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Gallet R, Su JB, Corboz D, Chiaroni PM, Bizé A, Dai J, Panel M, Boucher P, Pallot G, Brehat J, Sambin L, Thery G, Mouri N, de Pommereau A, Denormandie P, Germain S, Lacampagne A, Teiger E, Marbán E, Ghaleh B. Three-vessel coronary infusion of cardiosphere-derived cells for the treatment of heart failure with preserved ejection fraction in a pre-clinical pig model. Basic Res Cardiol 2023; 118:26. [PMID: 37400630 DOI: 10.1007/s00395-023-00995-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is a major public health concern. Its outcome is poor and, as of today, barely any treatments have been able to decrease its morbidity or mortality. Cardiosphere-derived cells (CDCs) are heart cell products with anti-fibrotic, anti-inflammatory and angiogenic properties. Here, we tested the efficacy of CDCs in improving left ventricular (LV) structure and function in pigs with HFpEF. Fourteen chronically instrumented pigs received continuous angiotensin II infusion for 5 weeks. LV function was investigated through hemodynamic measurements and echocardiography at baseline, after 3 weeks of angiotensin II infusion before three-vessel intra-coronary CDC (n = 6) or placebo (n = 8) administration and 2 weeks after treatment (i.e., at completion of the protocol). As expected, arterial pressure was significantly and similarly increased in both groups. This was accompanied by LV hypertrophy that was not affected by CDCs. LV systolic function remained similarly preserved during the whole protocol in both groups. In contrast, LV diastolic function was impaired (increases in Tau, LV end-diastolic pressure as well as E/A, E/E'septal and E/E'lateral ratios) but CDC treatment significantly improved all of these parameters. The beneficial effect of CDCs on LV diastolic function was not explained by reduced LV hypertrophy or increased arteriolar density; however, interstitial fibrosis was markedly reduced. Three-vessel intra-coronary administration of CDCs improves LV diastolic function and reduces LV fibrosis in this hypertensive model of HFpEF.
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Affiliation(s)
- Romain Gallet
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Service de Cardiologie, Créteil, France
| | - Jin-Bo Su
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Daphné Corboz
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Paul-Matthieu Chiaroni
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Service de Cardiologie, Créteil, France
| | - Alain Bizé
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Jianping Dai
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Mathieu Panel
- PhyMedExp, Université de Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Pierre Boucher
- Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS, INSERM, PSL Research University, Paris, France
| | - Gaëtan Pallot
- Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS, INSERM, PSL Research University, Paris, France
| | - Juliette Brehat
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Lucien Sambin
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Guillaume Thery
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Nadir Mouri
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Département de biochimie-pharmacologie-biologie moléculaire-génétique médicale, Créteil, France
| | - Aurélien de Pommereau
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Pierre Denormandie
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Stéphane Germain
- Center for Interdisciplinary Research in Biology (CIRB), College de France, CNRS, INSERM, PSL Research University, Paris, France
| | - Alain Lacampagne
- PhyMedExp, Université de Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Emmanuel Teiger
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Service de Cardiologie, Créteil, France
| | - Eduardo Marbán
- Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Bijan Ghaleh
- Inserm U955-IMRB, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.
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Techiryan G, Weil BR, Young RF, Canty JM. Widespread intracoronary allogeneic cardiosphere-derived cell therapy with and without cyclosporine in reperfused myocardial infarction. Am J Physiol Heart Circ Physiol 2022; 323:H904-H916. [PMID: 36083793 PMCID: PMC9602689 DOI: 10.1152/ajpheart.00373.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 12/14/2022]
Abstract
Allogeneic cardiosphere-derived cell (CDC) therapy has been demonstrated to improve myocardial function when administered to reperfused myocardial infarcts. We previously pretreated animals with low-dose cyclosporine immunosuppression to limit allogeneic CDC rejection, but whether it is necessary and, if so, can be initiated at the time of reperfusion remains uncertain. Closed-chest swine (n = 29 animals) were subjected to a 90-min left anterior descending (LAD) coronary artery occlusion. Using a three-way blinded design, we randomized two groups to receive global intracoronary infusions of 20 × 106 CDCs 30 min after reperfusion. A third control group was treated with saline. One CDC group received cyclosporine 10 min before reperfusion (2.5 mg/kg iv and 100 mg/day po), whereas the other groups received placebos. After 1 mo, neither chronic infarct size relative to area at risk (saline control, 46.2 ± 4.0%; CDCs, 46.4 ± 2.1%; and CDCs + cyclosporine, 49.2 ± 3.1%; P = 0.79) nor ejection fraction (saline control, 51 ± 2%; CDCs, 51 ± 2%; and CDC + cyclosporine, 48 ± 2%; P = 0.42) were different among treatment groups. Multiple histological measures of cellular remodeling, myocyte proliferation, and apoptosis were also not different among treatment groups. In contrast to previous studies, we were unable to reproduce the cardioprotective effects demonstrated by allogeneic CDCs without cyclosporine. Furthermore, initiation of intravenous cyclosporine at the time of reperfusion followed by oral therapy was not sufficient to elicit the functional improvement observed in studies where cyclosporine was started 72 h before CDC therapy. This suggests that oral cyclosporine pretreatment may be necessary to effect cardiac repair with allogeneic CDCs.NEW & NOTEWORTHY In a three-way blinded, randomized design, we determined whether allogeneic CDCs administered at reperfusion improved myocardial function and whether intravenous cyclosporine enhanced their efficacy. In contrast to prior studies using oral cyclosporine, CDCs with or without intravenous cyclosporine had no effect on function or infarct size. This indicates that CDCs may be most efficacious for treating chronic LV dysfunction where cyclosporine can be initiated at least 72 h before cell therapy.
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Affiliation(s)
- George Techiryan
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York
- The Clinical and Translational Research Center, University at Buffalo, Buffalo, New York
| | - Brian R Weil
- Veterans Affairs Western New York Health Care System, University at Buffalo, Buffalo, New York
- Department of Physiology and Biophysics, University at Buffalo, Buffalo, New York
- The Clinical and Translational Research Center, University at Buffalo, Buffalo, New York
| | - Rebeccah F Young
- Department of Medicine, University at Buffalo, Buffalo, New York
- The Clinical and Translational Research Center, University at Buffalo, Buffalo, New York
| | - John M Canty
- Veterans Affairs Western New York Health Care System, University at Buffalo, Buffalo, New York
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York
- Department of Physiology and Biophysics, University at Buffalo, Buffalo, New York
- Department of Medicine, University at Buffalo, Buffalo, New York
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York
- The Clinical and Translational Research Center, University at Buffalo, Buffalo, New York
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Transplantation of MITO cells, mitochondria activated cardiac progenitor cells, to the ischemic myocardium of mouse enhances the therapeutic effect. Sci Rep 2022; 12:4344. [PMID: 35318358 PMCID: PMC8941106 DOI: 10.1038/s41598-022-08583-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/10/2022] [Indexed: 12/14/2022] Open
Abstract
Given the potential for myocardial stem cell transplantation as a promising treatment for heart failure, numerous clinical trials have been conducted and its usefulness has been clearly confirmed. However, the low rate of engraftment of transplanted cells has become a clinical problem, and this needs to be improved in the case of transplanting cells to the heart. To address this issue, we report on attempts to prepare mitochondria-activated stem cells (MITO cells) for use in transplantation. MITO cells, which is cardiac progenitor cells (CPCs) activated by the mitochondrial delivery of resveratrol with an anti-oxidant and mitochondrial activation effects were successfully prepared using a mitochondrial targeting nanocarrier (MITO-Porter). The purpose of this study was to validate the therapeutic effect of cell transplantation by the MITO cells using a mouse model of myocardial ischemia–reperfusion. Mouse CPCs were used as transplanted cells. The transplantation of CPCs and MITO cells were conducted after myocardial ischemia–reperfusion, and the therapeutic effect was determined. The MITO cells transplanted group showed increase in postoperative weight gain, improve cardiac function and inhibition of fibrosis compared to the non-transplanted group and the CPC group. The transplantation of MITO cells to the ischemic myocardium showed a stronger transplantation effect compared to conventional CPC transplantation.
