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Bagno LL, Kanashiro-Takeuchi RM, Suncion VY, Golpanian S, Karantalis V, Wolf A, Wang B, Premer C, Balkan W, Rodriguez J, Valdes D, Rosado M, Block NL, Goldstein P, Morales A, Cai RZ, Sha W, Schally AV, Hare JM. Growth hormone-releasing hormone agonists reduce myocardial infarct scar in swine with subacute ischemic cardiomyopathy. J Am Heart Assoc 2015; 4:jah3883. [PMID: 25827134 PMCID: PMC4579962 DOI: 10.1161/jaha.114.001464] [Citation(s) in RCA: 21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Growth hormone-releasing hormone agonists (GHRH-As) stimulate cardiac repair following myocardial infarction (MI) in rats through the activation of the GHRH signaling pathway within the heart. We tested the hypothesis that the administration of GHRH-As prevents ventricular remodeling in a swine subacute MI model. METHODS AND RESULTS Twelve female Yorkshire swine (25 to 30 kg) underwent transient occlusion of the left anterior descending coronary artery (MI). Two weeks post MI, swine were randomized to receive injections of either 30 μg/kg GHRH-A (MR-409) (GHRH-A group; n=6) or vehicle (placebo group; n=6). Cardiac magnetic resonance imaging and pressure-volume loops were obtained at multiple time points. Infarct, border, and remote (noninfarcted) zones were assessed for GHRH receptor by immunohistochemistry. Four weeks of GHRH-A treatment resulted in reduced scar mass (GHRH-A: -21.9 ± 6.42%; P=0.02; placebo: 10.9 ± 5.88%; P=0.25; 2-way ANOVA; P=0.003), and scar size (percentage of left ventricular mass) (GHRH-A: -38.38 ± 4.63; P=0.0002; placebo: -14.56 ± 6.92; P=0.16; 2-way ANOVA; P=0.02). This was accompanied by improved diastolic strain. Unlike in rats, this reduced infarct size in swine was not accompanied by improved cardiac function as measured by serial hemodynamic pressure-volume analysis. GHRH receptors were abundant in cardiac tissue, with a greater density in the border zone of the GHRH-A group compared with the placebo group. CONCLUSIONS Daily subcutaneous administration of GHRH-A is feasible and safe in a large animal model of subacute ischemic cardiomyopathy. Furthermore, GHRH-A therapy significantly reduced infarct size and improved diastolic strain, suggesting a local activation of the GHRH pathway leading to the reparative process.
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Affiliation(s)
- Luiza L Bagno
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Rosemeire M Kanashiro-Takeuchi
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.) Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL (R.M.K.T., C.P., J.M.H.)
| | - Viky Y Suncion
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Samuel Golpanian
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Vasileios Karantalis
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Ariel Wolf
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Bo Wang
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Courtney Premer
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.) Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL (R.M.K.T., C.P., J.M.H.)
| | - Wayne Balkan
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Jose Rodriguez
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - David Valdes
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Marcos Rosado
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.)
| | - Norman L Block
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | | | - Azorides Morales
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.)
| | - Ren-Zhi Cai
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | - Wei Sha
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | - Andrew V Schally
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Bruce A. Carter Miami Veterans Affairs Healthcare System, Miami, FL (N.L.B., R.Z.C., W.S., A.V.S.)
| | - Joshua M Hare
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL (L.L.B., R.M.K.T., V.Y.S., S.G., V.K., A.W., B.W., C.P., W.B., J.R., D.V., M.R., J.M.H.) Department of Medicine, University of Miami Miller School of Medicine, Miami, FL (N.L.B., A.M., R.Z.C., W.S., A.V.S., J.M.H.) Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL (R.M.K.T., C.P., J.M.H.)
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Karantalis V, Suncion VY, McCall FC, Bagno LL, Wang B, Golpanian S, Mohsin S, Rodriguez JE, Valdes D, Rosado M, Balkan W, Mushtaq M, Susman MA, Hare JM. Abstract 128: Pim1 kinase Overexpression Enhances ckit+ Cardiac Stem Cells Cardioreparative Ability After Intramyocardial Delivery. Circ Res 2014. [DOI: 10.1161/res.115.suppl_1.128] [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
Background:
Pim-1 kinase plays an important role in cell division, survival and commitment towards myocardial lineage. We hypothesized that Pim-1 overexpression in ckit+ cardiac stem cell (CSCs) enhances cardioreparative effects.
