Preoperative mobilization of bone marrow-derived cells followed by revascularization surgery: early and long-term outcome

Glucocorticoid guides mobilization of bone marrow stem/progenitor cells via FPR and CXCR4 coupling

Background

Our previous studies have proved the efficient exogenous repairing responses via bone marrow stem and progenitor cells (BMSPCs). However, the trafficking of endogenous bone marrow stem and progenitor cells to and from the bone marrow (BM) is a highly regulated process that remains to be elucidated. We aimed to study the relative importance of the hypothalamic-pituitary-adrenal (HPA) axis in the glucocorticoid-induced BMSPC mobilization.

Methods

The circulating mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs) were examined in Crh (+/+, −/−) mice after running stress or glucocorticoid mini-infusion. The MSCs and EPCs were investigated ex vivo after treatment with glucocorticoid and glucocorticoid receptor (GR) antagonist, RU486. The expression of chemotaxis receptors, N-formyl peptide receptor (FPR), and Cys-X-Cys receptor 4 (CXCR4) of MSCs and EPCs as well as their colocalization were investigated after treatment with glucocorticoid, glucocorticoid receptor (GR) antagonist (RU486), and FPR antagonist (Cyclosporin H).

Results

Forced running stress increased circulating MSCs and EPCs in mice, which was blunted when Crh was knocked out, and positively related to the levels of serum glucocorticoid. Prolonged glucocorticoid mini-infusion imitated the stress-induced increase in circulating MSCs and EPCs in Crh^+/+ mice and rescued the impaired mobilization in circulating MSCs and EPCs in Crh^−/− mice. Meanwhile, glucocorticoid promoted the chemotaxis of MSCs and EPCs ex vivo via GR, inhibited by RU486 (10 μM). Concurrently, glucocorticoid increased the expression of FPR of MSCs and EPCs, but inhibited their expression of CXCR4, followed by their changing colocalization in the cytoplasm. The GC-induced colocalization of FPR and CXCR4 was blunted by Cyclosporin H (1 μM).

Conclusion

Glucocorticoid-induced CXCR4-FPR responsiveness selectively guides the mobilization of BMSPCs, which is essential to functional tissue repair.

Graphical abstract

Schematic view of the role of glucocorticoid on the mobilization of bone marrow-derived stem/progenitor cells subsets in the present study. The HPA axis activation promotes the release of glucocorticoid, which regulates the directional migration of MSCs and EPCs mainly via GR. The possible mechanisms refer to the signal coupling of FPR and CXCR4. Their two-sided changes regulated by glucocorticoid are involved in the egress of MSCs and EPCs from BM, which is helpful for wound healing. MSCs, mesenchymal stem cells; EPCs, endothelial progenitor cells.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13287-020-02071-1.

Off-pump Techniques of Surgical Myocardial Revascularization

BACKGROUND

Before the advent of CABG, standardized in the late '60s by Favaloro and Effler, patients with myocardial ischemia underwent indirect and heterogeneous off-pump methods of myocardial revascularization.

METHODS & RESULTS

Indirect revascularization, such as periaortic nerve plexus interruption, Vineberg operation, Sen procedure and, less remotely, TMR Laser and stem cell transplantation, represented some of the ways to achieve myocardial revascularization. Nowadays, direct coronary revascularization is the only established technique and may be performed either on-pump or off-pump.

CONCLUSION

The comparison of off-pump and on-pump myocardial revascularization paved the way to an endless debate between the advantages and disadvantages of each technique. In this article, we review the old and current off-pump approaches of surgical myocardial revascularization.