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Sousonis V, Sfakianaki T, Ntalianis A, Nanas I, Kontogiannis C, Aravantinos D, Kapelios C, Katsaros L, Nana M, Sampaziotis D, Sanoudou D, Papalois A, Malliaras K. Intracoronary Administration of Allogeneic Cardiosphere-Derived Cells Immediately Prior to Reperfusion in Pigs With Acute Myocardial Infarction Reduces Infarct Size and Attenuates Adverse Cardiac Remodeling. J Cardiovasc Pharmacol Ther 2021; 26:88-99. [PMID: 32677460 DOI: 10.1177/1074248420941672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Allogeneic cardiosphere-derived cells (CDCs) exert cardioprotective effects when administered intracoronarily after reperfusion in animal models of acute myocardial infarction (AMI). The "no-reflow" phenomenon develops rapidly post-reperfusion and may undermine the efficacy of cell therapy, due to poor cell delivery in areas of microvascular obstruction (MVO). We hypothesized that CDC-induced cardioprotection would be enhanced by cell administration prior to reperfusion, when microvasculature is still relatively intact, to facilitate widespread cell delivery within the ischemic area. METHODS AND RESULTS We studied 81 farm pigs; 55 completed the specified protocols. A dose-optimization study in infarcted pigs demonstrated that the doses of 5 million and 10 million CDCs are the maximum safe doses that can be administered intracoronarily at 5 minutes prior to and at 5 minutes post-reperfusion, respectively, without aggravating MVO. Quantification of acute cell retention by polymerase chain reaction demonstrated that cell delivery prior to reperfusion resulted in higher cardiac cell retention compared to delivery post-reperfusion. We then performed a randomized, placebo-controlled study to assess the long-term efficacy of intracoronary infusion of 5 million allogeneic CDCs, delivered at 5 minutes prior to reperfusion, in a porcine model of AMI. The CDC therapy resulted in decreased scar size, improved regional systolic function, and attenuation of adverse cardiac remodeling (manifested as preserved global systolic function, preserved end-systolic volume, and decreased interstitial fibrosis) compared to placebo at 30 days post-MI. CONCLUSIONS Dose-optimized intracoronary infusion of allogeneic CDCs prior to reperfusion in a porcine model of AMI is feasible, safe and confers long-term benefits.
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Affiliation(s)
- Vasileios Sousonis
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
- Center for New Biotechnologies and Precision Medicine, University of Athens School of Medicine, Athens, Greece
| | - Titika Sfakianaki
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | - Argirios Ntalianis
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | - Ioannis Nanas
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | - Christos Kontogiannis
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | - Dionysios Aravantinos
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | - Chris Kapelios
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | - Lampros Katsaros
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | - Maria Nana
- Third Department of Cardiology, University of Athens School of Medicine, Athens, Greece
| | | | - Despina Sanoudou
- Center for New Biotechnologies and Precision Medicine, University of Athens School of Medicine, Athens, Greece
- Fouth Department of Internal Medicine, Clinical Genomics and Pharmacogenomics Unit, Attikon Hospital, University of Athens School of Medicine, Athens, Greece
| | - Apostolos Papalois
- Experimental Educational and Research Center, ELPEN Pharmaceuticals, Athens, Greece
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Yamada Y, Hibino M, Sasaki D, Abe J, Harashima H. Power of mitochondrial drug delivery systems to produce innovative nanomedicines. Adv Drug Deliv Rev 2020; 154-155:187-209. [PMID: 32987095 DOI: 10.1016/j.addr.2020.09.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/22/2022]
Abstract
Mitochondria carry out various essential functions including ATP production, the regulation of apoptosis and possess their own genome (mtDNA). Delivering target molecules to this organelle, it would make it possible to control the functions of cells and living organisms and would allow us to develop a better understanding of life. Given the fact that mitochondrial dysfunction has been implicated in a variety of human disorders, delivering therapeutic molecules to mitochondria for the treatment of these diseases is an important issue. To date, several mitochondrial drug delivery system (DDS) developments have been reported, but a generalized DDS leading to therapy that exclusively targets mitochondria has not been established. This review focuses on mitochondria-targeted therapeutic strategies including antioxidant therapy, cancer therapy, mitochondrial gene therapy and cell transplantation therapy based on mitochondrial DDS. A particular focus is on nanocarriers for mitochondrial delivery with the goal of achieving mitochondria-targeting therapy. We hope that this review will stimulate the accelerated development of mitochondrial DDS.
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Affiliation(s)
- Yuma Yamada
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan; Laboratory for Biological Drug Development Based on DDS Technology, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan.
| | - Mitsue Hibino
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan
| | - Daisuke Sasaki
- Department of Pediatrics, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Jiro Abe
- Department of Pediatrics, Graduate School of Medicine, Hokkaido University, Kita-15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Hideyoshi Harashima
- Faculty of Pharmaceutical Sciences, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan; Laboratory for Biological Drug Development Based on DDS Technology, Hokkaido University, Kita-12, Nishi-6, Kita-ku, Sapporo 060-0812, Japan
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Chakravarty T, Henry TD, Kittleson M, Lima J, Siegel RJ, Slipczuk L, Pogoda JM, Smith RR, Malliaras K, Marbán L, Ascheim DD, Marbán E, Makkar RR. Allogeneic cardiosphere-derived cells for the treatment of heart failure with reduced ejection fraction: the Dilated cardiomYopathy iNtervention with Allogeneic MyocardIally-regenerative Cells (DYNAMIC) trial. EUROINTERVENTION 2020; 16:e293-e300. [DOI: 10.4244/eij-d-19-00035] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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7
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Wang S, Chen W, Ma L, Zou M, Dong W, Yang H, Sun L, Chen X, Duan J. Infant cardiosphere-derived cells exhibit non-durable heart protection in dilated cardiomyopathy rats. Cytotechnology 2019; 71:1043-1052. [PMID: 31583508 DOI: 10.1007/s10616-019-00328-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/25/2019] [Indexed: 12/18/2022] Open
Abstract
Stem cells provide a new strategy for the treatment of cardiac diseases; however, their effectiveness in dilated cardiomyopathy (DCM) has not been investigated. In this study, cardiosphere-derived cells (CDCs) were isolated from infants (≤ 24 months) and identified by the cell surface markers CD105, CD90, CD117 and CD45, which is consistent with a previous report, although increased CD34 expression was observed. The molecular expression profile of CDCs from infants was determined by RNA sequencing and compared with adult CDCs, showing that infant CDCs have almost completely altered gene expression patterns compared with adult CDCs. The upregulated genes in infant CDCs are mainly related to the biological processes of cell morphogenesis and differentiation. The molecular profile of infant CDCs was characterized by lower expression of inflammatory cytokines and higher expression of stem cell markers and growth factors compared to adult CDCs. After intramyocardial administration of infant CDCs in the heart of DCM rats, we found that infant CDCs remained in the heart of DCM rats for at least 7 days, improved DCM-induced cardiac function impairment and protected the myocardium by elevating the left ventricular ejection fraction and fraction shortening. However, the effectiveness of transplanted CDCs was reversed later, as increased fibrosis formation instead of angiogenesis was observed. We concluded that infant CDCs, with higher expression of stem cell markers and growth factors, exhibit non-durable heart protection due to limited residence time in the heart of DCM animals, suggesting that multiple administrations of the CDCs or post-regulation after transplantation may be the key for cell therapy in the future.
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Affiliation(s)
- Siyuan Wang
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China.,Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China
| | - Weidan Chen
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China
| | - Li Ma
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China
| | - Minghui Zou
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China
| | - Wenyan Dong
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China.,Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China
| | - Haili Yang
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China.,Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China
| | - Lei Sun
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China.,Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China
| | - Xinxin Chen
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China.
| | - Jinzhu Duan
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China. .,Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 JinSui Road, Guangzhou, 510120, Guangdong, China.
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8
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Marunouchi T, Sasaki K, Yano E, Tanonaka K. Transplantation of cardiac Sca-1-positive cells rather than c-Kit-positive cells preserves mitochondrial oxygen consumption of the viable myocardium following myocardial infarction in rats. J Pharmacol Sci 2019; 140:236-241. [PMID: 31375326 DOI: 10.1016/j.jphs.2019.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/29/2019] [Accepted: 07/09/2019] [Indexed: 01/12/2023] Open
Abstract
The cardiosphere-derived cell (CDC) is one of the candidate cells used for cardiac regenerative therapy. Cardiospheres are mixture of cells including c-Kit+ cells, stem cell antigen (Sca)-1+ cells, and other types of cardiac progenitor cells. In this study, we compared the effect of transplantation of isolated Sca-1+ cells and c-Kit+ cells with that of the crude CDCs (CrCDCs). Focusing on the differences in the ability for secretion of paracrine factors among 3 types of cells, we determined the effects of transplantation of these cells on cardiac intracellular signaling and mitochondrial function in rats with permanently ligated coronary arteries. We showed that the transplantation of these cells resulted in a preservation of the cardiac pump function and mitochondrial respiration at the 8th week after myocardial infarction. However, mitochondrial function in the c-Kit+ cell-transplanted group was lower than that in the other 2 groups. Furthermore, we found that activation levels of intracellular signaling proteins after cell transplantation may have been due to the ability of secretion of growth factors by these transplanted cell types. Our findings indicate the possibility that CrCDC and Sca-1+ cells rather than c-Kit+ cells may be used therapeutically to preserve cardiac function and energy metabolism after myocardial infarction.
