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A 3D Mathematical Model of Coupled Stem Cell-Nutrient Dynamics in Myocardial Regeneration Therapy. J Theor Biol 2022; 537:111023. [PMID: 35041851 DOI: 10.1016/j.jtbi.2022.111023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/04/2021] [Accepted: 01/09/2022] [Indexed: 11/23/2022]
Abstract
Stem cell therapy is a promising treatment for the regeneration of myocardial tissue injured by an ischemic event. Mathematical modeling of myocardial regeneration via stem cell therapy is a challenging task, since the mechanisms underlying the processes involved in the treatment are not yet fully understood. Many aspects must be accounted for, such as the spread of stem cells and nutrients, chemoattraction, cell proliferation, stages of cell maturation, differentiation, angiogenesis, stochastic effects, just to name a few. In this paper we propose a 3D mathematical model with a free boundary that aims to provide a qualitative description of some main aspects of the stem cell regenerative therapy in a simplified scenario. The paper mainly focuses on the description of the shrinking of the necrotic core during treatment. The stem cell and nutrients dynamics are described through coupled reaction-diffusion problems. Proliferation, chemoattraction, tissue regeneration and nutrient consumption are included in the model.
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Rodenberg EJ, Patel DS, Shirley B, Young BW, Taylor AF, Steidinger HR, Fisher SJ, Patel AN. Catheter-based retrograde coronary sinus infusion is a practical delivery technique for introducing biological molecules into the cardiac system. Catheter Cardiovasc Interv 2019; 94:669-676. [PMID: 30866153 DOI: 10.1002/ccd.28159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/31/2018] [Accepted: 02/06/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To demonstrate coronary sinus (CS) retrograde catheterization as a practicable technique for delivering biologics into the heart. BACKGROUND There are many options to deliver biologics into the heart. However, there is no single optimal technique when considering safety, biologic retention, and reproducibility. Retrograde delivery has the potential to address many of these concerns. This study evaluated retrograde CS infusion of luciferase-expressing plasmid in a porcine model using the Advance® CS Coronary Sinus Infusion Catheter and bioluminescence imaging to track the expression of the infused biological markers. METHODS Plasmid was delivered retrograde into the CS in one of three infusion volumes. Twenty-four hours post-infusion, hearts were excised and underwent bioluminescence imaging to characterize the expression of the infusates. Heart and lung biopsies were also assessed for luciferase expression using RT-qPCR. RESULTS Retrograde infusion was safe and successful in all nine test subjects. Luciferase detection was inconsistent in the low volume group. Bioluminescence was confined predominantly along the posterolateral left ventricle for medium volume infusions and was more broadly dispersed along the anterior side of the heart for high volume infusions. Tissue mRNA analysis corroborated the bioluminescence results, with the highest concentration of luciferase expression localized in the left ventricle. CONCLUSIONS Retrograde CS infusion is a promising technique for delivering biological molecules to the heart. Specifically, this study demonstrated that the low pressure coronary venous system accommodates a wide range of infusion volumes and that biological infusates can be maintained in situ following the resumption of coronary venous flow.
