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Mbituyimana B, Adhikari M, Qi F, Shi Z, Fu L, Yang G. Microneedle-based cell delivery and cell sampling for biomedical applications. J Control Release 2023; 362:692-714. [PMID: 37689252 DOI: 10.1016/j.jconrel.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023]
Abstract
Cell-based therapeutics are novel therapeutic strategies that can potentially treat many presently incurable diseases through novel mechanisms of action. Cell therapies may benefit from the ease, safety, and efficacy of administering therapeutic cells. Despite considerable recent technological and biological advances, several barriers remain to the clinical translation and commercialization of cell-based therapies, including low patient compliance, personal handling inconvenience, poor biosafety, and limited biocompatibility. Microneedles (MNs) are emerging as a promising biomedical device option for improved cell delivery with little invasion, pain-free administration, and simplicity of disposal. MNs have shown considerable promise in treating a wide range of diseases and present the potential to improve cell-based therapies. In this review, we first summarized the latest advances in the various types of MNs developed for cell delivery and cell sampling. Emphasis was given to the design and fabrication of various types of MNs based on their structures and materials. Then we focus on the recent biomedical applications status of MNs-mediated cell delivery and sampling, including tissue repair (wound healing, heart repair, and endothelial repair), cancer treatment, diabetes therapy, cell sampling, and other applications. Finally, the current status of clinical application, potential perspectives, and the challenges for clinical translation are also highlighted.
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Affiliation(s)
- Bricard Mbituyimana
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Manjila Adhikari
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Fuyu Qi
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Zhijun Shi
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China.
| | - Lina Fu
- College of Medicine, Huanghuai University, Zhumadian, Henan 463000, China; Zhumadian Central Hospital, Zhumadian, Henan 463000, China.
| | - Guang Yang
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China.
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Qayyum AA, van Klarenbosch B, Frljak S, Cerar A, Poglajen G, Traxler-Weidenauer D, Nadrowski P, Paitazoglou C, Vrtovec B, Bergmann MW, Chamuleau SAJ, Wojakowski W, Gyöngyösi M, Kraaijeveld A, Hansen KS, Vrangbaek K, Jørgensen E, Helqvist S, Joshi FR, Johansen EM, Follin B, Juhl M, Højgaard LD, Mathiasen AB, Ekblond A, Haack-Sørensen M, Kastrup J. Effect of allogeneic adipose tissue-derived mesenchymal stromal cell treatment in chronic ischaemic heart failure with reduced ejection fraction - the SCIENCE trial. Eur J Heart Fail 2023; 25:576-587. [PMID: 36644821 DOI: 10.1002/ejhf.2772] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/27/2022] [Accepted: 01/08/2023] [Indexed: 01/17/2023] Open
Abstract
AIMS The aim of the SCIENCE trial was to investigate whether a single treatment with direct intramyocardial injections of adipose tissue-derived mesenchymal stromal cells (CSCC_ASCs) was safe and improved cardiac function in patients with chronic ischaemic heart failure with reduced ejection fraction (HFrEF). METHODS AND RESULTS The study was a European multicentre, double-blind, placebo-controlled phase II trial using allogeneic CSCC_ASCs from healthy donors or placebo (2:1 randomization). Main inclusion criteria were New York Heart Association (NYHA) class II-III, left ventricular ejection fraction (LVEF) <45%, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels >300 pg/ml. CSCC_ASCs or placebo (isotonic saline) were injected directly into viable myocardium. The primary endpoint was change in left ventricular end-systolic volume (LVESV) at 6-month follow-up measured by echocardiography. A total of 133 symptomatic HFrEF patients were included. The treatment was safe without any drug-related severe adverse events or difference in cardiac-related adverse events during a 3-year follow-up period. There were no significant differences between groups during follow-up in LVESV (0.3 ± 5.0 ml, p = 0.945), nor in secondary endpoints of left ventricular end-diastolic volume (-2.0 ± 6.0 ml, p = 0.736) and LVEF (-1.6 ± 1.0%, p = 0.119). The NYHA class improved slightly within the first year in both groups without any difference between groups. There were no changes in 6-min walk test, NT-proBNP, C-reactive protein or quality of life the first year in any groups. CONCLUSION The SCIENCE trial demonstrated safety of intramyocardial allogeneic CSCC_ASC therapy in patients with chronic HFrEF. However, it was not possible to improve the pre-defined endpoints and induce restoration of cardiac function or clinical symptoms.
