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                  <mods:namePart>Fuster, Valentín</mods:namePart>
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                  <mods:namePart>Ibáñez, Borja</mods:namePart>
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                  <mods:namePart>Bernal, Juan A</mods:namePart>
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               <mods:identifier type="citation">Arterioscler Thromb Vasc Biol. 2015 Jan;35(1):50-9.</mods:identifier>
               <mods:identifier type="doi">10.1161/ATVBAHA.114.303617</mods:identifier>
               <mods:identifier type="e-issn">1524-4636</mods:identifier>
               <mods:identifier type="journal">Arteriosclerosis, thrombosis, and vascular biology</mods:identifier>
               <mods:identifier type="pubmedID">25341796</mods:identifier>
               <mods:identifier type="uri">http://hdl.handle.net/20.500.12105/17709</mods:identifier>
               <mods:abstract>OBJECTIVES&#xd;
Patients with mutations in the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene have hypercholesterolemia and are at high risk of adverse cardiovascular events. We aimed to stably express the pathological human D374Y gain-of-function mutant form of PCSK9 (PCSK9(DY)) in adult wild-type mice to generate a hyperlipidemic and proatherogenic animal model, achieved with a single systemic injection with adeno-associated virus (AAV).&#xd;
APPROACH AND RESULTS&#xd;
We constructed an AAV-based vector to support targeted transfer of the PCSK9(DY) gene to liver. After injection with 3.5×10(10) viral particles, mice in the C57BL/6J, 129/SvPasCrlf, or FVB/NCrl backgrounds developed long-term hyperlipidemia with a strong increase in serum low-density lipoprotein. Macroscopic and histological analysis showed atherosclerotic lesions in the aortas of AAV-PCSK9(DY) mice fed a high-fat-diet. Advanced lesions in these high-fat-diet-fed mice also showed evidence of macrophage infiltration and fibrous cap formation. Hepatic AAV-PCSK9(DY) infection did not result in liver damage or signs of immunologic response. We further tested the use of AAV-PCSK9(DY) to study potential genetic interaction with the ApoE gene. Histological analysis of ApoE(-/-) AAV-PCSK9(DY) mice showed a synergistic response to ApoE deficiency, with aortic lesions twice as extensive in ApoE(-/-) AAV-PCSK9(DY)-transexpressing mice as in ApoE(-/-) AAV-Luc controls without altering serum cholesterol levels.&#xd;
CONCLUSIONS&#xd;
Single intravenous AAV-PCSK9(DY) injection is a fast, easy, and cost-effective approach, resulting in rapid and long-term sustained hyperlipidemia and atherosclerosis. We demonstrate as a proof of concept the synergy between PCSK9(DY) gain-of-function and ApoE deficiency. This methodology could allow testing of the genetic interaction of several mutations without the need for complex and time-consuming backcrosses.</mods:abstract>
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                  <mods:title>Induction of sustained hypercholesterolemia by single adeno-associated virus-mediated gene transfer of mutant hPCSK9.</mods:title>
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