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Kobayashi H, Tohyama S, Ichimura H, Ohashi N, Chino S, Soma Y, Tani H, Tanaka Y, Yang X, Shiba N, Kadota S, Haga K, Moriwaki T, Morita-Umei Y, Umei TC, Sekine O, Kishino Y, Kanazawa H, Kawagishi H, Yamada M, Narita K, Naito T, Seto T, Kuwahara K, Shiba Y, Fukuda K. Regeneration of Nonhuman Primate Hearts With Human Induced Pluripotent Stem Cell-Derived Cardiac Spheroids. Circulation 2024; 150:611-621. [PMID: 38666382 DOI: 10.1161/circulationaha.123.064876] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 03/21/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND The clinical application of human induced pluripotent stem cell-derived cardiomyocytes (CMs) for cardiac repair commenced with the epicardial delivery of engineered cardiac tissue; however, the feasibility of the direct delivery of human induced pluripotent stem cell-derived CMs into the cardiac muscle layer, which has reportedly induced electrical integration, is unclear because of concerns about poor engraftment of CMs and posttransplant arrhythmias. Thus, in this study, we prepared purified human induced pluripotent stem cell-derived cardiac spheroids (hiPSC-CSs) and investigated whether their direct injection could regenerate infarcted nonhuman primate hearts. METHODS We performed 2 separate experiments to explore the appropriate number of human induced pluripotent stem cell-derived CMs. In the first experiment, 10 cynomolgus monkeys were subjected to myocardial infarction 2 weeks before transplantation and were designated as recipients of hiPSC-CSs containing 2×107 CMs or the vehicle. The animals were euthanized 12 weeks after transplantation for histological analysis, and cardiac function and arrhythmia were monitored during the observational period. In the second study, we repeated the equivalent transplantation study using more CMs (6×107 CMs). RESULTS Recipients of hiPSC-CSs containing 2×107 CMs showed limited CM grafts and transient increases in fractional shortening compared with those of the vehicle (fractional shortening at 4 weeks after transplantation [mean ± SD]: 26.2±2.1%; 19.3±1.8%; P<0.05), with a low incidence of posttransplant arrhythmia. Transplantation of increased dose of CMs resulted in significantly greater engraftment and long-term contractile benefits (fractional shortening at 12 weeks after transplantation: 22.5±1.0%; 16.6±1.1%; P<0.01, left ventricular ejection fraction at 12 weeks after transplantation: 49.0±1.4%; 36.3±2.9%; P<0.01). The incidence of posttransplant arrhythmia slightly increased in recipients of hiPSC-CSs containing 6×107 CMs. CONCLUSIONS We demonstrated that direct injection of hiPSC-CSs restores the contractile functions of injured primate hearts with an acceptable risk of posttransplant arrhythmia. Although the mechanism for the functional benefits is not fully elucidated, these findings provide a strong rationale for conducting clinical trials using the equivalent CM products.
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Affiliation(s)
- Hideki Kobayashi
- Department of Cardiovascular Medicine (H. Kobayashi, K.K.), Shinshu University, Matsumoto, Japan
| | - Shugo Tohyama
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Hajime Ichimura
- Division of Cardiovascular Surgery, Department of Surgery (H.I., N.O., S.C., Y.T., T.S.), Shinshu University, Matsumoto, Japan
- School of Medicine, Department of Regenerative Science and Medicine (H.I., Y.T., X.Y., N.S., S.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Noburo Ohashi
- Division of Cardiovascular Surgery, Department of Surgery (H.I., N.O., S.C., Y.T., T.S.), Shinshu University, Matsumoto, Japan
| | - Shuji Chino
- Division of Cardiovascular Surgery, Department of Surgery (H.I., N.O., S.C., Y.T., T.S.), Shinshu University, Matsumoto, Japan
| | - Yusuke Soma
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Hidenori Tani
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Yuki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery (H.I., N.O., S.C., Y.T., T.S.), Shinshu University, Matsumoto, Japan
- School of Medicine, Department of Regenerative Science and Medicine (H.I., Y.T., X.Y., N.S., S.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Xiao Yang
- School of Medicine, Department of Regenerative Science and Medicine (H.I., Y.T., X.Y., N.S., S.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Naoko Shiba
- School of Medicine, Department of Regenerative Science and Medicine (H.I., Y.T., X.Y., N.S., S.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Shin Kadota
- School of Medicine, Department of Regenerative Science and Medicine (H.I., Y.T., X.Y., N.S., S.K., Y. Shiba), Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences (S.K., H. Kawagishi, K.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Kotaro Haga
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Taijun Moriwaki
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Yuika Morita-Umei
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
- Kanagawa Institute of Industrial Science and Technology, Japan (Y.M.-U.)
| | - Tomohiko C Umei
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Otoya Sekine
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Yoshikazu Kishino
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Hideaki Kanazawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Hiroyuki Kawagishi
- Department of Molecular Pharmacology (H. Kawagishi, M.Y.), Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences (S.K., H. Kawagishi, K.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Mitsuhiko Yamada
- Department of Molecular Pharmacology (H. Kawagishi, M.Y.), Shinshu University, Matsumoto, Japan
| | - Kazumasa Narita
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine (K.N., T.N.), Shinshu University, Matsumoto, Japan
- Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan (K.N., T.N.)
| | - Takafumi Naito
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine (K.N., T.N.), Shinshu University, Matsumoto, Japan
- Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan (K.N., T.N.)
| | - Tatsuichiro Seto
- Division of Cardiovascular Surgery, Department of Surgery (H.I., N.O., S.C., Y.T., T.S.), Shinshu University, Matsumoto, Japan
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine (H. Kobayashi, K.K.), Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences (S.K., H. Kawagishi, K.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Yuji Shiba
- School of Medicine, Department of Regenerative Science and Medicine (H.I., Y.T., X.Y., N.S., S.K., Y. Shiba), Shinshu University, Matsumoto, Japan
- Institute for Biomedical Sciences (S.K., H. Kawagishi, K.K., Y. Shiba), Shinshu University, Matsumoto, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (S.T., Y. Soma, H.T., K.H., T.M., Y.M.-U., T.C.U., O.S., Y.K., H. Kanazawa, K.F.)