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Affiliation(s)
- Abbas Ali Qayyum
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bas van Klarenbosch
- Department of Cardiology and Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sabina Frljak
- Advanced Heart Failure and Transplantation Center, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Andraz Cerar
- Advanced Heart Failure and Transplantation Center, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Gregor Poglajen
- Advanced Heart Failure and Transplantation Center, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Pawel Nadrowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Bojan Vrtovec
- Advanced Heart Failure and Transplantation Center, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Martin W Bergmann
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Steven A J Chamuleau
- Department of Cardiology and Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wojtek Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Mariann Gyöngyösi
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Adriaan Kraaijeveld
- Department of Cardiology and Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kristian Schultz Hansen
- Faculty of Social Sciences and the Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karsten Vrangbaek
- Faculty of Social Sciences and the Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Erik Jørgensen
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Helqvist
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Francis Richard Joshi
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Mønsted Johansen
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bjarke Follin
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Morten Juhl
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisbeth Drozd Højgaard
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Bruun Mathiasen
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Annette Ekblond
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Mandana Haack-Sørensen
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Kastrup
- Department of Cardiology and Cardiology Stem Cell Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Fang Z, Chen P, Tang S, Chen A, Zhang C, Peng G, Li M, Chen X. Will mesenchymal stem cells be future directions for treating radiation-induced skin injury? Stem Cell Res Ther 2021; 12:179. [PMID: 33712078 PMCID: PMC7952822 DOI: 10.1186/s13287-021-02261-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/01/2021] [Indexed: 01/09/2023] Open
Abstract
Radiation-induced skin injury (RISI) is one of the common serious side effects of radiotherapy (RT) for patients with malignant tumors. Mesenchymal stem cells (MSCs) are applied to RISI repair in some clinical cases series except some traditional options. Though direct replacement of damaged cells may be achieved through differentiation capacity of MSCs, more recent data indicate that various cytokines and chemokines secreted by MSCs are involved in synergetic therapy of RISI by anti-inflammatory, immunomodulation, antioxidant, revascularization, and anti-apoptotic activity. In this paper, we not only discussed different sources of MSCs on the treatment of RISI both in preclinical studies and clinical trials, but also summarized the applications and mechanisms of MSCs in other related regenerative fields.
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Affiliation(s)
- Zhuoqun Fang
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Penghong Chen
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Shijie Tang
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Aizhen Chen
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Chaoyu Zhang
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Guohao Peng
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Ming Li
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China
| | - Xiaosong Chen
- Department of Plastic Surgery, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, Fujian, People's Republic of China.
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Campos de Carvalho AC, Kasai-Brunswick TH, Bastos Carvalho A. Cell-Based Therapies for Heart Failure. Front Pharmacol 2021; 12:641116. [PMID: 33912054 PMCID: PMC8072383 DOI: 10.3389/fphar.2021.641116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 02/11/2021] [Indexed: 02/05/2023] Open
Abstract
Heart failure has reached epidemic proportions with the advances in cardiovascular therapies for ischemic heart diseases and the progressive aging of the world population. Efficient pharmacological therapies are available for treating heart failure, but unfortunately, even with optimized therapy, prognosis is often poor. Their last therapeutic option is, therefore, a heart transplantation with limited organ supply and complications related to immunosuppression. In this setting, cell therapies have emerged as an alternative. Many clinical trials have now been performed using different cell types and injection routes. In this perspective, we will analyze the results of such trials and discuss future perspectives for cell therapies as an efficacious treatment of heart failure.
