Background, In a previous study we have demonstrated significant reduction
of intimal hyperplasia after adenovirus-mediated gene transfer of p53 prote
in to the injured rat carotid artery. The purpose of this study was to eluc
idate whether apoptosis is one of the mechanisms responsible for this reduc
tion. Apoptosis, a physiologic cell death process that stabilizes cell numb
ers in tissues, can be independently induced by p53.
Methods. In vivo gene transfer was used in isolated segments of balloon-inj
ured rat carotid arteries. Genetically modified adenovirus encoding for wil
d-type p53 protein (AdWTp53) was applied at 8 x 10(10) plaque-forming units
/mL. Control rats received either adenovirus null at the same concentration
or balloon injury alone. Arteries were harvested at 24 and 48 hours after
the procedure. Apoptosis was detected in tissue sections by in situ termina
l deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end
labeling (TUNEL) assay. Specimens were graded either negative or positive l
ess than 10%, 10% to 20%, 20% to 30%, or greater than 30% according to the
number of apoptotic cells in the medial or intimal layer per high powerfiel
d. Specimens were also subjected to DNA agarose gel electrophoresis and tra
nsmission, electron microscopy.
Results. With the TUNEL, assay no apoptosis was visualized at 24 and 48 hou
rs in the controls (n = 5 in each group), whereas in the AdWTp53 groups (n
= 5 in each) all specimens presented apoptosis (P < .05, AdWTp53 vs control
s). The average grade of apoptotic cells detected in the medial layer in th
e AdWTp53 groups was less than 10% to 20% at 24 hours and 20% to 30% at 48
hours. The DNA agarose gel electrophoresis failed to detect a DNA laddering
pattern, characteristic of apoptosis. Electron microscopy revealed morphol
ogic changes typical of apoptosis in the treated group, whereas specimens f
rom control group did not reveal any apoptotic features.
Conclusions. Ar 48 hours after balloon injury alone, no apoptosis was obser
ved in the vessel wall. However; when p53 gene was transferred apoptosis wa
s visualized in all specimens with greater intensity at 48 hours after inju
ry. Promotion of apoptosis may play a hey role in the mechanism by which p5
3 gene decreases intimal hyperplasia.