Key result
rAAV.Tβ4 improves ejection fraction in diabetic ischemic hearts, but less efficiently than in wild-type hearts.
Why the study?
Diabetes causes microcirculatory rarefaction, which may impair ischemic myocardial responsiveness to proangiogenic factors, but whether microvascular destabilization affects organ function and therapeutic neovascularization was unknown.
Does therapeutic neovascularization with rAAV.Tβ4 or rAAV.VEGF-A improve myocardial vascularization and ejection fraction in diabetic models of chronic ischemia?
Population
Explanted human hearts from end-stage heart failure patients, plus diabetic and wild-type pigs
Comparison
Diabetic vs wild-type hearts and treatment with rAAV.Tb4 vs rAAV.VEGF-A
Design
Translational human explant and porcine experimental study
Authors
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“It will be a while before this kind of therapy can be used in humans. But we were able to show for the first time in a transgenic large animal model, which closely models human type I diabetes mellitus, how diabetes damages the heart. That opens up new perspectives for treating patients. It also further reinforces our awareness of how important it is to diagnose diabetes early.”
“These cells normally form a layer wrapped around the small blood vessels. We believe that this layer has a stabilizing function. When it is damaged, the entire blood vessel becomes unstable and ultimately breaks up.”
rAAV.Tβ4 shows blunted EF benefit in diabetic models; hypothesis-generating for microvascular-targeted therapies in diabetes.
Does therapeutic neovascularization with rAAV.Tβ4 or rAAV.VEGF-A improve myocardial vascularization and ejection fraction in diabetic models of chronic ischemia?
Absolute Event Rate: 34.5% vs 44.8%
Diabetes mellitus causes microvascular destabilization and capillary rarefaction, which blunts the efficacy of therapeutic neovascularization with rAAV.Tβ4 in a large animal model of chronic ischemia.
Hinkel et al. (2017) studied End-stage heart failure and chronic myocardial ischemia in diabetes mellitus. rAAV.Tβ4 vs. rAAV.VEGF-A and wild-type controls was evaluated on Ejection fraction (EF). Therapeutic neovascularization with rAAV.Tβ4 improved ejection fraction in diabetic ischemic hearts (34.5%), but less efficiently than in wild-type hearts (44.8%).
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