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Affiliation(s)
- Antonio Carlos Campos de Carvalho
- Laboratory of Cellular and Molecular Cardiology, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- National Center of Structural Biology and Bioimaging (CENABIO), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- National Institute of Science and Technology in Regenerative Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Antonio Carlos Campos de Carvalho,
| | - Tais H. Kasai-Brunswick
- National Center of Structural Biology and Bioimaging (CENABIO), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- National Institute of Science and Technology in Regenerative Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Bastos Carvalho
- Laboratory of Cellular and Molecular Cardiology, Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- National Institute of Science and Technology in Regenerative Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Hassouna A, M. Abd Elgwad M, Fahmy H. Stromal Stem Cells: Nature, Biology and Potential Therapeutic Applications. STROMAL CELLS - STRUCTURE, FUNCTION, AND THERAPEUTIC IMPLICATIONS 2019. [DOI: 10.5772/intechopen.77346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Chamuleau SA, van der Naald M, Climent AM, Kraaijeveld AO, Wever KE, Duncker DJ, Fernández-Avilés F, Bolli R. Translational Research in Cardiovascular Repair. Circ Res 2018; 122:310-318. [DOI: 10.1161/circresaha.117.311565] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Steven A.J. Chamuleau
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
| | - Mira van der Naald
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
| | - Andreu M. Climent
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
| | - Adriaan O. Kraaijeveld
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
| | - Kim E. Wever
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
| | - Dirk J. Duncker
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
| | - Francisco Fernández-Avilés
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
| | - Roberto Bolli
- From the Department of Cardiology (S.A.J.C., M.v.d.N., A.O.K.) and Regenerative Medicine Center Utrecht (S.A.J.C., M.v.d.N.), University Medical Center Utrecht, The Netherlands; European Society of Cardiology Working Group on Cardiovascular Regenerative and Reparative Medicine (CARE), Biot, France (S.A.J.C., A.M.C., F.F.-A.); Department of Cardiology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, CIBERCV, Madrid,
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Pape ACH, Bakker MH, Tseng CCS, Bastings MMC, Koudstaal S, Agostoni P, Chamuleau SAJ, Dankers PYW. An Injectable and Drug-loaded Supramolecular Hydrogel for Local Catheter Injection into the Pig Heart. J Vis Exp 2015:e52450. [PMID: 26132631 PMCID: PMC4544772 DOI: 10.3791/52450] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Regeneration of lost myocardium is an important goal for future therapies because of the increasing occurrence of chronic ischemic heart failure and the limited access to donor hearts. An example of a treatment to recover the function of the heart consists of the local delivery of drugs and bioactives from a hydrogel. In this paper a method is introduced to formulate and inject a drug-loaded hydrogel non-invasively and side-specific into the pig heart using a long, flexible catheter. The use of 3-D electromechanical mapping and injection via a catheter allows side-specific treatment of the myocardium. To provide a hydrogel compatible with this catheter, a supramolecular hydrogel is used because of the convenient switching from a gel to a solution state using environmental triggers. At basic pH this ureido-pyrimidinone modified poly(ethylene glycol) acts as a Newtonian fluid which can be easily injected, but at physiological pH the solution rapidly switches into a gel. These mild switching conditions allow for the incorporation of bioactive drugs and bioactive species, such as growth factors and exosomes as we present here in both in vitro and in vivo experiments. The in vitro experiments give an on forehand indication of the gel stability and drug release, which allows for tuning of the gel and release properties before the subsequent application in vivo. This combination allows for the optimal tuning of the gel to the used bioactive compounds and species, and the injection system.
