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Adeliño R, Martínez-Falguera D, Curiel C, Teis A, Marsal R, Rodríguez-Leor O, Prat-Vidal C, Fadeuilhe E, Aranyó J, Revuelta-López E, Sarrias A, Bazan V, Andrés-Cordón JF, Roura S, Villuendas R, Lupón J, Bayes-Genis A, Gálvez-Montón C, Bisbal F. Electrophysiological effects of adipose graft transposition procedure (AGTP) on the post-myocardial infarction scar: A multimodal characterization of arrhythmogenic substrate. Front Cardiovasc Med 2022; 9:983001. [PMID: 36204562 PMCID: PMC9530287 DOI: 10.3389/fcvm.2022.983001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To assess the arrhythmic safety profile of the adipose graft transposition procedure (AGTP) and its electrophysiological effects on post-myocardial infarction (MI) scar. Background Myocardial repair is a promising treatment for patients with MI. The AGTP is a cardiac reparative therapy that reduces infarct size and improves cardiac function. The impact of AGTP on arrhythmogenesis has not been addressed. Methods MI was induced in 20 swine. Contrast-enhanced magnetic resonance (ce-MRI), electrophysiological study (EPS), and left-ventricular endocardial high-density mapping were performed 15 days post-MI. Animals were randomized 1:1 to AGTP or sham-surgery group and monitored with ECG-Holter. Repeat EPS, endocardial mapping, and ce-MRI were performed 30 days post-intervention. Myocardial SERCA2, Connexin-43 (Cx43), Ryanodine receptor-2 (RyR2), and cardiac troponin-I (cTnI) gene and protein expression were evaluated. Results The AGTP group showed a significant reduction of the total infarct scar, border zone and dense scar mass by ce-MRI (p = 0.04), and a decreased total scar and border zone area in bipolar voltage mapping (p < 0.001). AGTP treatment significantly reduced the area of very-slow conduction velocity (<0.2 m/s) (p = 0.002), the number of deceleration zones (p = 0.029), and the area of fractionated electrograms (p = 0.005). No differences were detected in number of induced or spontaneous ventricular arrhythmias at EPS and Holter-monitoring. SERCA2, Cx43, and RyR2 gene expression were decreased in the infarct core of AGTP-treated animals (p = 0.021, p = 0.018, p = 0.051, respectively). Conclusion AGTP is a safe reparative therapy in terms of arrhythmic risk and provides additional protective effect against adverse electrophysiological remodeling in ischemic heart disease.
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Affiliation(s)
- Raquel Adeliño
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
| | - Daina Martínez-Falguera
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Carolina Curiel
- Boston Scientific Department, Barcelona Delegation, Barcelona, Spain
| | - Albert Teis
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Roger Marsal
- Boston Scientific Department, Barcelona Delegation, Barcelona, Spain
| | - Oriol Rodríguez-Leor
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Prat-Vidal
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
| | - Edgar Fadeuilhe
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Júlia Aranyó
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Elena Revuelta-López
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Axel Sarrias
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Víctor Bazan
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | - Santiago Roura
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Roger Villuendas
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Lupón
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, Can Ruti Campus, Autonomous University of Barcelona, Barcelona, Spain
| | - Antoni Bayes-Genis
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, Can Ruti Campus, Autonomous University of Barcelona, Barcelona, Spain
| | - Carolina Gálvez-Montón
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Carolina Gálvez-Montón,
| | - Felipe Bisbal
- ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain
- Heart Institute (iCOR), Germans Trias i Pujol University Hospital, Barcelona, Spain
- CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Carolina Gálvez-Montón,
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iPSC Therapy for Myocardial Infarction in Large Animal Models: Land of Hope and Dreams. Biomedicines 2021; 9:biomedicines9121836. [PMID: 34944652 PMCID: PMC8698445 DOI: 10.3390/biomedicines9121836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
Myocardial infarction is the main driver of heart failure due to ischemia and subsequent cell death, and cell-based strategies have emerged as promising therapeutic methods to replace dead tissue in cardiovascular diseases. Research in this field has been dramatically advanced by the development of laboratory-induced pluripotent stem cells (iPSCs) that harbor the capability to become any cell type. Like other experimental strategies, stem cell therapy must meet multiple requirements before reaching the clinical trial phase, and in vivo models are indispensable for ensuring the safety of such novel therapies. Specifically, translational studies in large animal models are necessary to fully evaluate the therapeutic potential of this approach; to empirically determine the optimal combination of cell types, supplementary factors, and delivery methods to maximize efficacy; and to stringently assess safety. In the present review, we summarize the main strategies employed to generate iPSCs and differentiate them into cardiomyocytes in large animal species; the most critical differences between using small versus large animal models for cardiovascular studies; and the strategies that have been pursued regarding implanted cells' stage of differentiation, origin, and technical application.
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3
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Deep Learning Analyses to Delineate the Molecular Remodeling Process after Myocardial Infarction. Cells 2021; 10:cells10123268. [PMID: 34943776 PMCID: PMC8699769 DOI: 10.3390/cells10123268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 02/01/2023] Open
Abstract
Specific proteins and processes have been identified in post-myocardial infarction (MI) pathological remodeling, but a comprehensive understanding of the complete molecular evolution is lacking. We generated microarray data from swine heart biopsies at baseline and 6, 30, and 45 days after infarction to feed machine-learning algorithms. We cross-validated the results using available clinical and experimental information. MI progression was accompanied by the regulation of adipogenesis, fatty acid metabolism, and epithelial-mesenchymal transition. The infarct core region was enriched in processes related to muscle contraction and membrane depolarization. Angiogenesis was among the first morphogenic responses detected as being sustained over time, but other processes suggesting post-ischemic recapitulation of embryogenic processes were also observed. Finally, protein-triggering analysis established the key genes mediating each process at each time point, as well as the complete adverse remodeling response. We modeled the behaviors of these genes, generating a description of the integrative mechanism of action for MI progression. This mechanistic analysis overlapped at different time points; the common pathways between the source proteins and cardiac remodeling involved IGF1R, RAF1, KPCA, JUN, and PTN11 as modulators. Thus, our data delineate a structured and comprehensive picture of the molecular remodeling process, identify new potential biomarkers or therapeutic targets, and establish therapeutic windows during disease progression.
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Monguió-Tortajada M, Prat-Vidal C, Moron-Font M, Clos-Sansalvador M, Calle A, Gastelurrutia P, Cserkoova A, Morancho A, Ramírez MÁ, Rosell A, Bayes-Genis A, Gálvez-Montón C, Borràs FE, Roura S. Local administration of porcine immunomodulatory, chemotactic and angiogenic extracellular vesicles using engineered cardiac scaffolds for myocardial infarction. Bioact Mater 2021; 6:3314-3327. [PMID: 33778207 PMCID: PMC7973387 DOI: 10.1016/j.bioactmat.2021.02.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023] Open
Abstract
The administration of extracellular vesicles (EV) from mesenchymal stromal cells (MSC) is a promising cell-free nanotherapy for tissue repair after myocardial infarction (MI). However, the optimal EV delivery strategy remains undetermined. Here, we designed a novel MSC-EV delivery, using 3D scaffolds engineered from decellularised cardiac tissue as a cell-free product for cardiac repair. EV from porcine cardiac adipose tissue-derived MSC (cATMSC) were purified by size exclusion chromatography (SEC), functionally analysed and loaded to scaffolds. cATMSC-EV markedly reduced polyclonal proliferation and pro-inflammatory cytokines production (IFNγ, TNFα, IL12p40) of allogeneic PBMC. Moreover, cATMSC-EV recruited outgrowth endothelial cells (OEC) and allogeneic MSC, and promoted angiogenesis. Fluorescently labelled cATMSC-EV were mixed with peptide hydrogel, and were successfully retained in decellularised scaffolds. Then, cATMSC-EV-embedded pericardial scaffolds were administered in vivo over the ischemic myocardium in a pig model of MI. Six days from implantation, the engineered scaffold efficiently integrated into the post-infarcted myocardium. cATMSC-EV were detected within the construct and MI core, and promoted an increase in vascular density and reduction in macrophage and T cell infiltration within the damaged myocardium. The confined administration of multifunctional MSC-EV within an engineered pericardial scaffold ensures local EV dosage and release, and generates a vascularised bioactive niche for cell recruitment, engraftment and modulation of short-term post-ischemic inflammation.
