13
|
Sharp TE, Schena GJ, Hobby AR, Starosta T, Berretta RM, Wallner M, Borghetti G, Gross P, Yu D, Johnson J, Feldsott E, Trappanese DM, Toib A, Rabinowitz JE, George JC, Kubo H, Mohsin S, Houser SR. Cortical Bone Stem Cell Therapy Preserves Cardiac Structure and Function After Myocardial Infarction. Circ Res 2017; 121:1263-1278. [PMID: 28912121 DOI: 10.1161/circresaha.117.311174] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 08/30/2017] [Accepted: 09/14/2017] [Indexed: 12/20/2022]
Abstract
RATIONALE Cortical bone stem cells (CBSCs) have been shown to reduce ventricular remodeling and improve cardiac function in a murine myocardial infarction (MI) model. These effects were superior to other stem cell types that have been used in recent early-stage clinical trials. However, CBSC efficacy has not been tested in a preclinical large animal model using approaches that could be applied to patients. OBJECTIVE To determine whether post-MI transendocardial injection of allogeneic CBSCs reduces pathological structural and functional remodeling and prevents the development of heart failure in a swine MI model. METHODS AND RESULTS Female Göttingen swine underwent left anterior descending coronary artery occlusion, followed by reperfusion (ischemia-reperfusion MI). Animals received, in a randomized, blinded manner, 1:1 ratio, CBSCs (n=9; 2×107 cells total) or placebo (vehicle; n=9) through NOGA-guided transendocardial injections. 5-ethynyl-2'deoxyuridine (EdU)-a thymidine analog-containing minipumps were inserted at the time of MI induction. At 72 hours (n=8), initial injury and cell retention were assessed. At 3 months post-MI, cardiac structure and function were evaluated by serial echocardiography and terminal invasive hemodynamics. CBSCs were present in the MI border zone and proliferating at 72 hours post-MI but had no effect on initial cardiac injury or structure. At 3 months, CBSC-treated hearts had significantly reduced scar size, smaller myocytes, and increased myocyte nuclear density. Noninvasive echocardiographic measurements showed that left ventricular volumes and ejection fraction were significantly more preserved in CBSC-treated hearts, and invasive hemodynamic measurements documented improved cardiac structure and functional reserve. The number of EdU+ cardiac myocytes was increased in CBSC- versus vehicle- treated animals. CONCLUSIONS CBSC administration into the MI border zone reduces pathological cardiac structural and functional remodeling and improves left ventricular functional reserve. These effects reduce those processes that can lead to heart failure with reduced ejection fraction.
Collapse
Affiliation(s)
- Thomas E Sharp
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Giana J Schena
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Alexander R Hobby
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Timothy Starosta
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Remus M Berretta
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Markus Wallner
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Giulia Borghetti
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Polina Gross
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Daohai Yu
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Jaslyn Johnson
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Eric Feldsott
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Danielle M Trappanese
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Amir Toib
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Joseph E Rabinowitz
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Jon C George
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Hajime Kubo
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Sadia Mohsin
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.)
| | - Steven R Houser
- From the Department of Physiology, Cardiovascular Research Center (T.E.S., G.J.S., A.R.H., T.S., R.M.B., M.W., G.B., P.G., J.J., E.F., D.M.T., A.T., J.C.G., H.K., S.M., S.R.H.), Department of Clinical Sciences, Temple Clinical Research Institute (D.Y.), and Department of Pharmacology, Center for Translational Medicine (J.E.R.), Temple University Lewis Katz School of Medicine, Philadelphia, PA; Department of Cardiology, Temple University Hospital, Philadelphia, PA (J.C.G.); Section of Pediatric Cardiology, St. Christopher's Hospital for Children, Philadelphia, PA (A.T.); and Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (T.S.).
| |
Collapse
|