1
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Pierri A, Gagno G, Fluca A, Radaelli D, Bonuccelli D, Giusti L, Bulfoni M, Beltrami AP, Aleksova A, D’Errico S. COVID-19-Related Myocarditis: Are We There Yet? A Case Report of COVID-19-Related Fulminant Myocarditis. Biomedicines 2023; 11:2101. [PMID: 37626600 PMCID: PMC10452198 DOI: 10.3390/biomedicines11082101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
There is increasing evidence of cardiac involvement in COVID-19 cases, with a broad range of clinical manifestations spanning from acute life-threatening conditions such as ventricular dysrhythmias, myocarditis, acute myocardial ischemia and pulmonary thromboembolism to long-term cardiovascular sequelae. In particular, acute myocarditis represents an uncommon but frightening complication of SARS-CoV-2 infection. Even if many reports of SARS CoV-2 myocarditis are present in the literature, the majority of them lacks histological confirmation of cardiac injury. Here, we report a case of a young lady, who died suddenly a few days after testing positive for SARS-CoV-2, whose microscopic and genetics features suggested a direct cardiac involvement compatible with fulminant myocarditis.
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Affiliation(s)
- Alessandro Pierri
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34139 Trieste, Italy; (A.P.); (G.G.); (A.F.); or (A.A.)
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34139 Trieste, Italy;
| | - Giulia Gagno
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34139 Trieste, Italy; (A.P.); (G.G.); (A.F.); or (A.A.)
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34139 Trieste, Italy;
| | - Alessandra Fluca
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34139 Trieste, Italy; (A.P.); (G.G.); (A.F.); or (A.A.)
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34139 Trieste, Italy;
| | - Davide Radaelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34139 Trieste, Italy;
| | - Diana Bonuccelli
- Department of Legal Medicine, Azienda USL Toscana Nordovest, 55100 Lucca, Italy;
| | - Laura Giusti
- Department of Human Pathology, San Luca Hospital, Azienda USL Toscana Nordovest, 55100 Lucca, Italy;
| | - Michela Bulfoni
- Institute of Clinical Pathology, Academic Hospital “Santa Maria della Misericordia”, ASUFC, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (M.B.); (A.P.B.)
| | - Antonio P. Beltrami
- Institute of Clinical Pathology, Academic Hospital “Santa Maria della Misericordia”, ASUFC, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (M.B.); (A.P.B.)
| | - Aneta Aleksova
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34139 Trieste, Italy; (A.P.); (G.G.); (A.F.); or (A.A.)
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34139 Trieste, Italy;
| | - Stefano D’Errico
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34139 Trieste, Italy;
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2
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Ambrosini S, Montecucco F, Kolijn D, Pedicino D, Akhmedov A, Mohammed SA, Herwig M, Gorica E, Szabó PL, Weber L, Russo G, Vinci R, Matter CM, Liuzzo G, Brown PJ, Rossi FMV, Camici GG, Sciarretta S, Beltrami AP, Crea F, Podesser B, Lüscher TF, Kiss A, Ruschitzka F, Hamdani N, Costantino S, Paneni F. Methylation of the Hippo effector YAP by the methyltransferase SETD7 drives myocardial ischaemic injury: a translational study. Cardiovasc Res 2023; 118:3374-3385. [PMID: 35709329 DOI: 10.1093/cvr/cvac102] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/12/2022] [Accepted: 06/02/2022] [Indexed: 01/25/2023] Open
Abstract
AIMS Methylation of non-histone proteins is emerging as a central regulatory mechanism in health and disease. The methyltransferase SETD7 has shown to methylate and alter the function of a variety of proteins in vitro; however, its function in the heart is poorly understood. The present study investigates the role of SETD7 in myocardial ischaemic injury. METHODS AND RESULTS Experiments were performed in neonatal rat ventricular myocytes (NRVMs), SETD7 knockout mice (SETD7-/-) undergoing myocardial ischaemia/reperfusion (I/R) injury, left ventricular (LV) myocardial samples from patients with ischaemic cardiomyopathy (ICM), and peripheral blood mononuclear cells (PBMCs) from patients with ST-elevation MI (STEMI). We show that SETD7 is activated upon energy deprivation in cultured NRVMs and methylates the Hippo pathway effector YAP, leading to its cytosolic retention and impaired transcription of antioxidant genes manganese superoxide dismutase (MnSOD) and catalase (CAT). Such impairment of antioxidant defence was associated with mitochondrial reactive oxygen species (mtROS), organelle swelling, and apoptosis. Selective pharmacological inhibition of SETD7 by (R)-PFI-2 restored YAP nuclear localization, thus preventing mtROS, mitochondrial damage, and apoptosis in NRVMs. In mice, genetic deletion of SETD7 attenuated myocardial I/R injury, mtROS, and LV dysfunction by restoring YAP-dependent transcription of MnSOD and CAT. Moreover, in cardiomyocytes isolated from I/R mice and ICM patients, (R)-PFI-2 prevented mtROS accumulation, while improving Ca2+-activated tension. Finally, SETD7 was up-regulated in PBMCs from STEMI patients and negatively correlated with MnSOD and CAT. CONCLUSION We show a methylation-dependent checkpoint regulating oxidative stress during myocardial ischaemia. SETD7 inhibition may represent a valid therapeutic strategy in this setting.
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Affiliation(s)
- Samuele Ambrosini
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, viale Benedetto XV, 16132, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino Genova-Italian Cardiovascular Network, Largo Rosanna Benzi, 10, 16132 Genova, Italy
| | - Detmar Kolijn
- Institute of Physiology, Ruhr University, Universitätsstraße 150, 44801 Bochum, Germany.,Molecular and Experimental Cardiology, Ruhr University, Universitätsstraße 150, 44801 Bochum, Germany.,Department of Cardiology, St-Josef Hospital, Ruhr University, Gudrunstraße 56, 44791 Bochum, Germany
| | - Daniela Pedicino
- Dipartimento di Scienze Cardiovascolari e Toraciche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Alexander Akhmedov
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Shafeeq A Mohammed
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland
| | - Melissa Herwig
- Institute of Physiology, Ruhr University, Universitätsstraße 150, 44801 Bochum, Germany.,Molecular and Experimental Cardiology, Ruhr University, Universitätsstraße 150, 44801 Bochum, Germany.,Department of Cardiology, St-Josef Hospital, Ruhr University, Gudrunstraße 56, 44791 Bochum, Germany
| | - Era Gorica
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland.,Department of Pharmacy, University of Pisa, via Bonanno, 6, I-56126 Pisa, Italy
| | - Petra L Szabó
- Ludwig-Boltzmann-Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, Währinger Gürtel 18-20A-1090 Wien, Austria
| | - Lukas Weber
- Ludwig-Boltzmann-Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, Währinger Gürtel 18-20A-1090 Wien, Austria
| | - Giulio Russo
- Dipartimento di Scienze Cardiovascolari e Toraciche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Ramona Vinci
- Dipartimento di Scienze Cardiovascolari e Toraciche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Christian M Matter
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland.,University Heart Center, Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Giovanna Liuzzo
- Dipartimento di Scienze Cardiovascolari e Toraciche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Peter J Brown
- Structural Genomics Consortium, Univerity of Toronto, MaRS South Tower, Suite 700101 College Street, Toronto, ON M5G 1L7, Canada
| | - Fabio M V Rossi
- Biomedical Research Centre, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Giovanni G Camici
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland.,University Heart Center, Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland.,Department of Research and Education, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Sebastiano Sciarretta
- Dipartimento di Scienze e Biotecnologie Medico-Chirurgiche, Sapienza Università di Roma, C.so della Repubblica, 79, 04100 Latina LT, Italy.,Department of AngioCardioNeurology, IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli IS, Italy
| | - Antonio P Beltrami
- University of Udine, Piazzale Massimiliano Kolbe, 4, 33100 Udine, Italy.,Institute of Clinical Pathology, Academic Hospital "Santa Maria della Misericordia", ASUFC, 33100 Udine, Italy
| | - Filippo Crea
- Dipartimento di Scienze Cardiovascolari e Toraciche, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Via Giuseppe Moscati, 31, 00168 Rome, Italy
| | - Bruno Podesser
- Ludwig-Boltzmann-Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, Währinger Gürtel 18-20A-1090 Wien, Austria
| | - Thomas F Lüscher
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland.,Royal Brompton & Harefield Hospitals, Imperial College and King's College, Sydney Street, London SW3 6NP, UK
| | - Attila Kiss
- Ludwig-Boltzmann-Institute for Cardiovascular Research at the Center for Biomedical Research, Medical University of Vienna, Währinger Gürtel 18-20A-1090 Wien, Austria
| | - Frank Ruschitzka
- University Heart Center, Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Nazha Hamdani
- Institute of Physiology, Ruhr University, Universitätsstraße 150, 44801 Bochum, Germany.,Molecular and Experimental Cardiology, Ruhr University, Universitätsstraße 150, 44801 Bochum, Germany.,Department of Cardiology, St-Josef Hospital, Ruhr University, Gudrunstraße 56, 44791 Bochum, Germany
| | - Sarah Costantino
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland.,University Heart Center, Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Francesco Paneni
- Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland.,University Heart Center, Cardiology, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland.,Department of Research and Education, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
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3
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Cattaneo M, Beltrami AP, Thomas AC, Spinetti G, Alvino V, Avolio E, Veneziano C, Rolle IG, Sponga S, Sangalli E, Maciag A, Dal Piaz F, Vecchione C, Alenezi A, Paisey S, Puca AA, Madeddu P. The longevity-associated BPIFB4 gene supports cardiac function and vascularization in aging cardiomyopathy. Cardiovasc Res 2023:6986428. [PMID: 36635236 DOI: 10.1093/cvr/cvad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/24/2022] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
AIMS The aging heart naturally incurs a progressive decline in function and perfusion that available treatments cannot halt. However, some exceptional individuals maintain good health until the very late stage of their life due to favourable gene-environment interaction. We have previously shown that carriers of a longevity-associated variant (LAV) of the BPIFB4 gene enjoy prolonged health spans and lesser cardiovascular complications. Moreover, supplementation of LAV-BPIFB4 via an adeno-associated viral vector improves cardiovascular performance in limb ischemia, atherosclerosis, and diabetes models. Here, we asked if the LAV-BPIFB4 gene could address the unmet therapeutic need to delay the heart's spontaneous aging. METHODS AND RESULTS Immunohistological studies showed a remarkable reduction in vessel coverage by pericytes in failing hearts explanted from elderly patients. This defect was attenuated in patients carrying the homozygous LAV-BPIFB4 genotype. Moreover, pericytes isolated from older hearts showed low levels of BPIFB4, depressed pro-angiogenic activity, and loss of ribosome biogenesis. LAV-BPIFB4 supplementation restored pericyte function and pericyte-endothelial cell interactions through a mechanism involving the nucleolar protein nucleolin. Conversely, BPIFB4 silencing in normal pericytes mimed the heart failure pericytes. Finally, gene therapy with LAV-BPIFB4 prevented cardiac deterioration in middle-aged mice and rescued cardiac function and myocardial perfusion in older mice by improving microvasculature density and pericyte coverage. CONCLUSIONS We report the success of the LAV-BPIFB4 gene/protein in improving homeostatic processes in the heart's aging. These findings open to using LAV-BPIFB4 to reverse the decline of heart performance in older people.
