A single chain antibody against a viral RNA polymerase (TBSV-BS3-Statice)

Expression of antibodies in plant against essential viral proteins could provide an alternative approach to engineered viral resistance. Engineered single chain Fv antibodies scFV are particularly suitable for expression in plant because of their small size and the lack of assembly requirements. RNA-dependent RNA polymerases (RdRps) function as the catalytic subunit of viral replicases required for the replication of all positive strand RNA viruses. By using Phage technology we selected scFvs from a phage library using purified E.coli expressed TBSV(Tomato bushy stunt virus) replicase as antigen. The scFvs mediated-inhibition of RdRp activity was studied in vitro and in planta. In vitro experiments showed the inhibition of CNV(Cucumber necrosis virus) and TCV(Turnip crinkle virus) RdRp. Transient in planta assays based on agroinfiltration and an infectious clone of TBSV demonstrated the inhibition of the replication of TBSV(Tomato bushy stunt virus). Epitope mapping showed that the selected scFvs target the motif E of RdRp which is involved in template binding.Moreover T1 plants of transgenic lines of N. benthamiana expressing different scFvs either in the cytoplasm or the ER (endoplasmic reticulum) showed a high level of resistance against infection with TBSV and RCNMV(Red clover necrotic mosaic virus) upon inoculation with virus particles. This is the first report that scFvs against a RdRp of a plant viruses can inhibit viral replication in vivo. The resistance is even efficient against viruses belonging to different virus families.

Evaluation of a viral vector system, based on a defective interfering RNA of tomato bushy stunt virus, for protein expression and the induction of gene silencing

A viral vector system was developed based on a DI-RNA, a sub-viral particle derived from TBSV-BS3-statice. This newly designed vector system was tested for its applicability in protein expression and induction of gene silencing. Two strategies were pursued. The first strategy was replication of the DI-RNA by a transgenically expressed TBSV replicase and the second was the replication by a so called helper virus. It could be demonstrated by northern blot analysis that the replicase, expressed by the transgenic N. benthamiana plant line TR4 or supplied by the helper virus, is able to replicate DI-RNA introduced into the plant cells. Various genes were inserted into different DI constructs in order to study the vector system with regard to protein expression. However, independent of how the replicase was provided no detectable amounts of protein were produced in the plants. Possible reasons for this failure are identified: the lack of systemic movement of the DI-RNA in the transgenic TR4 plants and the occurrence of deletions in the inserted genes in both systems. As a consequence the two strategies were considered unsuitable for protein expression. The DI-RNA vector system was able to induce silencing of transgenes as well as endogenous genes. Several different p19 deficient helper virus constructs were made to evaluate their silencing efficiency in combination with our DI-RNA constructs. However, it was found that our vector system can not compete with other existing VIGS (virus induced gene silencing) systems in this field. Finally, the influence of DI sequences on mRNA stability on transient GUS expression experiments in GUS silenced plants was evaluated. The GUS reporter gene system was found to be unsuitable for distinguishing between expression levels of wild type plants and GUS silenced transgenic plants. The results indicate a positive effect of the DI sequences on the level of protein expression and therefore further research into this area is recommended.

Charakterisierung redundanter Kerntransportsignale des minoren Kapsidproteins L2 humaner Papillomviren