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Affiliation(s)
- Tetsuro Marunouchi
- Department of Molecular and Cellular Pharmacology, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Kyohei Sasaki
- Department of Molecular and Cellular Pharmacology, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Emi Yano
- Department of Molecular and Cellular Pharmacology, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Kouichi Tanonaka
- Department of Molecular and Cellular Pharmacology, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan.
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9
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Suzuki G, Weil BR, Young RF, Fallavollita JA, Canty JM. Nonocclusive multivessel intracoronary infusion of allogeneic cardiosphere-derived cells early after reperfusion prevents remote zone myocyte loss and improves global left ventricular function in swine with myocardial infarction. Am J Physiol Heart Circ Physiol 2019; 317:H345-H356. [PMID: 31125261 DOI: 10.1152/ajpheart.00124.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intracoronary cardiosphere-derived cells (icCDCs) infused into the infarct-related artery reduce scar volume but do not improve left ventricular (LV) ejection fraction (LVEF). We tested the hypothesis that this reflects the inability of regional delivery to prevent myocyte death or promote myocyte proliferation in viable myocardium remote from the infarct. Swine (n = 23) pretreated with oral cyclosporine (200 mg/day) underwent a 1-h left anterior descending coronary artery (LAD) occlusion, which reduced LVEF from 61.6 ± 1.0 to 45.3 ± 1.5% 30 min after reperfusion. At that time, animals received global infusion of allogeneic icCDCs (n = 8), regional infusion of icCDCs restricted to the LAD using the stop-flow technique (n = 8), or vehicle (n = 7). After 1 mo, global icCDCs increased LVEF from 44.8 ± 1.9 to 60.8 ± 3.8% (P < 0.05) with no significant change after LAD stop-flow icCDCs (44.8 ± 3.6 to 50.9 ± 3.1%) or vehicle (46.5 ± 2.5 to 47.7 ± 2.6%). In contrast, global icCDCs did not alter infarct volume (%LV mass) assessed at 2 days (11.2 ± 2.3 vs. 12.6 ± 2.3%), whereas it was reduced after LAD stop-flow icCDCs (7.1 ± 1.1%, P < 0.05). Histopathological analysis of remote myocardium after global icCDCs demonstrated a significant increase in myocyte proliferation (147 ± 32 vs. 14 ± 10 nuclei/106 myocytes, P < 0.05) and a reduction in myocyte apoptosis (15 ± 9 vs. 46 ± 10 nuclei/106 myocytes, P < 0.05) that increased myocyte nuclear density (1,264 ± 39 vs. 1,157 ± 33 nuclei/mm2, P < 0.05) and decreased myocyte diameter (13.2 ± 0.2 vs. 14.5 ± 0.3 μm, P < 0.05) compared with vehicle-treated controls. In contrast, remote zone changes after regional LAD icCDCs were no different from vehicle. These data indicate that changes in global LVEF after icCDCs are dependent upon preventing myocyte loss and hypertrophy in myocardium remote from the infarct. These arise from stimulating myocyte proliferation and reducing myocyte apoptosis indicating the importance of directing cell therapy to viable remote regions.NEW & NOTEWORTHY Administration of allogeneic cardiosphere-derived cells to the entire heart via global intracoronary infusion shortly after myocardial infarction favorably influenced left ventricular ejection fraction by preventing myocyte death and promoting myocyte proliferation in remote, noninfarcted myocardium in swine. In contrast, regional intracoronary cell infusion did not significantly affect remote zone myocyte remodeling. Global cell administration targeting viable myocardium remote from the infarct may be an effective approach to prevent adverse ventricular remodeling after myocardial infarction.
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Affiliation(s)
- Gen Suzuki
- Department of Medicine, University at Buffalo, Buffalo, New York.,Clinical and Translational Research Institute, University at Buffalo, Buffalo, New York
| | - Brian R Weil
- Physiology and Biophysics, University at Buffalo, Buffalo, New York.,Clinical and Translational Research Institute, University at Buffalo, Buffalo, New York
| | - Rebeccah F Young
- Department of Medicine, University at Buffalo, Buffalo, New York.,Clinical and Translational Research Institute, University at Buffalo, Buffalo, New York
| | - James A Fallavollita
- Veterans Affairs Western New York Health Care System, Buffalo, New York.,Department of Medicine, University at Buffalo, Buffalo, New York.,Clinical and Translational Research Institute, University at Buffalo, Buffalo, New York
| | - John M Canty
- Veterans Affairs Western New York Health Care System, Buffalo, New York.,Department of Medicine, University at Buffalo, Buffalo, New York.,Physiology and Biophysics, University at Buffalo, Buffalo, New York.,Biomedical Engineering, University at Buffalo, Buffalo, New York.,Clinical and Translational Research Institute, University at Buffalo, Buffalo, New York
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10
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Effects of cardiosphere-derived cell transplantation on cardiac mitochondrial oxygen consumption after myocardial infarction in rats. Biomed Pharmacother 2018; 108:883-892. [DOI: 10.1016/j.biopha.2018.09.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 12/31/2022] Open
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11
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Moore JB, Tang XL, Zhao J, Fischer AG, Wu WJ, Uchida S, Gumpert AM, Stowers H, Wysoczynski M, Bolli R. Epigenetically modified cardiac mesenchymal stromal cells limit myocardial fibrosis and promote functional recovery in a model of chronic ischemic cardiomyopathy. Basic Res Cardiol 2018; 114:3. [PMID: 30446837 PMCID: PMC6335654 DOI: 10.1007/s00395-018-0710-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/31/2018] [Indexed: 01/01/2023]
Abstract
Preclinical investigations support the concept that donor cells more oriented towards a cardiovascular phenotype favor repair. In light of this philosophy, we previously identified HDAC1 as a mediator of cardiac mesenchymal cell (CMC) cardiomyogenic lineage commitment and paracrine signaling potency in vitro-suggesting HDAC1 as a potential therapeutically exploitable target to enhance CMC cardiac reparative capacity. In the current study, we examined the effects of pharmacologic HDAC1 inhibition, using the benzamide class 1 isoform-selective HDAC inhibitor entinostat (MS-275), on CMC cardiomyogenic lineage commitment and CMC-mediated myocardial repair in vivo. Human CMCs pre-treated with entinostat or DMSO diluent control were delivered intramyocardially in an athymic nude rat model of chronic ischemic cardiomyopathy 30 days after a reperfused myocardial infarction. Indices of cardiac function were assessed by echocardiography and left ventricular (LV) Millar conductance catheterization 35 days after treatment. Compared with naïve CMCs, entinostat-treated CMCs exhibited heightened capacity for myocyte-like differentiation in vitro and superior ability to attenuate LV remodeling and systolic dysfunction in vivo. The improvement in CMC therapeutic efficacy observed with entinostat pre-treatment was not associated with enhanced donor cell engraftment, cardiomyogenesis, or vasculogenesis, but instead with more efficient inhibition of myocardial fibrosis and greater increase in myocyte size. These results suggest that HDAC inhibition enhances the reparative capacity of CMCs, likely via a paracrine mechanism that improves ventricular compliance and contraction and augments myocyte growth and function.
