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Biagi D, Fantozzi ET, Campos-Oliveira JC, Naghetini MV, Ribeiro AF, Rodrigues S, Ogusuku I, Vanderlinde R, Christie MLA, Mello DB, de Carvalho ACC, Valadares M, Cruvinel E, Dariolli R. In Situ Maturated Early-Stage Human-Induced Pluripotent Stem Cell-Derived Cardiomyocytes Improve Cardiac Function by Enhancing Segmental Contraction in Infarcted Rats. J Pers Med 2021; 11:jpm11050374. [PMID: 34064343 PMCID: PMC8147857 DOI: 10.3390/jpm11050374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/21/2021] [Accepted: 04/30/2021] [Indexed: 02/05/2023] Open
Abstract
The scant ability of cardiomyocytes to proliferate makes heart regeneration one of the biggest challenges of science. Current therapies do not contemplate heart re-muscularization. In this scenario, stem cell-based approaches have been proposed to overcome this lack of regeneration. We hypothesize that early-stage hiPSC-derived cardiomyocytes (hiPSC-CMs) could enhance the cardiac function of rats after myocardial infarction (MI). Animals were subjected to the permanent occlusion of the left ventricle (LV) anterior descending coronary artery (LAD). Seven days after MI, early-stage hiPSC-CMs were injected intramyocardially. Rats were subjected to echocardiography pre-and post-treatment. Thirty days after the injections were administered, treated rats displayed 6.2% human cardiac grafts, which were characterized molecularly. Left ventricle ejection fraction (LVEF) was improved by 7.8% in cell-injected rats, while placebo controls showed an 18.2% deterioration. Additionally, cell-treated rats displayed a 92% and 56% increase in radial and circumferential strains, respectively. Human cardiac grafts maturate in situ, preserving proliferation with 10% Ki67 and 3% PHH3 positive nuclei. Grafts were perfused by host vasculature with no evidence for immune rejection nor ectopic tissue formations. Our findings support the use of early-stage hiPSC-CMs as an alternative therapy to treat MI. The next steps of preclinical development include efficacy studies in large animals on the path to clinical-grade regenerative therapy targeting human patients.
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Affiliation(s)
- Diogo Biagi
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Evelyn Thais Fantozzi
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Julliana Carvalho Campos-Oliveira
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Marcus Vinicius Naghetini
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Antonio Fernando Ribeiro
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Sirlene Rodrigues
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Isabella Ogusuku
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
- Gene Center and Department of Biochemistry, Ludwig-Maximilians-Universität München, 81377 München, Germany
| | - Rubia Vanderlinde
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Michelle Lopes Araújo Christie
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (M.L.A.C.); (D.B.M.); (A.C.C.d.C.)
| | - Debora Bastos Mello
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (M.L.A.C.); (D.B.M.); (A.C.C.d.C.)
| | - Antonio Carlos Campos de Carvalho
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (M.L.A.C.); (D.B.M.); (A.C.C.d.C.)
| | - Marcos Valadares
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Estela Cruvinel
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
| | - Rafael Dariolli
- PluriCell Biotech, São Paulo 05508-000, Brazil; (D.B.); (E.T.F.); (J.C.C.-O.); (M.V.N.); (A.F.R.J.); (S.R.); (I.O.); (R.V.); (M.V.); (E.C.)
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence:
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Shin HS, Shin HH, Shudo Y. Current Status and Limitations of Myocardial Infarction Large Animal Models in Cardiovascular Translational Research. Front Bioeng Biotechnol 2021; 9:673683. [PMID: 33996785 PMCID: PMC8116580 DOI: 10.3389/fbioe.2021.673683] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/06/2021] [Indexed: 01/16/2023] Open
Abstract
Establishing an appropriate disease model that mimics the complexities of human cardiovascular disease is critical for evaluating the clinical efficacy and translation success. The multifaceted and complex nature of human ischemic heart disease is difficult to recapitulate in animal models. This difficulty is often compounded by the methodological biases introduced in animal studies. Considerable variations across animal species, modifications made in surgical procedures, and inadequate randomization, sample size calculation, blinding, and heterogeneity of animal models used often produce preclinical cardiovascular research that looks promising but is irreproducible and not translatable. Moreover, many published papers are not transparent enough for other investigators to verify the feasibility of the studies and the therapeutics' efficacy. Unfortunately, successful translation of these innovative therapies in such a closed and biased research is difficult. This review discusses some challenges in current preclinical myocardial infarction research, focusing on the following three major inhibitors for its successful translation: Inappropriate disease model, frequent modifications to surgical procedures, and insufficient reporting transparency.