Das minore Kapsidprotein L2 humaner Papillomviren wird im Laufe des HPV-Lebenszyklus zweimal in den Zellkern importiert und akkumuliert dort an den Nukleären Domänen 10 (ND10). Der erste Kernimport erfolgt in der frühen Phase der Infektion zusammen mit der Virus-DNA. Für den Zusammenbau von Virionen wird neu synthetisiertes L2-Protein ein weiteres Mal in den Kern transportiert. Im Rahmen dieser Arbeit konnte die Domäne von L2 identifiziert werden, die für den Kernimport von HPV16 L2 absolut notwendig ist. Dabei gelang es diesen Bereich auf 25 Aminosäuren einzuengen. Sowohl während der frühen Phase der Infektion als auch während der Morphogenese scheint die zentrale, basische Aminosäureregion 291-315 (mNLS) hauptverantwortlich für die Interaktion mit Kernimportrezeptoren zu sein. Möglicherweise leisten dabei flankierende Sequenzen einen Beitrag zur Stabilisierung der notwendigen Konformation. Des Weiteren gelang die Identifizierung der Aminosäuren, die für die Funktionalität des mNLS essentiell sind. Hierbei handelt es sich um ein zentrales Arginin-Motiv, bestehend aus vier dicht beieinander liegenden Argininen, dessen Mutation den Kernimport von L2 während Infektion und Morphogenese verhindert. Untersuchungen mit HPV16 und HPV18 L2-Proteinen verdeutlichten, dass es möglicherweise ein universelles Motiv zu sein scheint und in verschiedenen HPV-Typen konserviert ist. Flankiert wird dieses Arginin-Motiv von konservierten Serinen und Threoninen. Wie die Analyse von Punktmutationen zeigte, sind diese Aminosäuren für den Kernimport von L2 ohne Bedeutung. Interessanterweise verhinderte aber die Mutation TS295/6A die Kolokalisation von L2 mit ND10 im Zellkern. L2wt rekrutiert den transkriptionellen Regulator Daxx. Auch diese Funktion ging bei der Mutante TS295/6A verloren. Diese Ergebnisse zeigen, dass nicht nur die ND10-Lokalisationsdomäne (AS 390-420) in L2 sondern auch weitere Aminosäuren oder Domänen für die Assoziation mit ND10 und die Rekrutierung von Daxx verantwortlich sein könnten. Auf der Suche nach zellulären Faktoren, die eine Rolle im mNLS-vermittelten Kernimport spielen, wurde zunächst die Bedeutung von Hsc70 untersucht. Während der Morphogenese maskiert Hsc70 den C-Terminus von L2 und verhindert damit unerwünschte Interaktionen mit Mikrotubuli im Zytoplasma. Es existieren aber weitere noch unbekannte Hsc70-Bindedomänen in L2, die möglicherweise den Kernimport ebenfalls beeinflussen können. Wie die Untersuchungen deutlich machten, ist der zentrale, basische Bereich von L2 aber nicht mit Hsc70 assoziiert und der mNLS-vermittelte Kernimport findet unabhängig von Hsc70 statt. In einem siRNA-Screen wurde anschließend die Rolle von Karyopherinen während der Infektion untersucht. Sowohl Kapß2-siRNA als auch Kapß3-siRNA waren in der Lage unabhängig voneinander die Infektion von HPV16-Pseudovirionen zu reduzieren. Für beide Karyopherine konnte in der Vergangenheit in vitro die Interaktion mit HPV16 L2 nachgewiesen werden. Das L2-Protein ist das einzige virale Protein, das während der Infektion die Virus-DNA in den Kern begleitet (Day et al., 2004). Demzufolge ist es auch das einzige virale Protein, das mit Importinen während der Infektion interagiert. Möglicherweise sind also beide Karyopherine in der Lage sein L2 während der Infektion in den Kern zu importieren. Abschließend wurden Präzipitationsversuche durchgeführt, die zur Identifizierung möglicher Bindungspartner des mNLS führen sollten. In diesen Versuchen konnte eine erhöhte Bindungsaffiniät zu den beiden Importinen Kapß1 und Kapß2 festgestellt werden. Möglicherweise ist das L2-Protein mit seiner mNLS in der Lage mehrere Importrezeptoren zu binden und für den Kernimport zu nutzen. Eines dieser Importine ist Kapß2. Dieser Importrezeptor scheint sowohl bei der Infektion als auch während der Morphogenese den Kernimport von L2 durch die Bindung an das mNLS zu vermitteln.

Accuracy of liver stiffness measurement using fibroscan ® to predict the response to antiviral therapy in patients with chronic hepatitis c viral infection

Introduction: Antiviral therapy can prevent disease progression in patients with chronic hepatitis C . Transient Elastografy (TE; Fibroscan) is an accurate surrogate marker to liver fibrosis, by measuring liver stiffness (LS). LS decrease has been associated with sustained virologic response (SVR). Aim: to assess the changes of LS measurments in CHC patients during and one year after Interferon (IFN)-based antiviral therapy (IFN/ribavirin) or (telaprevir+IFN/ribavirin). Methods: consecutive 69 CHC patients (53.6% females, mean age 57.9 ± 11.4) who underwent antiviral therapy for at least 20 weeks were enrolled. LS was measured using FibroScan at baseline, after three months, at the end of treatment and one year after treatment discontinuation. Fibrosis was graded using METAVIR score. Results: twenty patients treated with triple therapy and 49 with IFN/ribavirin. Fifty patients had SVR and 19 were non-responders. SVR patients: F0-F1, F2 and F3 patients (39.1%, 7.2% and 17.4%; respectively) showed no significant LS decrease (P= 0.186, 0.068 and 0.075; respectively). Conversely, in F4 patients (36.2%) LS was significantly decreased (P=0.015) after one year of treatment completion. In all patients with no SVR, no significant decrease in LS was observed. Interestingly, all Patients with F4 fibrosis (even non-responders) showed an initial significant decrease in LS (P=0.024) at 3 months after the start of treatment. However, this decrease was not predictive of SVR; area under the ROC curve 0.369 (CI %: 0.145-0.592) P= 0.265. Conclusion: Our study showed that initial decrease in LSM, especially in patients with higher baseline fibrosis score is unlikely to predict an SVR. In addition no significant association was found between clinical or virological parameters and fibrosis improvement. Further studies are needed to delineate the most appropriate clinical scenarios for the LSM by Fibroscan in chronic hepatitis C and its role in monitoring the response to antiviral treatment.