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Affiliation(s)
- A C H Pape
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology
| | - Maarten H Bakker
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology
| | - Cheyenne C S Tseng
- Department of Cardiology, Division Heart and Lungs, Interuniversity Cardiology Institute of the Netherlands (ICIN), University Medical Center Utrecht
| | - Maartje M C Bastings
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology
| | - Stefan Koudstaal
- Department of Cardiology, Division Heart and Lungs, Interuniversity Cardiology Institute of the Netherlands (ICIN), University Medical Center Utrecht
| | - Pierfrancesco Agostoni
- Department of Cardiology, Division Heart and Lungs, Interuniversity Cardiology Institute of the Netherlands (ICIN), University Medical Center Utrecht
| | - Steven A J Chamuleau
- Department of Cardiology, Division Heart and Lungs, Interuniversity Cardiology Institute of the Netherlands (ICIN), University Medical Center Utrecht
| | - Patricia Y W Dankers
- Institute for Complex Molecular Systems, Department of Biomedical Engineering, Laboratory of Chemical Biology, Eindhoven University of Technology;
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Abstract
Stem cells are cells specialized cell, capable of renewing themselves through cell division and can differentiate into multi-lineage cells. These cells are categorized as embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs) and adult stem cells. Mesenchymal stem cells (MSCs) are adult stem cells which can be isolated from human and animal sources. Human MSCs (hMSCs) are the non-haematopoietic, multipotent stem cells with the capacity to differentiate into mesodermal lineage such as osteocytes, adipocytes and chondrocytes as well ectodermal (neurocytes) and endodermal lineages (hepatocytes). MSCs express cell surface markers like cluster of differentiation (CD)29, CD44, CD73, CD90, CD105 and lack the expression of CD14, CD34, CD45 and HLA (human leucocyte antigen)-DR. hMSCs for the first time were reported in the bone marrow and till now they have been isolated from various tissues, including adipose tissue, amniotic fluid, endometrium, dental tissues, umbilical cord and Wharton's jelly which harbours potential MSCs. hMSCs have been cultured long-term in specific media without any severe abnormalities. Furthermore, MSCs have immunomodulatory features, secrete cytokines and immune-receptors which regulate the microenvironment in the host tissue. Multilineage potential, immunomodulation and secretion of anti-inflammatory molecules makes MSCs an effective tool in the treatment of chronic diseases. In the present review, we have highlighted recent research findings in the area of hMSCs sources, expression of cell surface markers, long-term in vitro culturing, in vitro differentiation potential, immunomodulatory features, its homing capacity, banking and cryopreservation, its application in the treatment of chronic diseases and its use in clinical trials.
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de Jong R, van Hout GPJ, Houtgraaf JH, Kazemi K, Wallrapp C, Lewis A, Pasterkamp G, Hoefer IE, Duckers HJ. Intracoronary infusion of encapsulated glucagon-like peptide-1-eluting mesenchymal stem cells preserves left ventricular function in a porcine model of acute myocardial infarction. Circ Cardiovasc Interv 2014; 7:673-83. [PMID: 25294400 DOI: 10.1161/circinterventions.114.001580] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Engraftment and survival of stem cells in the infarcted myocardium remain problematic in cell-based therapy for cardiovascular disease. To overcome these issues, encapsulated mesenchymal stem cells (eMSCs) were developed that were transfected to produce glucagon-like peptide-1, an incretin hormone with known cardioprotective effects, alongside MSC endogenous paracrine factors. This study was designed to investigate the efficacy of different doses of intracoronary infusion of eMSC in a porcine model of acute myocardial infarction (AMI). METHODS AND RESULTS One hundred pigs were subjected to a moderate AMI (posterolateral AMI; n=50) or a severe AMI (anterior AMI; n=50), whereupon surviving animals (n=36 moderate, n=33 severe) were randomized to receive either intracoronary infusion of 3 incremental doses of eMSC or Ringers' lactate control. Cardiac function was assessed using invasive hemodynamics, echocardiography, and histological analysis. A trend was observed in the moderate AMI model, whereas in the severe AMI model, left ventricular ejection fraction improved by +9.3% (P=0.004) in the best responding eMSC group, because of a preservation of left ventricular end-systolic volume. Arteriolar density increased 3-fold in the infarct area (8.4±0.9/mm(2) in controls versus 22.2±2.6/mm(2) in eMSC group; P<0.001). Although not statistically significant, capillary density was 30% higher in the border zone (908.1±99.7/mm(2) in control versus 1209.0±64.6/mm(2) in eMSC group; P=ns). CONCLUSIONS eMSCs enable sustained local delivery of cardioprotective proteins to the heart, thereby enhancing angiogenesis and preserving contractile function in an animal AMI model.