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Affiliation(s)
| | - Antonio P Beltrami
- Department of Medicine, University of Udine, Academic Hospital of Udine, ASUFC, Udine, Italy
| | - Anita C Thomas
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gaia Spinetti
- Cardiovascular Department, IRCCS Multimedica, Milan, Italy
| | - Valeria Alvino
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Elisa Avolio
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Claudia Veneziano
- Department of Medicine, University of Udine, Academic Hospital of Udine, ASUFC, Udine, Italy
| | - Irene Giulia Rolle
- Department of Medicine, University of Udine, Academic Hospital of Udine, ASUFC, Udine, Italy
| | - Sandro Sponga
- Department of Medicine, University of Udine, Academic Hospital of Udine, ASUFC, Udine, Italy
| | - Elena Sangalli
- Cardiovascular Department, IRCCS Multimedica, Milan, Italy
| | - Anna Maciag
- Cardiovascular Department, IRCCS Multimedica, Milan, Italy
| | - Fabrizio Dal Piaz
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.,Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy
| | - Aishah Alenezi
- Wales Research & Diagnostic Positron Emission Tomography Imaging Centre, Cardiff University, UK
| | - Stephen Paisey
- Wales Research & Diagnostic Positron Emission Tomography Imaging Centre, Cardiff University, UK
| | - Annibale A Puca
- Cardiovascular Department, IRCCS Multimedica, Milan, Italy.,Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Paolo Madeddu
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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4
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Gaetano C, Pesce M, Beltrami AP, Capogrossi MC. Editorial: Cardiovascular cell senescence in aging and disease. Front Cardiovasc Med 2023; 10:1177395. [PMID: 37034337 PMCID: PMC10080112 DOI: 10.3389/fcvm.2023.1177395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Affiliation(s)
- Carlo Gaetano
- Laboratorio di Epigenetica, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
- Correspondence: Carlo Gaetano Maurizio C. Capogrossi
| | - Maurizio Pesce
- Unità di Ingegneria Tissutale Cardiovascolare, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Antonio P. Beltrami
- Dipartimento di Medicina, Istituto di Anatomia Patologica Universitaria, Azienda Ospedaliero Universitaria “S. Maria della Misericordia”, Udine, Italy
| | - Maurizio C. Capogrossi
- Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States
- Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
- Correspondence: Carlo Gaetano Maurizio C. Capogrossi
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5
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Ambrosini S, Montecucco F, Koljin D, Akhmedov A, Pedicino D, Mohammed SA, Kiss A, Beltrami AP, Luscher TF, Crea F, Ruschitzka F, Hamdani N, Costantino S, Paneni F. A methylation-dependent checkpoint by SETD7 promotes myocardial ischemic injury in mice and men. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Despite appropriate revascularization strategies, a significant number of patients with myocardial infarction (MI) develop ischemic heart failure suggesting that breakthrough therapies are yet to be approved in this setting. Methylation of non-histone proteins is emerging as a central regulatory mechanism in health and disease. The methyltransferase SETD7 has been shown to methylate and alter the function of a variety of proteins in vitro, however, its function in the heart is poorly understood.
Purpose
To determine the role of SETD7 in myocardial ischemic injury.
Methods
Neonatal rat ventricular myocytes (NRVM) were exposed to normal glucose levels or glucose deprivation (GD) for 15 h, in the presence of the selective SETD7 inhibitor (R)-PFI-2 or its inactive enantiomer (S)-PFI-2. Western blot and real-time PCR were employed to investigate the effects of energy stress on SETD7 and the Hippo pathway, while apoptosis and oxidative stress were assessed by Caspase-3 activity assay and mitoSOX staining. YAP transcriptional activity was assessed by chromatin immunoprecipitation assay (ChIP) while its localization and methylation were examined by confocal microscopy and immunoblotting, respectively. SETD7 knockout (SETD7−/−) mice and wild-type (WT) littermates underwent myocardial ischemia-reperfusion (I/R) injury (1h coronary ligation /24 h of reperfusion) followed by assessment of cardiac function by echocardiography. Left ventricular (LV) myocardial samples were collected from I/R mice and patients with ischemic cardiomyopathy (ICM), and isolated cardiomyocytes were treated with (R)-PFI-2. Finally, SETD7 expression was also assessed in peripheral blood mononuclear cells (PBMCs) from patients with ST-elevation MI (STEMI).
Results
SETD7 was activated upon energy deprivation in cultured NRVMs and methylated YAP, leading to its cytosolic retention and impaired transcription of antioxidant genes MnSOD and CAT. Pharmacological inhibition of SETD7 by (R)-PFI-2 restored YAP nuclear localization thus preventing mitochondrial reactive oxygen species (mtROS) and apoptosis. SETD7 deletion in mice attenuated I/R injury, mtROS and LV dysfunction by restoring YAP-dependent transcriptional programs. SETD7/YAP dysregulation was also observed in LV specimens from ICM patients. Moreover, in cardiomyocytes isolated from I/R mice and ICM patients, (R)-PFI-2 restored YAP nuclear localization, prevented mtROS accumulation while improving myofibrillar protein contractility and Ca2+ sensitivity. Finally, SETD7 was upregulated in PBMCs from STEMI patients and negatively correlated with the expression of MnSOD and CAT.
Conclusions
SETD7-dependent methylation of YAP is an important mechanism underpinning myocardial oxidative stress and apoptosis during ischemia. Pharmacological modulation of SETD7 by (R)-PFI-2 may represent a potential therapeutic approach to prevent myocardial ischemic damage through modulation of the Hippo pathway.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): University of Zurich
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Affiliation(s)
- S Ambrosini
- University of Zurich , Schlieren , Switzerland
| | | | - D Koljin
- Ruhr University Bochum , Bochum , Germany
| | - A Akhmedov
- University of Zurich , Schlieren , Switzerland
| | - D Pedicino
- IRCCS Foundation Agostino Gemelli University Hospital , Rome , Italy
| | | | - A Kiss
- Ludwig Boltzmann Cluster for Cardiovascular Research , Vienna , Austria
| | | | - T F Luscher
- University of Zurich , Schlieren , Switzerland
| | - F Crea
- IRCCS Foundation Agostino Gemelli University Hospital , Rome , Italy
| | - F Ruschitzka
- University Hospital Zurich, University Heart Center, Cardiology , Zurich , Switzerland
| | - N Hamdani
- Ruhr University Bochum , Bochum , Germany
| | | | - F Paneni
- University of Zurich , Schlieren , Switzerland
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6
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Avolio E, Carrabba M, Milligan R, Kavanagh Williamson M, Beltrami AP, Gupta K, Elvers KT, Gamez M, Foster RR, Gillespie K, Hamilton F, Arnold D, Berger I, Davidson AD, Hill D, Caputo M, Madeddu P. The SARS-CoV-2 Spike protein disrupts human cardiac pericytes function through CD147 receptor-mediated signalling: a potential non-infective mechanism of COVID-19 microvascular disease. Clin Sci (Lond) 2021; 135:2667-2689. [PMID: 34807265 DOI: 10.1101/2020.12.21.423721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/13/2021] [Accepted: 11/22/2021] [Indexed: 05/19/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a broad range of clinical responses including prominent microvascular damage. The capacity of SARS-CoV-2 to infect vascular cells is still debated. Additionally, the SARS-CoV-2 Spike (S) protein may act as a ligand to induce non-infective cellular stress. We tested this hypothesis in pericytes (PCs), which are reportedly reduced in the heart of patients with severe coronavirus disease-2019 (COVID-19). Here we newly show that the in vitro exposure of primary human cardiac PCs to the SARS-CoV-2 wildtype strain or the α and δ variants caused rare infection events. Exposure to the recombinant S protein alone elicited signalling and functional alterations, including: (1) increased migration, (2) reduced ability to support endothelial cell (EC) network formation on Matrigel, (3) secretion of pro-inflammatory molecules typically involved in the cytokine storm, and (4) production of pro-apoptotic factors causing EC death. Next, adopting a blocking strategy against the S protein receptors angiotensin-converting enzyme 2 (ACE2) and CD147, we discovered that the S protein stimulates the phosphorylation/activation of the extracellular signal-regulated kinase 1/2 (ERK1/2) through the CD147 receptor, but not ACE2, in PCs. The neutralisation of CD147, either using a blocking antibody or mRNA silencing, reduced ERK1/2 activation, and rescued PC function in the presence of the S protein. Immunoreactive S protein was detected in the peripheral blood of infected patients. In conclusion, our findings suggest that the S protein may prompt PC dysfunction, potentially contributing to microvascular injury. This mechanism may have clinical and therapeutic implications.
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Affiliation(s)
- Elisa Avolio
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Michele Carrabba
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Rachel Milligan
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, U.K
| | | | | | - Kapil Gupta
- School of Biochemistry, University of Bristol, Bristol, U.K
| | - Karen T Elvers
- Medicines Discovery Institute, Cardiff University, Cardiff, U.K
| | - Monica Gamez
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Rebecca R Foster
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Kathleen Gillespie
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Fergus Hamilton
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - David Arnold
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Imre Berger
- School of Biochemistry, University of Bristol, Bristol, U.K
- Max Planck Bristol Centre for Minimal Biology, University of Bristol, Bristol, U.K
| | - Andrew D Davidson
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, U.K
| | - Darryl Hill
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, U.K
| | - Massimo Caputo
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Paolo Madeddu
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
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7
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Avolio E, Carrabba M, Milligan R, Kavanagh Williamson M, Beltrami AP, Gupta K, Elvers KT, Gamez M, Foster RR, Gillespie K, Hamilton F, Arnold D, Berger I, Davidson AD, Hill D, Caputo M, Madeddu P. The SARS-CoV-2 Spike protein disrupts human cardiac pericytes function through CD147 receptor-mediated signalling: a potential non-infective mechanism of COVID-19 microvascular disease. Clin Sci (Lond) 2021; 135:2667-2689. [PMID: 34807265 PMCID: PMC8674568 DOI: 10.1042/cs20210735] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/13/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a broad range of clinical responses including prominent microvascular damage. The capacity of SARS-CoV-2 to infect vascular cells is still debated. Additionally, the SARS-CoV-2 Spike (S) protein may act as a ligand to induce non-infective cellular stress. We tested this hypothesis in pericytes (PCs), which are reportedly reduced in the heart of patients with severe coronavirus disease-2019 (COVID-19). Here we newly show that the in vitro exposure of primary human cardiac PCs to the SARS-CoV-2 wildtype strain or the α and δ variants caused rare infection events. Exposure to the recombinant S protein alone elicited signalling and functional alterations, including: (1) increased migration, (2) reduced ability to support endothelial cell (EC) network formation on Matrigel, (3) secretion of pro-inflammatory molecules typically involved in the cytokine storm, and (4) production of pro-apoptotic factors causing EC death. Next, adopting a blocking strategy against the S protein receptors angiotensin-converting enzyme 2 (ACE2) and CD147, we discovered that the S protein stimulates the phosphorylation/activation of the extracellular signal-regulated kinase 1/2 (ERK1/2) through the CD147 receptor, but not ACE2, in PCs. The neutralisation of CD147, either using a blocking antibody or mRNA silencing, reduced ERK1/2 activation, and rescued PC function in the presence of the S protein. Immunoreactive S protein was detected in the peripheral blood of infected patients. In conclusion, our findings suggest that the S protein may prompt PC dysfunction, potentially contributing to microvascular injury. This mechanism may have clinical and therapeutic implications.