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Affiliation(s)
- Marta Monguió-Tortajada
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,REMAR-IVECAT Group, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Prat-Vidal
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Miriam Moron-Font
- REMAR-IVECAT Group, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain
| | - Marta Clos-Sansalvador
- REMAR-IVECAT Group, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Alexandra Calle
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Madrid, Spain
| | - Paloma Gastelurrutia
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Adriana Cserkoova
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain
| | - Anna Morancho
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute (VHIR), UAB, Barcelona, Spain
| | - Miguel Ángel Ramírez
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), Madrid, Spain
| | - Anna Rosell
- Neurovascular Research Laboratory, Vall d'Hebron Research Institute (VHIR), UAB, Barcelona, Spain
| | - Antoni Bayes-Genis
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Cardiology Service, Germans Trias i Pujol University Hospital, Badalona, Spain.,Department of Medicine, UAB, Barcelona, Spain
| | - Carolina Gálvez-Montón
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Francesc E Borràs
- REMAR-IVECAT Group, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain.,Nephrology Service, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Santiago Roura
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol (IGTP), Can Ruti Campus, Badalona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.,Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Barcelona, 08500, Spain
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Lin Y, Ding S, Chen Y, Xiang M, Xie Y. Cardiac Adipose Tissue Contributes to Cardiac Repair: a Review. Stem Cell Rev Rep 2021; 17:1137-1153. [PMID: 33389679 DOI: 10.1007/s12015-020-10097-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
Cardiac adipose tissue is a metabolically active adipose tissue in close proximity to heart. Recent studies emphasized the benefits of cardiac adipose tissue in heart remodeling, such as reducing infarction size, enhancing neovascularization and regulating immune response, through a series of cellular mechanisms. In the present manuscript, we provide a comprehensive review regarding the role of cardiac adipose tissue in cardiac repair. We focus on different cardiac adipose tissues according to their distinguished anatomical structures. This review summarizes the latest evidence on the relationship between cardiac adipose tissue and cardiac repair. Cardiac adipose tissues (CAT) were systematically reviewed in the current manuscript which focused on the components of CAT, debates about cardiac adipose stem cells and their effect on heart.
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Affiliation(s)
- Yan Lin
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Siyin Ding
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Yuwen Chen
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Meixiang Xiang
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
| | - Yao Xie
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
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6
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Spotlight on epigenetic reprogramming in cardiac regeneration. Semin Cell Dev Biol 2020; 97:26-37. [DOI: 10.1016/j.semcdb.2019.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/02/2019] [Accepted: 04/15/2019] [Indexed: 02/06/2023]
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7
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Bornachea O, Vea A, Llorente-Cortes V. Interplay between epicardial adipose tissue, metabolic and cardiovascular diseases. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2018; 30:230-239. [PMID: 29903689 DOI: 10.1016/j.arteri.2018.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/24/2018] [Accepted: 03/19/2018] [Indexed: 01/26/2023]
Abstract
Cardiovascular disease is the primary cause of death in obese and diabetic patients. In these groups of patients, the alterations of epicardial adipose tissue (EAT) contribute to both vascular and myocardial dysfunction. Therefore, it is of clinical interest to determine the mechanisms by which EAT influences cardiovascular disease. Two key factors contribute to the tight intercommunication among EAT, coronary arteries and myocardium. One is the close anatomical proximity between these tissues. The other is the capacity of EAT to secrete cytokines and other molecules with paracrine and vasocrine effects on the cardiovascular system. Epidemiological studies have demonstrated that EAT thickness is associated with not only metabolic syndrome but also atherosclerosis and heart failure. The evaluation of EAT using imaging modalities, although effective, presents several disadvantages including radiation exposure, limited availability and elevated costs. Therefore, there is a clinical interest in EAT as a source of new biomarkers of cardiovascular and endocrine alterations. In this review, we revise the mechanisms involved in the protective and pathological role of EAT and present the molecules released by EAT with greater potential to become biomarkers of cardiometabolic alterations.
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Affiliation(s)
- Olga Bornachea
- Institute of Biomedical Research IIB-Sant Pau, Barcelona, Spain; Institute of Biomedical Research of Barcelona (IibB)-CSIC, Barcelona, Spain
| | - Angela Vea
- Institute of Biomedical Research IIB-Sant Pau, Barcelona, Spain
| | - Vicenta Llorente-Cortes
- Institute of Biomedical Research IIB-Sant Pau, Barcelona, Spain; Institute of Biomedical Research of Barcelona (IibB)-CSIC, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
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8
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Perea-Gil I, Gálvez-Montón C, Prat-Vidal C, Jorba I, Segú-Vergés C, Roura S, Soler-Botija C, Iborra-Egea O, Revuelta-López E, Fernández MA, Farré R, Navajas D, Bayes-Genis A. Head-to-head comparison of two engineered cardiac grafts for myocardial repair: From scaffold characterization to pre-clinical testing. Sci Rep 2018; 8:6708. [PMID: 29712965 PMCID: PMC5928167 DOI: 10.1038/s41598-018-25115-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 04/12/2018] [Indexed: 01/09/2023] Open
Abstract
Cardiac tissue engineering, which combines cells and supportive scaffolds, is an emerging treatment for restoring cardiac function after myocardial infarction (MI), although, the optimal construct remains a challenge. We developed two engineered cardiac grafts, based on decellularized scaffolds from myocardial and pericardial tissues and repopulated them with adipose tissue mesenchymal stem cells (ATMSCs). The structure, macromechanical and micromechanical scaffold properties were preserved upon the decellularization and recellularization processes, except for recellularized myocardium micromechanics that was ∼2-fold stiffer than native tissue and decellularized scaffolds. Proteome characterization of the two acellular matrices showed enrichment of matrisome proteins and major cardiac extracellular matrix components, considerably higher for the recellularized pericardium. Moreover, the pericardial scaffold demonstrated better cell penetrance and retention, as well as a bigger pore size. Both engineered cardiac grafts were further evaluated in pre-clinical MI swine models. Forty days after graft implantation, swine treated with the engineered cardiac grafts showed significant ventricular function recovery. Irrespective of the scaffold origin or cell recolonization, all scaffolds integrated with the underlying myocardium and showed signs of neovascularization and nerve sprouting. Collectively, engineered cardiac grafts -with pericardial or myocardial scaffolds- were effective in restoring cardiac function post-MI, and pericardial scaffolds showed better structural integrity and recolonization capability.