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Affiliation(s)
| | - Dimki S Patel
- Human Therapeutics Division, Intrexon Corporation, Germantown, Maryland
| | - Brad Shirley
- Cook BioDevice, Cook Regentec LLC, Indianapolis, Indiana
| | - Brandt W Young
- Non-Clinical Testing, Cook Research Incorporated, West Lafayette, Indiana
| | - Amanda F Taylor
- Cell Manufacturing Solutions, Cook Regentec LLC, Indianapolis, Indiana
| | | | - Scott J Fisher
- Emerging Therapies, Precigen, Inc., Germantown, Maryland
| | - Amit N Patel
- Division of Cardiothoracic Surgery, University of Miami, Miller School of Medicine, Miami, Florida
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Rationale and design of a prospective, randomised study of retrograde application of bone marrow aspirate concentrate (BMAC) through coronary sinus in patients with congestive heart failure of ischemic etiology (the RETRO study). BMC Cardiovasc Disord 2019; 19:32. [PMID: 30704414 PMCID: PMC6357383 DOI: 10.1186/s12872-019-1011-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/23/2019] [Indexed: 01/27/2023] Open
Abstract
Background Heart failure (HF) is a major chronic illness and results in high morbidity and mortality. The most frequent cause of HF with reduced ejection fraction (HFREF) is coronary artery disease (CAD). Although revascularisation of ischemic myocardium lead to improvements in myocardial contractility and systolic function, it cannnot restore the viability of the already necrotic myocardium. Methods/design The aim of our prospective randomised study is to assess the efficacy of the retrograde application of non-selected bone marrow autologous cells concentrate (BMAC) in patients with HFREF of ischemic aetiology. The evaluated preparation is concentrated BMAC, obtained using Harvest SmartPReP2 (Harvest Technologies, Plymouth, MA, USA). The study population will be a total of 40 patients with established CAD, systolic dysfunction with LV EF of ≤40% and HF in the NYHA class 3. Patients have been on standard HF therapy for 3 months and in a stabilised state for at least 1 month, before enrolling in the clinical study. Patients will be randomised 1:1 to either retrograde BMAC administration via coronary sinus or standard HF therapy. The primary end-points (left ventricular end-systolic and end-diastolic diameters [LVESd/EDd] and volumes [LVESV/EDV] and left ventricular ejection fraction [LV EF]) will be assessed by magnetic resonance imaging. The follow-up period will be 12 month. Discussion The application of bone marrow stem cells into affected areas of the myocardium seems to be a promising treatment of ischemic cardiomyopathy. The Harvest BMAC contains the entire population of nuclear cells from bone marrow aspirates together with platelets. The presence of both platelets and additional granulocytes can have a positive effect on the neovascularisation potential of the resulting concentrate. Our assumption is that retrograde administration on non-selected BMAC via coronary sinus, due to the content of platelets and growth factors, might improve left ventricular function and parameters compared to standard HF therapy. Furthermore, it will be associated with improved exercise tolerance in the six-minute corridor walk test and an improvement in the life quality of patients without increasing the incidence of severe ventricular arrythmias. Trial registration (ClinicalTrials.gov; https://clinicaltrials.gov; NCT03372954).
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Hu M, Guo G, Huang Q, Cheng C, Xu R, Li A, Liu N, Liu S. The harsh microenvironment in infarcted heart accelerates transplanted bone marrow mesenchymal stem cells injury: the role of injured cardiomyocytes-derived exosomes. Cell Death Dis 2018; 9:357. [PMID: 29500342 PMCID: PMC5834521 DOI: 10.1038/s41419-018-0392-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 12/11/2022]
Abstract
Stem cell therapy can be used to repair and regenerate damaged hearts tissue; nevertheless, the low survival rate of transplanted cells limits their therapeutic efficacy. Recently, it has been proposed that exosomes regulate multiple cellular processes by mediating cell survival and communication among cells. The following study investigates whether injured cardiomyocytes-derived exosomes (cardiac exosomes) affect the survival of transplanted bone marrow mesenchymal stem cells (BMSCs) in infarcted heart. To mimic the harsh microenvironment in infarcted heart that the cardiomyocytes or transplanted BMSCs encounter in vivo, cardiomyocytes conditioned medium and cardiac exosomes collected from H2O2-treated cardiomyocytes culture medium were cultured with BMSCs under oxidative stress in vitro. Cardiomyocytes conditioned medium and cardiac exosomes significantly accelerated the injury of BMSCs induced by H2O2; increased cleaved caspase-3/caspase-3 and apoptotic percentage, and decreased the ratio of Bcl-2/Bax and cell viability in those cells. Next, we explored the role of cardiac exosomes in the survival of transplanted BMSCs in vivo by constructing a Rab27a knockout (KO) mice model by a transcription activator-like effector nuclease (TALEN) genome-editing technique; Rab27a is a family of GTPases, which has critical role in secretion of exosomes. Male mouse GFP-modified BMSCs were implanted into the viable myocardium bordering the infarction in Rab27a KO and wild-type female mice. The obtained results showed that the transplanted BMSCs survival in infarcted heart was increased in Rab27a KO mice by the higher level of Y-chromosome Sry DNA, GFP mRNA, and the GFP fluorescence signal intensity. To sum up, these findings revealed that the injured cardiomyocytes-derived exosomes accelerate transplanted BMSCs injury in infarcted heart, thus highlighting a new mechanism underlying the survival of transplanted cells after myocardial infarction.
