Kim E J, Li R K, Weisel R D, Mickle D A, Jia Z Q, Tomita S, Sakai T, Yau T M
Toronto General Hospital, Toronto General Research Institute, University Health Network, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
J Thorac Cardiovasc Surg. 2001 Nov;122(5):963-71. doi: 10.1067/mtc.2001.117623.
Myocardial angiogenesis may improve regional perfusion and perhaps function after cardiac injury. We evaluated the effect of endothelial cell transplantation into a myocardial scar on angiogenesis and ventricular function, as an alternative to angiogenic gene or protein therapy.
A transmural myocardial scar was created in the left ventricular free wall of rat hearts by cryoinjury. Allogeneic aortic endothelial cells were injected into the scar 2 weeks after cryoinjury. A cluster of transplanted cells was identified at the site of injection 1 day and 1 week after transplantation, but not after 2 weeks. The size of this cluster of transplanted cells decreased as vascular density in the transplanted scar tissue increased with time. Six weeks after transplantation, vascular density was significantly greater in transplanted hearts than in control hearts. Regional blood flow, by microsphere analysis, was greater in the transplanted rats. Systolic and diastolic ventricular function was similar between groups. In a second series of experiments, syngeneic aortic endothelial cells labeled with bromodeoxyuridine were transplanted 2 weeks after cryoinjury. Vascular density in the transplanted scar was greater than in controls. Labeled transplanted endothelial cells were identified forming part of the newly developed blood vessels. No difference in vascular density was found between allogeneic and syngeneic cell transplantation. Vascular endothelial growth factor was not expressed at greater levels in the transplanted cells or the myocardial scar.
Transplanted endothelial cells stimulated angiogenesis, were incorporated into the new vessels, and increased regional perfusion in myocardial scar tissue, but did not improve global function in this cryoinjury rat model.
心肌血管生成可能改善心脏损伤后的局部灌注,或许还能改善心脏功能。我们评估了将内皮细胞移植到心肌瘢痕中对血管生成和心室功能的影响,以此作为血管生成基因或蛋白治疗的替代方法。
通过冷冻损伤在大鼠心脏左心室游离壁形成透壁性心肌瘢痕。冷冻损伤2周后将同种异体主动脉内皮细胞注射到瘢痕中。移植后1天和1周在注射部位可识别出一簇移植细胞,但2周后未发现。随着移植瘢痕组织中血管密度随时间增加,这簇移植细胞的大小减小。移植后6周,移植心脏的血管密度显著高于对照心脏。通过微球分析,移植大鼠的局部血流量更大。两组间心室收缩和舒张功能相似。在第二系列实验中,冷冻损伤2周后移植用溴脱氧尿苷标记的同基因主动脉内皮细胞。移植瘢痕中的血管密度高于对照组。可识别出标记的移植内皮细胞构成新形成血管的一部分。同种异体和同基因细胞移植之间的血管密度没有差异。移植细胞或心肌瘢痕中血管内皮生长因子的表达水平没有更高。
移植的内皮细胞刺激了血管生成,被纳入新血管中,并增加了心肌瘢痕组织的局部灌注,但在这个冷冻损伤大鼠模型中并未改善整体功能。