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Affiliation(s)
- Elisa Avolio
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Michele Carrabba
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Rachel Milligan
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, U.K
| | | | | | - Kapil Gupta
- School of Biochemistry, University of Bristol, Bristol, U.K
| | - Karen T Elvers
- Medicines Discovery Institute, Cardiff University, Cardiff, U.K
| | - Monica Gamez
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Rebecca R Foster
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Kathleen Gillespie
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Fergus Hamilton
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - David Arnold
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Imre Berger
- School of Biochemistry, University of Bristol, Bristol, U.K
- Max Planck Bristol Centre for Minimal Biology, University of Bristol, Bristol, U.K
| | - Andrew D Davidson
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, U.K
| | - Darryl Hill
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, U.K
| | - Massimo Caputo
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
| | - Paolo Madeddu
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, U.K
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8
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Aleksova A, Sinagra G, Beltrami AP, Pierri A, Ferro F, Janjusevic M, Gagno G. Biomarkers in the management of acute heart failure: state of the art and role in COVID-19 era. ESC Heart Fail 2021; 8:4465-4483. [PMID: 34609075 PMCID: PMC8652929 DOI: 10.1002/ehf2.13595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/07/2021] [Accepted: 08/19/2021] [Indexed: 12/14/2022] Open
Abstract
Acute heart failure (AHF) affects millions of people worldwide, and it is a potentially life‐threatening condition for which the cardiologist is more often brought into play. It is crucial to rapidly identify, among patients presenting with dyspnoea, those with AHF and to accurately stratify their risk, in order to define the appropriate setting of care, especially nowadays due to the coronavirus disease 2019 (COVID‐19) outbreak. Furthermore, with physical examination being limited by personal protective equipment, the use of new alternative diagnostic and prognostic tools could be of extreme importance. In this regard, usage of biomarkers, especially when combined (a multimarker approach) is beneficial for establishment of an accurate diagnosis, risk stratification and post‐discharge monitoring. This review highlights the use of both traditional biomarkers such as natriuretic peptides (NP) and troponin, and emerging biomarkers such as soluble suppression of tumourigenicity (sST2) and galectin‐3 (Gal‐3), from patients' emergency admission to discharge and follow‐up, to improve risk stratification and outcomes in terms of mortality and rehospitalization.
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Affiliation(s)
- Aneta Aleksova
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and Department of Medical Surgical and Health Science, University of Trieste, Via Valdoni 7, Trieste, 34149, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and Department of Medical Surgical and Health Science, University of Trieste, Via Valdoni 7, Trieste, 34149, Italy
| | - Antonio P Beltrami
- Clinical Pathology Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC) and Department of Medicine (DAME), University of Udine, Udine, 33100, Italy
| | - Alessandro Pierri
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and Department of Medical Surgical and Health Science, University of Trieste, Via Valdoni 7, Trieste, 34149, Italy
| | | | - Milijana Janjusevic
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and Department of Medical Surgical and Health Science, University of Trieste, Via Valdoni 7, Trieste, 34149, Italy
| | - Giulia Gagno
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and Department of Medical Surgical and Health Science, University of Trieste, Via Valdoni 7, Trieste, 34149, Italy
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9
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Avolio E, Mangialardi G, Slater SC, Alvino VV, Gu Y, Cathery W, Beltrami AP, Katare R, Heesom K, Caputo M, Madeddu P. Secreted Protein Acidic and Cysteine Rich Matricellular Protein is Enriched in the Bioactive Fraction of the Human Vascular Pericyte Secretome. Antioxid Redox Signal 2021; 34:1151-1164. [PMID: 33226850 DOI: 10.1089/ars.2019.7969] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Aims: To ascertain if human pericytes produce SPARC (acronym for Secreted Protein Acidic and Cysteine Rich), a matricellular protein implicated in the regulation of cell proliferation, migration, and cell-matrix interactions; clarify if SPARC expression in cardiac pericytes is modulated by hypoxia; and determine the functional consequences of SPARC silencing. Results: Starting from the recognition that the conditioned media (CM) of human pericytes promote proliferation and migration of cardiac stromal cells, we screened candidate mediators by mass-spectrometry analysis. Of the 14 high-confidence proteins (<1% FDR) identified in the bioactive fractions of the pericyte CM, SPARC emerged as the top-scored matricellular protein. SPARC expression was validated using ELISA and found to be upregulated by hypoxia/starvation in pericytes that express platelet-derived growth factor receptor α (PDGFRα). This subfraction is acknowledged to play a key role in extracellular matrix remodeling. Studies in patients with acute myocardial infarction showed that peripheral blood SPARC correlates with the levels of creatine kinase Mb, a marker of cardiac damage. Immunohistochemistry analyses of infarcted hearts revealed that SPARC is expressed in vascular and interstitial cells. Silencing of SPARC reduced the pericyte ability to secrete collagen1a1, without inhibiting the effects of CM on cardiac and endothelial cells. These data indicate that SPARC is enriched in the bioactive fraction of the pericyte CM, is induced by hypoxia and ischemia, and is essential for pericyte ability to produce collagen. Innovation: This study newly indicates that pericytes are a source of the matricellular protein SPARC. Conclusion: Modulation of SPARC production by pericytes may have potential implications for postinfarct healing.
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Affiliation(s)
- Elisa Avolio
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Giuseppe Mangialardi
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Sadie C Slater
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Valeria V Alvino
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Yue Gu
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - William Cathery
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Antonio P Beltrami
- Dipartimento Area Medica, Istituto di Anatomia Patologica Universitaria, Università degli Studi di Udine, Udine, Italy
| | - Rajesh Katare
- Department of Physiology, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Kate Heesom
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Massimo Caputo
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Paolo Madeddu
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
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10
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Aleksova A, Ferro F, Gagno G, Cappelletto C, Santon D, Rossi M, Ippolito G, Zumla A, Beltrami AP, Sinagra G. COVID-19 and renin-angiotensin system inhibition: role of angiotensin converting enzyme 2 (ACE2) - Is there any scientific evidence for controversy? J Intern Med 2020; 288:410-421. [PMID: 32459372 PMCID: PMC7283873 DOI: 10.1111/joim.13101] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022]
Abstract
Renin-angiotensin system (RAS) blockers are extensively used worldwide to treat many cardiovascular disorders, where they are effective in reducing both mortality and morbidity. These drugs are known to induce an increased expression of angiotensin-converting enzyme 2 (ACE2). ACE2 acts as receptor for the novel SARS coronavirus-2 (SARS-CoV-2) which raising the important issue of possible detrimental effects that RAS blockers could exert on the natural history and pathogenesis of the coronavirus disease-19 (COVID-19) and associated excessive inflammation, myocarditis and cardiac arrhythmias. We review the current knowledge on the interaction between SARS-CoV-2 infection and RAS blockers and suggest a scientific rationale for continuing RAS blockers therapy in patients with COVID-19 infection.
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Affiliation(s)
- A Aleksova
- From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - F Ferro
- From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - G Gagno
- From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - C Cappelletto
- From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - D Santon
- From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - M Rossi
- From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
| | - G Ippolito
- National Institute for Infectious Diseases Lazzaro Spallanzani - IRCCS, Rome, Italy
| | - A Zumla
- Division of Infection and Immunity, University College London, London, UK.,National Institute of Health Research, Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - G Sinagra
- From the, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy
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11
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Dang Z, Avolio E, Thomas AC, Faulkner A, Beltrami AP, Cervellin C, Carrizzo A, Maciag A, Gu Y, Ciaglia E, Finato N, Damato A, Spinetti G, Alenzi A, Paisey SJ, Vecchione C, Puca AA, Madeddu P. Transfer of a human gene variant associated with exceptional longevity improves cardiac function in obese type 2 diabetic mice through induction of the SDF-1/CXCR4 signalling pathway. Eur J Heart Fail 2020; 22:1568-1581. [PMID: 32384208 PMCID: PMC8220375 DOI: 10.1002/ejhf.1840] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 12/23/2022] Open
Abstract
AIMS Homozygosity for a four-missense single-nucleotide polymorphism haplotype of the human BPIFB4 gene is enriched in long-living individuals. Delivery of this longevity-associated variant (LAV) improved revascularisation and reduced endothelial dysfunction and atherosclerosis in mice through a mechanism involving the stromal cell-derived factor-1 (SDF-1). Here, we investigated if delivery of the LAV-BPIFB4 gene may attenuate the progression of diabetic cardiomyopathy. METHODS AND RESULTS Compared with age-matched lean controls, diabetic db/db mice showed altered echocardiographic indices of diastolic and systolic function and histological evidence of microvascular rarefaction, lipid accumulation, and fibrosis in the myocardium. All these alterations, as well as endothelial dysfunction, were prevented by systemic LAV-BPIFB4 gene therapy using an adeno-associated viral vector serotype 9 (AAV9). In contrast, AAV9 wild-type-BPIFB4 exerted no benefit. Interestingly, LAV-BPIFB4-treated mice showed increased SDF-1 levels in peripheral blood and myocardium and up-regulation of the cardiac myosin heavy chain isoform alpha, a contractile protein that was reduced in diabetic hearts. SDF-1 up-regulation was instrumental to LAV-BPIFB4-induced benefit as both haemodynamic and structural improvements were inhibited by an orally active antagonist of the SDF-1 CXCR4 receptor. CONCLUSIONS In mice with type-2 diabetes, LAV-BPIFB4 gene therapy promotes an advantageous remodelling of the heart, allowing it to better withstand diabetes-induced stress. These results support the viability of transferring healthy characteristics of longevity to attenuate diabetic cardiac disease.
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Affiliation(s)
- Zexu Dang
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Elisa Avolio
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Anita C. Thomas
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Ashton Faulkner
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | | | | | | | - Anna Maciag
- Cardiovascular DepartmentIRCCS MultimedicaMilanItaly
| | - Yue Gu
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoBaronissi (SA)Italy
| | | | - Antonio Damato
- Vascular Pathophysiology Unit, IRCCS NeuromedPozzilliItaly
| | - Gaia Spinetti
- Cardiovascular DepartmentIRCCS MultimedicaMilanItaly
| | - Aishah Alenzi
- PETIC, School of MedicineUniversity of CardiffCardiffUK
| | | | - Carmine Vecchione
- Vascular Pathophysiology Unit, IRCCS NeuromedPozzilliItaly
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoBaronissi (SA)Italy
| | - Annibale A. Puca
- Cardiovascular DepartmentIRCCS MultimedicaMilanItaly
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoBaronissi (SA)Italy
| | - Paolo Madeddu
- Translational Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
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12
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Avolio E, Thomas A, Katare R, Al Haj Zen A, Beltrami AP, Leor J, Caputo M, Madeddu P. P1936Selective inhibition of the Mek1/2-Erk1/2 signalling pathway induces the differentiation of human cardiac pericyte-like cells into contractile vascular smooth muscle cells. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Arteriogenesis is key for tissue repair but whether myocardial stromal cells contribute to this phenomenon remains unknown.
Purpose
Investigate if cardiac pericytes are a druggable target for therapeutic arteriogenesis.
Methods and results
The localization of pericyte-like cells (PCs) was assessed in the human and murine heart by immunohistochemistry of typical antigenic markers. CD34+ PCs co-expressing NG2 and PDGFRβ but not endothelial cell (EC) or vascular smooth muscle cell (VSMC) antigens were identified in peri-arterial position in normal hearts. Interestingly, we also found rare PCs co-expressing αSMA in the peri-infarct myocardium, suggesting these cells could represent a transitory phenotype between PCs and VSMCs. Next, we isolated human cardiac PCs by immunosorting for CD31 and CD34 and established the purity of the isolated CD34+CD31- fraction by flow cytometry. Following culture expansion, cardiac PCs maintain the typical antigenic profile except for CD34. Moreover, we confirmed the PCs' ability to promote angiogenesis in-vitro. The withdrawal of EGF and bFGF from the culture media for 10 days induced the differentiation of PCs into mature VSMCs, as documented by a massive upregulation of contractile genes MYH11, CNN1 and ACTA2 (200-, 35- and 15-folds increase versus naïve PCs, p<0.01), which was followed by the induction of SM-MHC, Smoothelin B, αSMA, Calponin and SM22α proteins (p<0.05 versus PCs). In addition, PC-derived cells lost migratory capacity, secreted elastin, and responded to endothelin-1 in a contraction assay, thus phenocopying the behaviour of control coronary artery-derived VSMCs. We excluded contamination of the PC preparation by verifying similar phenomena occur in PCs expanded from single cell clonogeneic assays. Moreover, the process is partially reversible, with PC-derived VSMCs being able to reacquire some intermediate markers following EGF/bFGF re-challenge. ECs secrete EGF and bFGF, with this GF signalling being enhanced by hypoxia, suggesting ECs may control the PC phenotype in a paracrine fashion. Mechanistic studies revealed the Mek1/2-Erk1/2-Elk1 signalling is accountable for the transcriptional repression of VSMC genes in PCs. Accordingly, a selective Mek1/2 inhibitor (PD0325901) was able to switch the definitive VSMC phenotype of PCs maintained in full media. The drug prevented the phosphorylation of Erk1/2 and its downstream target Elk1. This likely relieves the complex SRF/MyocD and abolishes the transcriptional repression at the gene promoter.