Development of new molecular methods for the diagnosis and the study of viral diseases of fish

The increase in aquaculture operations worldwide has provided new opportunities for the transmission of aquatic viruses. The occurrence of viral diseases remains a significant limiting factor in aquaculture production and for the sustainability. The ability to identify quickly the presence/absence of a pathogenic organism in fish would have significant advantages for the aquaculture systems. Several molecular methods have found successful application in fish pathology both for confirmatory diagnosis of overt diseases and for detection of asymptomatic infections. However, a lot of different variants occur among fish host species and virus strains and consequently specific methods need to be developed and optimized for each pathogen and often also for each host species. The first chapter of this PhD thesis presents a complete description of the major viruses that infect fish and provides a relevant information regarding the most common methods and emerging technologies for the molecular diagnosis of viral diseases of fish. The development and application of a real time PCR assay for the detection and quantification of lymphocystivirus was described in the second chapter. It showed to be highly sensitive, specific, reproducible and versatile for the detection and quantitation of lymphocystivirus. The use of this technique can find multiple application such as asymptomatic carrier detection or pathogenesis studies of different LCDV strains. The third chapter, a multiplex RT-PCR (mRT-PCR) assay was developed for the simultaneous detection of viral haemorrhagic septicaemia (VHS), infectious haematopoietic necrosis (IHN), infectious pancreatic necrosis (IPN) and sleeping disease (SD) in a single assay. This method was able to efficiently detect the viral RNA in tissue samples, showing the presence of single infections and co-infections in rainbow trout samples. The mRT-PCR method was revealed to be an accurate and fast method to support traditional diagnostic techniques in the diagnosis of major viral diseases of rainbow trout.