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Affiliation(s)
- Joseph B Moore
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA.
| | - Xian-Liang Tang
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
| | - John Zhao
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
| | - Annalara G Fischer
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
| | - Wen-Jian Wu
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
| | - Shizuka Uchida
- Department of Medicine, Cardiovascular Innovation Institute, University of Louisville, Louisville, KY, USA
| | - Anna M Gumpert
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
| | - Heather Stowers
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
| | - Marcin Wysoczynski
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
| | - Roberto Bolli
- Institute of Molecular Cardiology, Division of Cardiovascular Medicine, University of Louisville, 580 S. Preston Street, Louisville, KY, 40292, USA
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12
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Abstract
After a myocardial infarction, heart tissue becomes irreversibly damaged, leading to scar formation and inevitably ischemic heart failure. Of the many available interventions after a myocardial infarction, such as percutaneous intervention or pharmacological optimization, none can reverse the ischemic insult on the heart and restore cardiac function. Thus, the only available cure for patients with scarred myocardium is allogeneic heart transplantation, which comes with extensive costs, risks, and complications. However, multiple studies have shown that the heart is, in fact, not an end-stage organ and that there are endogenous mechanisms in place that have the potential to spark regeneration. Stem cell therapy has emerged as a potential tool to tap into and activate this endogenous framework. Particularly promising are stem cells derived from cardiac tissue itself, referred to as cardiosphere-derived cells (CDCs). CDCs can be extracted and isolated from the patient's myocardium and then administered by intramyocardial injection or intracoronary infusion. After early success in the animal model, multiple clinical trials have demonstrated the safety and efficacy of autologous CDC therapy in humans. Clinical trials with allogeneic CDCs showed early promising results and pose a potential "off-the-shelf" therapy for patients in the acute setting after a myocardial infarction. The mechanism responsible for CDC-induced cardiac regeneration seems to be a combination of triggering native cardiomyocyte proliferation and recruitment of endogenous progenitor cells, which most prominently occurs via paracrine effects. A further understanding of the mediators involved in paracrine signaling can help with the development of a stem cell-free therapy, with all the benefits and none of the associated complications.
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13
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Nana-Leventaki E, Nana M, Poulianitis N, Sampaziotis D, Perrea D, Sanoudou D, Rontogianni D, Malliaras K. Cardiosphere-Derived Cells Attenuate Inflammation, Preserve Systolic Function, and Prevent Adverse Remodeling in Rat Hearts With Experimental Autoimmune Myocarditis. J Cardiovasc Pharmacol Ther 2018; 24:70-77. [DOI: 10.1177/1074248418784287] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Cardiosphere-derived cells (CDCs) have yielded promising efficacy signals in early-phase clinical trials of ischemic and nonischemic cardiomyopathy. The potential efficacy of CDCs in acute myocarditis, an inflammatory cardiomyopathy without effective therapy, remains unexplored. Given that CDCs produce regenerative, cardioprotective, anti-inflammatory, and anti-fibrotic effects (all of which could be beneficial in acute myocarditis), we investigated the efficacy of intracoronary delivery of CDCs in a rat model of experimental autoimmune myocarditis. Methods: Lewis rats underwent induction of experimental autoimmune myocarditis by subcutaneous footpad injection of purified porcine cardiac myosin supplemented with Mycobacterium tuberculosis on days 1 and 7. On day 10, rats were randomly assigned to receive global intracoronary delivery of 500 000 CDCs or vehicle. Global intracoronary delivery was performed by injection of cells or vehicle into the left ventricular (LV) cavity during transient occlusion of the aortic root. Rats were euthanized 18 days after infusion. Cardiac volumes and systolic function were assessed by serial echocardiography, performed on days 1, 10, and 28. Myocardial inflammation, T-cell infiltration, and cardiac fibrosis were evaluated by histology. Results: Experimental autoimmune myocarditis was successfully induced in 14/14 rats that completed follow-up. Left ventricular ejection fraction (LVEF) and volumes were comparable on days 1 and 10 between groups. CDC infusion resulted in increased LVEF (81.5% ± 3% vs 65.4% ± 8%, P < .001) and decreased LV end-systolic volume (43 ± 15 vs 100 ± 24 μL, P < .001) compared to placebo administration at 18 days post-infusion. Cardiosphere-derived cell infusion decreased myocardial inflammation (7.4% ± 7% vs 20.7% ± 4% of myocardium, P = .007), cardiac fibrosis (16.6% ± 13% vs 38.1% ± 3% of myocardium, P = .008), and myocardial T-cell infiltration (30.4 ± 29 vs 125.8 ± 49 cells per field, P = .005) at 18 days post-infusion compared to placebo administration. Conclusion: Intracoronary delivery of CDCs attenuates myocardial inflammation, T-cell infiltration, and fibrosis while preventing myocarditis-induced systolic dysfunction and adverse remodeling in rats with experimental autoimmune myocarditis.
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Affiliation(s)
- E. Nana-Leventaki
- Third Department of Cardiology, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - M. Nana
- Third Department of Cardiology, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - N. Poulianitis
- Department of Pathology, Evangelismos Hospital, Athens, Greece
| | - D. Sampaziotis
- Department of Pathology, Evangelismos Hospital, Athens, Greece
| | - D. Perrea
- Laboratory for Experimental Surgery and Surgical Research “N.S. Christeas”, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - D. Sanoudou
- Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Fourth Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - D. Rontogianni
- Department of Pathology, Evangelismos Hospital, Athens, Greece
| | - K. Malliaras
- Third Department of Cardiology, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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14
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Marbán E. A mechanistic roadmap for the clinical application of cardiac cell therapies. Nat Biomed Eng 2018; 2:353-361. [PMID: 30740264 DOI: 10.1038/s41551-018-0216-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The development of cells for regenerative therapy has encountered many pitfalls on its path to clinical translation. In cardiology, clinical studies of heart-targeted cell therapies began two decades ago, yet progress towards reaching an approved product has been slow. In this Perspective, I provide an overview of recent cardiac cell therapies, with a focus on the hurdles limiting the translation of cell products from research laboratories to clinical practice. By focusing on heart failure as a target indication, I argue that strategies for overcoming limitations in clinical translation require an increasing emphasis on mechanism-supported efficacy, rather than on phenomenological observations. As research progresses from cells to paracrine mechanisms to defined factors, identifying those defined factors that are involved in achieving superior therapeutic efficacy will better inform the use of cells as therapeutic candidates. The next generation of cell-free biologics may provide the benefits of cell therapy without the intrinsic limitations of whole-cell products.
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Affiliation(s)
- Eduardo Marbán
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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15
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Eitoku T, Baba K, Kondou M, Kurita Y, Fukushima Y, Hirai K, Ohtsuki S, Ishigami S, Sano S, Oh H. Transcoronary cell infusion with the stop-flow technique in children with single-ventricle physiology. Pediatr Int 2018; 60:240-246. [PMID: 29266671 DOI: 10.1111/ped.13485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/14/2017] [Accepted: 12/15/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Almost all reports on cardiac regeneration therapy have referred to adults, and only a few have focused on transcoronary infusion of cardiac progenitor cells using the stop-flow technique in children. METHODS Intracoronary autologous cardiosphere-derived cell (CDC) transfer was conducted at Okayama University as a phase 1 clinical trial for seven patients with hypoplastic left heart syndrome between January 2011 and December 2012, and as a phase 2 clinical trial for 34 patients with single-ventricle physiology between July 2013 and March 2015. RESULTS A total of 41 patients with single-ventricle physiology underwent transcoronary infusion of CDC with the stop-flow technique. The median age was 33 months (range, 5-70 months) and the median weight was 10.1 kg (range, 4.1-16.0 kg). Transient adverse events occurred during the procedure, including ST-segment elevation or depression, hypotension, bradycardia, and coronary artery vasospasm. All patients completely recovered. There were no major procedure-related adverse events. In this study, transcoronary infusion of CDC using the stop-flow technique was successfully completed in all patients. CONCLUSION Transcoronary infusion of CDC using the stop-flow technique in children is a feasible and safe procedure.