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Affiliation(s)
- Renate de Jong
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Gerardus P J van Hout
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Jaco H Houtgraaf
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Kushan Kazemi
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Christine Wallrapp
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Andrew Lewis
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Gerard Pasterkamp
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Imo E Hoefer
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.)
| | - Henricus J Duckers
- From the Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, The Netherlands (R.d.J., J.H.H., K.K.); Experimental Cardiology Laboratory, University and Medical Center Utrecht, The Netherlands (G.P.J.v.H., G.P., I.E.H.); BTG International Germany GmbH, Alzenau, Germany (C.W.); Biocompatibles UK Ltd, a BTG International Group Company, Farnham, United Kingdom (A.L.); and Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.D.).
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10
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Azene N, Fu Y, Maurer J, Kraitchman DL. Tracking of stem cells in vivo for cardiovascular applications. J Cardiovasc Magn Reson 2014; 16:7. [PMID: 24406054 PMCID: PMC3925252 DOI: 10.1186/1532-429x-16-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 12/11/2013] [Indexed: 01/14/2023] Open
Abstract
In the past ten years, the concept of injecting stem and progenitor cells to assist with rebuilding damaged blood vessels and myocardial tissue after injury in the heart and peripheral vasculature has moved from bench to bedside. Non-invasive imaging can not only provide a means to assess cardiac repair and, thereby, cellular therapy efficacy but also a means to confirm cell delivery and engraftment after administration. In this first of a two-part review, we will review the different types of cellular labeling techniques and the application of these techniques in cardiovascular magnetic resonance and ultrasound. In addition, we provide a synopsis of the cardiac cellular clinical trials that have been performed to-date.
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Affiliation(s)
- Nicole Azene
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, MD, USA
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University, Baltimore, MD, USA
| | - Yingli Fu
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, MD, USA
| | - Jeremy Maurer
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, MD, USA
| | - Dara L Kraitchman
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, Baltimore, MD, USA
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University, Baltimore, MD, USA
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, 314 Park Building, Baltimore, MD 21287, USA
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11
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Mesenchymal stem cell therapy for cardiac inflammation: immunomodulatory properties and the influence of toll-like receptors. Mediators Inflamm 2013; 2013:181020. [PMID: 24391353 PMCID: PMC3872440 DOI: 10.1155/2013/181020] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/14/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND After myocardial infarction (MI), the inflammatory response is indispensable for initiating reparatory processes. However, the intensity and duration of the inflammation cause additional damage to the already injured myocardium. Treatment with mesenchymal stem cells (MSC) upon MI positively affects cardiac function. This happens likely via a paracrine mechanism. As MSC are potent modulators of the immune system, this could influence this postinfarct immune response. Since MSC express toll-like receptors (TLR), danger signal (DAMP) produced after MI could influence their immunomodulatory properties. SCOPE OF REVIEW Not much is known about the direct immunomodulatory efficiency of MSC when injected in a strong inflammatory environment. This review focuses first on the interactions between MSC and the immune system. Subsequently, an overview is provided of the effects of DAMP-associated TLR activation on MSC and their immunomodulative properties after myocardial infarction. MAJOR CONCLUSIONS MSC can strongly influence most cell types of the immune system. TLR signaling can increase and decrease this immunomodulatory potential, depending on the available ligands. Although reports are inconsistent, TLR3 activation may boost immunomodulation by MSC, while TLR4 activation suppresses it. GENERAL SIGNIFICANCE Elucidating the effects of TLR activation on MSC could identify new preconditioning strategies which might improve their immunomodulative properties.
