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Takejima AL, Machado-Júnior PAB, Blume GG, Simeoni RB, Francisco JC, Tonial MS, Marqueze LFB, Noronha L, Olandoski M, Abdelwahid E, Carvalho KATDE, Pinho RA, Guarita-Souza LC. Bone-marrow mononuclear cells and acellular human amniotic membrane improve global cardiac function without inhibition of the NLRP3 Inflammasome in a rat model of heart failure. AN ACAD BRAS CIENC 2024; 96:e20230053. [PMID: 38451595 DOI: 10.1590/0001-3765202420230053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/19/2023] [Indexed: 03/08/2024] Open
Abstract
Recent studies have suggested that therapies with stem cells and amniotic membrane can modulate the inflammation following an ischemic injury in the heart. This study evaluated the effects of bone-marrow mononuclear cells (BMMC) and acellular human amniotic membrane (AHAM) on cardiac function and NLRP3 complex in a rat model of heart failure.On the 30th day,the echocardiographic showed improvements on ejection fraction and decreased pathological ventricular remodeling on BMMC and AHAM groups.Oxidative stress analysis was similar between the three groups,and the NLRP3 inflammasome activity were not decreased with the therapeutic use of both BMMC and AHAM,in comparison to the control group.
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Affiliation(s)
- Aline L Takejima
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Paulo André B Machado-Júnior
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Gustavo G Blume
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Rossana Baggio Simeoni
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Julio Cesar Francisco
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Murilo S Tonial
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Luis Felipe B Marqueze
- Pontifícia Universidade Católica do Paraná (PUCPR), Laboratory of Exercise Biochemistry in Health, School of Medicine, 1555 Imaculada Conceição Street, Prado Velho, 80215-901 Curitiba, PR, Brazil
| | - Lucia Noronha
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Marcia Olandoski
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
| | - Eltyeb Abdelwahid
- Northwestern University, Feinberg School of Medicine, Feinberg Cardiovascular Research Institute, 303 E. Chicago Ave., Tarry 14-725, 60611 Chicago, IL, USA
| | - Katherine A T DE Carvalho
- The Pelé Pequeno Príncipe Institute, Cell Therapy and Biotechnology in Regenerative Medicine Department, Child and Adolescent Health Research & Pequeno Príncipe Faculties, 1632 Silva Jardim Ave., Água Verde, 80240-020 Curitiba, PR, Brazil
| | - Ricardo A Pinho
- Pontifícia Universidade Católica do Paraná (PUCPR), Laboratory of Exercise Biochemistry in Health, School of Medicine, 1555 Imaculada Conceição Street, Prado Velho, 80215-901 Curitiba, PR, Brazil
| | - Luiz César Guarita-Souza
- Pontifícia Universidade Católica do Paraná (PUCPR), Experimental Laboratory of Institute of Biological and Health Sciences, 1555 Imaculada Conceição Street, 80215-901 Curitiba, PR, Brazil
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2
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Wang C, Li J, Zhang B, Li Y. Safety and efficacy of bone marrow-derived cells therapy on cardiomyopathy: a meta-analysis. Stem Cell Res Ther 2019; 10:137. [PMID: 31109372 PMCID: PMC6528271 DOI: 10.1186/s13287-019-1238-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Controversial results still existed on the clinical utility of bone marrow-derived cells (BMCs) for cardiomyopathy (CMP). This study aims to reveal the true power of this promising approach by synthesizing all the available data on this subject matter. METHODS Twenty studies including 1418 patients were identified from systematic search. Weighted mean differences for changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), 6-min walk distance, and NYHA functional class were estimated with a random-effects model. Major adverse cardiovascular event (MACE), rehospitalization, all-cause mortality, and patients' quality of life were also calculated. RESULTS Compared with the control group, BMC therapy resulted in greater LVEF (3.72%, 95% CI 2.31 to 5.13, P < 0.0001), 6-min walk distance (53.16, 95% CI 25.17 to 81.10, P = 0.0002), NYHA functional class (- 0.48, 95% CI - 0.65 to - 0.31, P < 0.0001), and smaller LVESV (- 16.79, 95% CI - 27.21 to - 6.38, P = 0.002). BMC treatment significantly reduced the mortality rate and improved patients' quality of life. No significant difference was found between the BMCs and control group in LVEDV, MACE, and rehospitalization rate. However, the outcomes showed a clear trend in favor of the BMC group. Subgroup analysis showed that LVEF improved greater in a subgroup of intracoronary infusion, BMSC, or higher cell dose. CONCLUSION The results of the current meta-analysis suggest that BMC treatment for CMP is safe and feasible. This therapy was associated with persistent improvements in LV function, LV remodeling, functional class, patients' survival, and quality of life. Intracoronary infusion of high-dose (> 108) BMSC might be a better therapeutic option for CMP patients. Further evidences are needed to verify our results.
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Affiliation(s)
- Chao Wang
- Department of Cardiology, Tianjin Nankai Hospital, No. 6 Changjiang Road, Nankai District, Tianjin, China.
| | - Jingzhao Li
- Department of Cardiology, Tianjin Nankai Hospital, No. 6 Changjiang Road, Nankai District, Tianjin, China
| | - Boya Zhang
- Department of Cardiology, Tianjin Nankai Hospital, No. 6 Changjiang Road, Nankai District, Tianjin, China
| | - Yongjian Li
- Department of Cardiology, Tianjin Nankai Hospital, No. 6 Changjiang Road, Nankai District, Tianjin, China
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3
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Tao Z, Tan S, Chen W, Chen X. Stem Cell Homing: a Potential Therapeutic Strategy Unproven for Treatment of Myocardial Injury. J Cardiovasc Transl Res 2018; 11:403-411. [PMID: 30324254 DOI: 10.1007/s12265-018-9823-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/26/2018] [Indexed: 02/06/2023]
Abstract
Despite advances in the prevention and therapeutic modalities of ischemic heart disease, morbidity and mortality post-infarction heart failure remain big challenges in modern society. Stem cell therapy is emerging as a promising therapeutic strategy. Stem cell homing, the ability of stem cells to find their destination, is receiving more attention. Identification of specific cues and understanding the signaling pathways that direct stem cells to targeted destination will improve stem cell homing efficiency. This review discusses the cellular and molecular mechanism of stem cell homing at length in the light of literature and analyzes the problem and considerations of this approach as a treatment strategy for the treatment of ischemic heart disease clinically.