Drug delivery, entry and intracellular trafficking of polymeric nanoparticles

Polymere Nanopartikel sind kleine Teilchen, die vielseitige Einsatzmöglichkeiten für den Transport von Wirkstoffen bieten. Da Nanomaterialien in diesen biomedizinischen Anwendungen oft mit biologischen Systemen in Berührung kommen, erfordert das eine genaue Untersuchung ihrer gegenseitigen Wechselwirkungen. In diesem speziellen Forschungsgebiet, welches sich auf die Interaktionen von Nanomaterialien mit biologischen Komponenten konzentriert, wurde bereits eine Vielzahl verschiedener Nanopartikel-Zell-Interaktionen (z. B. Nanotoxizität, Wirkstofftransport-mechanismen) analysiert. Bezüglich der Untersuchungen zu nanopartikulären Wirkstofftransport-mechanismen ist es im Allgemeinen akzeptiert, dass ein erfolgreicher zellulärer Transport hauptsächlich von der Aufnahme des Nanotransporters abhängt. Deshalb analysieren wir in dieser Arbeit (1) den Wirkstofftransportmechanismus für biologisch-abbaubare eisenhaltige Poly-L-Milchsäure Nanopartikel (PLLA-Fe-PMI) sowie (2) die Aufnahmemechanismen und die intrazellulären Transportwege von nicht-abbaubaren superparamagnetischen Polystyrolnanopartikeln (SPIOPSN). rnIn dieser Arbeit identifizieren wir einen bisher unbekannten und nicht-invasiven Wirkstoff-transportmechanismus. Dabei zeigt diese Studie, dass der subzelluläre Transport der nanopartikulärer Fracht nicht unbedingt von einer Aufnahme der Nanotransporter abhängt. Der identifizierte Arzneimitteltransportmechanismus basiert auf einem einfachen physikochemischen Kontakt des hydrophoben Poly-L-Milchsäure-Nanopartikels mit einer hydrophoben Oberfläche, wodurch die Freisetzung der nanopartikulären Fracht ausgelöst wird. In Zellexperimenten führt die membranvermittelte Freisetzung der nanopartikulären Fracht zu ihrem sofortigen Transport in TIP47+- und ADRP+- Lipidtröpfchen. Der Freisetzungsmechanismus („kiss-and-run") kann durch die kovalente Einbindung des Frachtmoleküls in das Polymer des Nanopartikels blockiert werden.rnWeiterhin wird in Langzeitversuchen gezeigt, dass die Aufnahme der untersuchten polymeren Nanopartikel von einem Makropinozytose-ähnlichen Mechanismus gesteuert wird. Im Laufe dieser Arbeit werden mehrere Faktoren identifiziert, die in diesem Aufnahmemechanismus eine Rolle spielen. Darunter fallen unter anderem die kleinen GTPasen Rac1 und ARF1, die die Aufnahme von SPIOPSN beeinflussen. Darauffolgend werden die intrazellulären Transportwege der Nanopartikel untersucht. Mit Hilfe eines neuartigen Massenspektrometrieansatzes wird der intrazelluläre Transport von nanopartikelhaltigen endozytotischen Vesikeln rekonstruiert. Intensive Untersuchungen identifizieren Marker von frühen Endosomen, späten Endosomen/ multivesikulären Körpern, Rab11+- Endosomen, Flotillin-Vesikeln, Lysosomen und COP-Vesikeln. Schließlich wird der Einfluss des lysosomalen Milieus auf die Proteinhülle der Nanopartikel untersucht. Hier wird gezeigt, dass die adsorbierte Proteinhülle auf den Nanopartikeln in die Zelle transportiert wird und anschließend im Lysosom abgebaut wird. rnInsgesamt verdeutlicht diese Arbeit, dass die klassische Strategie des nanopartikulären und invasiven Wirkstofftransportmechanismuses überdacht werden muss. Weiterhin lässt sich aus den Daten schlussfolgern, dass polymere Nanopartikel einem atypischen Makropinozytose-ähnlichen Aufnahmemechanismus unterliegen. Dies resultiert in einem intrazellulären Transport der Nanopartikel von Makropinosomen über multivesikuläre Körperchen zu Lysosomen.rn

Leishmania major promastigote entry of an autophagy-like compartment and amastigote escape from the parasitophorous vacuole

In this thesis, we investigated the interaction of the obligate intracellular parasite Leishmania (L.) major with two phenotypes of human monocyte derived macrophages (hMDMs). Thereby we focused on the development and maturation of the parasitophorous vacuole (PV) and could show that compartment development is dependent on the parasite stage.rnFocusing on the ultrastructure of PVs containing axenic amastigotes, we demonstrated that the parasites are partially located in damaged PVs or in the cytoplasm of the host. Moreover, we visualized multiple amastigotes in a common PV 144 h p.i. in pro-inflammatory hMDM I but not in anti-inflammatory hMDM II indicating different PV development. rnRegarding the promastigote form, we demonstrated a different uptake of viable and apoptotic L. major promastigotes by hMDMs. Viable promastigotes are predominantly taken up via the flagellum tip whereas apoptotic promastigotes enter the cells via the parasite body. Analyzing compartment maturation, we found that 20-30% of the PVs get positive for the early maturation markers PI3P and EEA1 independent of the viability of the parasites and unaffected by the human macrophage type. Subsequently, 25-40% of the parasites acquire the autophagy marker LC3 on their PV, what is independent of the viability of the parasites as well. We quantified this and in hMDM II less LC3-positive compartments formed compared to hMDM I. Analyzing the ultrastructure, we investigated that the compartments consist of a single-membrane PV characteristic for LC3-associated phagocytosis (LAP). Involvement of LAP was confirmed by demonstrating that the protein kinase ULK1 is dispensable for LC3-compartment formation around Leishmania PVs. Visualizing compartment dynamics in real time showed that apoptotic promastigotes are degraded in LC3-positve compartments, whereas viable promastigotes are able to get rid of LC3-protein on their PV suggesting an involvement in parasite development and survival. In this thesis, we established a lentiviral based fluorescent imaging technique that we combined with High-Pressure-Freezing (HPF) and high-resolution 3D electron microscopy. We visualized a promastigote in a LC3-compartment whose ultrastructure showed an opening of the PV to the outside. To identify new LAP markers involved in Leishmania infection, we established an immuno-magnetic isolation protocol for the purification of Leishmania containing compartments.rnIn conclusion, this study suggests that L. major compartment biogenesis and maturation in pro- and anti-inflammatory human macrophages is dependent on the parasite stage and is different between axenic amastigotes, viable promastigotes and apoptotic promastigotes. Understanding the development and maturation of Leishmania parasites in human host cells is important to control and combat the neglected disease leishmaniasis in the future.rn