Conclusions
Cardiac PCs have a VSMC potential which is under the inhibitory control of the Mek1/2-Erk1/2-Elk1 signalling. Mek1/2 inhibitors showed promises for the treatment of melanoma and solid tumours. A novel application of this class of compounds to improve arteriogenesis in myocardial ischemia is fascinating. The caveat about their potential cardiotoxicity could be less relevant with short duration treatments of myocardial ischemia.
Acknowledgement/Funding
British Heart Foundation Centre for Regenerative Medicine Award (II) - “Centre for Vascular Regeneration” (RM/17/3/33381)
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Affiliation(s)
- E Avolio
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - A Thomas
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - R Katare
- University of Otago, Dunedin, New Zealand
| | | | - A P Beltrami
- University of Udine, Department of Medical and Biological Sciences, Udine, Italy
| | - J Leor
- Neufeld Cardiac Research Institute, Tel Aviv, Israel
| | - M Caputo
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
| | - P Madeddu
- University of Bristol, Bristol Medical School, Bristol, United Kingdom
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13
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Veneziano C, Cervellin C, Caragnano A, Bulfoni M, Villa F, Sponga S, Livi U, Finato N, Cesselli D, Madeddu P, Puca AA, Beltrami AP. P746Protective role of the longevity associated variant of BPIFB4 in chronic ischemia. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A rare Longevity Associated Variant (LAV) of the gene BPIFB4, whose protein product can be secreted, is recessively associated with extreme longevity, positively impacting the cardiovascular system and promoting therapeutic angiogenesis in an hindlimb ischemia model.
Aim
Aim of this work is to verify if LAV-BPIFB4 may temper the phenotype of chronic ischemia in humans, thus suggesting its therapeutic potential.
Methods and results
39 hearts explanted from patients affected by end-stage ischemic heart disease were studied. Of these, 7 were homozygous for BPIFB4-LAV. Homozygous and non-homozygous patients did not differ in sex, age and in the prevalence of comorbidities or risk factors. However, the time elapsed from myocardial infarction to transplantation was significantly longer for LAV homozygous with respect to LAV heterozygous patients (159±95 vs 58±27 months, p=0.045). Histologically, while BPIFB4 levels did not differ in accordance with the genotype, the fraction of Tunel+and 53BP1+apoptotic and senescent myocytes was significantly lower in homozygous patients (1.2±0.4% vs 23.8±21.7%, p=0.026 and 31.5±6.7% vs 44.4±6.1%, p=0.031, respectively). Significantly lower levels of lipoperoxides and higher levels of Parkin were observed in homozygous hearts too. Next, we directly tested the role of BPIFB4 on PDGFRb+ NG2+Tbx18+cardiac pericytes/mural cells (PM) cultured from normal atria (PMnorm, n=10) and from ischemic failing hearts (PMfail, n=7). BPIFB4 gene transcript was significantly more expressed in PMnorm than PMfail. Silencing BPIFB4 expression in PMnorm significantly increased the proportion of senescent gH2AX+Ki67-cells (3.6±2.9% vs 13.6±9.5%, p=0.049). Conversely, addition of recombinant LAV BPIFB4 protein to PMfail cultures significantly reduced the rate of senescent cells (21.1±9.4% vs 6.0±4.8%, p=0.03), an effect that was not observed with the administration of WT BPIFB4. PMfail cultures exposed to LAV BPIFB4 significantly reversed alterations observed with pathology, such as the accumulation of both lipofuscins and of very elongated and interconnected mitochondria in the cell cytoplasm, as well as elevated mitochondrial superoxide anion levels. Finally, a larger fraction of PMnorm cells showed, with respect to PMfail, the nuclear translocation of vitamin D receptor (74.6±6.1% vs 50.1±14.4, p=0.04), coupled with a significant upregulation of its, longevity associated, target gene Klotho. Importantly, LAV BPIFB4 significantly increased the fraction of PMfail with vitamin D receptor nuclear localization (55.8±17.6% vs 85.1±8.2%, p=0.005).
Conclusion
LAV BPIFB4 could attenuate the progression of ischemic heart disease to heart failure. Part of its protective effect may be due to its ability to reduce mitochondrial oxidative stress and to revert the senescent phenotype of cardiac derived cells.
Acknowledgement/Funding
CARIPLO foundation
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Affiliation(s)
| | | | | | | | - F Villa
- IRCCS Multimedica of Milan, Milan, Italy
| | - S Sponga
- University Hospital Santa Maria della Misericordia, Cardiothoracic Surgery, Udine, Italy
| | - U Livi
- University Hospital Santa Maria della Misericordia, Cardiothoracic Surgery, Udine, Italy
| | - N Finato
- University Hospital Santa Maria della Misericordia, Istituto di Anatomia Patologica, Udine, Italy
| | | | - P Madeddu
- University of Bristol, Bristol, United Kingdom
| | - A A Puca
- University of Salerno, Salerno, Italy
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14
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Zanello A, Mazzega E, Caragnano A, Bulfoni M, Sponga S, Livi U, Battistella A, Lazzarino M, Cesselli D, Beltrami AP. P752Pericyte/mural cells of ischemic human hearts show impairment of mechanotransduction, attenuating YAP signaling. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
The Hippo pathway, that is upregulated in human heart failure, can restrain cardiac regeneration and impair arteriogenesis, preventing the nuclear translocation of the transcriptional coactivator YAP. Actin dynamics and mechanotransduction pathways are critical regulators of YAP subcellular localization.
Aim
To investigate if cardiac pathology alters mechanotransduction pathways, modulating the nucleocytoplasmic shuttling of YAP.
Methods and results
PDGFRb+ NG2+Tbx18+cardiac pericytes/mural cells (PM) cultured from normal atria (PMnorm, n=6) and from ischemic failing hearts (PMfail, n=6) were compared. From a transcriptomic standpoint, biological processes and molecular functions associated with cell adhesion and actin cytoskeleton were differentially expressed by PMfail vs PMnorm. The morphological analysis of the two cell types showed that PMfail were significantly larger (2,455±160μm2 vs 3518±334μm2, p=0.04) and less polarized (aspect ratio: 3±0.9 vs 2±0.1, p=0.002) with respect to PMnorm. Consistently, PMfail showed a significantly smaller number of Paxillin+ focal adhesions/cell area and impaired migratory properties. Furthermore, PMfail showed contact inhibition of cell proliferation at significantly lower cell density with respect to PMnorm, paralleled by a significantly lower fraction of cells expressing YAP in their nuclei at a density of 500 cells/mm2 (28.1±12.7% vs 87.0±23.6%, p=0.029). Given the link between mechanotransduction, response to substrate stiffness and extracellular matrix composition, we evaluated the responses of PM plated on a soft (16kPa), intermediate (231kPa) and very hard (in order to GPa) polyacrylamide gels coated with two different fibronectin (FN) concentrations (1 and 25μg/mL). Atomic force microscopy measure of cell stiffness, showed that, while PMnorm significantly increase their intracellular stiffness (804±311Pa vs 1,320±394Pa, p=0.014) as a function of extracellular stiffness (soft vs very hard), PMfail do not. These results were paralleled by YAP and Myocardin Related Transcription Factor-A (MRTF-A) shuttling, that are translocated in the nuclei of PMnorm in response to substrate stiffness and fibronectin concentration significantly more than in the nuclei of PMfail cells. Analysis of CTGF, CYR61 and ANKRD1 gene expression corroborated these data. Finally, we demonstrated that serum deprivation, inhibitors of both actin polymerization (latrunculin-A), and Rho-associated Kinase (ROCK, Y23763) significantly inhibited the nuclear translocation of both YAP and MRTF-A and cell proliferation. Conversely, the MEK1/2 inhibitor I-1040 exerted opposite effects.
Conclusion
PM isolated from ischemic hearts are characterized by altered mechanotransduction properties that impair a correct nuclear translocation of the cotranscriptional regulators YAP and MRTF-A in response to environmental cues. Pharmacologic modulation of regulators of this pathway may revert the pathologic phenotype.
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Affiliation(s)
| | | | | | | | - S Sponga
- University Hospital Santa Maria della Misericordia, Cardiothoracic Surgery, Udine, Italy
| | - U Livi
- University Hospital Santa Maria della Misericordia, Cardiothoracic Surgery, Udine, Italy
| | - A Battistella
- Italian National Research Council (CNR), Istituto Officina dei Materiali (IOM), Trieste, Italy
| | - M Lazzarino
- Italian National Research Council (CNR), Istituto Officina dei Materiali (IOM), Trieste, Italy
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15
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Beltrami AP, Spinetti G. Editorial: Mechanisms and Implications of the Aging of Cardiovascular Regenerative Cells. Front Cardiovasc Med 2018; 5:93. [PMID: 30065930 PMCID: PMC6056607 DOI: 10.3389/fcvm.2018.00093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 06/26/2018] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Gaia Spinetti
- Laboratory of Cardiovascular Research, IRCCS MultiMedica, Milan, Italy
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16
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Parisse P, Rago I, Ulloa Severino L, Perissinotto F, Ambrosetti E, Paoletti P, Ricci M, Beltrami AP, Cesselli D, Casalis L. Atomic force microscopy analysis of extracellular vesicles. Eur Biophys J 2017; 46:813-820. [PMID: 28866771 DOI: 10.1007/s00249-017-1252-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 08/23/2017] [Accepted: 08/27/2017] [Indexed: 12/17/2022]
Affiliation(s)
- P Parisse
- INSTM-ST Unit, Trieste, Italy.