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Affiliation(s)
- Isaac Perea-Gil
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain
| | - Carolina Gálvez-Montón
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain
| | - Cristina Prat-Vidal
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain.,Centre of Regenerative Medicine in Barcelona, Barcelona, Spain
| | - Ignasi Jorba
- Biophysics and Bioengineering Unit, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Institute for Bioengineering of Catalonia, The Barcelona Institute of Science and Technology, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain
| | | | - Santiago Roura
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain
| | - Carolina Soler-Botija
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain.,CIBER de Enfermedades Cardiovasculares, Madrid, Spain
| | - Oriol Iborra-Egea
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain
| | - Elena Revuelta-López
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain
| | - Marco A Fernández
- Flow Cytometry Facility, Germans Trias i Pujol Research Institute, Campus Can Ruti, Badalona, Spain
| | - Ramon Farré
- Biophysics and Bioengineering Unit, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Institute for Bioengineering of Catalonia, The Barcelona Institute of Science and Technology, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Daniel Navajas
- Biophysics and Bioengineering Unit, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Institute for Bioengineering of Catalonia, The Barcelona Institute of Science and Technology, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Antoni Bayes-Genis
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain. .,CIBER de Enfermedades Cardiovasculares, Madrid, Spain. .,Cardiology Service, Germans Trias i Pujol University Hospital, Badalona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.
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Affiliation(s)
- Santiago Roura
- ICREC Research Program, Germans Trias i Pujol Health Research Institut, Badalona, Spain
- Center of Regenerative Medicine in Barcelona, Barcelona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Gálvez-Montón
- ICREC Research Program, Germans Trias i Pujol Health Research Institut, Badalona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni Bayes-Genis
- ICREC Research Program, Germans Trias i Pujol Health Research Institut, Badalona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Cardiology Service, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
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10
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Roura S, Gálvez-Montón C, Mirabel C, Vives J, Bayes-Genis A. Mesenchymal stem cells for cardiac repair: are the actors ready for the clinical scenario? Stem Cell Res Ther 2017; 8:238. [PMID: 29078809 PMCID: PMC5658929 DOI: 10.1186/s13287-017-0695-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
For years, sufficient progress has been made in treating heart failure following myocardial infarction; however, the social and economic burdens and the costs to world health systems remain high. Moreover, treatment advances have not resolved the underlying problem of functional heart tissue loss. In this field of research, for years we have actively explored innovative biotherapies for cardiac repair. Here, we present a general, critical overview of our experience in using mesenchymal stem cells, derived from cardiac adipose tissue and umbilical cord blood, in a variety of cell therapy and tissue engineering approaches. We also include the latest advances and future challenges, including good manufacturing practice and regulatory issues. Finally, we evaluate whether recent approaches hold potential for reliable translation to clinical trials.
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Affiliation(s)
- Santiago Roura
- ICREC Research Program, Germans Trias i Pujol Health Research Institute, Badalona, Spain. .,Center of Regenerative Medicine in Barcelona, Barcelona, Spain. .,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain. .,ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP), Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain.
| | - Carolina Gálvez-Montón
- ICREC Research Program, Germans Trias i Pujol Health Research Institute, Badalona, Spain.,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Clémentine Mirabel
- Servei de Teràpia Cel∙lular, Banc de Sang i Teixits, Edifici Dr. Frederic Duran i Jordà, Passeig Taulat, 116, 08005, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 129-139, 08035, Barcelona, Spain
| | - Joaquim Vives
- Servei de Teràpia Cel∙lular, Banc de Sang i Teixits, Edifici Dr. Frederic Duran i Jordà, Passeig Taulat, 116, 08005, Barcelona, Spain.,Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 129-139, 08035, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Bayes-Genis
- ICREC Research Program, Germans Trias i Pujol Health Research Institute, Badalona, Spain. .,CIBERCV, Instituto de Salud Carlos III, Madrid, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. .,Heart Institute, Hospital Universitari Germans Trias i Pujol University Hospital, Carretera de Canyet s/n, 08916, Badalona, Barcelona, Spain.
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Gálvez-Montón C, Soler-Botija C, Iborra-Egea O, Díaz-Güemes I, Martí M, Iglesias-García O, Prat-Vidal C, Crisóstomo V, Llucià-Valldeperas A, Perea-Gil I, Roura S, Sánchez-Margallo FM, Raya Á, Bayes-Genis A. Preclinical Safety Evaluation of Allogeneic Induced Pluripotent Stem Cell-Based Therapy in a Swine Model of Myocardial Infarction. Tissue Eng Part C Methods 2017; 23:736-744. [PMID: 28699384 DOI: 10.1089/ten.tec.2017.0156] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The combination of biomatrices and induced pluripotent stem cell (iPSC) derivatives to aid repair and myocardial scar formation may soon become a reality for cardiac regenerative medicine. However, the tumor risk associated with residual undifferentiated cells remains an important safety concern of iPSC-based therapies. This concern is not satisfactorily addressed in xenotransplantation, which requires immune suppression of the transplanted animal. In this study, we assessed the safety of transplanting undifferentiated iPSCs in an allogeneic setting. Given that swine are commonly used as large animal models in cardiac medicine, we used porcine iPSCs (p-iPSCs) in conjunction with bioengineered constructs that support recovery after acute myocardial infarction. Histopathology analyses found no evidence of p-iPSCs or p-iPSC-derived cells within the host myocardium or biomatrices after 30 and 90 days of follow-up. Consistent with the disappearance of the implanted cells, we could not observe functional benefit of these treatments in terms of left ventricular ejection fraction, cardiac output, ventricular volumes, or necrosis. We therefore conclude that residual undifferentiated iPSCs should pose no safety concern when used on immune-competent recipients in an allogeneic setting, at least in the context of cardiac regenerative medicine.