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Affiliation(s)
- Ming Hu
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China
| | - Guixian Guo
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China
| | - Qiang Huang
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China
| | - Chuanfang Cheng
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China
| | - Ruqin Xu
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China
| | - Aiqun Li
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China
| | - Ningning Liu
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.
| | - Shiming Liu
- Guangzhou Institute of Cardiovascular Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.
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Cheng W, Law PK. Conceptual Design and Procedure for an Autonomous Intramyocardial Injection Catheter. Cell Transplant 2017; 26:735-751. [PMID: 27938487 PMCID: PMC5657718 DOI: 10.3727/096368916x694256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/09/2017] [Indexed: 11/24/2022] Open
Abstract
This article discusses existing catheter systems and proposes a conceptual design and procedure for an autonomous cell injection catheter for the purpose of transferring committed myogenic or undifferentiated stem cells into the infarct boundary zones of the left ventricle. Operation of existing catheters used for cell delivery is far from optimal. Commercial injection catheters available are handheld devices operated manually by means of tip deflection and torque capabilities. Interventionists require a hefty learning curve and often encounter difficulties in catheter stabilization and infarct detection, resulting in lengthy operation times and nonprecise injections. We examined current technologies and proposed a design incorporating robotic positional control, feedback signals, and an adaptable operational sequence to overcome these problems. The design provides the basis for robotic catheter construction that is able to autonomously assist the physician in transferring myogenic cells to the left ventricle infarct boundary zones.
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Affiliation(s)
- Weyland Cheng
- Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan, P.R. China
- Cell Therapy Institute, Wuhan, P.R. China
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Zhang Z, Yang C, Shen M, Yang M, Jin Z, Ding L, Jiang W, Yang J, Chen H, Cao F, Hu T. Autophagy mediates the beneficial effect of hypoxic preconditioning on bone marrow mesenchymal stem cells for the therapy of myocardial infarction. Stem Cell Res Ther 2017; 8:89. [PMID: 28420436 PMCID: PMC5395756 DOI: 10.1186/s13287-017-0543-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/04/2017] [Accepted: 03/23/2017] [Indexed: 12/12/2022] Open
Abstract
Background Stem cell therapy has emerged as a promising therapeutic strategy for myocardial infarction (MI). However, the poor viability of transplanted stem cells hampers their therapeutic efficacy. Hypoxic preconditioning (HPC) can effectively promote the survival of stem cells. The aim of this study was to investigate whether HPC improved the functional survival of bone marrow mesenchymal stem cells (BM-MSCs) and increased their cardiac protective effect. Methods BM-MSCs, isolated from Tg(Fluc-egfp) mice which constitutively express both firefly luciferase (Fluc) and enhanced green fluorescent protein (eGFP), were preconditioned with HPC (1% O2) for 12 h, 24 h, 36 h, and 48 h, respectively, followed by 24 h of hypoxia and serum deprivation (H/SD) injury. Results HPC dose-dependently increased the autophagy in BM-MSCs. However, the protective effects of HPC for 24 h are most pronounced. Moreover, hypoxic preconditioned BM-MSCs (HPCMSCs) and nonhypoxic preconditioned BM-MSCs (NPCMSCs) were transplanted