BACKGROUND: Graft survival is the most important factor for morbidity and mortality in cardiac transplantation. Improved immunosuppression significantly reduced early graft rejection. However, acute rejection may predispose to chronic rejection. Targeting both phases of the recipient's immune-reactivity by means of long-acting recombinant adeno-associated viral vectors (AAVs) encoding anti-inflammatory and cardioprotective factors appears to be a promising therapeutic approach. We investigate thymosin   4 (T  4) possessing anti-inflammatory and prosurvival abilities, as a means for pretransplant gene therapy. METHODS: Heterotopic, abdominal transplantation of cardiac allografts into landrace or into Munich mini @entity1707 (n=5 per group) was performed. Transplants were transduced with @entity4700 .9 before transplantation by means of in situ perfusion of the donor organ. Vascuar endothelial growth factor and @entity4700 .9.T  4 or @entity4700 .9.LacZ were added to the autologous blood used for perfusing the grafts for a period of 45 min. Immunosuppression was applied for 10 days after the operation. Transgene expression, capillary density, graft function, survival, and rejection were assessed. RESULTS: The @entity4700 .9 transduction induced robust overexpression of the transgene. In addition, T  4 ameliorated @entity32 , @entity39 , vascular reaction (acute rejection) and in parallel improved capillary density. In addition, graft survival was significantly prolonged (10  3 days @entity4700 .9.LacZ vs. 31  4 days @entity4700 .9.T  4). In the mini @entity1707 model, regional myocardial function of the grafts was improved by T  4 transduction compared to LacZ (9.1%  0.9% subendocardial segment shortening in @entity4700 .9.LacZ vs. 15.8%  2.3% in @entity4700 .9.T  4). CONCLUSION: In situ @entity4700 .9-mediated gene transfer of thymosin b4 attenuated graft rejection in a heterotopic heart transplantation model. Perioperative cardioprotection by means of gene therapy might improve graft survival in cardiac allotransplantation.

Adeno-associated viral vector 2.9 thymosin   4 application attenuates rejection after heart transplantation: results of a preclinical study in the XXXX .

@entity4700 :: ('10804', 'Species') :: ['AAV2'] @entity1707 :: ('9823', 'Species') :: ['pigs', 'pig'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis']
@entity1707 :: (9823,Species) :: ['pig']