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Affiliation(s)
- Hye Sook Shin
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Heather Hyeyoon Shin
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Yasuhiro Shudo
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
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Nix C, Ishikawa K, Meyns B, Yasuda S, Adriaenssens T, Barth S, Zayat R, Leprince P, Lebreton G. Comparison of Hemodynamic Support by Impella vs. Peripheral Extra-Corporeal Membrane Oxygenation: A Porcine Model of Acute Myocardial Infarction. Front Cardiovasc Med 2020; 7:99. [PMID: 32587862 PMCID: PMC7299088 DOI: 10.3389/fcvm.2020.00099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/11/2020] [Indexed: 01/25/2023] Open
Abstract
Objectives: Several mechanical circulatory assist devices are used to treat critically ill patients requiring hemodynamic support during post-myocardial infarction or cardiogenic shock. However, little guidance is available to choose an appropriate device to match a particular patient's needs. An increased understanding of hemodynamic effects of the pump systems and their impact on myocardial pre-/afterload might help to better understand their behavior in different clinical settings. Methods: This was an open-labeled, randomized acute animal experiment. A model of acute univentricular myocardial injury by temporary balloon occlusion was used. The experiment was carried out in 10 juveniles female Piétrain pigs. The animals were randomized to mechanical hemodynamic support either by peripheral veno-arterial (VA-)ECMO or Impella CP. Results: While both devices were able to provide flows above 3 L/min and maintain sufficient end-organ perfusion, support by Impella resulted in a significantly more pronounced immediate effect on myocardial unloading: At the onset of device support, the remaining native cardiac output was reduced by 23.5 ± 15.3% ECMO vs. 66.2 ± 36.2% (Impella, p = 0.021). Native stroke volume was significantly decreased by Impella support compared to ECMO, indicating less mechanical work being conducted by the Impella-supported hearts despite similar total assisted cardiac output. Conclusions: Peripheral VA-ECMO and the transaortic Impella pump resulted in contrasting hemodynamic fingerprints. Both devices provided sufficient hemodynamic support and reduce left ventricular end-diastolic pressure in the acute setting. Treatment with the Impella device resulted in a more effective volume unloading of the left ventricle. A significant reduction in myocardial oxygen consumption equivalent was achieved by both devices: The Impella device resulted in a left-shift of the pressure-volume loop and a decreased pressure-volume-area (PVA), while VA-ECMO increased PVA but decreased heart rate. These data highlight the importance of specifically targeting heart rate in the management of AMI patients on hemodynamic support.