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Affiliation(s)
- Carolina Gálvez-Montón
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain .,2 CIBER Cardiovascular (CIBERCV), Instituto de Salud Carlos III , Madrid, Spain
| | - Carolina Soler-Botija
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain .,2 CIBER Cardiovascular (CIBERCV), Instituto de Salud Carlos III , Madrid, Spain
| | - Oriol Iborra-Egea
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain
| | - Idoia Díaz-Güemes
- 3 Jesús Usón Minimally Invasive Surgery Centre (JUMISC) , Cáceres, Spain
| | - Mercè Martí
- 4 Center of Regenerative Medicine in Barcelona , Barcelona, Spain
| | | | - Cristina Prat-Vidal
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain .,2 CIBER Cardiovascular (CIBERCV), Instituto de Salud Carlos III , Madrid, Spain
| | - Verónica Crisóstomo
- 2 CIBER Cardiovascular (CIBERCV), Instituto de Salud Carlos III , Madrid, Spain .,3 Jesús Usón Minimally Invasive Surgery Centre (JUMISC) , Cáceres, Spain
| | - Aida Llucià-Valldeperas
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain
| | - Isaac Perea-Gil
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain
| | - Santiago Roura
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain .,2 CIBER Cardiovascular (CIBERCV), Instituto de Salud Carlos III , Madrid, Spain .,4 Center of Regenerative Medicine in Barcelona , Barcelona, Spain
| | - Francisco M Sánchez-Margallo
- 2 CIBER Cardiovascular (CIBERCV), Instituto de Salud Carlos III , Madrid, Spain .,3 Jesús Usón Minimally Invasive Surgery Centre (JUMISC) , Cáceres, Spain
| | - Ángel Raya
- 4 Center of Regenerative Medicine in Barcelona , Barcelona, Spain .,5 Centro de Investigación Biomédica en Red de Bioingeniería , Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain .,6 Institució Catalana de Recerca i Estudis Avançats (ICREA) , Barcelona, Spain
| | - Antoni Bayes-Genis
- 1 ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Health Sciences Research Institute Germans Trias i Pujol (IGTP) , Barcelona, Spain .,2 CIBER Cardiovascular (CIBERCV), Instituto de Salud Carlos III , Madrid, Spain .,7 Department of Medicine, Universitat Autònoma de Barcelona (UAB) , Barcelona, Spain .,8 Cardiology Service, Hospital Universitari Germans Trias i Pujol , Barcelona, Spain
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12
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Gastelurrutia P, Gálvez-Montón C, Cámara ML, Bustamante-Munguira J, García-Pavia P, Avanzas P, Alberto San Román J, Pascual-Figal D, de Teresa E, Crespo-Leiro MG, Manito N, Núñez J, Fernández-Avilés F, Caballero Á, Teis A, Lupón J, Brugada R, Martín C, Silva J, Revilla-Orodea A, Cánovas SJ, Melero JM, Cuenca-Castillo JJ, Gonzalez-Pinto A, Bayes-Genis A. Rationale and design of a multicentre, prospective, randomised, controlled clinical trial to evaluate the efficacy of the adipose graft transposition procedure in patients with a myocardial scar: the AGTP II trial. BMJ Open 2017; 7:e017187. [PMID: 28780562 PMCID: PMC5724153 DOI: 10.1136/bmjopen-2017-017187] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Cardiac adipose tissue is a source of progenitor cells with regenerative capacity. Studies in rodents demonstrated that the intramyocardial delivery of cells derived from this tissue improves cardiac function after myocardial infarction (MI). We developed a new reparative approach for damaged myocardium that integrates the regenerative properties of cardiac adipose tissue with tissue engineering. In the adipose graft transposition procedure (AGTP), we dissect a vascularised flap of autologous pericardial adipose tissue and position it over the myocardial scarred area. Following encouraging results in acute and chronic MI porcine models, we performed the clinical trial (NCT01473433, AdiFLAP trial) to evaluate safety in patients with chronic MI undergoing coronary artery bypass graft. The good safety profile and trends in efficacy warranted a larger trial. STUDY DESIGN The AGTP II trial (NCT02798276) is an investigator initiated, prospective, randomised, controlled, multicentre study to assess the efficacy of the AGTP in 108 patients with non-revascularisable MI. Patients will be assigned to standard clinical practice or the AGTP. The primary endpoint is change in necrotic mass ratio by gadolinium enhancement at 91 and 365 days. Secondary endpoints include improvement in regional contractibility by MRI at 91 and 365 days; changes in functional MRI parameters (left ventricular ejection fraction, left and right ventricular geometric remodelling) at 91 and 365 days; levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) at 7, 91 and 365 days; appearance of arrhythmias from 24 hour Holter monitoring at 24 hours, and at 91 and 365 days; all cause death or re-hospitalisation at 365 days; and cardiovascular death or re-hospitalisation at 365 days. ETHICS AND DISSEMINATION The institutional review board approved the trial which will comply with the Declaration of Helsinki. All patients will provide informed consent. It may offer a novel, effective and technically simple technique for patients with no other therapeutic options. The results will be submitted to indexed medical journals and national and international meetings. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT02798276, pre-results.
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Affiliation(s)
- Paloma Gastelurrutia
- ICREC Research Program, Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Gálvez-Montón
- ICREC Research Program, Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Juan Bustamante-Munguira
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Hospital Universitari de Girona Josep Trueta, Girona, Spain
| | - Pablo García-Pavia
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - Pablo Avanzas
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Alberto San Román
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínico Universitario, Valladolid, ICICORELAB, Valladolid, Spain
| | - Domingo Pascual-Figal
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Eduardo de Teresa
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínico Universitario Virgen de la Victoria de Málaga, IDIMA, Málaga, Spain
| | - Maria G Crespo-Leiro
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Complejo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Spain
| | - Nicolás Manito
- Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
| | - Julio Núñez
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic de Valencia, Valencia, Spain
| | - Francisco Fernández-Avilés
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ángel Caballero
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Albert Teis
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Josep Lupón
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ramón Brugada
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitari de Girona Josep Trueta, Girona, Spain
| | - Carlos Martín
- Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - Jacobo Silva
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ana Revilla-Orodea
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínico Universitario, Valladolid, ICICORELAB, Valladolid, Spain
| | - Sergio J Cánovas
- Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Jose M Melero
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínico Universitario Virgen de la Victoria de Málaga, IDIMA, Málaga, Spain
| | - Jose J Cuenca-Castillo
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Complejo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Spain
| | - Angel Gonzalez-Pinto
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Antoni Bayes-Genis
- ICREC Research Program, Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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13
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Minimally Invasive Adipose Graft Transposition Procedure. J Cardiovasc Transl Res 2016; 10:66-68. [PMID: 28004360 DOI: 10.1007/s12265-016-9721-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 11/16/2016] [Indexed: 11/30/2022]
Abstract
Recently, a new surgical technique to rescue infarcted myocardium (AGTP) has already tested (NCT01473433, AdiFLAP Trial). Here, we present the new minimally invasive AGTP (mi-AGTP) by thoracoscopy.
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14
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Gálvez‐Montón C, Bragós R, Soler‐Botija C, Díaz‐Güemes I, Prat‐Vidal C, Crisóstomo V, Sánchez‐Margallo FM, Llucià‐Valldeperas A, Bogónez‐Franco P, Perea‐Gil I, Roura S, Bayes‐Genis A. Noninvasive Assessment of an Engineered Bioactive Graft in Myocardial Infarction: Impact on Cardiac Function and Scar Healing. Stem Cells Transl Med 2016; 6:647-655. [PMID: 28191775 PMCID: PMC5442807 DOI: 10.5966/sctm.2016-0063] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 07/28/2016] [Indexed: 01/09/2023] Open
Abstract
Cardiac tissue engineering, which combines cells and biomaterials, is promising for limiting the sequelae of myocardial infarction (MI). We assessed myocardial function and scar evolution after implanting an engineered bioactive impedance graft (EBIG) in a swine MI model. The EBIG comprises a scaffold of decellularized human pericardium, green fluorescent protein‐labeled porcine adipose tissue‐derived progenitor cells (pATPCs), and a customized‐design electrical impedance spectroscopy (EIS) monitoring system. Cardiac function was evaluated noninvasively by using magnetic resonance imaging (MRI). Scar healing was evaluated by using the EIS system within the implanted graft. Additionally, infarct size, fibrosis, and inflammation were explored by histopathology. Upon sacrifice 1 month after the intervention, MRI detected a significant improvement in left ventricular ejection fraction (7.5% ± 4.9% vs. 1.4% ± 3.7%; p = .038) and stroke volume (11.5 ± 5.9 ml vs. 3 ± 4.5 ml; p = .019) in EBIG‐treated animals. Noninvasive EIS data analysis showed differences in both impedance magnitude ratio (−0.02 ± 0.04 per day vs. −0.48 ± 0.07 per day; p = .002) and phase angle slope (−0.18° ± 0.24° per day vs. −3.52° ± 0.84° per day; p = .004) in EBIG compared with control animals. Moreover, in EBIG‐treated animals, the infarct size was 48% smaller (3.4% ± 0.6% vs. 6.5% ± 1%; p = .015), less inflammation was found by means of CD25+ lymphocytes (0.65 ± 0.12 vs. 1.26 ± 0.2; p = .006), and a lower collagen I/III ratio was detected (0.49 ± 0.06 vs. 1.66 ± 0.5; p = .019). An EBIG composed of acellular pericardium refilled with pATPCs significantly reduced infarct size and improved cardiac function in a preclinical model of MI. Noninvasive EIS monitoring was useful for tracking differential scar healing in EBIG‐treated animals, which was confirmed by less inflammation and altered collagen deposit. Stem Cells Translational Medicine2017;6:647–655
