Hu Cheng-heng, Wu Gui-fu, Wang Xiao-qing, Yang Yan-hua, Du Zhi-min, He Xiao-hong, Xiang Peng
Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University and Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou 510080, China.
Chin Med J (Engl). 2006 Sep 20;119(18):1499-506.
Human umbilical cord blood contains an abundance of immature stem/progenitor cells, which may participate in the repair of hearts that have been damaged by myocardial infarction (MI). This study aimed to evaluate the effects of human umbilical cord blood mononuclear cells (hUCBC) transplantation on cardiac function and left ventricular remodeling in rat model of MI.
Forty-five male Wistar rats were randomized into three groups: MI or control group (n = 15), MI plus cell transplantation (n = 15), and sham group (n = 15). Acute myocardial infarction (AMI) was established by ligating the left anterior descending artery, thereafter, hUCBC were implanted into the marginal area of infarcted myocardium. In MI/control group, DMEM was injected instead of hUCBC following the same protocol. Left ventricular function assessment was carried out by echocardiography and invasive hemodynamic measurements one month post MI. All rats were sacrificed for histological and immunochemical examinations.
The transplanted hUCBC survived and engaged in the process of myocardial repair in the host heart. Echocardiography demonstrated that left ventricular function improved significantly in the rats that underwent cell transplantation. Hemodynamic studies found a significantly decreased left ventricular end-diastolic pressure (LVEDP) [(21.08 +/- 8.10) mmHg vs (30.82 +/- 9.59) mmHg, P < 0.05], increase in +dp/dt(max) [(4.29 +/- 1.27) mmHg/ms vs (3.24 +/- 0.75) mmHg/ms, P < 0.05), and increase in -dp/dt(max) [(3.71 +/- 0.79) mmHg/ms vs (3.00 +/- 0.49) mmHg/ms, P < 0.05] among MI group with hUCBC transplantation when compared with MI/control group. Masson's trichrome staining revealed that the collagen density in the left ventricle was significantly lower in rats of transplantation group than that in the MI control groups [(6.33 +/- 2.69)% vs (11.10 +/- 3.75)%, P < 0.01]. Based on immunostaining of alpha-actin, the numbers of microvessels were significantly (P < 0.01) increased at the boundary of infarction site. Similarly higher mRNA expression of vascular endothelial growth factor (VEGF) 164 and VEGF188 were found at 7- and 28-day post cell transplantation in MI group with hUCBC transplantation when compared with MI/control group.
Transplanted hUCBC can survive in host myocardium without immunorejection, significantly improve left ventricular remodeling after AMI and promote a higher level of angiogenesis in the infarct zones. All these factors beneficially affect cardiac repair in the setting of MI. Therefore human umbilical cord blood may be potential source for cell-based therapy for AMI.
人脐带血含有大量未成熟的干/祖细胞,这些细胞可能参与心肌梗死(MI)损伤心脏的修复。本研究旨在评估人脐带血单个核细胞(hUCBC)移植对MI大鼠模型心功能和左心室重构的影响。
45只雄性Wistar大鼠随机分为三组:MI组或对照组(n = 15)、MI加细胞移植组(n = 15)和假手术组(n = 15)。通过结扎左前降支建立急性心肌梗死(AMI),之后将hUCBC植入梗死心肌的边缘区域。在MI/对照组中,按照相同方案注射DMEM代替hUCBC。MI后1个月通过超声心动图和有创血流动力学测量进行左心室功能评估。所有大鼠处死后进行组织学和免疫化学检查。
移植的hUCBC存活并参与宿主心脏的心肌修复过程。超声心动图显示,接受细胞移植的大鼠左心室功能显著改善。血流动力学研究发现,与MI/对照组相比,hUCBC移植的MI组左心室舒张末期压力(LVEDP)显著降低[(21.08±8.10)mmHg对(30.82±9.59)mmHg,P < 0.05],+dp/dt(max)增加[(4.29±1.27)mmHg/ms对(3.24±0.75)mmHg/ms,P < 0.05],-dp/dt(max)增加[(3.71±0.79)mmHg/ms对(3.00±0.49)mmHg/ms,P < 0.05]。Masson三色染色显示,移植组大鼠左心室的胶原密度显著低于MI对照组[(6.33±2.69)%对(11.10±3.75)%,P < 0.01]。基于α-肌动蛋白的免疫染色,梗死部位边界处微血管数量显著增加(P < 0.01)。同样,与MI/对照组相比,hUCBC移植的MI组在细胞移植后7天和28天发现血管内皮生长因子(VEGF)164和VEGF188的mRNA表达更高。
移植的hUCBC可在宿主心肌中存活而无免疫排斥反应,显著改善AMI后的左心室重构,并促进梗死区域更高水平的血管生成。所有这些因素均有利于MI情况下的心脏修复。因此,人脐带血可能是AMI细胞治疗的潜在来源。