into infarcted hearts. Longitudinal in vivo bioluminescence imaging (BLI) and immunofluorescent staining revealed that HPC enhanced the survival of engrafted BM-MSCs. Furthermore, HPCMSCs significantly reduced fibrosis, decreased apoptotic cardiomyocytes, and preserved heart function. However, the beneficial effect of HPC was abolished by autophagy inhibition with 3-methyladenine (3-MA) and Atg7siRNA. Conclusion This study demonstrates that HPC may improve the functional survival and the therapeutic efficiencies of engrafted BM-MSCs, at least in part through autophagy regulation. Hypoxic preconditioning may serve as a promising strategy for optimizing cell-based cardiac regenerative therapy. Electronic supplementary material The online version of this article (doi:10.1186/s13287-017-0543-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zheng Zhang
- Department of Cardiology, The General Hospital of the PLA Rocket Force, Beijing, 100088, China
| | - Chao Yang
- Department of Blood Transfusion, The General Hospital of the PLA Rocket Force, Beijing, 100088, China
| | - Mingzhi Shen
- Department of Cardiology, Hainan Branch of PLA General Hospital, Sanya, 572013, China
| | - Ming Yang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 201306, China.,School of Basic Medical Sciences, Taishan Medical University, Taian, Shandong, 271000, China
| | - Zhitao Jin
- Department of Cardiology, The General Hospital of the PLA Rocket Force, Beijing, 100088, China
| | - Liping Ding
- Department of Cardiology, The General Hospital of the PLA Rocket Force, Beijing, 100088, China
| | - Wei Jiang
- Department of Cardiology, The General Hospital of the PLA Rocket Force, Beijing, 100088, China
| | - Junke Yang
- Department of Cardiology, The General Hospital of the PLA Rocket Force, Beijing, 100088, China
| | - Haixu Chen
- Core Laboratory of Translational Medicine, Institute of Geriatrics, PLA general Hospital, Beijing, 100853, China
| | - Feng Cao
- Department of Cardiology, The General Hospital of Chinese People's Liberation Army, Beijing, 100853, China.
| | - Taohong Hu
- Department of Cardiology, The General Hospital of the PLA Rocket Force, Beijing, 100088, China.
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Chen C, Qu Z, Yin X, Shang C, Ao Q, Gu Y, Liu Y. Efficacy of umbilical cord-derived mesenchymal stem cell-based therapy for osteonecrosis of the femoral head: A three-year follow-up study. Mol Med Rep 2016; 14:4209-4215. [PMID: 27634376 PMCID: PMC5101965 DOI: 10.3892/mmr.2016.5745] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/30/2016] [Indexed: 01/16/2023] Open
Abstract
This is a retrospective analysis of the clinical effects of transplant of mesenchymal stem cells (MSCs) derived from human umbilical cord-derived MSCs (hUC-MSCs) for the treatment of osteonecrosis of the femoral head (ONFH). The biological characteristics of hUC-MSCs were assessed using flow cytometry. Nine eligible patients were enrolled in the study as they adhered to the Association Research Circulation Osseous (ARCO) classification of stage II–IIIa, and hUC-MSCs were grafted by intra-arterial infusion. Organize effective perfusion was assessed using the oxygen delivery index (ODI). The results showed that the ODI was increased at three days post-operation. The MRI results revealed that at 12 and 24 months after treatment, the necrotic volume of the femoral heads was significantly reduced. No obvious abnormalities were observed. Taken together, these data indicate that intra-arterially infused hUC-MSCs migrate into the necrotic field of femoral heads and differentiate into osteoblasts, thus improving the necrosis of femoral heads. This finding suggested that intra-arterial infusion of hUC-MSCs MSCs is a feasible and relatively safe method for the treatment of femoral head necrosis.