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Affiliation(s)
- Carolina Gálvez‐Montón
- ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain;
| | - Ramon Bragós
- Electronic and Biomedical Instrumentation Group, Electronic Engineering Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Carolina Soler‐Botija
- ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain;
| | | | - Cristina Prat‐Vidal
- ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain;
| | | | | | - Aida Llucià‐Valldeperas
- ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain;
| | - Paco Bogónez‐Franco
- Electronic and Biomedical Instrumentation Group, Electronic Engineering Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Isaac Perea‐Gil
- ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain;
| | - Santiago Roura
- ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain;
- Center of Regenerative Medicine in Barcelona, Barcelona, Spain
| | - Antoni Bayes‐Genis
- ICREC (Heart Failure and Cardiac Regeneration) Research Programme, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain;
- Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain;
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
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15
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A Cell-Enriched Engineered Myocardial Graft Limits Infarct Size and Improves Cardiac Function: Pre-Clinical Study in the Porcine Myocardial Infarction Model. JACC Basic Transl Sci 2016; 1:360-372. [PMID: 30167524 PMCID: PMC6113410 DOI: 10.1016/j.jacbts.2016.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/16/2016] [Accepted: 06/16/2016] [Indexed: 02/07/2023]
Abstract
Myocardial infarction (MI) remains a dreadful disease around the world, causing irreversible sequelae that shorten life expectancy and reduce quality of life despite current treatment. Here, the authors engineered a cell-enriched myocardial graft, composed of a decellularized myocardial matrix refilled with adipose tissue-derived progenitor cells (EMG-ATDPC). Once applied over the infarcted area in the swine MI model, the EMG-ATDPC improved cardiac function, reduced infarct size, attenuated fibrosis progression, and promoted neovascularization of the ischemic myocardium. The beneficial effects exerted by the EMG-ATDPC and the absence of identified adverse side effects should facilitate its clinical translation as a novel MI therapy in humans. MI remains a major cause of morbidity and mortality despite major treatment advances achieved during the past decades. Administration of an engineered myocardial graft, composed of decellularized myocardial matrix refilled with ATDPCs (EMG-ATDPC), in a porcine pre-clinical MI model, may support cardiac recovery following MI. Thirty days post-EMG-ATDPC implantation, cardiac magnetic resonance imaging and comprehensive histological analysis were performed to evaluate its impact on myocardial restoration. EMG-ATDPC resulted in better left ventricular ejection fraction, higher vessel density and neovascularization, and reduced infarct size by 68%, as well as limited fibrosis. Accordingly, EMG-ATDPC is ready to start the translational avenue toward phase I first-in-man clinical trials.
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Key Words
- ATDPC, adipose tissue-derived progenitor cells
- CMR, cardiac magnetic resonance imaging
- EMG, engineered myocardial graft
- GFP, green fluorescent protein
- IsoB4, isolectin B4
- LV, left ventricle/ventricular
- LVEF, left ventricular ejection fraction
- MI, myocardial infarction
- SMA, smooth muscle actin
- adipose tissue-derived progenitor cells
- cTnI, cardiac troponin I
- cardiac tissue engineering
- decellularized myocardial scaffold
- myocardial infarction
- pATDPC, porcine adipose tissue-derived progenitor cell
- pre-clinical model
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16
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Barbagli G, Pellegrini G, Corradini F, Montorsi F, Sansalone S, Butnaru D, Lazzeri M. One-stage Penile Urethroplasty Using Oral Mucosal Graft and Glue. Eur Urol 2016; 70:1069-1075. [PMID: 27160949 DOI: 10.1016/j.eururo.2016.04.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/18/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Repair of penile urethral strictures is a challenging problem for which different techniques have been suggested. OBJECTIVE To describe a new surgical technique for one-stage penile urethroplasty using an oral graft and glue, and to assess its safety and efficacy. DESIGN, SETTING, AND PARTICIPANTS A retrospective review of medical records for patients who underwent one-stage penile urethroplasty using oral mucosa and glue from February 2013 to October 2014 was performed. SURGICAL PROCEDURE The penile urethra was opened and the urethral plate was incised to create a wide window within which the oral graft was pasted with glue. The urethra was sutured over the catheter. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Clinical data were collected in a database. Intraoperative and postoperative complications and outcomes were assessed. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS Fourteen patients were included in the study. Median operative time was 60min. The median postoperative stay was 3 d. Three intraoperative and one postoperative complication occurred. In all patients, voiding cystourethrography 2 wk after surgery failed to show urethral fistula or sacculation. No patients complained of penile chordee or sexual dysfunction after surgery. Median follow-up was 16 mo. Among the 14 patients, 12 (85.7%) procedures were successful and two (14.3%) were failures. Study limitations include the small sample size and short follow-up. CONCLUSIONS An in vitro study and a one-stage reconstruction of penile urethral strictures with an oral mucosa graft and glue showed that the procedure is safe and efficient, but further studies including larger series of patients and longer follow-up are required. PATIENT SUMMARY We report on the repair of penile urethral stricture using one-stage urethroplasty with oral mucosa and glue. This new technique was safe and effective, with limited complications and satisfactory outcomes. We plan to increase the use of this technique in the future.
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Affiliation(s)
| | - Graziella Pellegrini
- Centre for Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Corradini
- Centre for Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Montorsi
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Salvatore Sansalone
- Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy
| | - Denis Butnaru
- Research Institute for Uronephrology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Massimo Lazzeri
- Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, Italy.
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17
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Bayes-Genis A, Gastelurrutia P, Cámara ML, Teis A, Lupón J, Llibre C, Zamora E, Alomar X, Ruyra X, Roura S, Revilla A, San Román JA, Gálvez-Montón C. First-in-man Safety and Efficacy of the Adipose Graft Transposition Procedure (AGTP) in Patients With a Myocardial Scar. EBioMedicine 2016; 7:248-54. [PMID: 27322478 PMCID: PMC4909363 DOI: 10.1016/j.ebiom.2016.03.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The present study evaluates the safety and efficacy of the Adipose Graft Transposition Procedure (AGTP) as a biological regenerative innovation for patients with a chronic myocardial scar. METHODS This prospective, randomized single-center controlled study included 10 patients with established chronic transmural myocardial scars. Candidates for myocardial revascularization were randomly allocated into two treatment groups. In the control arm (n=5), the revascularizable area was treated with CABG and the non-revascularizable area was left untouched. Patients in the AGTP-treated arm (n=5) were treated with CABG and the non-revascularizable area was covered by a biological adipose graft. The primary endpoint was the appearance of adverse effects derived from the procedure including hospital admissions and death, and 24-hour Holter monitoring arrhythmias at baseline, 1week, and 3 and 12months. Secondary endpoints of efficacy were assessed by cardiac MRI. FINDINGS No differences in safety were observed between groups in terms of clinical or arrhythmic events. On follow-up MRI testing, participants in the AGTP-treated arm showed a borderline smaller left ventricular end systolic volume (LVESV; p=0.09) and necrosis ratio (p=0.06) at 3months but not at 12months. The AGTP-treated patient with the largest necrotic area and most dilated chambers experienced a noted improvement in necrotic mass size (-10.8%), and ventricular volumes (LVEDV: -55.2mL and LVESV: -37.8mL at one year follow-up) after inferior AGTP. INTERPRETATION Our results indicate that AGTP is safe and may be efficacious in selected patients. Further studies are needed to assess its clinical value. (ClinicalTrials.org NCT01473433, AdiFlap Trial).
