Abstract
Sclerosis and reduced microvessel density characterize advanced stages of muscular dystrophy and hamper cell or gene delivery, precluding treatment of most individuals with Duchenne muscular dystrophy. Modified tendon fibroblasts expressing an angiogenic factor (placenta growth factor, PlGF) and a metalloproteinase (matrix metalloproteinase-9, MMP-9) are able to restore a vascular network and reduce collagen deposition, allowing efficient cell therapy in aged dystrophic mice. These data open the possibility of extending new therapies to currently untreatable individuals.
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References
Cossu, G. & Sampaolesi, M. New therapies for Duchenne muscular dystrophy: challenges, prospects and clinical trials. Trends Mol. Med. 13, 520–526 (2007).
Muntoni, F., Bushby, K. & van Ommen, G. 128th ENMC International Workshop on 'Preclinical optimization and Phase I/II Clinical Trials Using Antisense Oligonucleotides in Duchenne Muscular Dystrophy' 22–24 October 2004, Naarden, The Netherlands. Neuromuscul. Disord. 15, 450–457 (2005).
Minasi, M.G. et al. The meso-angioblast: a multipotent, self-renewing cell that originates from the dorsal aorta and differentiates into most mesodermal tissues. Development 129, 2773–2783 (2002).
Sampaolesi, M. et al. Cell therapy ofα-sarcoglycan null dystrophic mice through intra-arterial delivery of mesoangioblasts. Science 301, 487–492 (2003).
Sampaolesi, M. et al. Mesoangioblast stem cells ameliorate muscle function in dystrophic dogs. Nature 444, 574–579 (2006).
Rowland, L.P. Pathogenesis of muscular dystrophies. Arch. Neurol. 33, 315–321 (1976).
Marshall, P.A., Williams, P.E. & Goldspink, G. Accumulation of collagen and altered fiber-type ratios as indicators of abnormal muscle gene expression in the mdx dystrophic mouse. Muscle Nerve 12, 528–537 (1989).
Stedman, H.H. et al. The mdx mouse diaphragm reproduces the degenerative changes of Duchenne muscular dystrophy. Nature 352, 536–539 (1991).
Goldspink, G., Fernandes, K., Williams, P.E. & Wells, D.J. Age-related changes in collagen gene expression in the muscles of mdx dystrophic and normal mice. Neuromuscul. Disord. 4, 183–191 (1994).
Pastoret, C. & Sebille, A. mdx mice show progressive weakness and muscle deterioration with age. J. Neurol. Sci. 129, 97–105 (1995).
Kirkeby, S. & Mikkelsen, H. Macrophages and mast cells in dystrophic masseter muscle: a light and electron microscopic study. Br. J. Exp. Pathol. 69, 597–603 (1988).
Porter, J.D. et al. A chronic inflammatory response dominates the skeletal muscle molecular signature in dystrophin-deficient mdx mice. Hum. Mol. Genet. 11, 263–272 (2002).
Van Den Steen, P.E. et al. Biochemistry and molecular biology of gelatinase B or matrix metalloproteinase-9 (MMP-9). Crit. Rev. Biochem. Mol. Biol. 37, 375–536 (2002).
De Falco, S., Gigante, B. & Persico, M.G. Structure and function of placental growth factor. Trends Cardiovasc. Med. 12, 241–246 (2002).
Webster, D.F. & Burry, H.C. The effects of hypoxia on human skin, lung and tendon cells in vitro. Br. J. Exp. Pathol. 63, 50–55 (1982).
Forst, J. & Forst, R. Lower limb surgery in Duchenne muscular dystrophy. Neuromuscul. Disord. 9, 176–181 (1999).
Goodwin, A.M. In vitro assays of angiogenesis for assessment of angiogenic and anti-angiogenic agents. Microvasc. Res. 74, 172–183 (2007).
Allen, D.L., Harrison, B.C., Sartorius, C., Bymes, W.C. & Leinwand, L.A. Mutation of the IIB myosin heavy chain gene results in muscle fiber loss and compensatory hypertrophy. Am. J. Physiol. Cell Physiol. 280, C637–C645 (2001).
Bi, Y. et al. Identification of tendon stem/progenitor cells and the role of the extracellular matrix in their niche. Nat. Med. 13, 1219–1227 (2007).
Ferrari, G., Salvatori, G., Rossi, C., Cossu, G. & Mavilio, F. A retroviral vector containing a muscle-specific enhancer drives gene expression only in differentiated muscle fibers. Hum. Gene Ther. 6, 733–742 (1995).
Tajbakhsh, S. et al. A population of myogenic cells derived from the mouse neural tube. Neuron 13, 813–821 (1994).
Kobayashi, K. et al. Combination of in vivo angiopoietin-1 gene transfer and autologous bone marrow cell implantation for functional therapeutic angiogenesis. Arterioscler. Thromb. Vasc. Biol. 26, 1465–1472 (2006).
Galvez, B.G. et al. Complete repair of dystrophic skeletal muscle by mesoangioblasts with enhanced migration ability. J. Cell Biol. 174, 231–243 (2006).
Azeh, I. et al. Experimental pneumococcal meningitis in rabbits: the increase of matrix metalloproteinase-9 in cerebrospinal fluid correlates with leucocyte invasion. Neurosci. Lett. 256, 127–130 (1998).
Brunelli, S. et al. Nitric oxide release combined with nonsteroidal antiinflammatory activity prevents muscular dystrophy pathology and enhances stem cell therapy. Proc. Natl. Acad. Sci. USA 104, 264–269 (2007).
Woessner, J.F. Jr. The determination of hydroxyproline in tissue and protein samples containing small proportions of this imino acid. Arch. Biochem. Biophys. 93, 440–447 (1961).
Acknowledgements
We would like to thank E. Dejana (University of Milan) for the gift of HUVECs, BV13 antibody to vascular endothelial cadherin and for helpful discussion; S. Bernardini for advice on histology; and S. Iacovelli for technical help. This work was supported by grants from Duchenne Parent Project Onlus, BMW, Association Francaise contre les Myopathies, the Italian Ministry of Health and of Research (grant RBINO63EWP) and the European Community (MyoAmp).
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C.G. prepared vectors, transduced cells and carried out most of the experimental work; S.M.C. helped with data analysis and interpretation; F.D.G. did the histology; M.C. isolated the cells and did the work on mice; G.C. coordinated the project and wrote the manuscript.
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Gargioli, C., Coletta, M., De Grandis, F. et al. PlGF–MMP-9–expressing cells restore microcirculation and efficacy of cell therapy in aged dystrophic muscle. Nat Med 14, 973–978 (2008). https://doi.org/10.1038/nm.1852
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DOI: https://doi.org/10.1038/nm.1852