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12
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Houtgraaf JH, de Jong R, Kazemi K, de Groot D, van der Spoel TIG, Arslan F, Hoefer I, Pasterkamp G, Itescu S, Zijlstra F, Geleijnse ML, Serruys PW, Duckers HJ. Intracoronary infusion of allogeneic mesenchymal precursor cells directly after experimental acute myocardial infarction reduces infarct size, abrogates adverse remodeling, and improves cardiac function. Circ Res 2013; 113:153-66. [PMID: 23658436 DOI: 10.1161/circresaha.112.300730] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
RATIONALE Mesenchymal precursor cells (MPCs) are a specific Stro-3+ subpopulation of mesenchymal stem cells isolated from bone marrow. MPCs exert extensive cardioprotective effects, and are considered to be immune privileged. OBJECTIVE This study assessed the safety, feasibility, and efficacy of intracoronary delivery of allogeneic MPCs directly after acute myocardial infarction in sheep. METHODS AND RESULTS Initially, intracoronary delivery conditions were optimized in 20 sheep. These conditions were applied in a randomized study of 68 sheep with an anterior acute myocardial infarction. Coronary flow was monitored during MPC infusion, and cardiac function was assessed using invasive hemodynamics and echocardiography at baseline and during 8 weeks follow-up. Coronary flow remained within thrombolysis in myocardial infarction III definitions in all sheep during MPC infusion. Global left ventricular ejection fraction as measured by pressure-volume loop analysis deteriorated in controls to 40.7±2.6% after 8 weeks. In contrast, MPC treatment improved cardiac function to 52.8±0.7%. Echocardiography revealed significant improvement of both global and regional cardiac functions. Infarct size decreased by 40% in treated sheep, whereas infarct and border zone thickness were enhanced. Left ventricular adverse remodeling was abrogated by MPC therapy, resulting in a marked reduction of left ventricular volumes. Blood vessel density increased by >50% in the infarct and border areas. Compensatory cardiomyocyte hypertrophy was reduced in border and remote segments, accompanied by reduced collagen deposition and apoptosis. No microinfarctions in remote myocardial segments or histological abnormalities in unrelated organs were found. CONCLUSIONS Intracoronary infusion of allogeneic MPCs is safe, feasible, and markedly effective in a large animal model of acute myocardial infarction.
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Affiliation(s)
- Jaco H Houtgraaf
- Molecular Cardiology Laboratory, Thoraxcenter, Erasmus University Medical Center Rotterdam, The Netherlands
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13
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Liu J, van Mil A, Aguor ENE, Siddiqi S, Vrijsen K, Jaksani S, Metz C, Zhao J, Strijkers GJ, Doevendans PA, Sluijter JPG. MiR-155 inhibits cell migration of human cardiomyocyte progenitor cells (hCMPCs) via targeting of MMP-16. J Cell Mol Med 2013; 16:2379-86. [PMID: 22348515 PMCID: PMC3823431 DOI: 10.1111/j.1582-4934.2012.01551.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Undesired cell migration after targeted cell transplantation potentially limits beneficial effects for cardiac regeneration. MicroRNAs are known to be involved in several cellular processes, including cell migration. Here, we attempt to reduce human cardiomyocyte progenitor cell (hCMPC) migration via increasing microRNA-155 (miR-155) levels, and investigate the underlying mechanism. Human cardiomyocyte progenitor cells (hCMPCs) were transfected with pre-miR-155, anti-miR-155 or control-miR (ctrl-miR), followed by scratch- and transwell-assays. These functional assays displayed that miR-155 over-expression efficiently inhibited cell migration by 38 ± 3.6% and 59 ± 3.7% respectively. Conditioned medium from miR-155 transfected cells was collected and zymography analysis showed a significant decrease in MMP-2 and MMP-9 activities. The predicted 3'-UTR of MMP-16, an activator of MMP-2 and -9, was cloned into the pMIR-REPORT vector and luciferase assays were performed. Introduction of miR-155 significantly reduced luciferase activity which could be abolished by cotransfection with anti-miR-155 or target site mutagenesis. By using MMP-16 siRNA to reduce MMP-16 levels or by using an MMP-16 blocking antibody, hCMPC migration could be blocked as well. By directly targeting MMP-16, miR-155 efficiently inhibits cell migration via a reduction in MMP-2 and -9 activities. Our study shows that miR-155 might be used to improve local retention of hCMPCs after intramyocardial delivery.