Methods:
Immunosuppressed Yorkshire swine (n=31) received human ckit+ CSCs (n=9), Pim1 modified human ckit+ CSCs (n=9) or PBS (n=13) two weeks after myocardial infarction. Cardiac MRI and PV loops were obtained before and after cell administration.
Results:
At 8 weeks post transplantation, scar mass (Fig. 1A), viable tissue (Fig. 1B), ejection fraction (Fig. 1C) and stroke work (Fig. 1D) was significantly improved in Pim-1 modified ckit+ CSC compared to control ckit+, while both cell groups showed partial recovery compared to placebo (two way ANOVA, p<0.05). Both cell types similarly reduced preload (end diastolic pressure; Fig. 1E) and afterload (Arterial elastance; Fig 1F) compared to placebo, while only administration of Pim-1 CPCs improved regional contractility at both the infarct (Fig. 1G) and border zones (Fig. 1H). Collectively, mechanoenergetic recoupling was superior in the Pim-1 group compared to ckit+ controls (Cardiac Efficiency; Fig. 1I).
Conclusions:
Cardioreparative potential of CSCs delivered by intramyocardial injection to infarcted porcine hearts is significantly enhanced by overexpress Pim1, supporting translational development of Pim-1 as a validated genetic modification of CSCs for incorporation into clinical trials.
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Affiliation(s)
| | | | | | | | - Bo Wang
- Univ of Miami Miller Sch of Medicine, Miami, FL
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Bagno LL, Kanashiro Takeuchi R, Wang B, Suncion V, Karantalis V, Premer C, Golpanian S, Balkan W, Rodriguez JE, Valdes D, Rosado M, Wolf A, Block NL, Goldstein P, Morales A, Schally AV, Hare JM. Abstract 214: Reduction of Scar Tissue after GHRH-A Treatment in a Swine Model of Sub-acute Ischemic Cardiomyopathy. Circ Res 2014. [DOI: 10.1161/res.115.suppl_1.214] [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
Background:
Growth hormone-releasing hormone receptor agonists (GHRH-A) stimulate cardiac repair following myocardial infarction (MI) through the activation of the GHRH signaling pathway within the heart. We tested the hypothesis that the administration of GHRH-A prevents ventricular remodeling in a swine sub-acute MI model.
Methods:
Twelve female Yorkshire swine (25-30 Kg) underwent transient occlusion of the LAD coronary artery (MI). Two-weeks post-MI, swine were randomized to receive injections of either 30 μg/Kg GHRH-A (MR-409) (GHRH-A group; n=6) or vehicle (placebo group; n=6). Cardiac MRI, pressure volume loops and measures of endothelial function were obtained at multiple time points. Infarct-, border- and remote- (non-infarcted) zones were assessed by immunohistochemistry for the growth hormone-releasing hormone receptor (GHRHR).
Results:
Four-weeks of GHRH-A treatment resulted in reduced scar mass (GHRH-A group: –21.9±6.42%; p=0.02; placebo group: 10.9±5.88%; p=0.25; Two-way ANOVA; p=0.003), and reduced scar size (percent of left ventricle mass) (GHRH-A group: –38.38±4.63; p=0.0002; placebo group: –14.56± 6.92; p=0.16; Two-way ANOVA; p=0.02). Moreover, peripheral endothelial function was significantly increased compared to baseline values in the GHRH-A group (paired t-test; p=0.006) but not in the placebo group (p=0.99). Unlike in rats, this reduced infarct size in swine was not accompanied by improved cardiac function as measured by serial hemodynamic pressure-volume analysis. GHRH receptors were abundant in cardiac tissue, with a greater density in the border zone of the GHRH-A group compared to the placebo group. These data support the concept of direct post-infarction activation of cardiac signal transduction, and of enhancing this activation with systemic treatment by GHRH.
Conclusions:
Daily subcutaneous administration of GHRH-A is feasible and safe in female swine. Furthermore, GHRH-A therapy significantly reduced infarct size and increased endothelial function, suggesting that a local activation of the GHRH pathway leads to the regenerative process and preservation of peripheral endothelial function.
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