Ischemic heart disease is a leading
cause of death and reduced
quality of life worldwide. Although
revascularization strategies significantly reduce mortality after acute
myocardial infarction (MI), many patients with MI develop chronic
heart failure over time. We previously reported that human recombinant ANGPTL4 counteracts
ischemia-induced
vascular endothelial growth factor signaling and disruption of endothelial
cell-
cell adhesion, thereby inhibiting
vascular permeability. We were able to demonstrate that ANGPTL4 administration before MI resulted in protection of the coronary
capillary network, no-reflow syndrome, and reduced
infarct size in mice. We also demonstrated that the therapeutic effects observed with ANGPTL4 under ischemic conditions were caused by the FLD fragment, not the CCD fragment (WO 2016 / 110498). To further examine the therapeutic potential of the FLD fragment of ANGPTL4 at the onset of reperfusion, we herein used a porcine model, a clinically relevant model of acute
myocardial infarction that can be easily and safely translated into
patient treatment. We demonstrated that local (antegrade) delivery of the FLD ANGPTL4 to infarcted porcine hearts can efficiently target the
lesion site in a clinically relevant manner. A
single administration of the FLD of ANGPTL4 improved cardiac function,
infarct size,
fibrosis, and adverse remodeling parameters 28 days after MI. Short-term MI experiments, coupled with complementary mouse studies, demonstrated myocardial protection. Thus, a
single administration of the FLD of ANGPTL4 can reduce
ischemia-
reperfusion injury and protect against adverse postischemic cardiac remodeling and subsequent
ischemic heart failure.