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Affiliation(s)
- Jia Liu
- Department of Endocrinology, Provincial Hospital affiliated to Shandong University, Jinan, China
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14
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Houtgraaf JH, de Jong R, Monkhorst K, Tempel D, van de Kamp E, den Dekker WK, Kazemi K, Hoefer I, Pasterkamp G, Lewis AL, Stratford PW, Wallrapp C, Zijlstra F, Duckers HJ. Feasibility of intracoronary GLP-1 eluting CellBead™ infusion in acute myocardial infarction. Cell Transplant 2012; 22:535-43. [PMID: 22507673 DOI: 10.3727/096368912x638973] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Cell therapy is a field of growing interest in the prevention of post acute myocardial infarction (AMI) heart failure. Stem cell retention upon local delivery to the heart, however, is still unsatisfactory. CellBeads were recently developed as a potential solution to this problem. CellBeads are 170-μm alginate microspheres that contain mesenchymal stem cells (MSCs) genetically modified to express glucagon-like peptide-1 (GLP-1) supplementary to inherent paracrine factors. GLP-1 is an incretin hormone that has both antiapoptotic and cardioprotective effects. Transplanting CellBeads in the post-AMI heart might induce cardiomyocyte salvage and ultimately abrogate adverse cardiac remodeling. We aimed to investigate the feasibility of intracoronary infusion of CellBeads in a large animal model of AMI. Four pigs were used in a pilot study to assess the maximal safe dose of CellBeads. In the remaining 21 animals, an AMI was induced by balloon occlusion of the left circumflex coronary artery for 90 min. During reperfusion, 60,000 CellBeads (n = 11), control beads (n = 4), or lactated Ringers' (n = 6) were infused. Animals were sacrificed after 2 or 7 days, and the hearts were excised for histological analyses. Intracoronary infusion did not permanently affect coronary flow in any of the groups. Histological analysis revealed CellBeads containing viable MSCs up to 7 days. Viability and activity of the MSCs was confirmed by qPCR analysis that showed expression of recombinant GLP-1 and human genes after 2 and 7 days. CellBeads reduced inflammatory infiltration by 29% (p = 0.001). In addition, they decreased the extent of apoptosis by 25% (p = 0.001) after 2 days. We show that intracoronary infusion of 5 million encapsulated MSCs is safe and feasible. Also, several parameters indicate that the cells have paracrine effects, suggesting a potential therapeutic benefit of this new approach.
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Affiliation(s)
- Jaco H Houtgraaf
- Molecular Cardiology Laboratory, Thoraxcenter, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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15
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Cardiovascular imaging 2011 in the International Journal of Cardiovascular Imaging. Int J Cardiovasc Imaging 2012; 28:439-51. [PMID: 22476909 PMCID: PMC3326368 DOI: 10.1007/s10554-012-0040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Zhang WY, Ebert AD, Narula J, Wu JC. Imaging cardiac stem cell therapy: translations to human clinical studies. J Cardiovasc Transl Res 2011; 4:514-22. [PMID: 21538182 PMCID: PMC3657500 DOI: 10.1007/s12265-011-9281-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 04/14/2011] [Indexed: 12/21/2022]
Abstract
Stem cell therapy promises to open exciting new options in the treatment of cardiovascular diseases. Although feasible and clinically safe, the in vivo behavior and integration of stem cell transplants still remain largely unknown. Thus, the development of innovative non-invasive imaging techniques capable of effectively tracking such therapy in vivo is vital for a more in-depth investigation into future clinical applications. Such imaging modalities will not only generate further insight into the mechanisms behind stem cell-based therapy, but also address some major concerns associated with translational cardiovascular stem cell therapy. In the present review, we summarize the principles underlying three major stem cell tracking methods: (1) radioactive labeling for positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging, (2) iron particle labeling for magnetic resonance imaging (MRI), and (3) reporter gene labeling for bioluminescence, fluorescence, MRI, SPECT, and PET imaging. We then discuss recent clinical studies that have utilized these modalities to gain biological insights into stem cell fate.
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Affiliation(s)
- Wendy Y. Zhang
- Department of Medicine (Division of Cardiology), Stanford University School of Medicine
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine
| | - Antje D. Ebert
- Department of Medicine (Division of Cardiology), Stanford University School of Medicine
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine
| | - Jagat Narula
- Division of Cardiology, UC Irvine Medical Center, Orange, California, USA
| | - Joseph C. Wu
- Department of Medicine (Division of Cardiology), Stanford University School of Medicine
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine
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Gyöngyösi M, Dib N. Diagnostic and prognostic value of 3D NOGA mapping in ischemic heart disease. Nat Rev Cardiol 2011; 8:393-404. [DOI: 10.1038/nrcardio.2011.64] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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