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Gene therapy for refractory angina and cell therapy for heart failure: experience of a Brazilian research group

Gene Therapy volume 27, pages 40–50 (2020)Cite this article

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Abstract

Cell therapy has shown impressive effects in experimental cardiomyopathy models. To a lesser extent, gene therapy has also been studied. In both cases, translation to clinical therapy has been disappointing. This paper is intended to describe the experience and achievements of a multicenter working group located in Porto Alegre, southern Brazil, in experimental and translational research projects for cell-based and gene therapy methods in the treatment of dilated and ischemic cardiomyopathies. The results of preclinical and clinical studies showed that bone marrow mononuclear stem cells indeed have an effect in improving myocardial perfusion and contractile function, but the overall results are poorly translated to the clinical level. Gene therapy studies with direct myocardial injections of naked VEGF 165 plasmid showed improvement in myocardial perfusion and function in animal models. A randomized clinical trial found that this method is safe and improved myocardial perfusion, but the benefits disappeared after 1 year. An animal experiment associating VEGF 165 with angiopoietin was undertaken in mini pigs to extend the durability of that therapy. In conclusion, our efforts to better understand the mechanisms and functions of gene and cell-based therapies in cardiology resulted in significant findings and propose a future look at cell-free therapeutic approaches.

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Funding

These studies were funded by Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Financiadora de Estudos e Projetos (FINEP), and Ministério da Saúde/Departamento de Ciência e Tecnologia (MS/DECIT).

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  1. These authors contributed equally: Roberto Tofani Sant’Anna, Bruna Eibel

Authors and Affiliations

  1. Instituto de Cardiologia do Rio Grande do Sul, Av Princesa Isabel 395, 90620-001, Porto Alegre, RS, Brazil

    Roberto Tofani Sant’Anna, Bruna Eibel, Felipe Borsu de Salles, Imarilde Inês Giusti, Ivo Abrahão Nesralla, Nance Beyer Nardi & Renato Abdala Karam Kalil

  2. Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite 245, 90050-170, Porto Alegre, RS, Brazil

    Melissa Medeiros Markoski

  3. Global Research and Innovation Network – GRINN, Rua Doutor João Colin 1285, Sala 03, 89204-001, Joinville, SC, Brazil

    Clarissa Garcia Rodrigues

  4. Universidade Luterana do Brasil, Av Farroupilha, 8001, 92425-900, Canoas, RS, Brazil

    Nance Beyer Nardi

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  1. Roberto Tofani Sant’Anna
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Sant’Anna, R.T., Eibel, B., Markoski, M.M. et al. Gene therapy for refractory angina and cell therapy for heart failure: experience of a Brazilian research group. Gene Ther 27, 40–50 (2020). https://doi.org/10.1038/s41434-019-0087-2

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