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Affiliation(s)
- Antoni Bayes-Genis
- Cardiology Service, Germans Trias i Pujol University Hospital, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain.
| | - Paloma Gastelurrutia
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain
| | - Maria-Luisa Cámara
- Cardiac Surgery Service, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Albert Teis
- Cardiology Service, Germans Trias i Pujol University Hospital, Badalona, Spain; Clínica Creu Blanca, Barcelona, Spain
| | - Josep Lupón
- Cardiology Service, Germans Trias i Pujol University Hospital, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cinta Llibre
- Cardiology Service, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Elisabet Zamora
- Cardiology Service, Germans Trias i Pujol University Hospital, Badalona, Spain
| | | | - Xavier Ruyra
- Cardiac Surgery Service, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Santiago Roura
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain; Center of Regenerative Medicine in Barcelona, Barcelona, Spain
| | - Ana Revilla
- ICICORELAB, Clinic University Hospital, Valladolid, Spain
| | | | - Carolina Gálvez-Montón
- ICREC Research Program, Health Science Research Institute Germans Trias i Pujol, Badalona, Spain
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18
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Ma H, Liu J, Qian L. Fat for fostering: Regenerating injured heart using local adipose tissue. EBioMedicine 2016; 7:25-6. [PMID: 27322455 PMCID: PMC4909638 DOI: 10.1016/j.ebiom.2016.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 03/16/2016] [Indexed: 01/28/2023] Open
Affiliation(s)
- Hong Ma
- Department of Pathology and Laboratory Medicine, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Jiandong Liu
- Department of Pathology and Laboratory Medicine, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Li Qian
- Department of Pathology and Laboratory Medicine, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States.
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Lage R, Moscoso I, Fernández-Trasancos Á, Cebro M, Couselo M, Fandiño-Vaquero R, Bravo SB, Sierra J, González-Juanatey JR, Eiras S. Differential behaviour of epicardial adipose tissue-secretomes with high and low orosomucoid levels from patients with cardiovascular disease in H9C2 cells. Mol Cell Endocrinol 2015; 416:77-87. [PMID: 26343163 DOI: 10.1016/j.mce.2015.08.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 08/26/2015] [Accepted: 08/26/2015] [Indexed: 11/26/2022]
Abstract
Epicardial adipose tissue releases orosomucoid (ORM), an acute phase protein with multiple modulatory and protective properties. We aimed to identify the effect of EAT-supernatants according to their ORM levels on H9C2 cells. H9C2 were cultured with EAT-secretomes or ORM protein itself on a Real-Time Cell Analyser. Secretome proteins identification was performed by LC-mass spectrometry according to their ORM levels. Two of them were validated by ELISA in EAT-supernatants from 42 patients. ORM effect on H9C2 and neonatal rat cardiomyocytes apoptosis under hypoxia with or without fatty acid treatment was determined by Annexin-V flow cytometry measurement. Caspase-3 expression levels were determined by western blot in H9C2. Our results showed a differential effect of EAT-secretomes according their ORM levels. Although additional secreted proteins can contribute to their beneficial effects, ORM reduced hypoxia-induced apoptosis through caspase-3 inhibition. Our data showed the cardioprotective role of ORM and suggest that its quantification on EAT secretomes might help us to find new secreted factors with a cardioprotective role.
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Affiliation(s)
- Ricardo Lage
- Cardiology Group, Health Research Institute, University Clinical Hospital of Santiago de Compostela, Spain; Cardiovascular Area, Center for Research in Molecular Medicine and Chronic Diseases of Santiago de Compostela, University Clinical Hospital of Santiago de Compostela, Spain
| | - Isabel Moscoso
- Cardiology Group, Health Research Institute, University Clinical Hospital of Santiago de Compostela, Spain; Cardiovascular Area, Center for Research in Molecular Medicine and Chronic Diseases of Santiago de Compostela, University Clinical Hospital of Santiago de Compostela, Spain
| | - Ángel Fernández-Trasancos
- Cardiology Group, Health Research Institute, University Clinical Hospital of Santiago de Compostela, Spain
| | - María Cebro
- Cardiovascular Area, Center for Research in Molecular Medicine and Chronic Diseases of Santiago de Compostela, University Clinical Hospital of Santiago de Compostela, Spain
| | - Marinela Couselo
- Cardiovascular Area, Center for Research in Molecular Medicine and Chronic Diseases of Santiago de Compostela, University Clinical Hospital of Santiago de Compostela, Spain
| | - Rubén Fandiño-Vaquero
- Department of Cardiology and Coronary Unit, University Clinical Hospital of Santiago de Compostela, Spain
| | - Susana B Bravo
- Proteomic Unit, University Clinical Hospital of Santiago de Compostela, Spain
| | - Juan Sierra
- Department of Heart Surgery, University Clinical Hospital of Santiago de Compostela, Spain
| | - José Ramón González-Juanatey
- Cardiology Group, Health Research Institute, University Clinical Hospital of Santiago de Compostela, Spain; Cardiovascular Area, Center for Research in Molecular Medicine and Chronic Diseases of Santiago de Compostela, University Clinical Hospital of Santiago de Compostela, Spain; Department of Cardiology and Coronary Unit, University Clinical Hospital of Santiago de Compostela, Spain
| | - Sonia Eiras
- Cardiology Group, Health Research Institute, University Clinical Hospital of Santiago de Compostela, Spain.
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Postinfarction Functional Recovery Driven by a Three-Dimensional Engineered Fibrin Patch Composed of Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells. Stem Cells Transl Med 2015; 4:956-66. [PMID: 26106218 DOI: 10.5966/sctm.2014-0259] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 04/17/2015] [Indexed: 01/16/2023] Open
Abstract
Considerable research has been dedicated to restoring myocardial cell slippage and limiting ventricular remodeling after myocardial infarction (MI). We examined the ability of a three-dimensional (3D) engineered fibrin patch filled with human umbilical cord blood-derived mesenchymal stem cells (UCBMSCs) to induce recovery of cardiac function after MI. The UCBMSCs were modified to coexpress luciferase and fluorescent protein reporters, mixed with fibrin, and applied as an adhesive, viable construct (fibrin-cell patch) over the infarcted myocardium in mice (MI-UCBMSC group). The patch adhered well to the heart. Noninvasive bioluminescence imaging demonstrated early proliferation and differentiation of UCBMSCs within the construct in the postinfarct mice in the MI-UCBMSC group. The implanted cells also participated in the formation of new, functional microvasculature that connected the fibrin-cell patch to both the subjacent myocardial tissue and the host circulatory system. As revealed by echocardiography, the left ventricular ejection fraction and fractional shortening at sacrifice were improved in MI-UCBMSC mice and were markedly reduced in mice treated with fibrin alone and untreated postinfarction controls. In conclusion, a 3D engineered fibrin patch composed of UCBMSCs attenuated infarct-derived cardiac dysfunction when transplanted locally over a myocardial wound.
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Umbilical cord blood-derived mesenchymal stem cells: new therapeutic weapons for idiopathic dilated cardiomyopathy? Int J Cardiol 2014; 177:809-18. [PMID: 25305679 DOI: 10.1016/j.ijcard.2014.09.128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/08/2014] [Accepted: 09/23/2014] [Indexed: 02/07/2023]
Abstract
Dilated cardiomyopathy is the most frequent etiology of non-ischemic heart failure. In a majority of cases the causal mechanism is unknown, giving rise to the term 'idiopathic' dilated cardiomyopathy (IDCM). Major pathological derangements include patchy interstitial fibrosis, degenerated cardiomyocytes, and dilatation of the cardiac chambers, but recent evidence suggests that disease progression may also have the signature of cardiac endothelial dysfunction. As we better understand the molecular basis of IDCM, novel therapeutic approaches, mainly gene transfer and cell-based therapies, are being explored. Cells with regenerative potential have been extensively tested in cardiac diseases of ischemic origin in both pre-clinical and clinical settings. However, whether cell therapy has any clinical value in IDCM patients is still being evaluated. This article is a concise summary of cell therapy studies for IDCM, with a focus on recent advances that highlight the vascular potential exhibited by umbilical cord blood-derived mesenchymal stem cells (UCBMSCs). We also provide an overview of cardiac vasculature as a key regulator of subjacent myocardial integrity and function, and discuss the potential mechanisms of UCBMSC amelioration of IDCM myocardium. Consideration of these issues shows that these cells are conceivably new therapeutic agents for this complex and elusive human disorder.