Gamification e data entry: un caso di studio

Il gioco è un concetto che accompagna la vita di innumerevoli specie animali in forme, modi e tempi differenti. L’uomo scopre il gioco sin dai primi mesi di vita. Con l’obiettivo di migliorare la condizione emotiva dell'uomo nello svolgimento delle azioni quotidiane, nasce negli ultimi anni la gamification. Il termine consta nell’integrazione delle tecniche di progettazione dei giochi in contesti esterni ai giochi. Consiste nel progettare ponendo particolare attenzione sul coinvolgimento dell’utente per renderlo capace di sperimentare le emozioni tipiche dello svago: fierezza per le proprie azioni, qualunque esse siano. Gli ambiti di applicazione sono innumerevoli. Questa tesi si concentra sullo studio del contesto aziendale, focalizzandosi sulle mansioni di data entry, allo scopo di creare una piattaforma completa, composta da strumenti informatici ed elementi di gioco, che possa aumentare il coinvolgimento dei dipendenti nel proprio lavoro. Si è scelto questo tipo di attività in quanto composta da incarichi facilmente misurabili e allo stesso tempo poco appassionanti per il dipendente perché altamente meccanici e ripetitivi. La sperimentazione in questo ambito permette quindi di valutare con certezza matematica se i miglioramenti introdotti dall'integrazione delle tecniche di gamification nello stato d’animo dei dipendenti hanno anche la conseguenza di aumentare la produttività, verificando quindi se una piattaforma ludicizzata possa essere auto-sostenibile in ambito aziendale. Al termine della tesi si giungerà ad ottenere il progetto di un sistema completo, composto da software ed attività extra-informatiche, che i dipendenti valuteranno con un questionario. La piattaforma otterrà buoni voti necessitando principalmente di un maggior apporto contenutistico e del contributo professionale di un esperto progettista di giochi perché abbia le potenzialità per diventare un caso di successo.

Global lymphoid tissue remodeling during a viral infection is orchestrated by a B cell-lymphotoxin-dependent pathway

Adaptive immune responses are characterized by substantial restructuring of secondary lymphoid organs. The molecular and cellular factors responsible for virus-induced lymphoid remodeling are not well known to date. Here we applied optical projection tomography, a mesoscopic imaging technique, for a global analysis of the entire 3-dimensional structure of mouse peripheral lymph nodes (PLNs), focusing on B-cell areas and high endothelial venule (HEV) networks. Structural homeostasis of PLNs was characterized by a strict correlation between total PLN volume, B-cell volume, B-cell follicle number, and HEV length. After infection with lymphocytic choriomeningitis virus, we observed a substantial, lymphotoxin (LT) beta-receptor-dependent reorganization of the PLN microarchitecture, in which an initial B-cell influx was followed by 3-fold increases in PLN volume and HEV network length on day 8 after infection. Adoptive transfer experiments revealed that virus-induced PLN and HEV network remodeling required LTalpha(1)beta(2)-expressing B cells, whereas the inhibition of vascular endothelial growth factor-A signaling pathways had no significant effect on PLN expansion. In summary, lymphocytic choriomeningitis virus-induced PLN growth depends on a vascular endothelial growth factor-A-independent, LT- and B cell-dependent morphogenic pathway, as revealed by an in-depth mesoscopic analysis of the global PLN structure.

BTLA mediates inhibition of human tumor-specific CD8+ T cells that can be partially reversed by vaccination

The function of antigen-specific CD8+ T cells, which may protect against both infectious and malignant diseases, can be impaired by ligation of their inhibitory receptors, which include CTL-associated protein 4 (CTLA-4) and programmed cell death 1 (PD-1). Recently, B and T lymphocyte attenuator (BTLA) was identified as a novel inhibitory receptor with structural and functional similarities to CTLA-4 and PD-1. BTLA triggering leads to decreased antimicrobial and autoimmune T cell responses in mice, but its functions in humans are largely unknown. Here we have demonstrated that as human viral antigen-specific CD8+ T cells differentiated from naive to effector cells, their surface expression of BTLA was gradually downregulated. In marked contrast, human melanoma tumor antigen-specific effector CD8+ T cells persistently expressed high levels of BTLA in vivo and remained susceptible to functional inhibition by its ligand herpes virus entry mediator (HVEM). Such persistence of BTLA expression was also found in tumor antigen-specific CD8+ T cells from melanoma patients with spontaneous antitumor immune responses and after conventional peptide vaccination. Remarkably, addition of CpG oligodeoxynucleotides to the vaccine formulation led to progressive downregulation of BTLA in vivo and consequent resistance to BTLA-HVEM-mediated inhibition. Thus, BTLA activation inhibits the function of human CD8+ cancer-specific T cells, and appropriate immunotherapy may partially overcome this inhibition.