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Affiliation(s)
- Zhonghao Tao
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu, People's Republic of China
| | - Shihua Tan
- National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore
| | - Wen Chen
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu, People's Republic of China
| | - Xin Chen
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu, People's Republic of China.
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4
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Lindeman JHN, Zwaginga JJ, Kallenberg-Lantrua G, van Wissen RC, Schepers A, van Bockel HJ, Fibbe WE, Hamming JF. No Clinical Benefit of Intramuscular Delivery of Bone Marrow-derived Mononuclear Cells in Nonreconstructable Peripheral Arterial Disease: Results of a Phase-III Randomized-controlled Trial. Ann Surg 2018; 268:756-761. [PMID: 30004916 DOI: 10.1097/sla.0000000000002896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Prospects for no-option, end-stage peripheral artery disease (PAD) patients remain poor. Although results from open and semiblinded studies fuel hope for cell-based strategies in no-option patients, so far conclusions from the available placebo-controlled studies are not supportive. With the intention to end the remaining controversy with regard to cell therapy for PAD we conducted a confirmatory, double-blinded randomized placebo-controlled phase 3 trial. STUDY DESIGN This randomized controlled trial was registered (NCT00539266). Inclusion criteria included stable or progressive disabling PAD, no imminent need for amputation, absent accepted options for revascularization. Diabetic disease was an exclusion criterion. Bone marrow (500-700 mL) was harvested and bone marrow-derived mononuclear cells were concentrated to 40 mL. Concentrated cells or placebo (diluted blood) were intramuscularly injected at 40 locations of the calf muscle. RESULTS Fifty-four patients (mean (sd) age 58.2 (14.2) yrs, 58% males) were randomized. Twenty-eight patients received BM-MNCs, 26 placebo. Baseline criteria were similar in the 2 groups. No significant differences were observed for the primary (number of amputations, (pain free) walking distance) and secondary outcome parameters (ankle brachial index, pain scores, quality of life (SF-36)). DISCUSSION This fully blinded replication trial of autologous BM-MNC fails to confirm a benefit for cell therapy in no-option PAD patients, consequently BM-MNC therapy should not be offered as a clinical treatment. Apparent contrasting conclusions from open and controlled studies underscore the importance of a controlled trial design in evaluating cell-based interventions in PAD.
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Affiliation(s)
- Jan H N Lindeman
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap Jan Zwaginga
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Rob C van Wissen
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Abbey Schepers
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Hajo J van Bockel
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Willem E Fibbe
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap F Hamming
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
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5
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Naseri MH, Madani H, Ahmadi Tafti SH, Moshkani Farahani M, Kazemi Saleh D, Hosseinnejad H, Hosseini S, Hekmat S, Hossein Ahmadi Z, Dehghani M, Saadat A, Mardpour S, Hosseini SE, Esmaeilzadeh M, Sadeghian H, Bahoush G, Bassi A, Amin A, Fazeli R, Sharafi Y, Arab L, Movahhed M, Davaran S, Ramezanzadeh N, Kouhkan A, Hezavehei A, Namiri M, Kashfi F, Akhlaghi A, Sotoodehnejadnematalahi F, Vosough Dizaji A, Gourabi H, Syedi N, Shahverdi AH, Baharvand H, Aghdami N. COMPARE CPM-RMI Trial: Intramyocardial Transplantation of Autologous Bone Marrow-Derived CD133+ Cells and MNCs during CABG in Patients with Recent MI: A Phase II/III, Multicenter, Placebo-Controlled, Randomized, Double-Blind Clinical Trial. CELL JOURNAL 2018; 20:267-277. [PMID: 29633605 PMCID: PMC5893299 DOI: 10.22074/cellj.2018.5197] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 07/26/2017] [Indexed: 12/13/2022]
Abstract
Objective: The regenerative potential of bone marrow-derived mononuclear cells (MNCs) and CD133+ stem cells
in the heart varies in terms of their pro-angiogenic effects. This phase II/III, multicenter and double-blind trial is
designed to compare the functional effects of intramyocardial autologous transplantation of both cell types and
placebo in patients with recent myocardial infarction (RMI) post-coronary artery bypass graft. Materials and Methods: This was a phase II/III, randomized, double-blind, placebo-controlled trial COMPARE
CPM-RMI (CD133, Placebo, MNCs - recent myocardial infarction) conducted in accordance with the Declaration
of Helsinki that assessed the safety and efficacy of CD133 and MNCs compared to placebo in patients with
RMI. We randomly assigned 77 eligible RMI patients selected from 5 hospitals to receive CD133+ cells, MNC,
or a placebo. Patients underwent gated single photon emission computed tomography assessments at 6 and 18
months post-intramyocardial transplantation. We tested the normally distributed efficacy outcomes with a mixed
analysis of variance model that used the entire data set of baseline and between-group comparisons as well as
within subject (time) and group×time interaction terms. Results: There were no related serious adverse events reported. The intramyocardial transplantation of both
cell types increased left ventricular ejection fraction by 9% [95% confidence intervals (CI): 2.14% to 15.78%,
P=0.01] and improved decreased systolic wall thickening by -3.7 (95% CI: -7.07 to -0.42, P=0.03). The CD133
group showed significantly decreased non-viable segments by 75% (P=0.001) compared to the placebo and 60%
(P=0.01) compared to the MNC group. We observed this improvement at both the 6- and 18-month time points. Conclusion: Intramyocardial injections of CD133+ cells or MNCs appeared to be safe and efficient with superiority of
CD133+ cells for patients with RMI. Although the sample size precluded a definitive statement about clinical outcomes,
these results have provided the basis for larger studies to confirm definitive evidence about the efficacy of these cell
types (Registration Number: NCT01167751).