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Jiang Y, Chang P, Pei Y, Li B, Liu Y, Zhang Z, Yu J, Zhu D, Liu X. Intramyocardial injection of hypoxia-preconditioned adipose-derived stromal cells treats acute myocardial infarction: an in vivo study in swine. Cell Tissue Res 2014; 358:417-32. [PMID: 25135062 DOI: 10.1007/s00441-014-1975-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 07/23/2014] [Indexed: 12/21/2022]
Abstract
Hypoxic preconditioning is a promising method for improving the anti-apoptotic and paracrine signaling capabilities of adipose-derived stromal cells (ADSCs). The purpose of this study was to analyze the influence of different hypoxic conditions on ADSCs and the therapeutic effects of hypoxia-preconditioned ADSCs (HPADSCs) on an animal model of myocardial infarction (MI). For the in vitro studies, ADSCs were divided into five groups and cultured in different oxygen concentrations (1, 3, 5, 10, and 21 %). After 24 h, RT-PCR and western blots showed that 3 % oxygen preconditioning could improve the viability and cytokine secretion of the ADSCs. A Matrigel assay indicated that the HPADSC-conditioned medium could stimulate endothelial cells to form capillary-like tubes. For the in vivo studies, MI was induced by coronary occlusion in 24 mature Chinese minipigs. The animals were divided into three groups and treated by intramyocardial injection with vehicle alone (saline group), with 1 × 10(8) ADSCs cultured in normoxic conditions (ADSCs group) or with 1 × 10(8) ADSCs precultured in 3 % oxygen (HPADSCs group). SPECT and echocardiography demonstrated that cardiac function was improved significantly in the HPADSC transplant group compared with the vehicle control group (P < 0.05). Immunofluorescence showed fewer apoptotic cells and more small- to medium-sized vessels in the HPADSC transplantation group (P < 0.05). Three percent oxygen is the optimum preconditioning treatment for ADSCs. HPADSC transplantation can prevent ventricular remodeling and reduce the infarct size.
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Affiliation(s)
- Yiyao Jiang
- Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital Cardiovascular Clinical Hospital of Tianjin Medical University, 61# Third Avenue Tianjin Economic Development Area, Tianjin, 300457, China
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Fandiño-Vaquero R, Fernández-Trasancos A, Álvarez E, Ahmad S, Batista-Oliveira AL, Adrio B, Fernández ÁL, González-Juanatey JR, Eiras S. Orosomucoid secretion levels by epicardial adipose tissue as possible indicator of endothelial dysfunction in diabetes mellitus or inflammation in coronary artery disease. Atherosclerosis 2014; 235:281-8. [DOI: 10.1016/j.atherosclerosis.2014.05.921] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/02/2014] [Accepted: 05/10/2014] [Indexed: 02/05/2023]
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Prat-Vidal C, Gálvez-Montón C, Puig-Sanvicens V, Sanchez B, Díaz-Güemes I, Bogónez-Franco P, Perea-Gil I, Casas-Solà A, Roura S, Llucià-Valldeperas A, Soler-Botija C, Sánchez-Margallo FM, Semino CE, Bragos R, Bayes-Genis A. Online monitoring of myocardial bioprosthesis for cardiac repair. Int J Cardiol 2014; 174:654-61. [DOI: 10.1016/j.ijcard.2014.04.181] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 03/07/2014] [Accepted: 04/17/2014] [Indexed: 02/07/2023]
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Gálvez-Montón C, Prat-Vidal C, Díaz-Güemes I, Crisóstomo V, Soler-Botija C, Roura S, Llucià-Valldeperas A, Perea-Gil I, Sánchez-Margallo FM, Bayes-Genis A. Comparison of two preclinical myocardial infarct models: coronary coil deployment versus surgical ligation. J Transl Med 2014; 12:137. [PMID: 24885652 PMCID: PMC4047266 DOI: 10.1186/1479-5876-12-137] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 05/13/2014] [Indexed: 11/16/2022] Open
Abstract
Background Despite recent advances, myocardial infarction (MI) remains the leading cause of death worldwide. Pre-clinical animal models that closely mimic human MI are pivotal for a quick translation of research and swine have similarities in anatomy and physiology. Here, we compared coronary surgical ligation versus coil embolization MI models in swine. Methods Fifteen animals were randomly distributed to undergo surgical ligation (n = 7) or coil embolization (n = 8). We evaluated infarct size, scar fibrosis, inflammation, myocardial vascularization, and cardiac function by magnetic resonance imaging (MRI). Results Thirty-five days after MI, there were no differences between the models in infarct size (P = 0.53), left ventricular (LV) ejection fraction (P = 0.19), LV end systolic volume (P = 0.22), LV end diastolic volume (P = 0.84), and cardiac output (P = 0.89). Histologically, cardiac scars did not differ and the collagen content, collagen type I (I), collagen type III (III), and the I/III ratio were similar in both groups. Inflammation was assessed using specific anti-CD3 and anti-CD25 antibodies. There was similar activation of inflammation throughout the heart after coil embolization (P = 0.78); while, there were more activated lymphocytes in the infarcted myocardium in the surgical occlusion model (P = 0.02). Less myocardial vascularization in the infarction areas compared with the border and remote zones only in coil embolization animals was observed (P = 0.004 and P = 0.014, respectively). Conclusions Our results support that surgical occlusion and coil embolization MI models generate similar infarct size, cardiac function impairment, and myocardial fibrosis; although, inflammation and myocardial vascularization levels were closer to those found in humans when coil embolization was performed.
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Affiliation(s)
- Carolina Gálvez-Montón
- ICREC (Heart Failure and Cardiac Regeneration) Research Program, IGTP, Cardiology Service, Hospital Universitari Germans Trias i Pujol, Crta, Can Ruti, Camí de les Escoles, s/n, 08916 Badalona, Barcelona, Spain.
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Gálvez-Montón C, Ordoñez-Llanos J, de Luna AB, Bayes-Genis A. One hundred years of myocardial infarction. Eur Heart J 2013. [PMID: 23202667 DOI: 10.1093/eurheartj/ehs364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Carolina Gálvez-Montón
- ICREC Research Program, Fundació Institut d́Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain.