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Affiliation(s)
- Christoph Nix
- Department of Anesthesiology, RWTH Aachen University Hospital, Aachen, Germany.,Abiomed Europe GmbH, Aachen, Germany
| | - Kiyotake Ishikawa
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Bart Meyns
- Department of Cardiac Surgery, University Hospital UZ Leuven, Leuven, Belgium
| | - Shota Yasuda
- Department of Cardiac Surgery, University Hospital UZ Leuven, Leuven, Belgium
| | - Tom Adriaenssens
- Department of Cardiology, University Hospital UZ Leuven, Leuven, Belgium
| | | | - Rashad Zayat
- Department of Thoracic and Cardiovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Pascal Leprince
- Department of Thoracic and Cardiovascular Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Guillaume Lebreton
- Department of Cardiac Surgery, Hôpital Universitaire Pitié-Salpêtrière, Paris, France
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Santos Rizzo Zuttion MS, Dias Câmara DA, Dariolli R, Takimura C, Wenceslau C, Kerkis I. In vitro heterogeneity of porcine adipose tissue-derived stem cells. Tissue Cell 2019; 58:51-60. [PMID: 31133246 DOI: 10.1016/j.tice.2019.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 01/27/2023]
Abstract
Tissue-specific adult stem cells (ASC) are heterogeneous and characterized by a mix of progenitor cells that produce cells at various stages of differentiation, and ultimately different terminally differentiated cells. Understanding the heterogeneity of ASCs may lead to the development of improved protocols of cell isolation and optimized cell therapy clinical protocols. Using a combination of enzymatic and explant culture protocols, we obtained pADSC population, which is composed by two distinct morphologies: fibroblast-like cells (FLCs) and endothelial-like cells (ELCs). Both cell sub-types efficiently formed colonies, expressed CD90+/CD105+/CD44+, and differentially expressed such markers such as Nestin, Vimentin, Fibronectin, Cytokeratin, Connexin 43, CD31, CD34 and CD146 as well as the pluripotent stem cell markers Oct-4, Nanog and Sox2. Mixed populations of pADSCs did not lose their multipotentiality and the cells were able to undergo osteogenic, chondrogenic, adipogenic and myogenic differentiation. Furthermore, the mixed population spontaneously formed capillary tube structures. Our findings suggest that different subpopulations can be isolated from adipose tissue and that the ADSCs need to be better evaluated using a wide panel of different markers related to cell differentiation, which is important for stem cell therapy and regenerative medicine, particularly for advanced stem cells therapies - products that are currently under investigation or even use.
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Affiliation(s)
- Marilia Sanches Santos Rizzo Zuttion
- Laboratory of Genetics, Butantan Institute, Av. Vital Brasil, 1500 - Butantã, São Paulo, SP, 05503-900, Brazil; Federal University of São Paulo, R. Sena Madureira, 1500 - Vila Clementino, São Paulo, SP, 04021-001, Brazil.
| | - Diana Aparecida Dias Câmara
- Laboratory of Genetics, Butantan Institute, Av. Vital Brasil, 1500 - Butantã, São Paulo, SP, 05503-900, Brazil; Federal University of São Paulo, R. Sena Madureira, 1500 - Vila Clementino, São Paulo, SP, 04021-001, Brazil.
| | - Rafael Dariolli
- Heart Institute (InCor), University of São Paulo Medical School, Brazil: Av. Dr. Enéas de Carvalho Aguiar, 44 - Pinheiros, São Paulo, SP, 05403-900, Brazil.
| | - Celso Takimura
- Heart Institute (InCor), University of São Paulo Medical School, Brazil: Av. Dr. Enéas de Carvalho Aguiar, 44 - Pinheiros, São Paulo, SP, 05403-900, Brazil.
| | - Cristiane Wenceslau
- Laboratory of Genetics, Butantan Institute, Av. Vital Brasil, 1500 - Butantã, São Paulo, SP, 05503-900, Brazil.
| | - Irina Kerkis
- Laboratory of Genetics, Butantan Institute, Av. Vital Brasil, 1500 - Butantã, São Paulo, SP, 05503-900, Brazil; Federal University of São Paulo, R. Sena Madureira, 1500 - Vila Clementino, São Paulo, SP, 04021-001, Brazil.
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Dariolli R, Naghetini MV, Marques EF, Takimura CK, Jensen LS, Kiers B, Tsutsui JM, Mathias W, Lemos Neto PA, Krieger JE. Allogeneic pASC transplantation in humanized pigs attenuates cardiac remodeling post-myocardial infarction. PLoS One 2017; 12:e0176412. [PMID: 28448588 PMCID: PMC5407644 DOI: 10.1371/journal.pone.0176412] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 04/09/2017] [Indexed: 12/22/2022] Open
Abstract
Cell therapy repair strategies using adult mesenchymal stromal cells have shown promising evidence to prevent cardiac deterioration in rodents even in the absence of robust differentiation of the cells into cardiomyocytes. We tested whether increasing doses of porcine adipose-tissue derived mesenchymal stem cells (pASCs) increase cardiac tissue perfusion in pigs post-myocardial infarction (MI) receiving angiotensin-converting-enzyme inhibitor (ACE inhibitors) and Beta-blockers similarly to patients. Female pigs were subjected to MI induction by sponge permanent occlusion of left circumflex coronary artery (LCx) generating approximately 10% of injured LV area with minimum hemodynamic impact. We assessed tissue perfusion by real time myocardial perfusion echocardiography (RTMPE) using commercial microbubbles before and following pASCs treatment. Four weeks after the occlusion of the left circumflex artery, we transplanted placebo or pASCs (1, 2 and 4x106 cells/Kg BW) into the myocardium. The highest dose of pASCs increased myocardial vessel number and blood flow in the border (56% and 3.7-fold, respectively) and in the remote area (54% and 3.9-fold, respectively) while the non-perfused scar area decreased (up to 38%). We also found an increase of immature collagen fibers, although the increase in total tissue collagen and types I and III was similar in all groups. Our results provide evidence that pASCs-induced stimulation of tissue perfusion and accumulation of immature collagen fibers attenuates adverse remodeling post-MI beyond the normal beneficial effects associated with ACE inhibition and beta-blockade.