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Affiliation(s)
- Chun Chen
- Department of Vascular Interventional Surgery, Siping Hospital of China Medical University, Shenyang, Liaoning 110122, P.R. China
| | - Zhiguo Qu
- Department of Orthopaedic Surgery, Siping Hospital of China Medical University, Siping, Jilin 136000, P.R. China
| | - Xiaoguang Yin
- Tuhua Bioengineering Company Ltd., Siping, Jilin 136000, P.R. China
| | - Chunyu Shang
- Department of Vascular Interventional Surgery, Siping Hospital of China Medical University, Shenyang, Liaoning 110122, P.R. China
| | - Qiang Ao
- Department of Tissue Engineering, China Medical University, Shenyang, Liaoning 110122, P.R. China
| | - Yongquan Gu
- Department of Vascular Interventional Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, P.R. China
| | - Ying Liu
- Tuhua Bioengineering Company Ltd., Siping, Jilin 136000, P.R. China
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The Fate and Distribution of Autologous Bone Marrow Mesenchymal Stem Cells with Intra-Arterial Infusion in Osteonecrosis of the Femoral Head in Dogs. Stem Cells Int 2015; 2016:8616143. [PMID: 26779265 PMCID: PMC4686726 DOI: 10.1155/2016/8616143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 08/03/2015] [Accepted: 08/06/2015] [Indexed: 01/16/2023] Open
Abstract
This study aimed to investigate if autologous bone marrow mesenchymal stem cells (MSCs)
could treat osteonecrosis of the femoral head (ONFH) and what the fate and distribution of the
cells are in dogs. Twelve Beagle dogs were randomly divided into two groups: MSCs group and
SHAM operated group. After three weeks, dogs in MSCs group and SHAM operated group were
intra-arterially injected with autologous MSCs and 0.9% normal saline, respectively. Eight
weeks after treatment, the necrotic volume of the femoral heads was significantly reduced in
MSCs group. Moreover, the trabecular bone volume was increased and the empty lacunae rate was
decreased in MSCs group. In addition, the BrdU-positive MSCs were unevenly distributed in femoral
heads and various vital organs. But no obvious abnormalities were observed. Furthermore, most of
BrdU-positive MSCs in necrotic region expressed osteocalcin in MSCs group and a few expressed
peroxisome proliferator-activated receptor-γ (PPAR-γ). Taken together, these data
indicated that intra-arterially infused MSCs could migrate into the necrotic field of femoral heads
and differentiate into osteoblasts, thus improving the necrosis of femoral heads. It suggests that
intra-arterial infusion of autologous MSCs might be a feasible and relatively safe method for the treatment of femoral head necrosis.
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Thodeti CK. A bouquet for a broken heart: can flowers repair a damaged heart? Circ Res 2015; 116:1729-31. [PMID: 25999417 DOI: 10.1161/circresaha.115.306590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Charles K Thodeti
- From the Department of Integrative Medical Sciences, Northeast Ohio Medical University, Rootstown, OH.
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10
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Decuzzi P. Patient-specific computational modeling and magnetic nanoconstructs: tools for maximizing the efficacy of stem cell-based therapies. Methodist Debakey Cardiovasc J 2014; 9:223-8. [PMID: 24298315 DOI: 10.14797/mdcj-9-4-223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Stem cell transplantation has the potential to restore heart function following myocardial infarction. However, the success of any stem cell-based therapy is critically linked to the effective homing and early engraftment of the injected cells at the infarcted site. Here, a hierarchical multiscale computational model is proposed for predicting the patient-specific vascular transport and intratissue homing and migration of stem cells injected either systemically or locally. Starting with patient-specific data, such as the vascular geometry, blood flow, and location of the infarcted area, the computational model can be used to perform parametric analysis to identify optimal injection conditions in terms of administration route, injection site, catheter type, and infusion velocity. In addition to this, a new generation of magnetic nanoconstructs is introduced for labeling stem cells and monitoring their behavior in vivo via magnetic resonance imaging. These nanoconstructs also can be used for multimodal imaging, merging MRI and nuclear imaging, and the intracellular delivery of active agents to support stem cell differentiation. The convergence of computational modeling and novel nanoconstructs for stem cell labeling could improve our understanding in cell homing and early engraftment at the infarcted site and thus pave the way to more effective stem cell-based therapies.
