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| Author(s): |
Vanessa Boury Faiotto
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2014-12-19 |
| Examining board members: |
Erich Vinicius De Paula;
Fernando Luiz Affonso Fonseca;
Luiz Fernando Bittar Sckayer
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| Advisor: | Erich Vinicius De Paula |
| Abstract | |
Sepsis represents a potentially fatal condition that occurs when the body's response to infection results in injury to its own tissues. Gene therapy (GT) consists in modification of the repertory of somatic cells with therapeutic purposes, replacing defective genes that cause diseases. In sepsis, non-viral vectors, could represent an excellent strategy for therapeutic gene transfer, since they do not elicit intense immune responses in the individual and are expressed only transiently. Besides, their production is easy and inexpensive. Methods: The study was divided in 3 steps. First, two reporter genes (lacZ and F9) were tested in two experimental models of sepsis (endotoxemia and cecal ligation and puncture, CLP) to confirm the feasibility of gene transfer in the context of sepsis. We assessed expression by qualitative (histochemistry) and quantitative methods (functional evaluation, through coagulometric methods). Next we evaluated the efficacy of the therapeutic gene transfer of sFlt-1, a natural VEGF antagonist, in the endotoxemia model. Expression was evaluated by ELISA, and efficacy was evaluated by a survival curve. Mice were treated with pDNA containing the Flt1 (treatment) or lacZ (control) cDNA, 6 hours after challenge with LPS. Of note, sFlt-1 has been previously shown to protect from experimental sepsis due to its endothelial barrier (EB) stabilizing properties. In the last step, we evaluated serum levels of 4 proteins involved in the modulation of EB integrity, using serum samples of subjects diagnosed with severe sepsis and septic shock (n=53), through a commercial Multiplex kit. Results: In the first step, we could confirm the expression of both reporter genes by non-viral vectors in the endotoxemia model. Of note, expression of ?-galactosidase showed a notable increase when compared with control group. Similarly, we noted increased expression of factor IX in the mice which were submitted to gene transfer with pDNA, when compared with the controls that received the lacZ pDNA (111,4 ± 16,10 vs 64,73 ± 12,34; p<0,001) in the endotoxemia model, and similar result in the group without sepsis induction by endotoxemia (163,4± 73,46 vs 79,88 ± 9,39; p=0,0006). Expression was not confirmed in the CLP model, although the limited number of animals per group does not allow a definite conclusion on this matter. In relation to the second step, only 4/14 treated animals presented detectable levels of sFlt-1 by Elisa. In addition, no difference could be observed in the survival between treated and control animals. Together, these results confirme that gene transfer with non-viral vectors is feasible in the context of severe inflammation, but with a low efficiency and predictability. Finally, we demonstrated significant differences in serum levels of endoglin (higher expression) and HB-EGF (lower expression) in patients with septic shock, compared to controls. BMP-9 and FGF-2 levels were not significantly different in septic shock. Conclusions: Our study allows us to conclude that although feasible, the use of non-viral vectors does not seem to represent an effective therapeutic strategy in experimental sepsis. Larger studies are needed to validate the use of endoglin and HB-EGF as biomarkers of severe sepsis (AU) | |
| FAPESP's process: | 12/10752-7 - Pre-clinical evaluation of a therapeutic strategy of murine experimental sepsis based on gene therapy with non-viral vectors expressing sFlt-1 |
| Grantee: | Vanessa Boury Faiotto |
| Support Opportunities: | Scholarships in Brazil - Master |