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Affiliation(s)
- Rafael Dariolli
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Marcus V. Naghetini
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Euclydes F. Marques
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Celso K. Takimura
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Leonardo S. Jensen
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Bianca Kiers
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Jeane M. Tsutsui
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Wilson Mathias
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Pedro A. Lemos Neto
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Jose E. Krieger
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
- * E-mail:
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Tao B, Gao H, Zheng M, Luo Z, Liu L, Bai W, Wang J, Liu D, Ma S, Luo Z, Gao L, Wang Y, Cao F. Preclinical modeling and multimodality imaging of chronic myocardial infarction in minipigs induced by novel interventional embolization technique. EJNMMI Res 2016; 6:59. [PMID: 27393423 PMCID: PMC4938836 DOI: 10.1186/s13550-016-0214-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 06/29/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND This study was designed to establish a chronic myocardial infarction (MI) model in minipigs with a novel coronary sequential balloons-sponge embolism technique. METHODS Eighteen healthy minipigs (25-30 kg) were randomly divided into three groups for left anterior descending artery (LAD) occlusion: conventional balloon occlusion group (BO group, temporary balloon occlusion for 60 mins), half-balloon embolism group (HB group), and sequential balloon-balloon-sponge embolism group (BBS group, two half-balloons with one sponge as the embolism clot). The incidence of ventricular fibrillation (VF), total mortality, operating time, and vascular recanalization 3 months post-MI was recorded and compared. Echocardiography, multimodality nuclear medical imaging, and histology staining were applied for the evaluation of infarction. RESULTS Thirteen out of 18 minipigs survived after the operation, while 5 animals died with VF (3 in the BO group, 1 in the HB group, and 1 in the BBS group), with an 83.3 % (5/6 minipigs) acute procedural survival rate in embolism groups. The operating duration was 60.0 ± 0.5 mins, 21.4 ± 5.2 mins, and 31.2 ± 4.7 mins in the three groups, respectively. LAD recanalization was found in three animals of the HB group but none in the BBS group by angiography follow-up. The infarct sizes were more stable and larger in the HB group and BBS group than that in the BO group (P < 0.05, n = 13). CONCLUSIONS The method of sequential balloons-sponge embolization could induce myocardial infarction with consistent and sustained embolization and gain higher operation success rate and better repeatability in minipigs, which holds a promising method for preclinical MI study.
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Affiliation(s)
- Bo Tao
- Department of Cardiology, Chinese PLA General Hospital, Fuxing Street 28#, Haidian District, Beijing, 100853, China.,Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Haokao Gao
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Minwen Zheng
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Zhonghua Luo
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Liwen Liu
- Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Wei Bai
- Department of Ultrasonography, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Jing Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Daliang Liu
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Sai Ma
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Zhenli Luo
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Lei Gao
- Department of Cardiology, Chinese PLA General Hospital, Fuxing Street 28#, Haidian District, Beijing, 100853, China
| | - Yabin Wang
- Department of Cardiology, Chinese PLA General Hospital, Fuxing Street 28#, Haidian District, Beijing, 100853, China
| | - Feng Cao
- Department of Cardiology, Chinese PLA General Hospital, Fuxing Street 28#, Haidian District, Beijing, 100853, China.
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