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Affiliation(s)
- Paolo Decuzzi
- Houston Methodist Hospital Research Institute, Houston Methodist Hospital, Houston, Texas
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Huang Z, Shen Y, Sun A, Huang G, Zhu H, Huang B, Xu J, Song Y, Pei N, Ma J, Yang X, Zou Y, Qian J, Ge J. Magnetic targeting enhances retrograde cell retention in a rat model of myocardial infarction. Stem Cell Res Ther 2014; 4:149. [PMID: 24330751 PMCID: PMC4055006 DOI: 10.1186/scrt360] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 05/14/2013] [Accepted: 12/02/2013] [Indexed: 02/06/2023] Open
Abstract
Introduction Retrograde coronary venous infusion is a promising delivery method for cellular cardiomyoplasty. Poor cell retention is the major obstacle to the establishment of this method as the preferred route for cell delivery. Here, we explored whether magnetic targeting could enhance retrograde cell retention in a rat model of myocardial infarction. Methods Rat mesenchymal stem cells were labeled with superparamagnetic oxide nanoparticles. The magnetic responsiveness of MSCs was observed while cells flowed through a tube that served as a model of blood vessels in a 0.6-Tesla magnetic field. In a Sprague–Dawley rat model of acute myocardial infarction, 1 × 106 magnetic mesenchymal stem cells were transjugularly injected into the left cardiac vein while a 0.6-Tesla magnet was placed above the heart. The cardiac retention of transplanted cells was assessed by using quantitative Y chromosome-specific polymerase chain reaction, cardiac magnetic resonance imaging, and optical imaging. Cardiac function was measured by using echocardiography, and histologic analyses of infarct morphology and angiogenesis were obtained. Results The flowing iron oxide-labeled mesenchymal stem cells were effectively attracted to the area where the magnet was positioned. Twenty-four hours after cellular retrocoronary delivery, magnetic targeting significantly increased the cardiac retention of transplanted cells by 2.73- to 2.87-fold. Histologic analyses showed that more transplanted cells were distributed in the anterior wall of the left ventricle. The enhanced cell engraftment persisted for at least 3 weeks, at which time, left ventricular remodeling was attenuated, and cardiac function benefit was improved. Conclusions These results suggest that magnetic targeting offers new perspectives for retrograde coronary venous delivery to enhance cell retention and subsequent functional benefit in heart diseases.
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Jadczyk T, Faulkner A, Madeddu P. Stem cell therapy for cardiovascular disease: the demise of alchemy and rise of pharmacology. Br J Pharmacol 2014; 169:247-68. [PMID: 22712727 DOI: 10.1111/j.1476-5381.2012.01965.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Regenerative medicine holds great promise as a way of addressing the limitations of current treatments of ischaemic disease. In preclinical models, transplantation of different types of stem cells or progenitor cells results in improved recovery from ischaemia. Furthermore, experimental studies indicate that cell therapy influences a spectrum of processes, including neovascularization and cardiomyogenesis as well as inflammation, apoptosis and interstitial fibrosis. Thus, distinct strategies might be required for specific regenerative needs. Nonetheless, clinical studies have so far investigated a relatively small number of options, focusing mainly on the use of bone marrow-derived cells. Rapid clinical translation resulted in a number of small clinical trials that do not have sufficient power to address the therapeutic potential of the new approach. Moreover, full exploitation has been hindered so far by the absence of a solid theoretical framework and inadequate development plans. This article reviews the current knowledge on cell therapy and proposes a model theory for interpretation of experimental and clinical outcomes from a pharmacological perspective. Eventually, with an increased association between cell therapy and traditional pharmacotherapy, we will soon need to adopt a unified theory for understanding how the two practices additively interact for a patient's benefit.
