Cardiovascular disorders continue to lead national morbidity, mortality, and cost figures. Neointimal hyperplasia stands as the underlying pathophysiology of many of these disorders. Inflammation has been associated with neointimal hyperplasia and the related process of atherogenesis, although it remains uncertain whether arterial remodeling occurs by way of inflammatory dependent mechanisms, or whether the inflammation is a secondary event. The current proposal details a research and training program that combines didactic courses, quality interactions with established investigators, and a hypothesis driven mechanistic research plan. Additionally, it provides new training in cytokine biology, advanced immunohistochemistry methods and gene therapy approaches. The grant has been thoughtfully constructed to help the Principal Investigator reach his long-term career goal of independent investigatorship as an academic vascular surgeon and to simultaneously advance our understanding of the mechanisms of neointimal hyperplasia. The overall scientific hypothesis of this training program is that neointimal hyperplasia proceeds by way of inflammatory dependent mechanisms. In this project we will dissect the roles of the pro-inflammatory cytokine TNF-alpha, and the anti-inflammatory cytokine IL-10, in neointima formation. Preliminary studies in a murine model suggest absence of biologically active TNF-alpha results in ten-fold less neointima formation. The chronology and cellular mediators (leukocytes and smooth muscle cells) of this TNF-alpha effect are unknown, and will be defined in this study. Because TNF-alpha can signal through two distinct receptors, TNFRI (P55) and TNFRII (p75), we will ascertain (using a genetic approach) through which receptor is TNF-alpha signaling accomplished in the setting of arterial remodeling. We hypothesize that endogenous TNF- alpha chronically upregulates neointimal hyperplasia through enhanced artery wall inflammation by way of signaling through the p55 receptor. IL-10 is an anti-inflammatory cytokine that stands as a primary endogenous downregulator of TNF-alpha. Preliminary studies suggest that delivery of viral IL-10 by way of gene therapy approaches attenuates neointimal hyperplasia. Using genetic, pharmacologic, and gene therapy approaches we will determine if neointimal hyperplasia is modulated by IL-10 dependent mechanisms, and the cellular events by which this sequence proceeds. We hypothesize that Ill-10 downregulates neointimal hyperplasia. TNF-alpha and IL-10 mediated cellular processes serve as a potential site for therapeutically interrupting pathologic arterial remodeling.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HL004070-04
Application #
6607036
Study Section
Special Emphasis Panel (ZHL1-CSR-K (M1))
Program Officer
Schucker, Beth
Project Start
2000-07-01
Project End
2005-06-30
Budget Start
2003-07-01
Budget End
2004-06-30
Support Year
4
Fiscal Year
2003
Total Cost
$123,390
Indirect Cost
Name
University of Florida
Department
Surgery
Type
Schools of Medicine
DUNS #
969663814
City
Gainesville
State
FL
Country
United States
Zip Code
32611
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Jiang, Zhihua; Berceli, Scott A; Pfahnl, Chun L et al. (2004) Wall shear modulation of cytokines in early vein grafts. J Vasc Surg 40:345-50

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