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Affiliation(s)
- Takahiro Eitoku
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Kenji Baba
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Maiko Kondou
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshihiko Kurita
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yousuke Fukushima
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Kenta Hirai
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Shinichi Ohtsuki
- Department of Pediatric Cardiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Shuta Ishigami
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Shunji Sano
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Hidemasa Oh
- Department of Regenerative Medicine, Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
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16
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Canty JM, Weil BR. Cortical Bone Stem Cells Administered at Reperfusion Attenuate Remote Zone Myocyte Remodeling. Circ Res 2017; 121:1210-1212. [PMID: 29122940 DOI: 10.1161/circresaha.117.312075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- John M Canty
- From the VA Western New York Health Care System, Buffalo; Department of Medicine, Department of Physiology and Biophysics, and Department of Biomedical Engineering, Buffalo, NY; and Clinical and Translational Science Institute of the University at Buffalo, NY.
| | - Brian R Weil
- From the VA Western New York Health Care System, Buffalo; Department of Medicine, Department of Physiology and Biophysics, and Department of Biomedical Engineering, Buffalo, NY; and Clinical and Translational Science Institute of the University at Buffalo, NY
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17
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Sharma UC, Mosleh W, Chaudhari MR, Katkar R, Weil B, Evelo C, Cimato TR, Pokharel S, Blankesteijn WM, Suzuki G. Myocardial and Serum Galectin-3 Expression Dynamics Marks Post-Myocardial Infarction Cardiac Remodelling. Heart Lung Circ 2016; 26:736-745. [PMID: 28094123 DOI: 10.1016/j.hlc.2016.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/11/2016] [Accepted: 11/13/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Acute myocardial infarction (MI) causes significant changes in cardiac morphology and function. Galectin-3 is a novel and potentially therapeutically important mediator of cardiac remodelling. Myocardial and serum galectin-3 expression dynamics in response to the early cardiovascular outcomes after acute MI are not fully elucidated. METHODS We first performed a comprehensive longitudinal microarray analyses in mice after acute MI. We then measured the serum levels of galectin-3 in a translational porcine model of coronary microembolism-induced post-ischaemic cardiac remodelling. We validated our pre-clinical studies in humans by measuring serum galectin-3 levels of 52 patients with acute ST-elevation MI (STEMI) and 11 healthy controls. We analysed galectin-3 data in relation to the development of major adverse cardiovascular outcomes (MACO). RESULTS Of the 9,753 genes profiled at infarcted and remote myocardium at eight different time points, dynamic myocardial overexpression of galectin-3 mRNA was detected. In a pig model of diffuse myocardial damage and cardiac remodelling, galectin-3 localised to the areas of tissue damage and myocardial fibrosis, with proportionate increase of their serum galectin-3 expression levels. In humans, increased serum galectin-3 level was associated with in-hospital MACO. CONCLUSIONS In this translational study, we demonstrated that galectin-3 is dynamically overexpressed in response to acute MI-induced cardiac remodelling. Elevated galectin-3 levels are associated with the development of in-hospital MACO.
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Affiliation(s)
- Umesh C Sharma
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA.
| | - Wassim Mosleh
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
| | - Milind R Chaudhari
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
| | - Rujuta Katkar
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
| | - Brian Weil
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
| | - Chris Evelo
- Department of Bioinformatics-BiGCaT, University of Maastricht, Maastricht, The Netherlands
| | - Thomas R Cimato
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
| | - Saraswati Pokharel
- Department of Pathology and Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | - Gen Suzuki
- Division of Cardiovascular Medicine, University at Buffalo, Buffalo, NY, USA
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18
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Lang JK, Young RF, Ashraf H, Canty JM. Inhibiting Extracellular Vesicle Release from Human Cardiosphere Derived Cells with Lentiviral Knockdown of nSMase2 Differentially Effects Proliferation and Apoptosis in Cardiomyocytes, Fibroblasts and Endothelial Cells In Vitro. PLoS One 2016; 11:e0165926. [PMID: 27806113 PMCID: PMC5091915 DOI: 10.1371/journal.pone.0165926] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/19/2016] [Indexed: 12/18/2022] Open
Abstract
Numerous studies have shown a beneficial effect of cardiosphere-derived cell (CDC) therapy on regeneration of injured myocardium. Paracrine signaling by CDC secreted exosomes may contribute to improved cardiac function. However, it has not yet been demonstrated by a genetic approach that exosome release contributes to the therapeutic effect of transplanted CDCs. By employing a lentiviral knockdown (KD) strategy against neutral spingomyelinase 2 (nSMase2), a crucial gene in exosome secretion, we have defined the role of physiologically secreted human CDC-derived exosomes on cardiac fibroblast, endothelial cell and primary cardiomyocyte proliferation, cell death, migration and angiogenesis using a series of in vitro coculture assays. We found that secretion of hCDC-derived exosomes was effectively inhibited by nSMase2 lentiviral KD and shRNAi expression was stable and constitutive. hCDC exosome release contributed to the angiogenic and pro-migratory effects of hCDCs on HUVECs, decreased proliferation of fibroblasts, and decreased apoptosis of cardiomyocytes. These in vitro reactions support a role for exosome secretion as a paracrine mechanism of stem cell-mediated cardiac repair in vivo. Importantly, we have established a novel tool to test constitutive inhibition of exosome secretion in stem cell populations in animal models of cardiac disease.
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Affiliation(s)
- Jennifer K. Lang
- Department of Medicine, Division of Cardiology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, N.Y, 14203, United States of America
- * E-mail:
| | - Rebeccah F. Young
- Department of Medicine, Division of Cardiology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, N.Y, 14203, United States of America
| | - Hashmat Ashraf
- Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, N.Y, 14203, United States of America
| | - John M. Canty
- Department of Medicine, Division of Cardiology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, N.Y, 14203, United States of America
- VA WNY Healthcare System, Buffalo, N.Y., 14215, United States of America
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19
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Heart-Derived Stem Cells in Miniature Swine with Coronary Microembolization: Novel Ischemic Cardiomyopathy Model to Assess the Efficacy of Cell-Based Therapy. Stem Cells Int 2016; 2016:6940195. [PMID: 27738436 PMCID: PMC5055979 DOI: 10.1155/2016/6940195] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 08/18/2016] [Accepted: 08/24/2016] [Indexed: 01/15/2023] Open
Abstract
A major problem in translating stem cell therapeutics is the difficulty of producing stable, long-term severe left ventricular (LV) dysfunction in a large animal model. For that purpose, extensive infarction was created in sinclair miniswine by injecting microspheres (1.5 × 106 microspheres, 45 μm diameter) in LAD. At 2 months after embolization, animals (n = 11) were randomized to receive allogeneic cardiosphere-derived cells derived from atrium (CDCs: 20 × 106, n = 5) or saline (untreated, n = 6). Four weeks after therapy myocardial function, myocyte proliferation (Ki67), mitosis (phosphor-Histone H3; pHH3), apoptosis, infarct size (TTC), myocyte nuclear density, and cell size were evaluated. CDCs injected into infarcted and remodeled remote myocardium (global infusion) increased regional function and global function contrasting no change in untreated animals. CDCs reduced infarct volume and stimulated Ki67 and pHH3 positive myocytes in infarct and remote regions. As a result, myocyte number (nuclear density) increased and myocyte cell diameter decreased in both infarct and remote regions. Coronary microembolization produces stable long-term ischemic cardiomyopathy. Global infusion of CDCs stimulates myocyte regeneration and improves left ventricular ejection fraction. Thus, global infusion of CDCs could become a new therapy to reverse LV dysfunction in patients with asymptomatic heart failure.
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20
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Cardiac Strain in a Swine Model of Regional Hibernating Myocardium: Effects of CoQ10 on Contractile Reserve Following Bypass Surgery. J Cardiovasc Transl Res 2016; 9:368-73. [PMID: 27184805 DOI: 10.1007/s12265-016-9696-y] [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: 03/23/2016] [Accepted: 05/03/2016] [Indexed: 11/27/2022]
Abstract
There is conflicting clinical evidence whether administration of coenzyme Q10 (CoQ10) improves function following coronary artery bypass graft surgery (CABG). Using a swine model of hibernating myocardium, we tested whether daily CoQ10 would improve contractile function by MRI at 4-week post-CABG. Twelve pigs underwent a thoracotomy and had a constrictor placed on the left anterior descending (LAD). At 12 weeks, they underwent off-pump bypass and received daily dietary supplements of either CoQ10 (10 mg/kg/day) or placebo. At 4-week post-CABG, circumferential strain measurements in the hibernating LAD region from placebo and CoQ10 groups were not different and increased to a similar extent with dobutamine (-14.7 ± 0.6 versus -14.8 ± 0.1, respectively (NS)). Post-sacrifice, oxidant stress markers were obtained in the mitochondrial isolates and protein carbonyl in the placebo, and CoQ10 groups were 6.14 ± 0.36 and 5.05 ± 0.32 nmol/mg, respectively (NS). In summary, CoQ10 did not improve contractile reserve or reduce oxidant stress at 4-week post-CABG.