- Elettra, Sincrotrone Trieste S.C.p.A., Trieste, Italy.
| | - I Rago
- Elettra, Sincrotrone Trieste S.C.p.A., Trieste, Italy
- University of Trieste, Trieste, Italy
| | - L Ulloa Severino
- Elettra, Sincrotrone Trieste S.C.p.A., Trieste, Italy
- University of Trieste, Trieste, Italy
| | - F Perissinotto
- Elettra, Sincrotrone Trieste S.C.p.A., Trieste, Italy
- University of Trieste, Trieste, Italy
| | - E Ambrosetti
- INSTM-ST Unit, Trieste, Italy
- Elettra, Sincrotrone Trieste S.C.p.A., Trieste, Italy
- University of Trieste, Trieste, Italy
| | - P Paoletti
- Elettra, Sincrotrone Trieste S.C.p.A., Trieste, Italy
- SISSA, Scuola Internazionale Superiore di Studi Avanzati, Trieste, Italy
| | - M Ricci
- Biological and Soft Systems, Cavendish Laboratory, Cambridge University, Cambridge, UK
| | - A P Beltrami
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - D Cesselli
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - L Casalis
- INSTM-ST Unit, Trieste, Italy
- Elettra, Sincrotrone Trieste S.C.p.A., Trieste, Italy
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Mariuzzi L, Domenis R, Orsaria M, Marzinotto S, Londero AP, Bulfoni M, Candotti V, Zanello A, Ballico M, Mimmi MC, Calcagno A, Marchesoni D, Di Loreto C, Beltrami AP, Cesselli D, Gri G. Functional expression of aryl hydrocarbon receptor on mast cells populating human endometriotic tissues. J Transl Med 2016; 96:959-971. [PMID: 27348627 PMCID: PMC5008463 DOI: 10.1038/labinvest.2016.74] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 12/24/2022] Open
Abstract
Endometriosis is an inflammatory disease characterized by the presence of ectopic endometrial tissue outside the uterus. A diffuse infiltration of mast cells (MCs) is observed throughout endometriotic lesions, but little is known about how these cells contribute to the network of molecules that modulate the growth of ectopic endometrial implants and promote endometriosis-associated inflammation. The aryl hydrocarbon receptor (AhR), a transcription factor known to respond to environmental toxins and endogenous compounds, is present in MCs. In response to AhR activation, MCs produce IL-17 and reactive oxygen species, highlighting the potential impact of AhR ligands on inflammation via MCs. Here, we investigated the possibility that endometrial MCs promote an inflammatory microenvironment by sensing AhR ligands, thus sustaining endometriosis development. Using human endometriotic tissue (ET) samples, we performed the following experiments: (i) examined the cytokine expression profile; (ii) counted AhR-expressing MCs; (iii) verified the phenotype of AhR-expressing MCs to establish whether MCs have a tolerogenic (IL-10-positive) or inflammatory (IL-17-positive) phenotype; (iv) measured the presence of AhR ligands (tryptophan-derived kynurenine) and tryptophan-metabolizing enzymes (indoleamine 2,3-dioxygenase 1 (IDO1)); (v) treated ET organ cultures with an AhR antagonist in vitro to measure changes in the cytokine milieu; and (vi) measured the growth of endometrial stromal cells cultured with AhR-activated MC-conditioned medium. We found that ET tissue was conducive to cytokine production, orchestrating chronic inflammation and a population of AhR-expressing MCs that are both IL-17 and IL-10-positive. ET was rich in IDO1 and the AhR-ligand kynurenine compared with control tissue, possibly promoting MC activation through AhR. ET was susceptible to treatment with an AhR antagonist, and endometrial stromal cell growth was improved in the presence of soluble factors released by MCs on AhR activation. These results suggest a new mechanistic role of MCs in the pathogenesis of endometriosis.
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Affiliation(s)
- Laura Mariuzzi
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Rossana Domenis
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Maria Orsaria
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Stefania Marzinotto
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Ambrogio P Londero
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Michela Bulfoni
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Veronica Candotti
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Andrea Zanello
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Maurizio Ballico
- Section of Applied Physics, Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100 Udine, Italy
| | - Maria C Mimmi
- Section of Applied Physics, Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100 Udine, Italy
| | - Angelo Calcagno
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Diego Marchesoni
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Carla Di Loreto
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Antonio P Beltrami
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Daniela Cesselli
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Giorgia Gri
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
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18
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Avolio E, Meloni M, Spencer HL, Riu F, Katare R, Mangialardi G, Oikawa A, Rodriguez-Arabaolaza I, Dang Z, Mitchell K, Reni C, Alvino VV, Rowlinson J, Livi U, Cesselli D, Angelini G, Emanueli C, Beltrami AP, Madeddu P. Combined intramyocardial delivery of human pericytes and cardiac stem cells additively improves the healing of mouse infarcted hearts through stimulation of vascular and muscular repair. Circ Res 2015; 116:e81-94. [PMID: 25801898 DOI: 10.1161/circresaha.115.306146] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/23/2015] [Indexed: 12/15/2022]
Abstract
RATIONALE Optimization of cell therapy for cardiac repair may require the association of different cell populations with complementary activities. OBJECTIVE Compare the reparative potential of saphenous vein-derived pericytes (SVPs) with that of cardiac stem cells (CSCs) in a model of myocardial infarction, and investigate whether combined cell transplantation provides further improvements. METHODS AND RESULTS SVPs and CSCs were isolated from vein leftovers of coronary artery bypass graft surgery and discarded atrial specimens of transplanted hearts, respectively. Single or dual cell therapy (300 000 cells of each type per heart) was tested in infarcted SCID (severe combined immunodeficiency)-Beige mice. SVPs and CSCs alone improved cardiac contractility as assessed by echocardiography at 14 days post myocardial infarction. The effect was maintained, although attenuated at 42 days. At histological level, SVPs and CSCs similarly inhibited infarct size and interstitial fibrosis, SVPs were superior in inducing angiogenesis and CSCs in promoting cardiomyocyte proliferation and recruitment of endogenous stem cells. The combination of cells additively reduced the infarct size and promoted vascular proliferation and arteriogenesis, but did not surpass single therapies with regard to contractility indexes. SVPs and CSCs secrete similar amounts of hepatocyte growth factor, vascular endothelial growth factor, fibroblast growth factor, stem cell factor, and stromal cell-derived factor-1, whereas SVPs release higher quantities of angiopoietins and microRNA-132. Coculture of the 2 cell populations results in competitive as well as enhancing paracrine activities. In particular, the release of stromal cell-derived factor-1 was synergistically augmented along with downregulation of stromal cell-derived factor-1-degrading enzyme dipeptidyl peptidase 4. CONCLUSIONS Combinatory therapy with SVPs and CSCs may complementarily help the repair of infarcted hearts.
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Affiliation(s)
- Elisa Avolio
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Marco Meloni
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Helen L Spencer
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Federica Riu
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Rajesh Katare
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Giuseppe Mangialardi
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Atsuhiko Oikawa
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Iker Rodriguez-Arabaolaza
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Zexu Dang
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Kathryn Mitchell
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Carlotta Reni
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Valeria V Alvino
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Jonathan Rowlinson
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Ugolini Livi
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Daniela Cesselli
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Gianni Angelini
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Costanza Emanueli
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Antonio P Beltrami
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.)
| | - Paolo Madeddu
- From the Experimental Cardiovascular Medicine (E.A., H.L.S., F.R., R.K., G.M., A.O., I.R.-A., Z.D., K.M., C.R., V.V.A., J.R., P.M.) and Vascular Pathology and Regeneration (M.M., C.E.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom; Institute of Cardiovascular and Medical Sciences (M.M.), University of Glasgow, Glasgow, United Kingdom; Department of Physiology, University of Otago, Dunedin, New Zealand (R.K.); Department of Medical and Biological Sciences (D.C., A.P.B.) and Department of Experimental Medical and Clinical Sciences (U.L.), University of Udine, Udine, Italy; and Cardiac Surgery, Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (G.A.).
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19
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Domenis R, Lazzaro L, Calabrese S, Mangoni D, Gallelli A, Bourkoula E, Manini I, Bergamin N, Toffoletto B, Beltrami CA, Beltrami AP, Cesselli D, Parodi PC. Adipose tissue derived stem cells: in vitro and in vivo analysis of a standard and three commercially available cell-assisted lipotransfer techniques. Stem Cell Res Ther 2015; 6:2. [PMID: 25559708 PMCID: PMC4417272 DOI: 10.1186/scrt536] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 12/16/2014] [Accepted: 12/17/2014] [Indexed: 12/29/2022] Open
Abstract
Introduction Autologous fat grafting is commonly used to correct soft-tissue contour deformities. However, results are impaired by a variable and unpredictable resorption rate. Autologous adipose-derived stromal cells in combination with lipoinjection (cell-assisted lipotransfer) seem to favor a long-term persistence of fat grafts, thus fostering the development of devices to be used in the operating room at the point of care, to isolate the stromal vascular fraction (SVF) and produce SVF-enhanced fat grafts with safe and standardized protocols. Focusing on patients undergoing breast reconstruction by lipostructure, we analyzed a standard technique, a modification of the Coleman’s procedure, and three different commercially available devices (Lipokit, Cytori, Fastem), in terms of 1) ability to enrich fat grafts in stem cells and 2) clinical outcome at 6 and 12 months. Methods To evaluate the ability to enrich stem cells, we compared, for each patient (n = 20), the standard lipoaspirate with the respective stem cell-enriched one, analyzing yield, immunophenotype and colony-forming capacity of the SVF cells as well as immunophenotype, clonogenicity and multipotency of the obtained adipose stem cells (ASCs). Regarding the clinical outcome, we compared, by ultrasonography imaging, changes at 6 and 12 months in the subcutaneous thickness of patients treated with stem-cell enriched (n = 14) and standard lipoaspirates (n = 16). Results Both methods relying on the enzymatic isolation of primitive cells led to significant increase in the frequency, in the fat grafts, of SVF cells as well as of clonogenic and multipotent ASCs, while the enrichment was less prominent for the device based on the mechanical isolation of the SVF. From a clinical point of view, patients treated with SVF-enhanced fat grafts demonstrated, at six months, a significant superior gain of thickness of both the central and superior-medial quadrants with respect to patients treated with standard lipotransfer. In the median-median quadrant the effect was still persistent at 12 months, confirming an advantage of lipotransfer technique in enriching improving long-term fat grafts. Conclusions This comparative study, based on reproducible biological and clinical parameters and endpoints, showed an advantage of lipotransfer technique in enriching fat grafts in stem cells and in favoring, clinically, long-term fat grafts. Electronic supplementary material The online version of this article (doi:10.1186/scrt536) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rossana Domenis
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Lara Lazzaro
- Clinic of Plastic and Reconstructive Surgery of Udine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Sarah Calabrese
- Clinic of Plastic and Reconstructive Surgery of Udine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Damiano Mangoni
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Annarita Gallelli
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Evgenia Bourkoula
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Ivana Manini
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Natascha Bergamin
- Azienda Ospedaliero-Universitaria of Udine, P.le S. Maria della Misericordia 15, 33100, Udine, Italy.
| | - Barbara Toffoletto
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Carlo A Beltrami
- Azienda Ospedaliero-Universitaria of Udine, P.le S. Maria della Misericordia 15, 33100, Udine, Italy.
| | - Antonio P Beltrami
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Daniela Cesselli
- Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
| | - Pier Camillo Parodi
- Clinic of Plastic and Reconstructive Surgery of Udine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy. .,Azienda Ospedaliero-Universitaria of Udine, P.le S. Maria della Misericordia 15, 33100, Udine, Italy.