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Affiliation(s)
| | - Hoda Madani
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | | | | | | | - Hossein Hosseinnejad
- Department of Cardiac Surgery, Lavasani Hospital, Social Security Organization, Tehran, Iran
| | - Saeid Hosseini
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Hekmat
- Department of Nuclear Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zargham Hossein Ahmadi
- Transplantation Research Center, NRITLD, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Science, Darabad, Niavaran, Tehran, Iran
| | - Majid Dehghani
- Department of Cardiac Surgery, Lavasani Hospital, Social Security Organization, Tehran, Iran
| | - Alireza Saadat
- Department of Internal Medicine, Baqiyatallah Hospital, Tehran, Iran
| | - Soura Mardpour
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Seyedeh Esmat Hosseini
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.,Student Research Committee, School of Nursing and Midwifery , Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Esmaeilzadeh
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center , Iran University of Medical Sciences, Tehran, Iran
| | - Hakimeh Sadeghian
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Bahoush
- Department of Pediatrics, Ali Asghar Pediatric Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Bassi
- Department of Hematology and Oncology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Amin
- Department of Heart Failure and Transplantation, Fellowship in Heart Failure and Transplantation, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Roghayeh Fazeli
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Yaser Sharafi
- Department of Internal Medicine, Baqiyatallah Hospital, Tehran, Iran
| | - Leila Arab
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mansour Movahhed
- Department of Nuclear Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Davaran
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ramezanzadeh
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Kouhkan
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Ali Hezavehei
- Department of Internal Medicine, Lavasani Hospital, Social Security Organization, Tehran, Iran
| | - Mehrnaz Namiri
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Fahimeh Kashfi
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ali Akhlaghi
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Fattah Sotoodehnejadnematalahi
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Ahmad Vosough Dizaji
- Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hamid Gourabi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Naeema Syedi
- School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, South Australia, Australia
| | - Abdol Hosein Shahverdi
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hossein Baharvand
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Nasser Aghdami
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Pennella S, Reggiani Bonetti L, Migaldi M, Manenti A, Lonardi R, Giuliani E, Barbieri A, Farinetti A, Mattioli AV. Does stem cell therapy induce myocardial neoangiogenesis? Histological evaluation in an ischemia/reperfusion animal model. J Cardiovasc Med (Hagerstown) 2017; 18:277-282. [PMID: 26808415 DOI: 10.2459/jcm.0000000000000357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND In an experimental model in the rabbit, a myocardial ischemia-reperfusion injury was obtained. Subsequently, the effects of homologous bone marrow stem cell (BMSC) administration were studied. METHODS In 21 New Zealand adult rabbits, ischemia/reperfusion damage was induced by temporary occlusion of the anterior descending coronary artery. Homologous BMSCs were isolated, cultured and re-suspended for injection at the level of the ischemic zone. We evaluated the proangiogenetic effect of intramyocardial injections of BMSC at the peri-infarcted area. Histological evaluations were made after 20 days from the surgical procedure. RESULTS In rabbits treated with intramyocardial BMSC administration, we demonstrated histologically capillary neoangiogenesis, without signs of tissue immunological reaction or of generation of new myocardial cells. On the contrary, only minimal neovascular supply was detected in rabbits treated with intravenous administration of BMSC. Only typical signs of ischemic myocardium injury were observed in the control group. CONCLUSION These observations suggest that the effect of direct BMSC administration in ischemic myocardium could promote a capillary neoangiogenesis, which helps to prevent ischemic myocardial damage.
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Affiliation(s)
- Sonia Pennella
- aDepartment of Life Science bDepartment of Diagnostic Medicine cDepartment of Surgery, University of Modena and RE, Modena, Italy dIstituto Nazionale per le Ricerche Cardiovascolari
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7
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Korpi RM, Alestalo K, Ruuska T, Lammentausta E, Borra R, Yannopoulos F, Lehtonen S, Korpi JT, Lappi-Blanco E, Anttila V, Lehenkari P, Juvonen T, Blanco Sequieros R. Two novel direct SPIO labels and in vivo MRI detection of labeled cells after acute myocardial infarct. Acta Radiol Open 2017; 6:2058460117718407. [PMID: 28811932 PMCID: PMC5544151 DOI: 10.1177/2058460117718407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/08/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. Cellular decay due hypoxia requires rapid and validated methods for possible therapeutic cell transplantation. PURPOSE To develop direct and rapid superparamagnetic iron oxide (SPIO) cell label for a large-animal model and to assess in vivo cell targeting by magnetic resonance imaging (MRI) in an experimental AMI model. MATERIAL AND METHODS Bone marrow mononuclear cells (BMMNCs) were labeled with SPIO particles using two novel direct labeling methods (rotating incubation method and electroporation). Labeling, iron incorporation in cells and label distribution, cellular viability, and proliferation were validated in vitro. An AMI porcine model was used to evaluate the direct labeling method (rotating incubation method) by examining targeting of labeled BMMNCs using MRI and histology. RESULTS Labeling (1 h) did not alter either cellular differentiation potential or viability of cells in vitro. Cellular relaxation values at 9.4 T correlated with label concentration and MRI at 1.5 T showing 89 ± 4% signal reduction compared with non-labeled cells in vitro. In vivo, a high spatial correlation between MRI and histology was observed. The extent of macroscopic pathological myocardial changes (hemorrhage) correlated with altered function detected on MRI. CONCLUSION We demonstrated two novel direct SPIO labeling methods and demonstrated the feasibility of clinical MRI for monitoring targeting of the labeled cells in animal models of AMI.