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Affiliation(s)
- T Jadczyk
- Third Division of Cardiology, Medical University of Silesia, Katovice, Poland
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Zamilpa R, Navarro MM, Flores I, Griffey S. Stem cell mechanisms during left ventricular remodeling post-myocardial infarction: Repair and regeneration. World J Cardiol 2014; 6:610-620. [PMID: 25068021 PMCID: PMC4110609 DOI: 10.4330/wjc.v6.i7.610] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 02/21/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
Post-myocardial infarction (MI), the left ventricle (LV) undergoes a series of events collectively referred to as remodeling. As a result, damaged myocardium is replaced with fibrotic tissue consequently leading to contractile dysfunction and ultimately heart failure. LV remodeling post-MI includes inflammatory, fibrotic, and neovascularization responses that involve regulated cell recruitment and function. Stem cells (SCs) have been transplanted post-MI for treatment of LV remodeling and shown to improve LV function by reduction in scar tissue formation in humans and animal models of MI. The promising results obtained from the application of SCs post-MI have sparked a massive effort to identify the optimal SC for regeneration of cardiomyocytes and the paradigm for clinical applications. Although SC transplantations are generally associated with new tissue formation, SCs also secrete cytokines, chemokines and growth factors that robustly regulate cell behavior in a paracrine fashion during the remodeling process. In this review, the different types of SCs used for cardiomyogenesis, markers of differentiation, paracrine factor secretion, and strategies for cell recruitment and delivery are addressed.
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14
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Huang Z, Shen Y, Zhu H, Xu J, Song Y, Hu X, Shuning Z, Yang X, Sun A, Qian J, Ge J. New coronary retroinfusion technique in the Rat infarct model: transjugular cardiac vein catheterization. Exp Anim 2014; 62:197-203. [PMID: 23903054 PMCID: PMC4160951 DOI: 10.1538/expanim.62.197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cell delivery via the retrograde coronary route boasts less vessel embolism, myocardial
injury, and arrhythmogenicity when compared with those via antegrade coronary
administration or myocardial injection. However, conventional insertion into the coronary
sinus and consequent bleeding complication prevent its application in small animals. To
overcome the complication of bleeding, we described a modified coronary retroinfusion
technique via the jugular vein route in rats with myocardial infarction (MI). A flexible
wire with a bent end was inserted into the left internal jugular vein and advanced slowly
along the left superior vena cava. Under direct vision, the wire was run into the left
cardiac vein by rotating the wire and changing the position of its tip. A fine tube was
then advanced along the wire to the left cardiac vein. This modified technique showed less
lethal hemorrhage than the conventional technique. Retroinfusion via transjugular catheter
enabled efficient fluid or cell dissemination to the majority areas of the free wall of
the left ventricle, covering the infarcted anterior wall. In conclusion, transjugular
cardiac vein catheterization may make retrocoronary infusion a more safe and practical
route for delivering cell, drug, and gene therapy into the infarcted myocardium of
rats.
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Affiliation(s)
- Zheyong Huang
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai 200032, PR China
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Potential benefits of cell therapy in coronary heart disease. J Cardiol 2013; 62:267-76. [PMID: 23834957 DOI: 10.1016/j.jjcc.2013.05.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 05/21/2013] [Accepted: 05/24/2013] [Indexed: 12/31/2022]
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality in the world. In recent years, there has been an increasing interest both in basic and clinical research regarding the field of cell therapy for coronary heart disease (CHD). Several preclinical models of CHD have suggested that regenerative properties of stem and progenitor cells might help restoring myocardial functions in the event of cardiac diseases. Here, we summarize different types of stem/progenitor cells that have been tested in experimental and clinical settings of cardiac regeneration, from embryonic stem cells to induced pluripotent stem cells. Then, we provide a comprehensive description of the most common cell delivery strategies with their major pros and cons and underline the potential of tissue engineering and injectable matrices to address the crucial issue of restoring the three-dimensional structure of the injured myocardial region. Due to the encouraging results from preclinical models, the number of clinical trials with cell therapy is continuously increasing and includes patients with CHD and congestive heart failure. Most of the already published trials have demonstrated safety and feasibility of cell therapies in these clinical conditions. Several studies have also suggested that cell therapy results in improved clinical outcomes. Numerous ongoing clinical trials utilizing this therapy for CHD will address fundamental issues concerning cell source and population utilized, as well as the use of imaging techniques to assess cell homing and survival, all factors that affect the efficacy of different cell therapy strategies.