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Verardo R, Piazza S, Klaric E, Ciani Y, Bussadori G, Marzinotto S, Mariuzzi L, Cesselli D, Beltrami AP, Mano M, Itoh M, Kawaji H, Lassmann T, Carninci P, Hayashizaki Y, Forrest ARR, Beltrami CA, Schneider C. Specific Mesothelial Signature Marks the Heterogeneity of Mesenchymal Stem Cells From High-Grade Serous Ovarian Cancer. Stem Cells 2014; 32:2998-3011. [DOI: 10.1002/stem.1791] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 04/17/2014] [Accepted: 05/10/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Roberto Verardo
- Laboratorio Nazionale-Consorzio Interuniversitario Biotecnologie (LNCIB); Area Science Park Trieste Italy
| | - Silvano Piazza
- Laboratorio Nazionale-Consorzio Interuniversitario Biotecnologie (LNCIB); Area Science Park Trieste Italy
| | - Enio Klaric
- Laboratorio Nazionale-Consorzio Interuniversitario Biotecnologie (LNCIB); Area Science Park Trieste Italy
| | - Yari Ciani
- Laboratorio Nazionale-Consorzio Interuniversitario Biotecnologie (LNCIB); Area Science Park Trieste Italy
| | - Giulio Bussadori
- Laboratorio Nazionale-Consorzio Interuniversitario Biotecnologie (LNCIB); Area Science Park Trieste Italy
| | - Stefania Marzinotto
- Department of Medical and Biological Sciences; University of Udine; Udine Italy
| | - Laura Mariuzzi
- Department of Medical and Biological Sciences; University of Udine; Udine Italy
| | - Daniela Cesselli
- Department of Medical and Biological Sciences; University of Udine; Udine Italy
| | - Antonio P. Beltrami
- Department of Medical and Biological Sciences; University of Udine; Udine Italy
| | - Miguel Mano
- International Centre for Genetic Engineering and Biotechnology (ICGEB); Area Science Park Trieste Italy
| | - Masayoshi Itoh
- RIKEN Omics Science Center (OSC); Tsurumi-ku Yokohama Japan
| | - Hideya Kawaji
- RIKEN Omics Science Center (OSC); Tsurumi-ku Yokohama Japan
| | - Timo Lassmann
- RIKEN Omics Science Center (OSC); Tsurumi-ku Yokohama Japan
| | - Piero Carninci
- RIKEN Omics Science Center (OSC); Tsurumi-ku Yokohama Japan
| | | | | | - Carlo A. Beltrami
- International Centre for Genetic Engineering and Biotechnology (ICGEB); Area Science Park Trieste Italy
| | - Claudio Schneider
- Laboratorio Nazionale-Consorzio Interuniversitario Biotecnologie (LNCIB); Area Science Park Trieste Italy
- International Centre for Genetic Engineering and Biotechnology (ICGEB); Area Science Park Trieste Italy
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21
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Avolio E, Mangialardi G, Riu F, Katare R, Mitchell K, Dang Z, Spencer H, Meloni M, Beltrami AP, Madeddu P. P593Human vascular pericytes and cardiac progenitor cells combined transplantation for heart repair. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu098.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Avolio E, Gianfranceschi G, Caragnano A, Athanasakis E, Katare R, Meloni M, Beltrami CA, Cesselli D, Madeddu P, Beltrami AP. 289Pharmacologic rejuvenation of senescent human cardiac stem cells enhances myocardial repair. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu087.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Katare R, Oikawa A, Cesselli D, Beltrami AP, Avolio E, Muthukrishnan D, Munasinghe PE, Angelini G, Emanueli C, Madeddu P. Boosting the pentose phosphate pathway restores cardiac progenitor cell availability in diabetes. Cardiovasc Res 2013; 97:55-65. [PMID: 22997160 PMCID: PMC3619276 DOI: 10.1093/cvr/cvs291] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIMS Diabetes impinges upon mechanisms of cardiovascular repair. However, the biochemical adaptation of cardiac stem cells to sustained hyperglycaemia remains largely unknown. Here, we investigate the molecular targets of high glucose-induced damage in cardiac progenitor cells (CPCs) from murine and human hearts and attempt safeguarding CPC viability and function through reactivation of the pentose phosphate pathway. METHODS AND RESULTS Type-1 diabetes was induced by streptozotocin. CPC abundance was determined by flow cytometry. Proliferating CPCs were identified in situ by immunostaining for the proliferation marker Ki67. Diabetic hearts showed marked reduction in CPC abundance and proliferation when compared with controls. Moreover, Sca-1(pos) CPCs isolated from hearts of diabetic mice displayed reduced activity of key enzymes of the pentose phosphate pathway, glucose-6-phosphate dehydrogenase (G6PD), and transketolase, increased levels of superoxide and advanced glucose end-products (AGE), and inhibition of the Akt/Pim-1/Bcl-2 signalling pathway. Similarly, culture of murine CPCs or human CD105(pos) progenitor cells in high glucose inhibits the pentose phosphate and pro-survival signalling pathways, leading to the activation of apoptosis. In vivo and in vitro supplementation with benfotiamine reactivates the pentose phosphate pathway and rescues CPC availability and function. This benefit is abrogated by either G6PD silencing by small interfering RNA (siRNA) or Akt inhibition by dominant-negative Akt. CONCLUSION We provide new evidence of the negative impact of diabetes and high glucose on mechanisms controlling CPC redox state and survival. Boosting the pentose phosphate pathway might represent a novel mechanistic target for protection of CPC integrity.
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MESH Headings
- Animals
- Antigens, CD/metabolism
- Antigens, Ly/metabolism
- Apoptosis/drug effects
- Biomarkers/metabolism
- Blood Glucose/metabolism
- Cell Proliferation/drug effects
- Cell Survival/drug effects
- Cells, Cultured
- Diabetes Mellitus, Experimental/chemically induced
- Diabetes Mellitus, Experimental/drug therapy
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Type 1/chemically induced
- Diabetes Mellitus, Type 1/drug therapy
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 1/pathology
- Endoglin
- Flow Cytometry
- Glucosephosphate Dehydrogenase/genetics
- Glucosephosphate Dehydrogenase/metabolism
- Glycation End Products, Advanced/metabolism
- Humans
- Immunohistochemistry
- Ki-67 Antigen/metabolism
- Male
- Membrane Proteins/metabolism
- Mice
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Oxidative Stress/drug effects
- Pentose Phosphate Pathway/drug effects
- Proto-Oncogene Proteins c-akt/genetics
- Proto-Oncogene Proteins c-akt/metabolism
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Proto-Oncogene Proteins c-pim-1/metabolism
- RNA Interference
- Receptors, Cell Surface/metabolism
- Signal Transduction/drug effects
- Stem Cells/drug effects
- Stem Cells/metabolism
- Stem Cells/pathology
- Superoxides/metabolism
- Thiamine/analogs & derivatives
- Thiamine/pharmacology
- Transfection
- Transketolase/metabolism
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Affiliation(s)
- Rajesh Katare
- Chair of Experimental Cardiovascular Medicine, Bristol Heart Institute, University of Bristol, Level 7, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS28HW, UK
- Department of Physiology, Otago School of Medical Sciences, University of Otago, PO Box 913, Dunedin 9054, New Zealand
| | - Atsuhiko Oikawa
- Chair of Experimental Cardiovascular Medicine, Bristol Heart Institute, University of Bristol, Level 7, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS28HW, UK
| | - Daniela Cesselli
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Antonio P. Beltrami
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Elisa Avolio
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Deepti Muthukrishnan
- Department of Physiology, Otago School of Medical Sciences, University of Otago, PO Box 913, Dunedin 9054, New Zealand
| | - Pujika Emani Munasinghe
- Department of Physiology, Otago School of Medical Sciences, University of Otago, PO Box 913, Dunedin 9054, New Zealand
| | - Gianni Angelini
- Department of Cardiac Surgery, Bristol Heart Institute, University of Bristol, Bristol, UK
| | - Costanza Emanueli
- Chair of Vascular Pathology and Regeneration, Bristol Heart Institute, University of Bristol, Bristol, UK
| | - Paolo Madeddu
- Chair of Experimental Cardiovascular Medicine, Bristol Heart Institute, University of Bristol, Level 7, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS28HW, UK
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24
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OgÓrek B, Hosoda T, Rondon C, Gurusamy N, Gatti A, Bardelli S, Quaini F, Bussani R, Silvestri F, Daniela C, Beltrami AP, del Monte F, Rota M, Urbanek K, Buchholz BA, Leri A, Beltrami CA, Anversa P, Kajstura J. Abstract 19: Myocyte Turnover in the Aging Human Heart. Circ Res 2012. [DOI: 10.1161/res.111.suppl_1.a19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The controversy on the growth reserve of the adult human heart has not been resolved and the extent of myocyte renewal reported by different groups varies significantly. Additionally, myocyte regeneration has been claimed to decrease with aging, although cell death is markedly enhanced in the old myocardium. Thus, the effects of age and gender on the magnitude of myocyte turnover were determined. Myocyte replication, senescence and apoptosis were measured in normal female and male human hearts collected from patients 19 to 104 years of age who died from causes other than cardiovascular diseases. Myocardial aging was characterized by a time-dependent increase in the generation of amplifying cardiomyocytes in women and men. Levels of Ki67 and phospho-H3 were comparable in the young female and male heart but differed later in life. As a function of age, the pool of amplifying myocytes was 2-fold higher in women than men, pointing to enhanced myocyte renewal in the female heart. The frequency of p16
INK4a
-positive myocytes was higher in men than in women. From 19 to 104 years of age, the time-dependent increase in senescent myocytes was 0.68% per year in women and 0.89% per year in men; the 31% higher rate of accumulation of old myocytes in the aging male heart was significant. Myocyte apoptosis occurred only in p16
INK4a
-positive cells and was consistently higher in men than in women at all age intervals. However, the increase in myocyte apoptosis with age did not differ with gender. Based on these parameters, we measured the average age of cardiomyocytes, their age distribution, turnover rate and time to acquire the senescent phenotype to define the biology of myocardial aging as a function of lifespan. In the female heart, myocyte turnover occurs at a rate of 10%, 15% and 40% per year at 20, 60 and 100 years of age, respectively. Corresponding values in the male heart are 7%, 12% and 32% per year, documenting that cardiomyogenesis involves a large and progressively increasing number of parenchymal cells with aging. In conclusion, the human heart is a highly dynamic organ in which progressive myocyte loss is at least in part counteracted by enhanced myocyte renewal. Myocyte regeneration in the physiologically aging heart takes place at previously unexpected levels in both women and men.
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Affiliation(s)
| | - Toru Hosoda
- Brigham and Women's Hosp, Harvard Med Sch, Boston, MA,
| | - Carlos Rondon
- Brigham and Women's Hosp, Harvard Med Sch, Boston, MA,
| | | | | | | | | | | | | | | | | | | | - Marcello Rota
- Brigham and Women's Hosp, Harvard Med Sch, Boston, MA,
| | | | - Bruce A Buchholz
- Cntr for Accelerator Mass Spectrometry, Lawrence Livermore National Laboratory, Livermore, CA
| | - Annarosa Leri
- Brigham and Women's Hosp, Harvard Med Sch, Boston, MA,
| | | | - Piero Anversa
- Brigham and Women's Hosp, Harvard Med Sch, Boston, MA,
| | - Jan Kajstura
- Brigham and Women's Hosp, Harvard Med Sch, Boston, MA,
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25
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Amadesi S, Reni C, Katare R, Meloni M, Oikawa A, Beltrami AP, Avolio E, Cesselli D, Fortunato O, Spinetti G, Ascione R, Cangiano E, Valgimigli M, Hunt SP, Emanueli C, Madeddu P. Role for substance p-based nociceptive signaling in progenitor cell activation and angiogenesis during ischemia in mice and in human subjects. Circulation 2012; 125:1774-86, S1-19. [PMID: 22392530 DOI: 10.1161/circulationaha.111.089763] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Pain triggers a homeostatic alarm reaction to injury. It remains unknown, however, whether nociceptive signaling activated by ischemia is relevant for progenitor cells (PC) release from bone marrow. To this end, we investigated the role of the neuropeptide substance P (SP) and cognate neurokinin 1 (NK1) nociceptor in PC activation and angiogenesis during ischemia in mice and in human subjects. METHODS AND RESULTS The mouse bone marrow contains sensory fibers and PC that express SP. Moreover, SP-induced migration provides enrichment for PC that express NK1 and promote reparative angiogenesis after transplantation in a mouse model of limb ischemia. Acute myocardial infarction and limb ischemia increase SP levels in peripheral blood, decrease SP levels in bone marrow, and stimulate the mobilization of NK1-expressing PC, with these effects being abrogated by systemic administration of the opioid receptor agonist morphine. Moreover, bone marrow reconstitution with NK1-knockout cells results in depressed PC mobilization, delayed blood flow recovery, and reduced neovascularization after ischemia. We next asked whether SP is instrumental to PC mobilization and homing in patients with ischemia. Human PC express NK1, and SP-induced migration provides enrichment for proangiogenic PC. Patients with acute myocardial infarction show high circulating levels of SP and NK1-positive cells that coexpress PC antigens, such as CD34, KDR, and CXCR4. Moreover, NK1-expressing PC are abundant in infarcted hearts but not in hearts that developed an infarct after transplantation. CONCLUSIONS Our data highlight the role of SP in reparative neovascularization. Nociceptive signaling may represent a novel target of regenerative medicine.
