks), but subsequently developed neutralizing anti-cFIX (inhibitor). Previous work in the canine null mutation model has invariably resulted in inhibitor formation following treatment by either gene or protein replacement therapies. This study demonstrates that hepatic AAV gene transfer can result in sustained therapeutic expression in a large animal model characterized by increased risk of a neutralizing anti-FIX response.


2013 ◽  
Vol 62 (18) ◽  
pp. B249
Author(s):  
Athanasios Peppas ◽  
Jon Wilson ◽  
Yanping Cheng ◽  
Christopher Seguin ◽  
Masahiko Shibuya ◽  
...  

2015 ◽  
Vol 112 (43) ◽  
pp. E5844-E5853 ◽  
Author(s):  
William A. Beltran ◽  
Artur V. Cideciyan ◽  
Simone Iwabe ◽  
Malgorzata Swider ◽  
Mychajlo S. Kosyk ◽  
...  

Inherited retinal degenerations cause progressive loss of photoreceptor neurons with eventual blindness. Corrective or neuroprotective gene therapies under development could be delivered at a predegeneration stage to prevent the onset of disease, as well as at intermediate-degeneration stages to slow the rate of progression. Most preclinical gene therapy successes to date have been as predegeneration interventions. In many animal models, as well as in human studies, to date, retinal gene therapy administered well after the onset of degeneration was not able to modify the rate of progression even when successfully reversing dysfunction. We evaluated consequences of gene therapy delivered at intermediate stages of disease in a canine model of X-linked retinitis pigmentosa (XLRP) caused by a mutation in the Retinitis Pigmentosa GTPase Regulator (RPGR) gene. Spatiotemporal natural history of disease was defined and therapeutic dose selected based on predegeneration results. Then interventions were timed at earlier and later phases of intermediate-stage disease, and photoreceptor degeneration monitored with noninvasive imaging, electrophysiological function, and visual behavior for more than 2 y. All parameters showed substantial and significant arrest of the progressive time course of disease with treatment, which resulted in long-term improved retinal function and visual behavior compared with control eyes. Histology confirmed that the humanRPGRtransgene was stably expressed in photoreceptors and associated with improved structural preservation of rods, cones, and ON bipolar cells together with correction of opsin mislocalization. These findings in a clinically relevant large animal model demonstrate the long-term efficacy ofRPGRgene augmentation and substantially broaden the therapeutic window for intervention in patients withRPGR-XLRP.


Blood ◽  
1992 ◽  
Vol 79 (2) ◽  
pp. 356-364 ◽  
Author(s):  
RF Carter ◽  
AC Abrams-Ogg ◽  
JE Dick ◽  
SA Kruth ◽  
VE Valli ◽  
...  

Retroviral infection of bone marrow cells in long-term marrow cultures (LTMCs) offers several theoretical advantages over other methods for gene transfer into hematopoietic stem cells. To investigate the feasibility of this approach in a large animal model system, we subjected LTMCs from nine dogs to multiple infections with retrovirus containing the neomycin phosphotransferase gene (neo) during 21 days of culture. Feeder layers, cocultivation, polycations, and selection were not used. The in vitro gene transfer efficiency was 70% as determined by polymerase chain reaction amplification of neo sequences in colony- forming unit granulocyte-macrophage (CFU-GM) obtained from day-21 LTMCs. Day-21 LTMC cells were infused into autologous recipients with (four dogs) and without (three dogs) marrow-ablative conditioning. At 3 months posttransplant, up to 10% of marrow cells contained the neo gene. This percentage declined to 0.1% to 1% at 10 to 21 months posttransplant. Neo was also detected in individual CFU-GM, burst- forming unit-erythroid (BFU-E), and CFU-Mix progenitors derived from marrow up to 21 months postinfusion and in cultures of peripheral blood- derived T cells up to 19 months postinfusion. There was no difference in the percentage of neo-marked cells present when dogs that received marrow ablative conditioning were compared with dogs receiving no conditioning. Detection of neo-marked marrow cells almost 2 years after autologous transplantation in a large mammalian species shows that retroviral infection of marrow cells in LTMCs is a potentially nontoxic and efficient protocol for gene transfer. Further, our results suggest that marrow conditioning and in vivo selection pressure to retain transplanted cells may not be absolute requirements for the retention of genetically marked cells in vivo.


2016 ◽  
Vol 38 (03) ◽  
pp. 215-221
Author(s):  
Jae Murphy ◽  
Sarah Vreugde ◽  
Alkis Psaltis ◽  
P. Wormald ◽  
Alistair Jukes

AbstractNano-hemostats are synthetic amino acid chains that self-assemble into a scaffold under certain conditions. These have been shown to be effective in stopping bleeding in small animal models of hemorrhage. Proposed mechanisms for their effect are that they form a mesh analogous to the fibrin plug in native hemostasis and that they may potentiate both platelet activation and the coagulation cascade. These may potentially become valuable adjuncts to endoscopic skull base surgery where there is the potential for both major vessel injury and smaller perforator injury to eloquent areas where bipolar cautery may not be suitable. We present a summary of the clinical studies to date and a small pilot study of nano-hemostat in an endoscopic sheep model of major vessel hemorrhage to determine its efficacy in stopping bleeding in this potentially catastrophic complication.


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