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骨髓间充质细胞移植减轻急性心肌梗死后心力衰竭的左心室重构

[Bone marrow mesenchymal cell transplantation reduces left ventricular remodeling in heart failure following acute myocardial infarction].

作者信息

Guo Yu-tao, Li Xiao-ying, Wu Di, Yao Ke-qun, Chen Ping, Ma Kang-tao, Zhou Chun-yan

机构信息

Department of Geriatric Cardiology, General Hospital of the Chinese PLA, Beijing 100853, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Sep;34(9):784-8.

Abstract

OBJECTIVE

Bone marrow mesenchymal cell (MSC) transplantation has been shown to improve heart failure but the mechanism and the subsequent effects are unclear. We tested the hypothesis that MSC transplantation reduces left ventricular remodeling through the MMP/TIMP system in heart failure following acute myocardial infarction.

METHODS

Female SD rats underwent coronary artery ligation to induce myocardial infarction. Four weeks later, the rats were divided into the test group (n = 7) and the control group (n = 7), respectively. The donor MSCs were harvested and expanded from male SD rats (5 x 10(6) in 50 microl PBS) and injected into the ischemic myocardium, while the control group received the same volume of PBS. Left ventricular morphology was then evaluated in both groups through staining with H&E and Masson's trichrome. Immunohistochemical staining was used to examine the expressions of MMP2 and TIMP1, as well as type I and type III collagens, in the scar zones. The protein levels of MMP2 and TIMP1 were determined by Western blotting.

RESULTS

MSC differentiated into fibroblast-like cells at 21 days after transplantation in the test group. In addition, many inflammatory cells infiltrated and aggregated in the scar area, but this effect was reduced at day 7 after transplantation. The following changes were noted in the test group compared to the control group: ejection fraction and shortening fraction were higher [(63.43 +/- 3.97)% vs. (36.20 +/- 3.99)%, (31.71 +/- 1.98)% vs. (18.00 +/- 2.07)%, P < 0.05]; dp/dt(min) was reduced [(-4756.24 +/- 270.00) mm Hg/s vs. -2789.53 +/- 624.13) mm Hg/s, P < 0.05]; the left ventricular thinning ratio was significantly higher [(76.34 +/- 2.66)% vs. (64.37 +/- 2.36)%, P < 0.05]; the infarct size was smaller [(36.19 +/- 0.83)% vs. (42.12 +/- 1.88)%, P < 0.05]; type I collagen expression in the scar area was much higher; type III collagen expression was much lower; MMP2 expression was reduced and TIMP1 expression was increased.

CONCLUSION

MSC transplantation led to dynamic changes in the collagen network through regulation of MMP2/TIMP1 system and consequently interrupted the progress of adverse LV remodeling in heart failure following acute myocardial infarction.

摘要

目的

骨髓间充质细胞(MSC)移植已被证明可改善心力衰竭,但机制及后续影响尚不清楚。我们验证了以下假说:在急性心肌梗死后的心力衰竭中,MSC移植通过基质金属蛋白酶/金属蛋白酶组织抑制因子(MMP/TIMP)系统减少左心室重构。

方法

雌性SD大鼠行冠状动脉结扎诱导心肌梗死。四周后,将大鼠分别分为试验组(n = 7)和对照组(n = 7)。从雄性SD大鼠获取并扩增供体MSC(5×10⁶个细胞溶于50微升磷酸盐缓冲液),注入缺血心肌,而对照组注射相同体积的磷酸盐缓冲液。然后通过苏木精-伊红(H&E)染色和马松三色染色评估两组的左心室形态。采用免疫组织化学染色检测瘢痕区域MMP2、TIMP1以及I型和III型胶原蛋白的表达。通过蛋白质印迹法测定MMP2和TIMP1的蛋白水平。

结果

试验组中,MSC在移植后21天分化为成纤维细胞样细胞。此外,瘢痕区域有许多炎性细胞浸润和聚集,但在移植后第7天这种作用减弱。与对照组相比,试验组出现以下变化:射血分数和缩短分数更高[(63.43±3.97)%对(36.20±3.99)%,(31.71±1.98)%对(18.00±2.07)%,P<0.05];最小dp/dt降低[(-4756.24±270.00)毫米汞柱/秒对-2789.53±624.13)毫米汞柱/秒,P<0.05];左心室变薄率显著更高[(76.34±2.66)%对(64.37±2.36)%,P<0.05];梗死面积更小[(36.19±0.83)%对(42.12±1.88)%,P<0.05];瘢痕区域I型胶原蛋白表达更高;III型胶原蛋白表达更低;MMP2表达降低,TIMP1表达增加。

结论

MSC移植通过调节MMP2/TIMP1系统导致胶原网络动态变化,从而中断急性心肌梗死后心力衰竭中不良左心室重构的进程。

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