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Affiliation(s)
- Riikka M Korpi
- Department of Diagnostic Radiology, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Alestalo
- Department of Surgery and Clinical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Anatomy and Cell Biology, University of Oulu, Oulu, Finland
| | - Timo Ruuska
- Department of Anatomy and Cell Biology, University of Oulu, Oulu, Finland
| | - Eveliina Lammentausta
- Department of Diagnostic Radiology, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Ronald Borra
- Medical Imaging Center of Southwest Finland, Turku University Hospital, Turku, Findland
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Fredrik Yannopoulos
- Department of Surgery and Clinical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Siri Lehtonen
- MRC Oulu and Department of Obstetrics and Gynecology, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Oulu, Finland
| | - Jarkko T Korpi
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Elisa Lappi-Blanco
- Department of Pathology, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Vesa Anttila
- Department of Surgery and Clinical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Petri Lehenkari
- Department of Surgery and Clinical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Anatomy and Cell Biology, University of Oulu, Oulu, Finland
| | - Tatu Juvonen
- Department of Surgery and Clinical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Cardiac Surgery, HUCH Heart and Lung Center, Helsinki, Finland
| | - Roberto Blanco Sequieros
- Department of Diagnostic Radiology, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
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8
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Campbell NG, Kaneko M, Shintani Y, Narita T, Sawhney V, Coppen SR, Yashiro K, Mathur A, Suzuki K. Cell Size Critically Determines Initial Retention of Bone Marrow Mononuclear Cells in the Heart after Intracoronary Injection: Evidence from a Rat Model. PLoS One 2016; 11:e0158232. [PMID: 27380410 PMCID: PMC4933345 DOI: 10.1371/journal.pone.0158232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/13/2016] [Indexed: 01/16/2023] Open
Abstract
Intracoronary injection of bone marrow mononuclear cells (BMMNC) is an emerging treatment for heart failure. Initial donor cell retention in the heart is the key to the success of this approach, but this process remains insufficiently characterized. Although it is assumed that cell size of injected cells may influence their initial retention, no scientific evidence has been reported. We developed a unique model utilizing an ex-vivo rat heart perfusion system, enabling quantitative assessment of retention of donor cells after intracoronary injection. The initial (5 minutes after intracoronary injection) retention rate of BMMNC was as low as approximately 20% irrespective of donor cell doses injected (1×106, 8×106, 4×107). Quantitative cell-size assessment revealed a positive relationship between the size of BMMNC and retention ratio; larger subpopulations of BMMNC were more preferentially retained compared to smaller ones. Furthermore, a larger cell type—bone marrow-derived mesenchymal stromal cells (median size = 11.5μm versus 7.0μm for BMMNC)—had a markedly increased retention rate (77.5±1.8%). A positive relationship between the cell size and retention ratio was also seen in mesenchymal stromal cells. Flow-cytometric studies showed expression of cell-surface proteins, including integrins and selectin-ligands, was unchanged between pre-injection BMMNC and those exited from the heart, suggesting that biochemical interaction between donor cells and host coronary endothelium is not critical for BMMNC retention. Histological analyses showed that retained BMMNC and mesenchymal stromal cells were entrapped in the coronary vasculature and did not extravasate by 60 minutes after transplantation. Whilst BMMNC did not change coronary flow after intracoronary injection, mesenchymal stromal cells reduced it, suggesting coronary embolism, which was supported by the histological finding of intravascular cell-clump formation. These data indicate that cell-size dependent, passive (mechanical), intravascular entrapment is responsible for the initial donor cell retention after intracoronary injection of BMMNC in the heart having normal vasculatures (at least).
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Affiliation(s)
- Niall G. Campbell
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Masahiro Kaneko
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yasunori Shintani
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Takuya Narita
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Vinit Sawhney
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Steven R. Coppen
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Kenta Yashiro
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Anthony Mathur
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ken Suzuki
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- * E-mail:
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In Vivo Tracking of Cell Therapies for Cardiac Diseases with Nuclear Medicine. Stem Cells Int 2016; 2016:3140120. [PMID: 26880951 PMCID: PMC4737458 DOI: 10.1155/2016/3140120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 10/18/2015] [Accepted: 10/20/2015] [Indexed: 12/31/2022] Open
Abstract
Even though heart diseases are amongst the main causes of mortality and morbidity in the world, existing treatments are limited in restoring cardiac lesions. Cell transplantations, originally developed for the treatment of hematologic ailments, are presently being explored in preclinical and clinical trials for cardiac diseases. Nonetheless, little is known about the possible efficacy and mechanisms for these therapies and they are the center of continuous investigation. In this scenario, noninvasive imaging techniques lead to greater comprehension of cell therapies. Radiopharmaceutical cell labeling, firstly developed to track leukocytes, has been used successfully to evaluate the migration of cell therapies for myocardial diseases. A substantial rise in the amount of reports employing this methodology has taken place in the previous years. We will review the diverse radiopharmaceuticals, imaging modalities, and results of experimental and clinical studies published until now. Also, we report on current limitations and potential advances of radiopharmaceutical labeling for cell therapies in cardiac diseases.
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10
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Alestalo K, Miettinen JA, Vuolteenaho O, Huikuri H, Lehenkari P. Bone Marrow Mononuclear Cell Transplantation Restores Inflammatory Balance of Cytokines after ST Segment Elevation Myocardial Infarction. PLoS One 2015; 10:e0145094. [PMID: 26690350 PMCID: PMC4687062 DOI: 10.1371/journal.pone.0145094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/29/2015] [Indexed: 01/10/2023] Open
Abstract
Background Acute myocardial infarction (AMI) launches an inflammatory response and a repair process to compensate cardiac function. During this process, the balance between proinflammatory and anti-inflammatory cytokines is important for optimal cardiac repair. Stem cell transplantation after AMI improves tissue repair and increases the ventricular ejection fraction. Here, we studied in detail the acute effect of bone marrow mononuclear cell (BMMNC) transplantation on proinflammatory and anti-inflammatory cytokines in patients with ST segment elevation myocardial infarction (STEMI). Methods Patients with STEMI treated with thrombolysis followed by percutaneous coronary intervention (PCI) were randomly assigned to receive either BMMNC or saline as an intracoronary injection. Cardiac function was evaluated by left ventricle angiogram during the PCI and again after 6 months. The concentrations of 27 cytokines were measured from plasma samples up to 4 days after the PCI and the intracoronary injection. Results Twenty-six patients (control group, n = 12; BMMNC group, n = 14) from the previously reported FINCELL study (n = 80) were included to this study. At day 2, the change in the proinflammatory cytokines correlated with the change in the anti-inflammatory cytokines in both groups (Kendall’s tau, control 0.6; BMMNC 0.7). At day 4, the correlation had completely disappeared in the control group but was preserved in the BMMNC group (Kendall’s tau, control 0.3; BMMNC 0.7). Conclusions BMMNC transplantation is associated with preserved balance between pro- and anti-inflammatory cytokines after STEMI in PCI-treated patients. This may partly explain the favorable effect of stem cell transplantation after AMI.
