Overexpression of Cx43 in cells of the myocardial scar: Correction of post-infarct arrhythmias through heterotypic cell-cell coupling

Sci Rep. 2018 May 8;8(1):7145. doi: 10.1038/s41598-018-25147-8.

Abstract

Ventricular tachycardia (VT) is the most common and potentially lethal complication following myocardial infarction (MI). Biological correction of the conduction inhomogeneity that underlies re-entry could be a major advance in infarction therapy. As minimal increases in conduction of infarcted tissue markedly influence VT susceptibility, we reasoned that enhanced propagation of the electrical signal between non-excitable cells within a resolving infarct might comprise a simple means to decrease post-infarction arrhythmia risk. We therefore tested lentivirus-mediated delivery of the gap-junction protein Connexin 43 (Cx43) into acute myocardial lesions. Cx43 was expressed in (myo)fibroblasts and CD45+ cells within the scar and provided prominent and long lasting arrhythmia protection in vivo. Optical mapping of Cx43 injected hearts revealed enhanced conduction velocity within the scar, indicating Cx43-mediated electrical coupling between myocytes and (myo)fibroblasts. Thus, Cx43 gene therapy, by direct in vivo transduction of non-cardiomyocytes, comprises a simple and clinically applicable biological therapy that markedly reduces post-infarction VT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / complications
  • Arrhythmias, Cardiac / genetics*
  • Arrhythmias, Cardiac / pathology
  • Arrhythmias, Cardiac / therapy
  • Cicatrix / genetics*
  • Cicatrix / pathology
  • Cicatrix / therapy
  • Connexin 43 / administration & dosage
  • Connexin 43 / genetics*
  • Disease Models, Animal
  • Fibroblasts / metabolism
  • Genetic Therapy*
  • Genetic Vectors / therapeutic use
  • HEK293 Cells
  • Humans
  • Lentivirus / genetics
  • Mice
  • Muscle Cells / metabolism
  • Muscle Cells / pathology
  • Myoblasts / metabolism
  • Myoblasts / pathology
  • Myocardial Infarction / complications
  • Myocardial Infarction / genetics*
  • Myocardial Infarction / pathology
  • Myocardial Infarction / therapy
  • Tachycardia, Ventricular / complications
  • Tachycardia, Ventricular / genetics
  • Tachycardia, Ventricular / pathology
  • Tachycardia, Ventricular / therapy

Substances

  • Connexin 43