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Frederiksen HR, Glantz A, Vøls KK, Skov S, Tveden-Nyborg P, Freude K, Doehn U. CRISPR-Cas9 immune-evasive hESCs are rejected following transplantation into immunocompetent mice. Front Genome Ed 2024; 6:1403395. [PMID: 38863835 PMCID: PMC11165197 DOI: 10.3389/fgeed.2024.1403395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/07/2024] [Indexed: 06/13/2024] Open
Abstract
Although current stem cell therapies exhibit promising potential, the extended process of employing autologous cells and the necessity for donor-host matching to avert the rejection of transplanted cells significantly limit the widespread applicability of these treatments. It would be highly advantageous to generate a pluripotent universal donor stem cell line that is immune-evasive and, therefore, not restricted by the individual's immune system, enabling unlimited application within cell replacement therapies. Before such immune-evasive stem cells can be moved forward to clinical trials, in vivo testing via transplantation experiments in immune-competent animals would be a favorable approach preceding preclinical testing. By using human stem cells in immune competent animals, results will be more translatable to a clinical setting, as no parts of the immune system have been altered, although in a xenogeneic setting. In this way, immune evasiveness, cell survival, and unwanted proliferative effects can be assessed before clinical trials in humans. The current study presents the generation and characterization of three human embryonic stem cell lines (hESCs) for xenogeneic transplantation in immune-competent mice. The major histocompatibility complexes I- and II-encoding genes, B2M and CIITA, have been deleted from the hESCs using CRISPR-Cas9-targeted gene replacement strategies and knockout. B2M was knocked out by the insertion of murine CD47. Human-secreted embryonic alkaline phosphatase (hSEAP) was inserted in a safe harbor site to track cells in vivo. The edited hESCs maintained their pluripotency, karyotypic normality, and stable expression of murine CD47 and hSEAP in vitro. In vivo transplantation of hESCs into immune-competent BALB/c mice was successfully monitored by measuring hSEAP in blood samples. Nevertheless, transplantation of immune-evasive hESCs resulted in complete rejection within 11 days, with clear immune infiltration of T-cells on day 8. Our results reveal that knockout of B2M and CIITA together with species-specific expression of CD47 are insufficient to prevent rejection in an immune-competent and xenogeneic context.
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Affiliation(s)
- Henriette Reventlow Frederiksen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Søren Skov
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Tveden-Nyborg
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristine Freude
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Doehn
- Cell Therapy Research, Novo Nordisk A/S, Maaloev, Denmark
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Wu K, Wang Y, Yang H, Chen Y, Lu K, Wu Y, Liu C, Zhang H, Meng H, Yu Q, Zhang Y, Shen Z. Injectable Decellularized Extracellular Matrix Hydrogel Containing Stromal Cell-Derived Factor 1 Promotes Transplanted Cardiomyocyte Engraftment and Functional Regeneration after Myocardial Infarction. ACS APPLIED MATERIALS & INTERFACES 2023; 15:2578-2589. [PMID: 36598791 DOI: 10.1021/acsami.2c16682] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Transplantation of exogenous cardiomyocytes (CMs) is a hopeful method to treat myocardial infarction (MI). However, its clinical application still remains challenging due to low retention and survival rates of the transplanted cells. Herein, a stromal cell-derived factor 1 (SDF-1)-loaded injectable hydrogel based on a decellularized porcine extracellular matrix (dECM) is developed to encapsulate and deliver CMs locally to the infarct area of the heart. The soluble porcine cardiac dECM is composed of similar components such as the human cardiac ECM, which could be self-assembled into a nanofibrous hydrogel at physiological temperature to improve the retention of transplanted CMs. Furthermore, the chemokine SDF-1 could recruit endogenous cells to promote angiogenesis, mitigating the ischemic microenvironment and improving the survival of CMs. The results in vitro show that this composite hydrogel exhibits good biocompatibility, anti-apoptosis property, and chemotactic effects for mesenchymal stromal cells and endothelial cells through SDF-1-CXCR4 axis. Moreover, intramyocardial injection of this composite hydrogel to the infarcted area leads to the promotion of angiogenesis and inhibition of fibrosis, reducing the infarction size and improving the cardiac function. The combination of natural biomaterials, exogenous cells, and bioactive factors shows potential for MI treatment in the clinical application.
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Affiliation(s)
- Kui Wu
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
- Department of Cardiovascular Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, P. R. China
| | - Yuanyuan Wang
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
| | - Hong Yang
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
| | - Yihuan Chen
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
| | - Kunyan Lu
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou 215123, P. R. China
| | - Yong Wu
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
| | - Chunxia Liu
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
| | - Haixin Zhang
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou 215123, P. R. China
| | - Hanyu Meng
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
| | - Qian Yu
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University, Suzhou 215123, P. R. China
| | - Yanxia Zhang
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
| | - Zhenya Shen
- Department of Cardiovascular Surgery of the First Affiliated Hospital and Institute for Cardiovascular Science, Suzhou Medical College of Soochow University, Soochow University, Suzhou 215007, P. R. China
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