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Affiliation(s)
- Silvia Amadesi
- Laboratories of Experimental Cardiovascular Medicine, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
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26
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Abstract
The term "cellular senescence" denotes a cellular response to several stressors that results in irreversible growth arrest, alterations of the gene expression profile, epigenetic modifications, and an altered secretome, all of which eventually impair the reparative properties of primitive cells, adding a layer of complexity to the field of regenerative medicine. The purpose of this review is to illustrate how cellular senescence could affect tissue repair and to propose interventions that aim at interfering with it.
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Affiliation(s)
- A P Beltrami
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
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27
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Kajstura J, Gurusamy N, Ogórek B, Goichberg P, Clavo-Rondon C, Hosoda T, D'Amario D, Bardelli S, Beltrami AP, Cesselli D, Bussani R, del Monte F, Quaini F, Rota M, Beltrami CA, Buchholz BA, Leri A, Anversa P. Myocyte turnover in the aging human heart. Circ Res 2010; 107:1374-86. [PMID: 21088285 DOI: 10.1161/circresaha.110.231498] [Citation(s) in RCA: 229] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
RATIONALE The turnover of cardiomyocytes in the aging female and male heart is currently unknown, emphasizing the need to define human myocardial biology. OBJECTIVE The effects of age and gender on the magnitude of myocyte regeneration and the origin of newly formed cardiomyocytes were determined. METHODS AND RESULTS The interaction of myocyte replacement, cellular senescence, growth inhibition, and apoptosis was measured in normal female (n=32) and male (n=42) human hearts collected from patients 19 to 104 years of age who died from causes other than cardiovascular diseases. A progressive loss of telomeric DNA in human cardiac stem cells (hCSCs) occurs with aging and the newly formed cardiomyocytes inherit short telomeres and rapidly reach the senescent phenotype. Our data provide novel information on the superior ability of the female heart to sustain the multiple variables associated with the development of the senescent myopathy. At all ages, the female heart is equipped with a larger pool of functionally competent hCSCs and younger myocytes than the male myocardium. The replicative potential is higher and telomeres are longer in female hCSCs than in male hCSCs. In the female heart, myocyte turnover occurs at a rate of 10%, 14%, and 40% per year at 20, 60, and 100 years of age, respectively. Corresponding values in the male heart are 7%, 12%, and 32% per year, documenting that cardiomyogenesis involves a large and progressively increasing number of parenchymal cells with aging. From 20 to 100 years of age, the myocyte compartment is replaced 15 times in women and 11 times in men. CONCLUSIONS The human heart is a highly dynamic organ regulated by a pool of resident hCSCs that modulate cardiac homeostasis and condition organ aging.
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Affiliation(s)
- Jan Kajstura
- Department of Anesthesia and Medicine and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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28
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Pignatelli A, Ackman JB, Vigetti D, Beltrami AP, Zucchini S, Belluzzi O. A potential reservoir of immature dopaminergic replacement neurons in the adult mammalian olfactory bulb. Pflugers Arch 2008; 457:899-915. [PMID: 19011893 DOI: 10.1007/s00424-008-0535-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Accepted: 05/16/2008] [Indexed: 11/30/2022]
Abstract
A significant fraction of the interneurons added in adulthood to the glomerular layer (GL) of the olfactory bulb (OB) are dopaminergic (DA). In the OB, DA neurons are restricted to the GL, but using transgenic mice expressing eGFP under the tyrosine hydroxylase (TH) promoter, we also detected the presence of TH-GFP+ cells in the mitral and external plexiform layers. We hypothesized that these could be adult-generated neurons committed to become DA but not yet entirely differentiated. Accordingly, TH-GFP+ cells outside the GL exhibit functional properties (appearance of pacemaker currents, synaptic connection with the olfactory nerve, intracellular chloride concentration, and other) marking a gradient of maturity toward the dopaminergic phenotype along the mitral-glomerular axis. Finally, we propose that the establishment of a synaptic contact with the olfactory nerve is the key event allowing these cells to complete their differentiation toward the DA phenotype and to reach their final destination.
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Affiliation(s)
- Angela Pignatelli
- Sez. Fisiologia e Biofisica, Dipartimento di Biologia ed Evoluzione, Università degli Studi di Ferrara, Via Borsari 46, 44100, Ferrara, Italy
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29
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Baccarani U, Isola M, Adani GL, Benzoni E, Avellini C, Lorenzin D, Bresadola F, Uzzau A, Risaliti A, Beltrami AP, Soldano F, De Anna D, Bresadola V. Superiority of transplantation versus resection for the treatment of small hepatocellular carcinoma. Transpl Int 2008; 21:247-54. [DOI: 10.1111/j.1432-2277.2007.00597.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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30
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Bearzi C, Rota M, Hosoda T, Tillmanns J, Nascimbene A, De Angelis A, Yasuzawa-Amano S, Trofimova I, Siggins RW, LeCapitaine N, Cascapera S, Beltrami AP, D'Alessandro DA, Zias E, Quaini F, Urbanek K, Michler RE, Bolli R, Kajstura J, Leri A, Anversa P. Human cardiac stem cells. Proc Natl Acad Sci U S A 2007; 104:14068-73. [PMID: 17709737 PMCID: PMC1955818 DOI: 10.1073/pnas.0706760104] [Citation(s) in RCA: 697] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The identification of cardiac progenitor cells in mammals raises the possibility that the human heart contains a population of stem cells capable of generating cardiomyocytes and coronary vessels. The characterization of human cardiac stem cells (hCSCs) would have important clinical implications for the management of the failing heart. We have established the conditions for the isolation and expansion of c-kit-positive hCSCs from small samples of myocardium. Additionally, we have tested whether these cells have the ability to form functionally competent human myocardium after infarction in immunocompromised animals. Here, we report the identification in vitro of a class of human c-kit-positive cardiac cells that possess the fundamental properties of stem cells: they are self-renewing, clonogenic, and multipotent. hCSCs differentiate predominantly into cardiomyocytes and, to a lesser extent, into smooth muscle cells and endothelial cells. When locally injected in the infarcted myocardium of immunodeficient mice and immunosuppressed rats, hCSCs generate a chimeric heart, which contains human myocardium composed of myocytes, coronary resistance arterioles, and capillaries. The human myocardium is structurally and functionally integrated with the rodent myocardium and contributes to the performance of the infarcted heart. Differentiated human cardiac cells possess only one set of human sex chromosomes excluding cell fusion. The lack of cell fusion was confirmed by the Cre-lox strategy. Thus, hCSCs can be isolated and expanded in vitro for subsequent autologous regeneration of dead myocardium in patients affected by heart failure of ischemic and nonischemic origin.
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Affiliation(s)
- Claudia Bearzi
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Marcello Rota
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Toru Hosoda
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Jochen Tillmanns
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Angelo Nascimbene
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Antonella De Angelis
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Saori Yasuzawa-Amano
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Irina Trofimova
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Robert W. Siggins
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Nicole LeCapitaine
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Stefano Cascapera
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Antonio P. Beltrami
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - David A. D'Alessandro
- Department of Cardiac Surgery, Albert Einstein College of Medicine, New York, NY 10467; and
| | - Elias Zias
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Federico Quaini
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Konrad Urbanek
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Robert E. Michler
- Department of Cardiac Surgery, Albert Einstein College of Medicine, New York, NY 10467; and
| | - Roberto Bolli
- Institute of Molecular Cardiology, University of Louisville, Louisville, KY 40292
| | - Jan Kajstura
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Annarosa Leri
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
| | - Piero Anversa
- *Department of Medicine, Cardiovascular Research Institute, New York Medical College, Valhalla, NY 10595
- To whom correspondence should be addressed at:
Cardiovascular Research Institute, New York Medical College, Vosburgh Pavilion, Valhalla, NY 10595. E-mail:
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31
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Beltrami AP, Cesselli D, Bergamin N, Marcon P, Rigo S, Puppato E, D'Aurizio F, Verardo R, Piazza S, Pignatelli A, Poz A, Baccarani U, Damiani D, Fanin R, Mariuzzi L, Finato N, Masolini P, Burelli S, Belluzzi O, Schneider C, Beltrami CA. Multipotent cells can be generated in vitro from several adult human organs (heart, liver, and bone marrow). Blood 2007; 110:3438-46. [PMID: 17525288 DOI: 10.1182/blood-2006-11-055566] [Citation(s) in RCA: 244] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The aims of our study were to verify whether it was possible to generate in vitro, from different adult human tissues, a population of cells that behaved, in culture, as multipotent stem cells and if these latter shared common properties. To this purpose, we grew and cloned finite cell lines obtained from adult human liver, heart, and bone marrow and named them human multipotent adult stem cells (hMASCs). Cloned hMASCs, obtained from the 3 different tissues, expressed the pluripotent state-specific transcription factors Oct-4, NANOG, and REX1, displayed telomerase activity, and exhibited a wide range of differentiation potential, as shown both at a morphologic and functional level. hMASCs maintained a human diploid DNA content, and shared a common gene expression signature, compared with several somatic cell lines and irrespectively of the tissue of isolation. In particular, the pathways regulating stem cell self-renewal/maintenance, such as Wnt, Hedgehog, and Notch, were transcriptionally active. Our findings demonstrate that we have optimized an in vitro protocol to generate and expand cells from multiple organs that could be induced to acquire morphologic and functional features of mature cells even embryologically not related to the tissue of origin.
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Affiliation(s)
- Antonio P Beltrami
- Centro Interdipartimentale Medicina Rigenerativa, University of Udine, Piazzale Santa Maria della Misericordia, 33100 Udine, Italy.
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32
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Beltrami AP, Cesselli D, Bergamin N, Marcon P, Rigo S, Burelli S, Puppato E, D'Aurizio F, Bottecchia M, Masolini P, Mariuzzi L, Finato N, Beltrami CA. Investigation on possible cell sources to be utilized for cardiac cell therapy. Pathologica 2005; 97:185. [PMID: 16440647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Affiliation(s)
- A P Beltrami
- Istituto di Anatomia Patologica, Università di Udine
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Urbanek K, Torella D, Sheikh F, De Angelis A, Nurzynska D, Silvestri F, Beltrami CA, Bussani R, Beltrami AP, Quaini F, Bolli R, Leri A, Kajstura J, Anversa P. Myocardial regeneration by activation of multipotent cardiac stem cells in ischemic heart failure. Proc Natl Acad Sci U S A 2005; 102:8692-7. [PMID: 15932947 PMCID: PMC1150816 DOI: 10.1073/pnas.0500169102] [Citation(s) in RCA: 479] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this study, we tested whether the human heart possesses a cardiac stem cell (CSC) pool that promotes regeneration after infarction. For this purpose, CSC growth and senescence were measured in 20 hearts with acute infarcts, 20 hearts with end-stage postinfarction cardiomyopathy, and 12 control hearts. CSC number increased markedly in acute and, to a lesser extent, in chronic infarcts. CSC growth correlated with the increase in telomerase-competent dividing CSCs from 1.5% in controls to 28% in acute infarcts and 14% in chronic infarcts. The CSC mitotic index increased 29-fold in acute and 14-fold in chronic infarcts. CSCs committed to the myocyte, smooth muscle, and endothelial cell lineages increased approximately 85-fold in acute infarcts and approximately 25-fold in chronic infarcts. However, p16(INK4a)-p53-positive senescent CSCs also increased and were 10%, 18%, and 40% in controls, acute infarcts, and chronic infarcts, respectively. Old CSCs had short telomeres and apoptosis involved 0.3%, 3.8%, and 9.6% of CSCs in controls, acute infarcts, and chronic infarcts, respectively. These variables reduced the number of functionally competent CSCs from approximately 26,000/cm3 of viable myocardium in acute to approximately 7,000/cm3 in chronic infarcts, respectively. In seven acute infarcts, foci of spontaneous myocardial regeneration that did not involve cell fusion were identified. In conclusion, the human heart possesses a CSC compartment, and CSC activation occurs in response to ischemic injury. The loss of functionally competent CSCs in chronic ischemic cardiomyopathy may underlie the progressive functional deterioration and the onset of terminal failure.
