CONTEXT: Previous studies have shown that Cry61, a cysteine-rich gene, can induce angiogenesis to improve arterial flow in rabbits with ischemic limb disease. A swine study demonstrated that neovasculature resulting from the infusion of the gene boosts myocardial blood flow to treat myocardial infarction. Nuclear physician Dr. Pascal Merlet and colleagues in the nuclear medicine department of Hopital Bichat in Paris and the cardiology department of Hopital Universitaire Henri Mondor in Creteil, France, performed the experiment.
RESULTS: Seven pigs with artificially produced myocardial infarction were treated with an epicardial injection of 5 x 108 infectious units of an adenovirus carrying the therapeutic Cyr61 gene. As a control, seven other pigs with artificial infarcts received adenovirus without the agent. Stress-rest technetium-99m sestamibi SPECT perfusion performed four weeks later found a significant decrease in the extent and mean intensity of ischemic defects in the animals treated with the Cyr61 gene compared with the controls (p = 0.02).
IMPLICATIONS: Merlet concluded that the Cyr61 gene transfer stimulates myocardial angiogenesis, prompting great improvement in myocardial perfusion measured with standard SPECT imaging. The findings strengthen the case for Cyr61 as a therapeutic candidate to reverse severe myocardial ischemia.
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