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Affiliation(s)
- Kirsi Alestalo
- Surgery Clinic, Medical Research Center, Oulu University Hospital, Oulu, Finland
- Department of Anatomy and Cell Biology, Medical Research Center, University of Oulu, Oulu, Finland
- * E-mail:
| | - Johanna A. Miettinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Olli Vuolteenaho
- Department of Physiology, Institute of Biomedicine, University of Oulu, Oulu, Finland
| | - Heikki Huikuri
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Petri Lehenkari
- Surgery Clinic, Medical Research Center, Oulu University Hospital, Oulu, Finland
- Department of Anatomy and Cell Biology, Medical Research Center, University of Oulu, Oulu, Finland
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11
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Peng SY, Chou CJ, Cheng PJ, Tseng TY, Cheng WTK, Shaw SWS, Wu SC. Intramuscular Transplantation of Pig Amniotic Fluid-Derived Progenitor Cells Has Therapeutic Potential in a Mouse Model of Myocardial Infarction. Cell Transplant 2015; 24:1003-12. [DOI: 10.3727/096368914x680109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Acute myocardial infarction (MI) is a fatal event that causes a large number of deaths worldwide. MI results in pathological remodeling and decreased cardiac function, which could lead to heart failure and fatal arrhythmia. Cell therapy is a potential strategy to repair the damage through enhanced angiogenesis or by modulation of the inflammatory process via paracrine signaling. Amniotic fluid-derived progenitor cells (AFPCs) have been reported to differentiate into several lineages and can be used without ethical concerns or risk of teratoma formation. Since pigs are anatomically, physiologically, and genetically similar to humans, and pregnant pigs can be an abundant source of AFPCs, we used porcine AFPCs (pAFPCs) as our target cells. Intramyocardial injection of AFPCs has been shown to cure MI in animal models. However, intramuscular transplantation of cells has not been extensively investigated. In this study, we investigated the therapeutic potential of intramuscular injection of pAFPCs on acute MI. MI mice were divided into 1) PBS control, 2) medium cell dose (1 × 106 cells per leg; cell-M), and 3) high cell dose (4 × 106 cells per leg; cell-H) groups. Cells or PBS were directly injected into the hamstring muscle 20 min after MI surgery. Four weeks after MI surgery, the cell-M and cell-H groups exhibited significantly better ejection fraction, significantly greater wall thickness, smaller infarct scar sizes, and lower LV expansion index compared to the PBS group. Using in vivo imaging, we showed that the hamstring muscles from animals in the cell-M and cell-H groups had RFP-positive signals. In summary, intramuscular injection of porcine AFPCs reduced scar size, reduced pathological remodeling, and preserved heart function after MI.
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Affiliation(s)
- Shao-Yu Peng
- Institute of Biotechnology, National Taiwan University, Taipei, Taiwan
| | - Chih-Jen Chou
- Institute of Biotechnology, National Taiwan University, Taipei, Taiwan
| | - Po-Jen Cheng
- Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Tse-Yang Tseng
- Department of Animal Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Winston Teng-Kui Cheng
- Department of Animal Science and Technology, National Taiwan University, Taipei, Taiwan
- Department of Animal Science and Biotechnology, Tunghai University, Taichung, Taiwan
| | - S. W. Steven Shaw
- Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, College of Medicine, Taoyuan, Taiwan
- Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan
- Prenatal Cell and Gene Therapy Group, Institute for Women's Health, University College London, London, UK
| | - Shinn-Chih Wu
- Institute of Biotechnology, National Taiwan University, Taipei, Taiwan
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12
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Alestalo K, Korpi R, Mäkelä J, Lehtonen S, Mäkelä T, Yannopoulos F, Ylitalo K, Haapea M, Juvonen T, Anttila V, Lappi-Blanco E, Blanco Sequeiros R, Lehenkari P. High number of transplanted stem cells improves myocardial recovery after AMI in a porcine model. SCAND CARDIOVASC J 2015; 49:82-94. [PMID: 25705991 DOI: 10.3109/14017431.2015.1018311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The clinical data considering the bone marrow mononuclear cell (BMMNC) therapy in treatment for acute myocardial infarction (AMI) are controversial and the mechanisms remain unknown. Our objective was to study the cardiac function and changes in cytokine levels after administration of BMMNC in experimental AMI model. DESIGN Unlabeled or Super-Paramagnetic-Iron-Oxide-labeled BMMNCs or saline was injected into myocardium of 31 pigs after circumflex artery occlusion. Ejection fraction (EF) was measured preoperatively, postoperatively and at 21 days by echocardiography. Cardiac MRI was performed postoperatively and after 21 days in 7 BMMNC animals. Serum cytokine levels were measured at baseline, 24 h and 21 days. Cellular homing was evaluated comparing MRI and histology. RESULTS From baseline to 21 days EF decreased less in BMMNC group (EF mean control -19 SD 12 vs. BMMNC -4 SD 15 percentage points p = 0.02). Cytokine concentrations showed high variability between the animals. MRI correlated with histology in cell detection and revealed BMMNCs in the infarction area. By MRI, EF improved 11 percentage points. The improvement in EF was associated with the number of transplanted BMMNCs detected in the myocardium. CONCLUSION BMMNC injection after AMI improved cardiac function. Quantity of transplanted BMMNCs correlated with the improvement in cardiac function after AMI.
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Affiliation(s)
- Kirsi Alestalo
- Department of Surgery, Clinical Research Center, Oulu University Hospital, Oulu, Finland and Department of Surgery, Institute of Clinical Medicine, University of Oulu , Oulu , Finland
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13
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Yee K, Malliaras K, Kanazawa H, Tseliou E, Cheng K, Luthringer DJ, Ho CS, Takayama K, Minamino N, Dawkins JF, Chowdhury S, Duong DT, Seinfeld J, Middleton RC, Dharmakumar R, Li D, Marbán L, Makkar RR, Marbán E. Allogeneic cardiospheres delivered via percutaneous transendocardial injection increase viable myocardium, decrease scar size, and attenuate cardiac dilatation in porcine ischemic cardiomyopathy. PLoS One 2014; 9:e113805. [PMID: 25460005 PMCID: PMC4251970 DOI: 10.1371/journal.pone.0113805] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/30/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Epicardial injection of heart-derived cell products is safe and effective post-myocardial infarction (MI), but clinically-translatable transendocardial injection has never been evaluated. We sought to assess the feasibility, safety and efficacy of percutaneous transendocardial injection of heart-derived cells in porcine chronic ischemic cardiomyopathy. METHODS AND RESULTS We studied a total of 89 minipigs; 63 completed the specified protocols. After NOGA-guided transendocardial injection, we quantified engraftment of escalating doses of allogeneic cardiospheres or cardiosphere-derived cells in minipigs (n = 22) post-MI. Next, a dose-ranging, blinded, randomized, placebo-controlled ("dose optimization") study of transendocardial injection of the better-engrafting product was performed in infarcted minipigs (n = 16). Finally, the superior product and dose (150 million cardiospheres) were tested in a blinded, randomized, placebo-controlled ("pivotal") study (n = 22). Contrast-enhanced cardiac MRI revealed that all cardiosphere doses preserved systolic function and attenuated remodeling. The maximum feasible dose (150 million cells) was most effective in reducing scar size, increasing viable myocardium and improving ejection fraction. In the pivotal study, eight weeks post-injection, histopathology demonstrated no excess inflammation, and no myocyte hypertrophy, in treated minipigs versus controls. No alloreactive donor-specific antibodies developed over time. MRI showed reduced scar size, increased viable mass, and attenuation of cardiac dilatation with no effect on ejection fraction in the treated group compared to placebo. CONCLUSIONS Dose-optimized injection of allogeneic cardiospheres is safe, decreases scar size, increases viable myocardium, and attenuates cardiac dilatation in porcine chronic ischemic cardiomyopathy. The decreases in scar size, mirrored by increases in viable myocardium, are consistent with therapeutic regeneration.
