Shelby Meier1, Jose Abisambra2, J Brandon3, Assaf Gilad4, and Moriel Vandsburger1,5
1Physiology, University of Kentucky, Lexington, KY, United States, 2Physiology, University of Kentucky, 3University of Kentucky, 4Radiology and Radiological Sciences, Johns Hopkins University, 5Bioengineering, U.C. Berkeley, Berkeley, CA, United States
Synopsis
We utilized cardiac chemical exchange saturation transfer MRI and an artificial reporter gene, the Lysine Rich Protein (LRP), to image gene transfer in the mouse heart using 2 routes of viral vector administration.
Purpose
Cardiac gene therapy is emerging as a potential avenue by which to
prevent or treat adult heart failure without mechanical intervention (1, 2). In order to promote the development of such therapies it is necessary
to correlate gene delivery and expression patterns with functional outcomes.
Cardiac magnetic resonance is well suited for measurement of important outcome parameters
including regional contractile function, fibrosis and perfusion in both mice
and humans (3, 4). While pre-clinical research can utilize optical
based reporter gene strategies for non-invasive measurement of gene expression,
such methods are not clinically suitable. Chemical exchange saturation transfer
(CEST) – MRI has been used in conjunction with the CEST-MRI reporter gene
Lysine Rich Protein (LRP) for imaging of gene transfer and expression in tumors (5-7). In this study, we used cardiac CEST-MRI and LRP to quantify global and
focal gene transfer and expression in two mouse models of cardiac gene therapy
based on administration of adeno-associated viral vectors (AAV9). Methods
AAV9 preparation: AAV9 viral vectors contained LRP (AAV9-LRP) coupled
to the V5 epitope tag (CMV promoter) and enhanced green fluorescent protein
(eGFP). Empty AAV9 vectors (AAV9-Empty) were used for control studies.
Systemic Administration: Thirty male C57B6/J mice received a 100μL tail vein
injection of AAV9-LRP (n = 13), AAV9-Empty (n = 10), or saline (n = 7). Imaging
was performed at 1, 60, and 90 days post-injection after which hearts were
excised, sectioned and flash frozen. Western blot and V5 co-immunoprecipitation
were performed on tissue lysates.
Direct Injection: 100μL of AAV9-LRP (n = 9) or AAV9-Empty (n = 6) was
directly injected into the inferior wall of the left ventricle using the
pop-out technique described by Gao et al (8). Mice were imaged prior to and 15 and 45 days post
AAV9 injection after which hearts were flash frozen sectioned, and immuno-stained
for V5 with nuclear counter staining.
Imaging: In vivo imaging used a whole body cylindrical coil
for excitation and a dedicated 4-channel phased array surface coil for
detection in a 7T ClinScan (Bruker, Ettlingen, Germany). One midventricular
slice was imaged using a CEST-encoded steady state cine gradient echo sequence
described in Pumphrey et al (9). CEST-encoding used a 2.03s train of Gaussian pulses
(total power 4.7μT). Cine gradient echo data (TR/TE = 10/2.3 ms, flip angle =
15°, readout time = 500ms,
averages = 4) was acquired over 4 heart beats with inner loop averaging. Image
pairs were acquired following CEST preparation at offsets of ±3.76ppm.
Analysis: Registration of end diastolic frames from both
offsets in Matlab (Mathworks, Nattic, MA) enabled quantification of CEST
contrast as MTRasym =(S-3.76ppm–S3.76ppm)/S3.76ppm*100
on a pixel-wise basis. For systemic administration MTRasym values
were averaged over the entire left ventricle. MTRasym values for
direct injection were measured in regions of interest defined by immunostaining
patterns for AAV9-LRP, and regions of interest encompassing the inferior wall
for AAV9-Empty.
Statistics:
Differences in MTRasym between groups and over time were assessed
via repeated measures ANOVA.
Results
Systemic Injection: Cardiac MTRasym values were similar
among all mice at 1-day post injection (Figure 1). In mice receiving AAV9-LRP,
cardiac MTRasym values were significantly heightened by 60 days
(Figure 1) when compared to day 1 values and other groups, and remained
elevated at 90 days (Figure 1). Representative
maps of MTRasym are shown in Figure 2. Co-immunoprecipitation assays
confirmed robust expression of LRP-V5 in mice exposed to AAV9-LRP (Figure 3).
Direct Injection: MTRasym values were similarly
significantly elevated in regions of LRP expression at 15 and 45 days
post-injection when compared to AAV9-Empty (Figure 4). However, repeated
measurement revealed temporal heterogeneity in the magnitude of CEST contrast
within individual mice (Figure 4). Representative images, MTRasym
maps, and immuno-fluorescence images are shown in Figure 5.
Discussion
We used cardiac CEST-MRI to quantify spatio-temporal patterns of LRP
expression in two mouse models of gene transfer. When AAV9-LRP was administered
systemically, CEST contrast generated by LRP was observed throughout the
myocardium. In juxtaposition, when AAV9-LRP was directly injected into specific
myocardial regions CEST contrast was observed only in regions of LRP expression
as confirmed with immunofluorescence. The ability to quantify temporally
varying and regionally specific gene expression patterns will be useful for
optimizing methods of delivery and viral dosage for emerging gene therapy
strategies. Further, combined imaging of gene expression and quantitation of
functional outcomes including regional contractile function, perfusion, and
fibrosis will enable more robust examination of emerging gene therapies for
heart failure. Acknowledgements
No acknowledgement found.References
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