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21
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Canty JM, Weil BR, Suzuki G. Widespread Intracoronary Cardiopoietic Cell Infusion: Treating at the Time of Myocardial Reperfusion to Prevent Rather Than Reverse Established Left Ventricular Dysfunction Moves Us Closer to Practical Clinical Translation. Circ Res 2016; 118:1045-8. [PMID: 27034270 DOI: 10.1161/circresaha.116.308518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- John M Canty
- From the Department of Medicine (J.M.C., B.R.W., G.S.), Department of Physiology and Biophysics (J.M.C.), Department of Biomedical Engineering (J.M.C.), VA WNY Health Care System (J.M.C.), and Division of Cardiovascular Medicine, Clinical and Translational Research Center (J.M.C., B.R.W., G.S.), University at Buffalo, NY.
| | - Brian R Weil
- From the Department of Medicine (J.M.C., B.R.W., G.S.), Department of Physiology and Biophysics (J.M.C.), Department of Biomedical Engineering (J.M.C.), VA WNY Health Care System (J.M.C.), and Division of Cardiovascular Medicine, Clinical and Translational Research Center (J.M.C., B.R.W., G.S.), University at Buffalo, NY
| | - Gen Suzuki
- From the Department of Medicine (J.M.C., B.R.W., G.S.), Department of Physiology and Biophysics (J.M.C.), Department of Biomedical Engineering (J.M.C.), VA WNY Health Care System (J.M.C.), and Division of Cardiovascular Medicine, Clinical and Translational Research Center (J.M.C., B.R.W., G.S.), University at Buffalo, NY
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22
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Gallet R, Tseliou E, Dawkins J, Middleton R, Valle J, Angert D, Reich H, Luthringer D, Kreke M, Smith R, Marbán L, Marbán E. Intracoronary delivery of self-assembling heart-derived microtissues (cardiospheres) for prevention of adverse remodeling in a pig model of convalescent myocardial infarction. Circ Cardiovasc Interv 2016; 8:CIRCINTERVENTIONS.115.002391. [PMID: 25953823 DOI: 10.1161/circinterventions.115.002391] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Preclinical studies in rodents and pigs indicate that the self-assembling microtissues known as cardiospheres may be more effective than dispersed cardiosphere-derived cells. However, the more desirable intracoronary route has been assumed to be unsafe for cardiosphere delivery: Cardiospheres are large (30-150 μm), raising concerns about likely microembolization. We questioned these negative assumptions by evaluating the safety and efficacy of optimized intracoronary delivery of cardiospheres in a porcine model of convalescent myocardial infarction. METHODS AND RESULTS First, we standardized the size of cardiospheres by modifying culture conditions. Then, dosage was determined by infusing escalating doses of cardiospheres in the left anterior descending artery of naive pigs, looking for acute adverse effects. Finally, in a randomized efficacy study, 14 minipigs received allogeneic cardiospheres (1.3 × 10(6)) or vehicle 1 month after myocardial infarction. Animals underwent magnetic resonance imaging before infusion and 1 month later to assess left ventricular ejection fraction, scar mass, and viable mass. In the dosing study, we did not observe any evidence of microembolization after cardiosphere infusion. In the post-myocardial infarction study, cardiospheres preserved LV function, reduced scar mass and increased viable mass, whereas placebo did not. Moreover, cardiosphere decreased collagen content, and increased vessel densities and myocardial perfusion. Importantly, intracoronary cardiospheres decreased left ventricular end-diastolic pressure and increased cardiac output. CONCLUSIONS Intracoronary delivery of cardiospheres is safe. Intracoronary cardiospheres are also remarkably effective in decreasing scar, halting adverse remodeling, increasing myocardial perfusion, and improving hemodynamic status after myocardial infarction in pigs. Thus, cardiospheres may be viable therapeutic candidates for intracoronary infusion in selected myocardial disorders.
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Affiliation(s)
- Romain Gallet
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Eleni Tseliou
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - James Dawkins
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Ryan Middleton
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Jackelyn Valle
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - David Angert
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Heidi Reich
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Daniel Luthringer
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Michelle Kreke
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Rachel Smith
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Linda Marbán
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.)
| | - Eduardo Marbán
- From the Cedars-Sinai Heart Institute, Los Angeles, CA (R.G., E.T., J.D., R.M., J.V., D.A., H.R., D.L., M.K., R.S., L.M.); and Capricor Inc, Los Angeles, CA (M.K., R.S., L.M.).
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23
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Blázquez R, Sánchez-Margallo FM, Crisóstomo V, Báez C, Maestre J, Álvarez V, Casado JG. Intrapericardial Delivery of Cardiosphere-Derived Cells: An Immunological Study in a Clinically Relevant Large Animal Model. PLoS One 2016; 11:e0149001. [PMID: 26866919 PMCID: PMC4750976 DOI: 10.1371/journal.pone.0149001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/25/2016] [Indexed: 01/22/2023] Open
Abstract
Introduction The intrapericardial delivery has been defined as an efficient method for pharmacological agent delivery. Here we hypothesize that intrapericardial administration of cardiosphere-derived cells (CDCs) may have an immunomodulatory effect providing an optimal microenvironment for promoting cardiac repair. To our knowledge, this is the first report studying the effects of CDCs for myocardial repair using the intrapericardial delivery route. Material and Methods CDCs lines were isolated, expanded and characterized by flow cytometry and PCR. Their differentiation ability was determined using specific culture media and differential staining. 300,000 CDCs/kg were injected into the pericardial space of a swine myocardial infarcted model. Magnetic resonance imaging, biochemical analysis of pericardial fluid and plasma, cytokine measurements and flow cytometry analysis were performed. Results Our results showed that, phenotype and differentiation behavior of porcine CDCs were equivalent to previously described CDCs. Moreover, the intrapericardial administration of CDCs fulfilled the safety aspects as non-adverse effects were reported. Finally, the phenotypes of resident lymphocytes and TH1 cytokines in the pericardial fluid were significantly altered after CDCs administration. Conclusions The pericardial fluid could be considered as a safe and optimal vehicle for CDCs administration. The observed changes in the studied immunological parameters could exert a modulation in the inflammatory environment of infarcted hearts, indirectly benefiting the endogenous cardiac repair.
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Affiliation(s)
- Rebeca Blázquez
- Stem Cell Therapy Unit, 'Jesús Usón' Minimally Invasive Surgery Centre, Cáceres, Spain
| | | | - Verónica Crisóstomo
- Endoluminal Therapy and Diagnosis, 'Jesús Usón' Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Claudia Báez
- Endoluminal Therapy and Diagnosis, 'Jesús Usón' Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Juan Maestre
- Endoluminal Therapy and Diagnosis, 'Jesús Usón' Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Verónica Álvarez
- Stem Cell Therapy Unit, 'Jesús Usón' Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Javier G Casado
- Stem Cell Therapy Unit, 'Jesús Usón' Minimally Invasive Surgery Centre, Cáceres, Spain
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Widespread Myocardial Delivery of Heart-Derived Stem Cells by Nonocclusive Triple-Vessel Intracoronary Infusion in Porcine Ischemic Cardiomyopathy: Superior Attenuation of Adverse Remodeling Documented by Magnetic Resonance Imaging and Histology. PLoS One 2016; 11:e0144523. [PMID: 26784932 PMCID: PMC4718597 DOI: 10.1371/journal.pone.0144523] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/19/2015] [Indexed: 12/26/2022] Open
Abstract
Single-vessel, intracoronary infusion of stem cells under stop-flow conditions has proven safe but achieves only limited myocardial coverage. Continuous flow intracoronary delivery to one or more coronary vessels may achieve broader coverage for treating cardiomyopathy, but has not been investigated. Using nonocclusive coronary guiding catheters, we infused allogeneic cardiosphere-derived cells (CDCs) either in a single vessel or sequentially in all three coronary arteries in porcine ischemic cardiomyopathy and used magnetic resonance imaging (MRI) to assess structural and physiological outcomes. Vehicle-infused animals served as controls. Single-vessel stop-flow and continuous-flow intracoronary infusion revealed equivalent effects on scar size and function. Sequential infusion into each of the three major coronary vessels under stop-flow or continuous-flow conditions revealed equal efficacy, but less elevation of necrotic biomarkers with continuous-flow delivery. In addition, multi-vessel delivery resulted in enhanced global and regional tissue function compared to a triple-vessel placebo-treated group. The functional benefits after global cell infusion were accompanied histologically by minimal inflammatory cellular infiltration, attenuated regional fibrosis and enhanced vessel density in the heart. Sequential multi-vessel non-occlusive delivery of CDCs is safe and provides enhanced preservation of left ventricular function and structure. The current findings provide preclinical validation of the delivery method currently undergoing clinical testing in the Dilated cardiomYopathy iNtervention With Allogeneic MyocardIally-regenerative Cells (DYNAMIC) trial of CDCs in heart failure patients.