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Sheng CC, Zhou L, Hao J. Current stem cell delivery methods for myocardial repair. BIOMED RESEARCH INTERNATIONAL 2012; 2013:547902. [PMID: 23509740 PMCID: PMC3591183 DOI: 10.1155/2013/547902] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 09/14/2012] [Indexed: 12/25/2022]
Abstract
Heart failure commonly results from an irreparable damage due to cardiovascular diseases (CVDs), the leading cause of morbidity and mortality in the United States. In recent years, the rapid advancements in stem cell research have garnered much praise for paving the way to novel therapies in reversing myocardial injuries. Cell types currently investigated for cellular delivery include embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), and adult stem cell lineages such as skeletal myoblasts, bone-marrow-derived stem cells (BMSCs), mesenchymal stem cells (MSCs), and cardiac stem cells (CSCs). To engraft these cells into patients' damaged myocardium, a variety of approaches (intramyocardial, transendocardial, transcoronary, venous, intravenous, intracoronary artery and retrograde venous administrations and bioengineered tissue transplantation) have been developed and explored. In this paper, we will discuss the pros and cons of these delivery modalities, the current state of their therapeutic potentials, and a multifaceted evaluation of their reported clinical feasibility, safety, and efficacy. While the issues of optimal delivery approach, the best progenitor stem cell type, the most effective dose, and timing of administration remain to be addressed, we are highly optimistic that stem cell therapy will provide a clinically viable option for myocardial regeneration.
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Affiliation(s)
- Calvin C. Sheng
- School of Medicine, Vanderbilt University, 2220 Pierce Avenue, Nashville, TN 37232, USA
| | - Li Zhou
- School of Medicine, Vanderbilt University, 2220 Pierce Avenue, Nashville, TN 37232, USA
| | - Jijun Hao
- College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA
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Simón-Yarza T, Formiga FR, Tamayo E, Pelacho B, Prosper F, Blanco-Prieto MJ. Vascular endothelial growth factor-delivery systems for cardiac repair: an overview. Am J Cancer Res 2012; 2:541-52. [PMID: 22737191 PMCID: PMC3381347 DOI: 10.7150/thno.3682] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 12/23/2011] [Indexed: 11/05/2022] Open
Abstract
Since the discovery of the Vascular Endothelial Growth Factor (VEGF) and its leading role in the angiogenic process, this has been seen as a promising molecule for promoting neovascularization in the infarcted heart. However, even though several clinical trials were initiated, no therapeutic effects were observed, due in part to the short half life of this factor when administered directly to the tissue. In this context, drug delivery systems appear to offer a promising strategy to overcome limitations in clinical trials of VEGF.The aim of this paper is to review the principal drug delivery systems that have been developed to administer VEGF in cardiovascular disease. Studies published in the last 5 years are reviewed and the main features of these systems are explained. The tissue engineering concept is introduced as a therapeutic alternative that holds promise for the near future.
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Pincott ES, Burch M. Potential for stem cell use in congenital heart disease. Future Cardiol 2012; 8:161-9. [DOI: 10.2217/fca.12.13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This article reports on the evolving field of stem cell therapy and its impact on the management of cardiac pathology, in particular congenital heart disease. To date, stem cell therapy has focused on cardiomyoplasty for heart muscle disease, stem cell therapies are already in clinical use for these disorders. Research is now also supporting the potential role of stem cell therapy for congenital heart disease. In the future it may be possible to use stem cells to create cellular grafts and structures that may be surgically implanted into the disordered heart using bioengineering technology. Different types of stem cells have been evaluated and the identification of specific cardiac stem cells offers great potential. Preliminary animal studies investigating fetal cardiac therapies are also underway. These new directions for stem cell research provide exciting potential for the future management of congenital heart disease.
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Affiliation(s)
- Emma Siân Pincott
- Department of Cardiology, Great Ormond Street Hospital, Great Ormond Street, London, UK
| | - Michael Burch
- Department of Cardiology, Great Ormond Street Hospital, Great Ormond Street, London, UK
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