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Affiliation(s)
- Kristine Yee
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | | | - Hideaki Kanazawa
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Eleni Tseliou
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Ke Cheng
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
- Department of Molecular Biomedical Sciences and Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, North Carolina, United States of America
| | | | - Chak-Sum Ho
- Gift of Life Michigan, Ann Arbor, Michigan, United States of America
| | - Kentaro Takayama
- National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Naoto Minamino
- National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - James F. Dawkins
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Supurna Chowdhury
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Doan Trang Duong
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Jeffrey Seinfeld
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Ryan C. Middleton
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Rohan Dharmakumar
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, California, United States of America
| | - Debiao Li
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, California, United States of America
| | - Linda Marbán
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
- Capricor, Beverly Hills, California, United States of America
| | - Raj R. Makkar
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
| | - Eduardo Marbán
- Cedars-Sinai Heart Institute, Los Angeles, California, United States of America
- Capricor, Beverly Hills, California, United States of America
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14
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Lehtinen M, Pätilä T, Vento A, Kankuri E, Suojaranta-Ylinen R, Pöyhiä R, Harjula A. Prospective, randomized, double-blinded trial of bone marrow cell transplantation combined with coronary surgery - perioperative safety study. Interact Cardiovasc Thorac Surg 2014; 19:990-6. [PMID: 25142068 DOI: 10.1093/icvts/ivu265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We present here a sub-study of our prospective, randomized, double-blinded trial of bone marrow mononuclear cell (BMMC) transplantation with coronary artery bypass surgery (CABG) (ClinicalTrials.gov Identifier: NCT00418418), evaluating our secondary end-point concerning hospital stay as well as perioperative morbidity. Injecting a substantial amount of biologically active cells into a diseased myocardium inspires concerns for safety, a concern overlooked in previous trials. METHODS We evaluated the immediate perioperative effects of intramyocardial injection of autologous BMMCs combined with CABG. In a randomized double-blinded manner, 39 patients received injections either of BMMCs (n = 20) or of vehicle medium (n = 19). The patients' haemodynamics, arterial blood gases, systemic vein oxygen level, blood glucose, acid-base balance, lactate, haemoglobin, body temperature and diuresis, as well as medications needed, were recorded in the operating theatre and in the intensive care unit (ICU) every 4 h throughout the first postoperative 24 h. RESULTS No dissimilarities in these parameters were detectable. In the ICU, the median need for adrenaline was 0.0086 µg/kg/min (first quartile 0.0000, third quartile 0.0204) for controls and 0.0090 µg/kg/min (0.0000, 0.0353) for BMMC patients (P = 0.757); for noradrenaline, 0.0586 µg/kg/min (0.0180, 0.0888) for controls and 0.0279 µg/kg/min (0.0145, 0.0780) for BMMC patients (P = 0.405). The median stay at the ICU was 2 days for both groups (1, 2 for controls; 1, 3 for BMMCs; P = 0.967). Within the first postoperative day, one control patient had an elevated level of creatine kinase-myocardial band fraction mass (CK-MBm) up to >100 µg/l; no BMMC patient showed elevated CK-MBm levels (P = 0.474). CONCLUSIONS Both intramyocardial BMMC and placebo injections appear safe during surgery and immediate ICU stay after treatment of heart failure.
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15
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Nystedt J, Anderson H, Tikkanen J, Pietilä M, Hirvonen T, Takalo R, Heiskanen A, Satomaa T, Natunen S, Lehtonen S, Hakkarainen T, Korhonen M, Laitinen S, Valmu L, Lehenkari P. Cell surface structures influence lung clearance rate of systemically infused mesenchymal stromal cells. Stem Cells 2013; 31:317-26. [PMID: 23132820 DOI: 10.1002/stem.1271] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 10/13/2012] [Indexed: 12/13/2022]
Abstract
The promising clinical effects of mesenchymal stromal/stem cells (MSCs) rely especially on paracrine and nonimmunogenic mechanisms. Delivery routes are essential for the efficacy of cell therapy and systemic delivery by infusion is the obvious goal for many forms of MSC therapy. Lung adhesion of MSCs might, however, be a major obstacle yet to overcome. Current knowledge does not allow us to make sound conclusions whether MSC lung entrapment is harmful or beneficial, and thus we wanted to explore MSC lung adhesion in greater detail. We found a striking difference in the lung clearance rate of systemically infused MSCs derived from two different clinical sources, namely bone marrow (BM-MSCs) and umbilical cord blood (UCB-MSCs). The BM-MSCs and UCB-MSCs used in this study differed in cell size, but our results also indicated other mechanisms behind the lung adherence. A detailed analysis of the cell surface profiles revealed differences in the expression of relevant adhesion molecules. The UCB-MSCs had higher expression levels of α4 integrin (CD49d, VLA-4), α6 integrin (CD49f, VLA-6), and the hepatocyte growth factor receptor (c-Met) and a higher general fucosylation level. Strikingly, the level of CD49d and CD49f expression could be functionally linked with the lung clearance rate. Additionally, we saw a possible link between MSC lung adherence and higher fibronectin expression and we show that the expression of fibronectin increases with MSC culture confluence. Future studies should aim at developing methods of transiently modifying the cell surface structures in order to improve the delivery of therapeutic cells.