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25
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Kapelios CJ, Nanas JN, Malliaras K. Allogeneic cardiosphere-derived cells for myocardial regeneration: current progress and recent results. Future Cardiol 2016; 12:87-100. [DOI: 10.2217/fca.15.72] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Early-phase clinical testing of autologous cardiosphere-derived cells (CDCs) has yielded intriguing results, consistent with therapeutic myocardial regeneration. However, autologous therapy is associated with significant technical, timing, economic and logistic constraints, prompting researchers to explore the potential of allogeneic CDC therapy. CDCs exhibit a favorable immunologic antigenic profile and are hypoimmunogenic in vitro. Preclinical studies in immunologically mismatched animals demonstrate that allogeneic CDC transplantation without immunosuppression is safe and produces sustained functional and structural benefits through stimulation of endogenous regenerative pathways. Currently, allogeneic human CDCs are being tested clinically in the ALLSTAR and DYNAMIC trials. Potential establishment of clinical safety and efficacy of allogeneic CDCs combined with generation of highly standardized, ‘off-the-shelf’ allogeneic cellular products would facilitate broad clinical adoption of cell therapy.
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Affiliation(s)
- Chris J Kapelios
- 3rd Department of Cardiology, University of Athens School of Medicine, 67 Mikras Asias Street, 11 527, Athens, Greece
| | - John N Nanas
- 3rd Department of Cardiology, University of Athens School of Medicine, 67 Mikras Asias Street, 11 527, Athens, Greece
| | - Konstantinos Malliaras
- 3rd Department of Cardiology, University of Athens School of Medicine, 67 Mikras Asias Street, 11 527, Athens, Greece
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26
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Immunotolerant Properties of Mesenchymal Stem Cells: Updated Review. Stem Cells Int 2015; 2016:1859567. [PMID: 26839557 PMCID: PMC4709780 DOI: 10.1155/2016/1859567] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/03/2015] [Accepted: 10/11/2015] [Indexed: 12/24/2022] Open
Abstract
Stem cell transplantation is a potential therapeutic option to regenerate damaged myocardium and restore function after infarct. Current research is focused on the use of allogeneic mesenchymal stem cells (MSCs) due to their unique immunomodulatory characteristics and ability to be harvested from young and healthy donors. Both animal and human studies support the immunoprivileged state of MSCs and even demonstrate improvements in cardiac function after transplantation. This research continues to be a topic of interest, as advances will ultimately enable the clinical use of these universal cells for therapy after a myocardial infarction. Updated in vitro, in vivo, and clinical trial studies are discussed in detail in the following review.
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27
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Suzuki G. Translational research of adult stem cell therapy. World J Cardiol 2015; 7:707-718. [PMID: 26635920 PMCID: PMC4660467 DOI: 10.4330/wjc.v7.i11.707] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/12/2015] [Accepted: 09/28/2015] [Indexed: 02/06/2023] Open
Abstract
Congestive heart failure (CHF) secondary to chronic coronary artery disease is a major cause of morbidity and mortality world-wide. Its prevalence is increasing despite advances in medical and device therapies. Cell based therapies generating new cardiomyocytes and vessels have emerged as a promising treatment to reverse functional deterioration and prevent the progression to CHF. Functional efficacy of progenitor cells isolated from the bone marrow and the heart have been evaluated in preclinical large animal models. Furthermore, several clinical trials using autologous and allogeneic stem cells and progenitor cells have demonstrated their safety in humans yet their clinical relevance is inconclusive. This review will discuss the clinical therapeutic applications of three specific adult stem cells that have shown particularly promising regenerative effects in preclinical studies, bone marrow derived mesenchymal stem cell, heart derived cardiosphere-derived cell and cardiac stem cell. We will also discuss future therapeutic approaches.
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Lo CY, Weil BR, Palka BA, Momeni A, Canty JM, Neelamegham S. Cell surface glycoengineering improves selectin-mediated adhesion of mesenchymal stem cells (MSCs) and cardiosphere-derived cells (CDCs): Pilot validation in porcine ischemia-reperfusion model. Biomaterials 2015; 74:19-30. [PMID: 26433489 DOI: 10.1016/j.biomaterials.2015.09.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 12/20/2022]
Abstract
Promising results are emerging in clinical trials focused on stem cell therapy for cardiology applications. However, the low homing and engraftment of the injected cells to target tissue continues to be a problem. Cellular glycoengineering can address this limitation by enabling the targeting of stem cells to sites of vascular injury/inflammation. Two such glycoengineering methods are presented here: i. The non-covalent incorporation of a P-selectin glycoprotein ligand-1 (PSGL-1) mimetic 19Fc[FUT7(+)] via lipid-protein G fusion intermediates that intercalate onto the cell surface, and ii. Over-expression of the α(1,3)fucosyltransferse FUT7 in cells. Results demonstrate the efficient coupling of 19Fc[FUT7(+)] onto both cardiosphere-derived cells (CDCs) and mesenchymal stem cells (MSCs), with coupling being more efficient when using protein G fused to single-tailed palmitic acid rather than double-tailed DOPE (1,2-dioleoyl-sn-glycero-3-phosphoethanolamine). This non-covalent cellular modification was mild since cell proliferation and stem-cell marker expression was unaltered. Whereas coupling using 19Fc[FUT7(+)] enhanced cell capture on recombinant P-selectin or CHO-P cell surfaces, α(1,3)fucosylation was necessary for robust binding to E-selectin and inflamed endothelial cells under shear. Pilot studies confirm the safety and homing efficacy of the modified stem cells to sites of ischemia-reperfusion in the porcine heart. Overall, glycoengineering with physiological selectin-ligands may enhance stem cell engraftment.
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Affiliation(s)
- Chi Y Lo
- Department of Chemical and Biological Engineering, The State University of New York, 906 Furnas Hall, Buffalo, NY 14260, USA; Department of Anesthesiology, The State University of New York, 252 Farber Hall, Buffalo, NY 14214, USA; Division of Cardiovascular Medicine, The State University of New York, Clinical Translational Research Center, 875 Ellicott Street, Buffalo, NY 14203, USA
| | - Brian R Weil
- Division of Cardiovascular Medicine, The State University of New York, Clinical Translational Research Center, 875 Ellicott Street, Buffalo, NY 14203, USA
| | - Beth A Palka
- Division of Cardiovascular Medicine, The State University of New York, Clinical Translational Research Center, 875 Ellicott Street, Buffalo, NY 14203, USA
| | - Arezoo Momeni
- Department of Chemical and Biological Engineering, The State University of New York, 906 Furnas Hall, Buffalo, NY 14260, USA
| | - John M Canty
- Division of Cardiovascular Medicine, The State University of New York, Clinical Translational Research Center, 875 Ellicott Street, Buffalo, NY 14203, USA; VA Western New York Health Care System, Buffalo, NY 14215, USA
| | - Sriram Neelamegham
- Department of Chemical and Biological Engineering, The State University of New York, 906 Furnas Hall, Buffalo, NY 14260, USA; The NY State Center for Excellence in Bioinformatics and Life Sciences, The State University of New York, 701 Ellicott St., Buffalo, NY 14203, USA.