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Affiliation(s)
- Konrad Urbanek
- Cardiovascular Research Institute, Department of Medicine, New York Medical College, Valhalla, NY 10595, USA
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Kazakov AV, Muller P, Beltrami AP, Pfeiffer P, Chizelli D, Bem M. [Stem cells and regeneration of human myocardium]. Kardiologiia 2005; 45:65-75. [PMID: 16353069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
A concept of impossibility of appearance of novel cardiomyocytes in the heart of adult men in exchange for those lost due to cardiovascular diseases had dominated medicine and biology for many long decades. However ability of human myocardium to regenerate was demonstrated during recent years in multiple studies. This dictated necessity to reconsider previously generally accepted concept. At present researchers and practicing physicians actively discuss possibility of the use of transplantation of bone marrow stem cells, proper cardiac stem cells, skeletal muscle myoblasts or precursors of endothelial cells in patients with myocardial infarction and heart failure in order to restore normal cardiac structure and function. Another potential method of restoration of the myocardium in patients with cardiovascular diseases is the use of cytokines which stimulate migration of stem cells into myocardium and their differentiation into cardiomyocytes.
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Beltrami AP, Barlucchi L, Torella D, Baker M, Limana F, Chimenti S, Kasahara H, Rota M, Musso E, Urbanek K, Leri A, Kajstura J, Nadal-Ginard B, Anversa P. Adult cardiac stem cells are multipotent and support myocardial regeneration. Cell 2003; 114:763-76. [PMID: 14505575 DOI: 10.1016/s0092-8674(03)00687-1] [Citation(s) in RCA: 2408] [Impact Index Per Article: 114.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The notion of the adult heart as terminally differentiated organ without self-renewal potential has been undermined by the existence of a subpopulation of replicating myocytes in normal and pathological states. The origin and significance of these cells has remained obscure for lack of a proper biological context. We report the existence of Lin(-) c-kit(POS) cells with the properties of cardiac stem cells. They are self-renewing, clonogenic, and multipotent, giving rise to myocytes, smooth muscle, and endothelial cells. When injected into an ischemic heart, these cells or their clonal progeny reconstitute well-differentiated myocardium, formed by blood-carrying new vessels and myocytes with the characteristics of young cells, encompassing approximately 70% of the ventricle. Thus, the adult heart, like the brain, is mainly composed of terminally differentiated cells, but is not a terminally differentiated organ because it contains stem cells supporting its regeneration. The existence of these cells opens new opportunities for myocardial repair.
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Affiliation(s)
- Antonio P Beltrami
- Cardiovascular Research Institute, Department of Medicine, New York Medical College, Valhalla, NY 10595, USA
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Cautero M, Beltrami AP, di Prampero PE, Capelli C. Breath-by-breath alveolar oxygen transfer at the onset of step exercise in humans: methodological implications. Eur J Appl Physiol 2002; 88:203-13. [PMID: 12458363 DOI: 10.1007/s00421-002-0671-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2002] [Indexed: 10/27/2022]
Abstract
The effects of using different algorithms to estimate the time constant of changes in oxygen uptake at the onset of square-wave 120 W cycloergometric exercise were evaluated in seven subjects. The volume of oxygen taken up at the alveoli (VO(2Ai)) was determined breath-by-breath (BB) from the volume of O(2) transferred at the mouth (VO(2mi)) minus the corresponding volume changes in O(2) stores in the alveoli: VO(2Ai)= VO(2mi)-[V(Ai-1)(FO(2Ai)- FO(2Ai-1))+ FO(2Ai) x Delta V(Ai)], where V(Ai-1) is the alveolar volume at the end of the previous breath, FO(2Ai) and FO(2Ai-1) are estimated from the fractions of end-tidal O(2) in the current and previous breaths, respectively, and Delta V(Ai) is the change in volume during breath i. These quantities can be measured BB, with the exception of V(Ai-1) which must be assumed. The respiratory cycle has been defined as the time elapsing between identical fractions of expiratory gas in two successive breaths. Using this approach, since FO(2Ai)= FO(2Ai-1), any assumption regarding V(Ai-1) becomes unnecessary. In the present study, VO(2Ai) was calculated firstly, by using this approach, and secondly by setting different V(Ai-1) values (from 0 to FRC+0.5 l, where FRC is the functional residual capacity). Values for alveolar O(2) flow (VO(2Ai)), as calculated from the quotient of VO(2Ai) divided by breath duration, were then fitted bi-exponentially. The time constant of the phase II kinetics of VO(2Ai) (tau(2)) was linearly related to V(Ai-1), increasing from 36.6 s (V(Ai-1)=0) to 46.8 s (V(Ai-1)=FRC+0.5 l) while tau(2) estimated using the first approach amounted to 34.3 s. We concluded that, firstly, the first approach allowed us to calculate O(2A) during transitions in step exercise; and secondly, when using methods wherein V(Ai-1) must be assumed, tau(2) depended on V(Ai-1).
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Affiliation(s)
- M Cautero
- Dipartimento di Scienze e Tecnologie Biomediche, School of Medicine, P. le Kolbe 4, 33100, Udine, Italy.
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Abstract
BACKGROUND Cases in which a male patient receives a heart from a female donor provide an unusual opportunity to test whether primitive cells translocate from the recipient to the graft and whether cells with the phenotypic characteristics of those of the recipient ultimately reside in the donor heart. The Y chromosome can be used to detect migrated undifferentiated cells expressing stem-cell antigens and to discriminate between primitive cells derived from the recipient and those derived from the donor. METHODS We examined samples from the atria of the recipient and the atria and ventricles of the graft by fluorescence in situ hybridization to determine whether Y chromosomes were present in eight hearts from female donors implanted into male patients. Primitive cells bearing Y chromosomes that expressed c-kit, MDR1, and Sca-1 were also investigated. RESULTS Myocytes, coronary arterioles, and capillaries that had a Y chromosome made up 7 to 10 percent of those in the donor hearts and were highly proliferative. As compared with the ventricles of control hearts, the ventricles of the transplanted hearts had markedly increased numbers of cells that were positive for c-kit, MDR1, or Sca-1. The number of primitive cells was higher in the atria of the hosts and the atria of the donor hearts than in the ventricles of the donor hearts, and 12 to 16 percent of these cells contained a Y chromosome. Undifferentiated cells were negative for markers of bone marrow origin. Progenitor cells expressing MEF2, GATA-4, and nestin (which identify the cells as myocytes) and Flk1 (which identifies the cells as endothelial cells) were identified. CONCLUSIONS Our results show a high level of cardiac chimerism caused by the migration of primitive cells from the recipient to the grafted heart. Putative stem cells and progenitor cells were identified in control myocardium and in increased numbers in transplanted hearts.
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Affiliation(s)
- Federico Quaini
- Department of Medicine, New York Medical College, Valhalla 10595, USA
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Cesselli D, Jakoniuk I, Barlucchi L, Beltrami AP, Hintze TH, Nadal-Ginard B, Kajstura J, Leri A, Anversa P. Oxidative stress-mediated cardiac cell death is a major determinant of ventricular dysfunction and failure in dog dilated cardiomyopathy. Circ Res 2001; 89:279-86. [PMID: 11485979 DOI: 10.1161/hh1501.094115] [Citation(s) in RCA: 255] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cell death has been questioned as a mechanism of ventricular failure. In this report, we tested the hypothesis that apoptotic death of myocytes, endothelial cells, and fibroblasts is implicated in the development of the dilated myopathy induced by ventricular pacing. Accumulation of reactive oxygen products such as nitrotyrosine, potentiation of the oxidative stress response by p66(shc) expression, formation of p53 fragments, release of cytochrome c, and caspase activation were examined to establish whether these events were coupled with apoptotic cell death in the paced dog heart. Myocyte, endothelial cell, and fibroblast apoptosis was detected before indices of severe impairment of cardiac function became apparent. Cell death increased with the duration of pacing, and myocyte death exceeded endothelial cell and fibroblast death throughout. Nitrotyrosine formation and p66(shc) levels progressively increased with pacing and were associated with cell apoptosis. Similarly, p50 (DeltaN) fragments augmented paralleling the degree of cell death in the failing heart. Moreover, cytochrome c release and activation of caspase-9 and -3 increased from 1 to 4 weeks of pacing. In conclusion, cardiac cell death precedes ventricular decompensation and correlates with the time-dependent deterioration of function in this model. Oxidative stress may be critical for activation of apoptosis in the overloaded heart.
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Affiliation(s)
- D Cesselli
- Department of Medicine, New York Medical College, Valhalla, NY, USA
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Beltrami AP, Urbanek K, Kajstura J, Yan SM, Finato N, Bussani R, Nadal-Ginard B, Silvestri F, Leri A, Beltrami CA, Anversa P. Evidence that human cardiac myocytes divide after myocardial infarction. N Engl J Med 2001; 344:1750-7. [PMID: 11396441 DOI: 10.1056/nejm200106073442303] [Citation(s) in RCA: 1073] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The scarring of the heart that results from myocardial infarction has been interpreted as evidence that the heart is composed of myocytes that are unable to divide. However, recent observations have provided evidence of proliferation of myocytes in the adult heart. Therefore, we studied the extent of mitosis among myocytes after myocardial infarction in humans. METHODS Samples from the border of the infarct and from areas of the myocardium distant from the infarct were obtained from 13 patients who had died 4 to 12 days after infarction. Ten normal hearts were used as controls. Myocytes that had entered the cell cycle in preparation for cell division were measured by labeling of the nuclear antigen Ki-67, which is associated with cell division. The fraction of myocyte nuclei that were undergoing mitosis was determined, and the mitotic index (the ratio of the number of nuclei undergoing mitosis to the number not undergoing mitosis) was calculated. The presence of mitotic spindles, contractile rings, karyokinesis, and cytokinesis was also recorded. RESULTS In the infarcted hearts, Ki-67 expression was detected in 4 percent of myocyte nuclei in the regions adjacent to the infarcts and in 1 percent of those in regions distant from the infarcts. The reentry of myocytes into the cell cycle resulted in mitotic indexes of 0.08 percent and 0.03 percent, respectively, in the zones adjacent to and distant from the infarcts. Events characteristic of cell division--the formation of the mitotic spindles, the formation of contractile rings, karyokinesis, and cytokinesis--were identified; these features demonstrated that there was myocyte proliferation after myocardial infarction. CONCLUSIONS Our results challenge the dogma that the adult heart is a postmitotic organ and indicate that the regeneration of myocytes may be a critical component of the increase in muscle mass of the myocardium.
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Affiliation(s)
- A P Beltrami
- Department of Medicine, New York Medical College, Valhalla 10595, USA
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