Chemical inhibitors of the calcium entry channel TRPV6

Calcium entry channels in the plasma membrane are thought to play a major role in maintaining cellular Ca(2+) levels, crucial for growth and survival of normal and cancer cells. The calcium-selective channel TRPV6 is expressed in prostate, breast, and other cancer cells. Its expression coincides with cancer progression, suggesting that it drives cancer cell growth. However, no specific inhibitors for TRPV6 have been identified thus far.

Phylogenetic approach reveals that virus genotype largely determines HIV set-point viral load

HIV virulence, i.e. the time of progression to AIDS, varies greatly among patients. As for other rapidly evolving pathogens of humans, it is difficult to know if this variance is controlled by the genotype of the host or that of the virus because the transmission chain is usually unknown. We apply the phylogenetic comparative approach (PCA) to estimate the heritability of a trait from one infection to the next, which indicates the control of the virus genotype over this trait. The idea is to use viral RNA sequences obtained from patients infected by HIV-1 subtype B to build a phylogeny, which approximately reflects the transmission chain. Heritability is measured statistically as the propensity for patients close in the phylogeny to exhibit similar infection trait values. The approach reveals that up to half of the variance in set-point viral load, a trait associated with virulence, can be heritable. Our estimate is significant and robust to noise in the phylogeny. We also check for the consistency of our approach by showing that a trait related to drug resistance is almost entirely heritable. Finally, we show the importance of taking into account the transmission chain when estimating correlations between infection traits. The fact that HIV virulence is, at least partially, heritable from one infection to the next has clinical and epidemiological implications. The difference between earlier studies and ours comes from the quality of our dataset and from the power of the PCA, which can be applied to large datasets and accounts for within-host evolution. The PCA opens new perspectives for approaches linking clinical data and evolutionary biology because it can be extended to study other traits or other infectious diseases.

Host and viral genetic correlates of clinical definitions of HIV-1 disease progression

Various patterns of HIV-1 disease progression are described in clinical practice and in research. There is a need to assess the specificity of commonly used definitions of long term non-progressor (LTNP) elite controllers (LTNP-EC), viremic controllers (LTNP-VC), and viremic non controllers (LTNP-NC), as well as of chronic progressors (P) and rapid progressors (RP).

Long-term safety of intramuscular gene transfer of non-viral FGF1 for peripheral artery disease

Peripheral artery disease is a progressive disease. Primary ischemic leg symptoms are muscle fatigue, discomfort or pain during ambulation, known as intermittent claudication. The most severe manifestation of peripheral artery disease is critical limb ischemia (CLI). The long-term safety of gene therapy in peripheral artery disease remains unclear. This four center peripheral artery disease registry was designed to evaluate the long-term safety of the intramuscular non-viral fibroblast growth factor-1 (NV1FGF), a plasmid-based angiogenic gene for local expression of fibroblast growth factor-1 versus placebo in patients with peripheral artery disease who had been included in five different phase I and II trials. Here we report a 3-year follow-up in patients suffering from CLI or intermittent claudication. There were 93 evaluable patients, 72 of them in Fontaine stage IV (47 NV1FGF versus 25 placebo) and 21 patients in Fontaine stage IIb peripheral artery disease (15 NV1FGF versus 6 placebo). Safety parameters included rates of non-fatal myocardial infarction (MI), stroke, death, cancer, retinopathy and renal dysfunction. At 3 years, in 93 patients included this registry, there was no increase in retinopathy or renal dysfunction associated with delivery of this angiogenic factor. There was also no difference in the number of strokes, MI or deaths, respectively, for NV1FGF versus placebo. In the CLI group, new cancer occurred in two patients in the NV1FGF group. Conclusions that can be drawn from this relatively small patient group are limited because of the number of patients followed and can only be restricted to safety. Yet, data presented may be valuable concerning rates in cancer, retinopathy, MI or strokes following angiogenesis gene therapy in the absence of any long-term data in angiogenesis gene therapy. It may take several years until data from larger patient populations will become available.