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Gálvez-Montón C, Prat-Vidal C, Roura S, Soler-Botija C, Bayes-Genis A. Ingeniería tisular cardiaca y corazón bioartificial. Rev Esp Cardiol 2013. [DOI: 10.1016/j.recesp.2012.11.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Gálvez-Montón C, Prat-Vidal C, Roura S, Soler-Botija C, Bayes-Genis A. Update: Innovation in cardiology (IV). Cardiac tissue engineering and the bioartificial heart. ACTA ACUST UNITED AC 2013; 66:391-9. [PMID: 24775822 DOI: 10.1016/j.rec.2012.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 11/21/2012] [Indexed: 01/16/2023]
Abstract
Heart failure is the end-stage of many cardiovascular diseases-such as acute myocardial infarction-and remains one of the most appealing challenges for regenerative medicine because of its high incidence and prevalence. Over the last 20 years, cardiomyoplasty, based on the isolated administration of cells with regenerative capacity, has been the focal point of most studies aimed at regenerating the heart. Although this therapy has proved feasible in the clinical setting, the degree of infarcted myocardium regenerated and of improved cardiac function are at best modest. Hence, tissue engineering has emerged as a novel technology using cells with regenerative capacity, biological and/or synthetic materials, growth, proangiogenic and differentiation factors, and online registry systems, to induce the regeneration of whole organs or locally damaged tissue. The next step, seen recently in pioneering animal studies, is de novo generation of bioartificial hearts by decellularization and preservation of supporting structures for their subsequent repopulation with new contractile, vascular muscle tissue. Ultimately, this new approach would entail transplantation of the "rebuilt" heart, reestablishing cardiac function in the recipient.
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Affiliation(s)
- Carolina Gálvez-Montón
- Grupo de Investigación ICREC, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.
| | - Cristina Prat-Vidal
- Grupo de Investigación ICREC, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Santiago Roura
- Grupo de Investigación ICREC, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Carolina Soler-Botija
- Grupo de Investigación ICREC, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
| | - Antoni Bayes-Genis
- Grupo de Investigación ICREC, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain; Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departamento de Medicina, UAB, Barcelona, Spain
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Prat-Vidal C, Gálvez-Montón C, Nonell L, Puigdecanet E, Astier L, Solé F, Bayes-Genis A. Identification of temporal and region-specific myocardial gene expression patterns in response to infarction in swine. PLoS One 2013; 8:e54785. [PMID: 23372767 PMCID: PMC3556027 DOI: 10.1371/journal.pone.0054785] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 12/14/2012] [Indexed: 11/19/2022] Open
Abstract
Molecular mechanisms associated with pathophysiological changes in ventricular remodelling due to myocardial infarction (MI) remain poorly understood. We analyzed changes in gene expression by microarray technology in porcine myocardial tissue at 1, 4, and 6 weeks post-MI.MI was induced by coronary artery ligation in 9 female pigs (30-40 kg). Animals were randomly sacrificed at 1, 4, or 6 weeks post-MI (n = 3 per group) and 3 healthy animals were also included as control group. Total RNA from myocardial samples was hybridized to GeneChip® Porcine Genome Arrays. Functional analysis was obtained with the Ingenuity Pathway Analysis (IPA) online tool. Validation of microarray data was performed by quantitative real-time PCR (qRT-PCR).More than 8,000 different probe sets showed altered expression in the remodelling myocardium at 1, 4, or 6 weeks post-MI. Ninety-seven percent of altered transcripts were detected in the infarct core and 255 probe sets were differentially expressed in the remote myocardium. Functional analysis revealed 28 genes de-regulated in the remote myocardial region in at least one of the three temporal analyzed stages, including genes associated with heart failure (HF), systemic sclerosis and coronary artery disease. In the infarct core tissue, eight major time-dependent gene expression patterns were recognized among 4,221 probe sets commonly altered over time. Altered gene expression of ACVR2B, BID, BMP2, BMPR1A, LMNA, NFKBIA, SMAD1, TGFB3, TNFRSF1A, and TP53 were further validated.The clustering of similar expression patterns for gene products with related function revealed molecular footprints, some of them described for the first time, which elucidate changes in biological processes at different stages after MI.
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Affiliation(s)
- Cristina Prat-Vidal
- Imperial College Research Ethics Committee (Heart Failure and Cardiac Regeneration) Research Program, Health Sciences Research Institute Germans Trias i Pujol. Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - Carolina Gálvez-Montón
- Imperial College Research Ethics Committee (Heart Failure and Cardiac Regeneration) Research Program, Health Sciences Research Institute Germans Trias i Pujol. Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - Lara Nonell
- Servei d'Anàlisi de Microarrays, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Eulàlia Puigdecanet
- Servei d'Anàlisi de Microarrays, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Laura Astier
- Imperial College Research Ethics Committee (Heart Failure and Cardiac Regeneration) Research Program, Health Sciences Research Institute Germans Trias i Pujol. Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - Francesc Solé
- Servei d'Anàlisi de Microarrays, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | - Antoni Bayes-Genis
- Imperial College Research Ethics Committee (Heart Failure and Cardiac Regeneration) Research Program, Health Sciences Research Institute Germans Trias i Pujol. Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain
- Department of Medicine, University Autonomous of Barcelona, Barcelona, Spain
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Bayes-Genis A, Gálvez-Montón C, Prat-Vidal C, Soler-Botija C. Cardiac adipose tissue: a new frontier for cardiac regeneration? Int J Cardiol 2012; 167:22-5. [PMID: 22709728 DOI: 10.1016/j.ijcard.2012.05.082] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 05/27/2012] [Indexed: 11/16/2022]
Abstract
The human heart has limited regenerative capacity. We focused on cardiac adipose tissue as a source of progenitor cells and biological matrix material for salvaging injured myocardium. First, a population of human adult mesenchymal-like progenitors derived from cardiac adipose tissue, with inherent cardiac and endothelial cell potential, was identified and characterized. Next, a salvage strategy was tested, where a pericardial-derived, vascularized, adipose flap was used to cover oxygen-deprived myocardium in a porcine model. The fat flap reduced the myocardial scar size, in both acute and chronic infarcts. A human clinical trial to examine this novel intervention is currently underway.
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Affiliation(s)
- Antoni Bayes-Genis
- ICREC, Heart Failure and Cardiac Regeneration, Research Program, Health Sciences Research Institute Germans Trias i Pujol, Cardiology Service, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
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Gálvez-Montón C, Prat-Vidal C, Roura S, Soler-Botija C, Llucià-Valldeperas A, Díaz-Güemes I, Sánchez-Margallo FM, Bayes-Genis A. Post-infarction scar coverage using a pericardial-derived vascular adipose flap. Pre-clinical results. Int J Cardiol 2011; 166:469-74. [PMID: 22137092 DOI: 10.1016/j.ijcard.2011.11.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 10/29/2011] [Accepted: 11/04/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Myocardial salvage after coverage with a fat flap was recently demonstrated in acute coronary occlusion. The effect of this novel therapeutic strategy on a chronic myocardial scar is unknown. METHODS Myocardial infarction (MI) was induced by coil deployment in the mid circumflex artery in the swine model. Two weeks after infarction, a pericardial-derived adipose flap was transposed, fully covering the scar, in the treated group. Infarct size and histopathology were analyzed on post mortem sections. To assess cell migration, adenoviral eGFP vectors were injected in the adipose flap and expression was evaluated upon sacrifice both at the flap and myocardium. Magnetic resonance imaging (MRI) was used to measure left ventricular (LV) ejection fraction and ventricular volumes at baseline, 2 weeks post-MI, and at 6 weeks. RESULTS One month after flap transposition, histopathology confirmed a 34% reduction in infarct size (8.7% vs. 5.7%; P=0.04) and the presence of vascular connections at the flap-myocardium interface. High eGFP expression was detected at the infarct core both at the gene and protein level (negligible signal was detected at the flap on sacrifice). At the functional level, changes in LV ejection fraction and volumes (end-systolic and end-diastolic) were not significantly different between groups (all P values>0.1). CONCLUSIONS Our data support the use of post-infarction scar coverage with a pericardial-derived fat flap to reduce infarct size, due partly to neovascular connections and cell trafficking at the flap-myocardium interface. Further studies are needed to validate the functional and clinical relevance of this intervention.
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