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29
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Weil BR, Suzuki G, Leiker MM, Fallavollita JA, Canty JM. Comparative Efficacy of Intracoronary Allogeneic Mesenchymal Stem Cells and Cardiosphere-Derived Cells in Swine with Hibernating Myocardium. Circ Res 2015; 117:634-44. [PMID: 26271689 DOI: 10.1161/circresaha.115.306850] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/12/2015] [Indexed: 01/29/2023]
Abstract
RATIONALE Allogeneic bone marrow-derived mesenchymal stem cells (MSCs) and cardiosphere-derived cells (CDCs) have each entered clinical trials, but a direct comparison of these cell types has not been performed in a large animal model of hibernating myocardium. OBJECTIVE Using completely blinded methodology, we compared the efficacy of global intracoronary allogeneic MSCs (icMSCs, ≈35×10(6)) and CDCs (icCDCs, ≈35×10(6)) versus vehicle in cyclosporine-immunosuppressed swine with a chronic left anterior descending coronary artery stenosis (n=26). METHODS AND RESULTS Studies began 3 months after instrumentation when wall thickening was reduced (left anterior descending coronary artery % wall thickening [mean±SD], 38±11% versus 83±26% in remote; P<0.01) and similar among groups. Four weeks after treatment, left anterior descending coronary artery % wall thickening increased similarly after icCDCs and icMSCs, whereas it remained depressed in vehicle-treated controls (icMSCs, 51±13%; icCDCs, 51±17%; vehicle, 34±3%, treatments P<0.05 versus vehicle). There was no change in myocardial perfusion. Both icMSCs and icCDCs increased left anterior descending coronary artery myocyte nuclear density (icMSCs, 1601±279 nuclei/mm(2); icCDCs, 1569±294 nuclei/mm(2); vehicle, 973±181 nuclei/mm(2); treatments P<0.05 versus vehicle) and reduced myocyte diameter (icMSCs, 16.4±1.5 μm; icCDCs, 16.8±1.2 μm; vehicle, 20.2±3.7 μm; treatments P<0.05 versus vehicle) to the same extent. Similar changes in myocyte nuclear density and diameter were observed in the remote region of cell-treated animals. Cell fate analysis using Y-chromosome fluorescent in situ hybridization demonstrated rare cells from sex-mismatched donors. CONCLUSIONS Allogeneic icMSCs and icCDCs exhibit comparable therapeutic efficacy in a large animal model of hibernating myocardium. Both cell types produced equivalent increases in regional function and stimulated myocyte regeneration in ischemic and remote myocardium. The activation of endogenous myocyte proliferation and regression of myocyte cellular hypertrophy support a common mechanism of cardiac repair.
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Affiliation(s)
- Brian R Weil
- From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY
| | - Gen Suzuki
- From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY
| | - Merced M Leiker
- From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY
| | - James A Fallavollita
- From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY
| | - John M Canty
- From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY.
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30
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Abstract
Stem cell therapy has the optimistic goal of regenerating the myocardium as defined by re-growth of lost or destroyed myocardium. As applied to patients with heart failure, many confuse or limit the regenerative definition to just improving myocardial function and/or decreasing myocardial scar formation, which may not be the most important clinical outcome to achieve in this promising field of molecular medicine. Many different stem cell-based therapies have been tested and have demonstrated a safe and feasible profile in adult patients with heart failure, but with varied efficacious end points reported. Although not achieved as of yet, the encompassing goal to regenerate the heart is still believed to be within reach using these cell-based therapies in adult patients with heart failure, as the first-generation therapies are now being tested in different phases of clinical trials. Similar efforts to foster the translation of stem cell therapy to children with heart failure have, however, been limited. In this review, we aim to summarise the findings from pre-clinical models and clinical experiences to date that have focussed on the evaluation of stem cell therapy in children with heart failure. Finally, we present methodological considerations pertinent to the design of a stem cell-based trial for children with heart failure, as they represent a population of patients with very different sets of issues when compared with adult patients. As has been taught by many learned clinicians, children are not small adults!
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31
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Keith MCL, Tokita Y, Tang XL, Ghafghazi S, Moore JB, Hong KU, Elmore JB, Amraotkar AR, Guo H, Ganzel BL, Grubb KJ, Flaherty MP, Vajravelu BN, Wysoczynski M, Bolli R. Effect of the stop-flow technique on cardiac retention of c-kit positive human cardiac stem cells after intracoronary infusion in a porcine model of chronic ischemic cardiomyopathy. Basic Res Cardiol 2015; 110:503. [PMID: 26150250 DOI: 10.1007/s00395-015-0503-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 06/05/2015] [Accepted: 06/15/2015] [Indexed: 01/03/2023]
Abstract
It is commonly thought that the optimal method for intracoronary administration of cells is to stop coronary flow during cell infusion, in order to prolong cell/vascular wall contact, enhance adhesion, and promote extravasation of cells into the interstitial space. However, occlusion of a coronary artery with a balloon involves serious risks of vascular damage and/or dissection, particularly in non-stented segments such as those commonly found in patients with heart failure. It remains unknown whether the use of the stop-flow technique results in improved donor cell retention. Acute myocardial infarction was produced in 14 pigs. One to two months later, pigs received 10 million indium-111 oxyquinoline (oxine)-labeled c-kit(pos) human cardiac stem cells (hCSCs) via intracoronary infusion with (n = 7) or without (n = 7) balloon inflation. Pigs received cyclosporine to prevent acute graft rejection. Animals were euthanized 24 h later and hearts harvested for radioactivity measurements. With the stop-flow technique, the retention of hCSCs at 24 h was 5.41 ± 0.80 % of the injected dose (n = 7), compared with 4.87 ± 0.62 % without coronary occlusion (n = 7), (P = 0.60). When cells are delivered intracoronarily in a clinically relevant porcine model of chronic ischemic cardiomyopathy, the use of the stop-flow technique does not result in greater myocardial cell retention at 24 h compared with non-occlusive infusion. These results have practical implications for the design of cell therapy trials. Our observations suggest that the increased risk of complications secondary to coronary manipulation and occlusion is not warranted.
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Affiliation(s)
- Matthew C L Keith
- Institute of Molecular Cardiology, University of Louisville, 550 S Jackson Street, ACB Bldg, 3rd Floor, Louisville, KY, 40202, USA
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32
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Keith MCL, Tang XL, Tokita Y, Li QH, Ghafghazi S, Moore IV J, Hong KU, Elmore B, Amraotkar A, Ganzel BL, Grubb KJ, Flaherty MP, Hunt G, Vajravelu B, Wysoczynski M, Bolli R. Safety of intracoronary infusion of 20 million C-kit positive human cardiac stem cells in pigs. PLoS One 2015; 10:e0124227. [PMID: 25905721 PMCID: PMC4408046 DOI: 10.1371/journal.pone.0124227] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/27/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There is mounting interest in using c-kit positive human cardiac stem cells (c-kit(pos) hCSCs) to repair infarcted myocardium in patients with ischemic cardiomyopathy. A recent phase I clinical trial (SCIPIO) has shown that intracoronary infusion of 1 million hCSCs is safe. Higher doses of CSCs may provide superior reparative ability; however, it is unknown if doses >1 million cells are safe. To address this issue, we examined the effects of 20 million hCSCs in pigs. METHODS Right atrial appendage samples were obtained from patients undergoing cardiac surgery. The tissue was processed by an established protocol with eventual immunomagnetic sorting to obtain in vitro expanded hCSCs. A cumulative dose of 20 million cells was given intracoronarily to pigs without stop flow. Safety was assessed by measurement of serial biomarkers (cardiac: troponin I and CK-MB, renal: creatinine and BUN, and hepatic: AST, ALT, and alkaline phosphatase) and echocardiography pre- and post-infusion. hCSC retention 30 days after infusion was quantified by PCR for human genomic DNA. All personnel were blinded as to group assignment. RESULTS Compared with vehicle-treated controls (n=5), pigs that received 20 million hCSCs (n=9) showed no significant change in cardiac function or end organ damage (assessed by organ specific biomarkers) that could be attributed to hCSCs (P>0.05 in all cases). No hCSCs could be detected in left ventricular samples 30 days after infusion. CONCLUSIONS Intracoronary infusion of 20 million c-kit positive hCSCs in pigs (equivalent to ~40 million hCSCs in humans) does not cause acute cardiac injury, impairment of cardiac function, or liver and renal injury. These results have immediate translational value and lay the groundwork for using doses of CSCs >1 million in future clinical trials. Further studies are needed to ascertain whether administration of >1 million hCSCs is associated with greater efficacy in patients with ischemic cardiomyopathy.
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Affiliation(s)
- Matthew C. L. Keith
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Xian-Liang Tang
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Yukichi Tokita
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Qian-hong Li
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Shahab Ghafghazi
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Joseph Moore IV
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Kyung U. Hong
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Brandon Elmore
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Alok Amraotkar
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Brian L. Ganzel
- Department of Cardiothoracic Surgery, University of Louisville, Louisville, Kentucky, United States of America
| | - Kendra J. Grubb
- Department of Cardiothoracic Surgery, University of Louisville, Louisville, Kentucky, United States of America
| | - Michael P. Flaherty
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Gregory Hunt
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Bathri Vajravelu
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Marcin Wysoczynski
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
| | - Roberto Bolli
- Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America
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Affiliation(s)
- Brody Wehman
- From the Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore
| | - Sunjay Kaushal
- From the Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore.
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