Kutschka Ingo, Chen Ian Y, Kofidis Theo, Arai Takayasu, von Degenfeld Georges, Sheikh Ahmad Y, Hendry Stephen L, Pearl Jeremy, Hoyt Grant, Sista Ramachadra, Yang Phillip C, Blau Helen M, Gambhir Sanjiv S, Robbins Robert C
Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California, USA.
Circulation. 2006 Jul 4;114(1 Suppl):I167-73. doi: 10.1161/CIRCULATIONAHA.105.001297.
Cardiac cell transplantation is limited by poor graft viability. We aimed to enhance the survival of transplanted cardiomyoblasts using growth factor-supplemented collagen matrices.
H9c2 cardiomyoblasts were lentivirally transduced to express firefly luciferase and green fluorescent protein (GFP). Lewis rats underwent ligation of the left anterior descending artery (LAD) ligation to induce an anterior wall myocardial infarction. Hearts (n=9/group) were harvested and restored ex vivo with 1 x 10(6) genetically labeled H9c2 cells either in (1) saline-suspension, or seeded onto (2) collagen-matrix (Gelfoam [GF];), (3) GF/Matrigel (GF/MG), (4) GF/MG/VEGF (10 microg/mL), or (5) GF/MG/FGF (10 microg/mL). Hearts were then abdominally transplanted into syngeneic recipients (working heart model). Controls (n=6/group) underwent infarction followed by GF implantation or saline injection. Cell survival was evaluated using optical bioluminescence on days 1, 5, 8, 14, and 28 postoperatively. At 4 weeks, fractional shortening and ejection fraction were determined using echocardiography and magnetic resonance imaging, respectively. Graft characteristics were assessed by immunohistology. Bioluminescence signals on days 5, 8, and 14 were higher for GF-based grafts compared with plain H9c2 injections (P<0.03). Signals were higher for GF/MG grafts compared with GF alone (P<0.02). GFP-positive, spindle-shaped H9c2 cells were found integrated in the infarct border zones at day 28. Left ventricular (LV) function of hearts implanted with collagen-based grafts was better compared with controls (P<0.05). Vascular endothelial growth factor or fibroblast growth factor did not further improve graft survival or heart function.
Collagen matrices enhance early survival of H9c2 cardiomyoblasts after transplantation into ischemic hearts and lead to improved LV function. Further optimization of the graft design should make restoration of large myocardial infarctions by tissue engineering approaches effective.
心脏细胞移植受限于移植物的低存活率。我们旨在使用补充生长因子的胶原基质来提高移植心肌母细胞的存活率。
利用慢病毒转导H9c2心肌母细胞以表达萤火虫荧光素酶和绿色荧光蛋白(GFP)。对Lewis大鼠进行左前降支动脉(LAD)结扎以诱导前壁心肌梗死。收获心脏(每组n = 9),并在体外将1×10⁶个基因标记的H9c2细胞用以下方式进行恢复:(1)生理盐水悬浮液,或接种到(2)胶原基质(明胶海绵[GF]),(3)GF/基质胶(GF/MG),(4)GF/MG/血管内皮生长因子(VEGF,10 μg/mL),或(5)GF/MG/成纤维细胞生长因子(FGF,10 μg/mL)上。然后将心脏腹腔内移植到同基因受体中(工作心脏模型)。对照组(每组n = 6)进行梗死,随后植入GF或注射生理盐水。在术后第1、5、8、14和28天使用光学生物发光评估细胞存活情况。在4周时,分别使用超声心动图和磁共振成像测定缩短分数和射血分数。通过免疫组织学评估移植物特征。与单纯注射H9c2相比,基于GF的移植物在第5、8和14天的生物发光信号更高(P < 0.03)。与单独的GF相比,GF/MG移植物的信号更高(P < 0.02)。在第28天发现GFP阳性、梭形的H9c2细胞整合在梗死边缘区。与对照组相比,植入基于胶原移植物的心脏左心室(LV)功能更好(P < 0.05)。血管内皮生长因子或成纤维细胞生长因子未进一步改善移植物存活或心脏功能。
胶原基质可提高H9c2心肌母细胞移植到缺血心脏后的早期存活率,并改善左心室功能。移植物设计的进一步优化应使通过组织工程方法修复大面积心肌梗死有效。