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Affiliation(s)
- Johanna Nystedt
- Advanced Therapies and Product Development, Finnish Red Cross Blood Service, Helsinki, Finland.
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16
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Mäkelä T, Yannopoulos F, Alestalo K, Mäkelä J, Lepola P, Anttila V, Lehtonen S, Kiviluoma K, Takalo R, Juvonen T, Lehenkari P. Intra-arterial bone marrow mononuclear cell distribution in experimental global brain ischaemia. SCAND CARDIOVASC J 2012; 47:114-20. [DOI: 10.3109/14017431.2012.750377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Tuomas Mäkelä
- Department of Surgery, Oulu University Hospital, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Fredrik Yannopoulos
- Department of Surgery, Oulu University Hospital, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Kirsi Alestalo
- Department of Surgery, Oulu University Hospital, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Jussi Mäkelä
- Department of Surgery, Oulu University Hospital, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Pasi Lepola
- Department of Diagnostic Radiology, Oulu University Hospital, University of Oulu,
Oulu, Finland
| | - Vesa Anttila
- Department of Surgery, Oulu University Hospital, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Siri Lehtonen
- Department of Anatomy and Cell Biology, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Kai Kiviluoma
- Department of Anaesthesiology, Oulu University Hospital, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Reijo Takalo
- Department of Diagnostic Radiology, Oulu University Hospital, University of Oulu,
Oulu, Finland
| | - Tatu Juvonen
- Department of Surgery, Oulu University Hospital, University of Oulu and Clinical Research Center,
Oulu, Finland
| | - Petri Lehenkari
- Department of Anatomy and Cell Biology, University of Oulu and Clinical Research Center,
Oulu, Finland
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17
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Wen Y, Chen B, Wang C, Ma X, Gao Q. Bone marrow-derived mononuclear cell therapy for patients with ischemic heart disease and ischemic heart failure. Expert Opin Biol Ther 2012; 12:1563-73. [DOI: 10.1517/14712598.2012.721764] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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18
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Lehtonen ST, Mäkelä J, Ohlmeier S, Ylitalo K, Juvonen T, Anttila V, Lehenkari P. Analysis of molecular changes after autologous cell therapy in swine myocardial infarction tissue can reveal novel targets for future therapy. J Tissue Eng Regen Med 2012; 8:97-105. [DOI: 10.1002/term.1502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 01/24/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Siri T. Lehtonen
- Institute of Clinical Medicine; Department of Surgery and Clinical Research Center, Oulu University Hospital and University of Oulu; Finland
- Institute of Biomedicine, Department of Anatomy and Cell Biology; University of Oulu; Finland
| | - Jussi Mäkelä
- Institute of Clinical Medicine; Department of Surgery and Clinical Research Center, Oulu University Hospital and University of Oulu; Finland
| | - Steffen Ohlmeier
- Proteomics Core Facility; Biocenter Oulu and University of Oulu; Finland
| | - Kari Ylitalo
- Institute of Clinical Medicine; Department of Internal Medicine and Oulu University Hospital, University of Oulu; Finland
| | - Tatu Juvonen
- Institute of Clinical Medicine; Department of Surgery and Clinical Research Center, Oulu University Hospital and University of Oulu; Finland
| | - Vesa Anttila
- Institute of Clinical Medicine; Department of Surgery and Clinical Research Center, Oulu University Hospital and University of Oulu; Finland
| | - Petri Lehenkari
- Institute of Biomedicine, Department of Anatomy and Cell Biology; University of Oulu; Finland
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19
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Makela J, Yannopoulos F, Ylitalo K, Makikallio T, Lehtonen S, Lappi-Blanco E, Dahlbacka S, Rimpilainen E, Kaakinen H, Juvonen T, Lehenkari P, Anttila V. Granulation tissue is altered after intramyocardial and intracoronary bone marrow-derived cell transfer for experimental acute myocardial infarction. Cardiovasc Pathol 2012; 21:132-42. [DOI: 10.1016/j.carpath.2011.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 06/12/2011] [Accepted: 06/30/2011] [Indexed: 12/21/2022] Open
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20
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Kouris NA, Squirrell JM, Jung JP, Pehlke CA, Hacker T, Eliceiri KW, Ogle BM. A nondenatured, noncrosslinked collagen matrix to deliver stem cells to the heart. Regen Med 2012; 6:569-82. [PMID: 21916593 DOI: 10.2217/rme.11.48] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
AIMS Stem cell transplantation holds promise as a therapeutic approach for the repair of damaged myocardial tissue. One challenge of this approach is efficient delivery and long-term retention of the stem cells. Although several synthetic and natural biomaterials have been developed for this purpose, the ideal formulation has yet to be identified. MATERIALS & METHODS Here we investigate the utility of a nondenatured, noncrosslinked, commercially available natural biomaterial (TissueMend(®) [TEI Biosciences, Boston, MA, USA]) for delivery of human mesenchymal stem cells (MSCs) to the murine heart. RESULTS We found that MSCs attached, proliferated and migrated within and out of the TissueMend matrix in vitro. Human MSCs delivered to damaged murine myocardium via the matrix (2.3 × 10(4) ± 0.8 × 10(4) CD73(+) cells/matrix) were maintained in vivo for 3 weeks and underwent at least three population doublings during that period (21.9 × 10(4) ± 14.4 × 10(4) CD73(+) cells/matrix). In addition, collagen within the TissueMend matrix could be remodeled by MSCs in vivo, resulting in a significant decrease in the coefficient of alignment of fibers (0.12 ± 0.12) compared with the matrix alone (0.28 ± 0.07), and the MSCs were capable of migrating out of the matrix and into the host tissue. CONCLUSION Thus, TissueMend matrix offers a commercially available, biocompatible and malleable vehicle for the delivery and retention of stem cells to the heart.
