将自体间充质干细胞和内皮祖细胞经冠状动脉移植到梗死的人心肌中。

Transcoronary transplantation of autologous mesenchymal stem cells and endothelial progenitors into infarcted human myocardium.

作者信息

Katritsis Demosthenes G, Sotiropoulou Panagiota A, Karvouni Evangelia, Karabinos Ilias, Korovesis Socrates, Perez Sonia A, Voridis Eutychios M, Papamichail Michael

机构信息

Department of Cardiology, Athens Euroclinic, Athens, Greece.

出版信息

Catheter Cardiovasc Interv. 2005 Jul;65(3):321-9. doi: 10.1002/ccd.20406.

Abstract

The aim of the study was to investigate whether a combination of mesenchymal stem cells (MSCs) capable of differentiating into cardiac myocytes and endothelial progenitors (EPCs) that mainly promote neoangiogenesis might be able to facilitate tissue repair in myocardial scars. Previous studies have shown that intracoronary transplantation of autologous bone marrow stem cells results in improvement of contractility in infracted areas of human myocardium. Eleven patients with an anteroseptal myocardial infarction (MI) underwent transcoronary transplantation of bone marrow-derived MSCs and EPCs to the infarcted area through the left anterior descending artery. Eleven age- and sex-matched patients served as controls. Wall motion score index was significantly lower at follow-up in the transplantation (P = 0.04) but not in the control group. On stress echocardiography, there was improvement of myocardial contractility in one or more previously nonviable myocardial segments in 5 out of 11 patients (all with recent infarctions) and in none of the controls (P = 0.01). Restoration of uptake of Tc(99m) sestamibi in one or more previously nonviable myocardial scars was seen in 6 out of 11 patients subjected to transplantation and in none of the controls (P = 0.02). Cell transplantation was an independent predictor of improvement of nonviable tissue. Intracoronary transplantation of MSCs and EPCs is feasible, safe, and may contribute to regional regeneration of myocardial tissue early or late following MI.

摘要

本研究的目的是调查能够分化为心肌细胞的间充质干细胞(MSCs)与主要促进新生血管形成的内皮祖细胞(EPCs)的组合是否能够促进心肌瘢痕的组织修复。先前的研究表明,自体骨髓干细胞冠状动脉内移植可改善人心肌梗死区域的收缩功能。11例前间隔心肌梗死(MI)患者通过左前降支将骨髓来源的MSCs和EPCs经冠状动脉移植至梗死区域。11例年龄和性别匹配的患者作为对照。随访时移植组的壁运动评分指数显著降低(P = 0.04),而对照组未降低。在负荷超声心动图检查中,11例患者中有5例(均为近期梗死患者)一个或多个先前无活力的心肌节段的心肌收缩功能得到改善,而对照组无一例改善(P = 0.01)。11例接受移植的患者中有6例在一个或多个先前无活力的心肌瘢痕中恢复了锝(99m)甲氧基异丁基异腈摄取,而对照组无一例恢复(P = 0.02)。细胞移植是无活力组织改善的独立预测因素。MSCs和EPCs冠状动脉内移植是可行、安全的,并且可能在MI后早期或晚期有助于心肌组织的区域再生。

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