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Affiliation(s)
- Nicholas A Kouris
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
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21
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Villet OM, Siltanen A, Pätilä T, Mahar MAA, Vento A, Kankuri E, Harjula A. Advances in cell transplantation therapy for diseased myocardium. Stem Cells Int 2011; 2011:679171. [PMID: 21776283 PMCID: PMC3138051 DOI: 10.4061/2011/679171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Accepted: 04/02/2011] [Indexed: 11/24/2022] Open
Abstract
The overall objective of cell transplantation is to repopulate postinfarction scar with contractile cells, thus improving systolic function, and to prevent or to regress the remodeling process. Direct implantation of isolated myoblasts, cardiomyocytes, and bone-marrow-derived cells has shown prospect for improved cardiac performance in several animal models and patients suffering from heart failure. However, direct implantation of cultured cells can lead to major cell loss by leakage and cell death, inappropriate integration and proliferation, and cardiac arrhythmia. To resolve these problems an approach using 3-dimensional tissue-engineered cell constructs has been investigated. Cell engineering technology has enabled scaffold-free sheet development including generation of communication between cell graft and host tissue, creation of organized microvascular network, and relatively long-term survival after in vivo transplantation.
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Affiliation(s)
- Outi M Villet
- Department of Cardiothoracic Surgery, University of Helsinki Meilahti Hospital, P.O. Box 340, FIN-00029 HUS, Finland
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22
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Templin C, Lüscher TF, Landmesser U. [Stem and progenitor cell-based therapy approaches: current developments on treatment of acute myocardial infarction and chronic ischemic cardiomyopathy]. Herz 2011; 35:445-56. [PMID: 20967401 DOI: 10.1007/s00059-010-3397-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Percutaneous coronary intervention (PCI) for coronary revascularization in conjunction with an optimized pharmacological treatment can reduce adverse left ventricular remodeling and dysfunction in patients with acute myocardial infarction. Despite these modern therapeutic strategies a significant number of these patients continue to develop adverse cardiac remodeling and LV dysfunction which is associated with a poor prognosis. Stem and progenitor cell-based approaches for treatment of acute myocardial infarction and chronic ischemic cardiomyopathy are an interesting direction of current experimental and clinical research. The current review article provides a summary of recent developments of cell-based therapies of ischemic heart disease, including the assessment of the repair and regeneration capacity of different stem and progenitor cell populations. In addition the advantages and disadvantages of different modes of cell application and potential strategies for the improvement of stem and progenitor cell function for their use in cell-based cardiovascular therapies will be described.
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Affiliation(s)
- C Templin
- Klinik für Kardiologie, UniversitätsSpital Zürich, Rämistr. 100, 8091, Zürich, Schweiz.
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[Usefulness of intracoronary therapy with progenitor cells in patients with dilated cardiomyopathy: Bridge or alternative to heart transplantation?]. An Pediatr (Barc) 2011; 74:218-25. [PMID: 21398194 DOI: 10.1016/j.anpedi.2011.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Revised: 02/05/2011] [Accepted: 02/07/2011] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Some paediatric publications have recently raised the value of intracoronary therapy with autologous bone marrow-derived progenitor cells (APCs) in children with dilated cardiomyopathy (DCM) and heart failure. We describe the usefulness of this treatment in two infants with severe DCM and heart failure, who had been transferred to our hospital for cardiac transplant evaluation. PATIENTS AND METHODS The first patient was a 3 months old male weighing 4 kg. The second was a 4 months old male weighing 5 kg. At the time of admission, both were in poor clinical condition (NYHA IV), with severe dilation and systolic dysfunction (ejection fraction [EF]<30%) of the left ventricle and marked elevation of NT-proBNP, requiring treatment with mechanical ventilation and inotropic iv infusion. After mobilization with G-CSF for 4 days, APCs were obtained from peripheral blood by leukocytapheresis, administering them by a slow intracoronary bolus injection using a stop-flow technique (6.15x106 CD34-positive cells/Kg in the first patient, and 10.55x106 CD34-positive cells/Kg in the second). RESULTS Since the first week after the procedure, clinical status of patients improved and echocardiography showed a decrease in left ventricular dilation. A month later, there was a significant improvement in EF (> 40%) and NT-proBNP levels, subsequently maintained throughout the follow-up. However, four months later in the first patient, the left ventricle dilated again and its function slightly worsened, but without any significant impact in his clinical status. CONCLUSIONS Intracoronary therapy with APCs can be an alternative in children, especially infants, with DCM and heart failure. It can reduce the waiting list mortality, improve clinical status and provide more time on the waiting list to receive a suitable organ, or even to make transplantation unnecessary.
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Abstract
Chronic ischemic heart disease patients are already being treated worldwide with bone marrow stem cells both in the context of clinical studies and in therapy trials. By combining this therapy with established revascularization procedures such as bypass surgery, a high level of patient safety can be achieved. To date, no stem cell-related cardiac complications following intramyocardial injection of bone marrow-derived stem cells during CABG (coronary artery bypass graft) surgery have been reported. The functional advantage conferred by surgical bone marrow stem cell therapy is a 7.2% increase in LVEF (left ventricular ejection fraction) compared to controls. Randomized placebo-controlled trials, like the German trial PERFECT, are needed to obtain a more evidence-based assessment of this therapy.
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Abstract
BACKGROUND Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Despite the advances in medical and catheter-based therapy for acute myocardial infarction the 1-year mortality remains as high as 13% and the 5-year prognosis for patients with heart failure remains as high as 50%. Left ventricular systolic dysfunction, a major determinant of prognosis, is associated with significant loss of cardiomyocytes which was previously thought to be irreversible as the heart was considered a post-mitotic organ. SOURCES OF DATA Review of literature published in peer reviewed journals and ClinicalTrials.Gov website. AREAS OF AGREEMENT There is now growing evidence that the human heart is capable of undergoing repair and in recent years there has been an increase in basic and clinical research with the aim of harnessing the regenerative properties of stem cells in order to facilitate restoration of myocardial function. AREAS OF CONTROVERSY The mechanisms of action of cell therapy with regards to cardiac repair remain unsatisfactorily understood and the magnitude of benefit demonstrated in animal models is yet to be fully translated in humans. GROWING POINTS The number of clinical trials continues to increase and include treating patients with acute myocardial infarction and chronic heart failure secondary to ischaemic heart disease or dilated cardiomyopathy. AREAS TIMELY FOR DEVELOPING RESEARCH The future of this field of research will require closer collaboration between scientists and clinicians to understand how cell therapy works and to define the ideal cell type and method of delivery to be able to derive maximum benefit.
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Affiliation(s)
- Abdul M Mozid
- Department of Cardiology, The London Chest Hospital, UK
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