Medical Department I, Klinikum Grossh, Ludwig-Maximilians University, Marchioninistrasse 15, Munich 81377, Germany.
Eur Heart J. 2012 Jan;33(1):129-37. doi: 10.1093/eurheartj/ehr302. Epub 2011 Aug 17.
Although pharmacological interventions that mobilize stem cells and enhance their homing to damaged tissue can limit adverse post-myocardial infarction (MI) remodelling, cardiomyocyte renewal with this approach is limited. While experimental cell cycle induction can promote cardiomyocyte renewal following MI, this process must compete with the more rapid processes of scar formation and adverse remodelling. The current study tested the hypothesis that the combination of enhanced stem cell mobilization/homing and cardiomyocyte cell cycle induction would result in increased myocardial renewal in injured hearts.
Myocardial infarction was induced by coronary artery ligation in adult MHC-cycD2 transgenic mice (which exhibit constitutive cardiomyocyte cell cycle activity) and their non-transgenic littermates. Mice were then treated with saline or with granulocyte colony-stimulating factor (G-CSF) plus the dipeptidylpeptidase-IV (DPP-IV) inhibitor Diprotin A (DipA) for 7 days. Infarct thickness and cardiomyocyte number/infarct/section were significantly improved in MHC-cycD2 mice with G-CSF plus DipA treatment when compared with MHC-cycD2 transgene expression or G-CSF plus DipA treatment alone. Echocardiographic analyses revealed that stem cell mobilization/homing and cardiomyocyte cell cycle activation had an additive effect on functional recovery.
These data strongly suggest that G-CSF plus DPP-IV inhibition, combined with cardiomyocyte cell cycle activation, leads to enhanced myocardial regeneration following MI. The data are also consistent with the notion that altering adverse post-injury remodelling renders the myocardium more permissive for cardiomyocyte repopulation.
虽然动员干细胞并增强其向受损组织归巢的药理学干预可以限制心肌梗死后的不良重塑,但这种方法的心肌细胞再生能力有限。虽然实验性细胞周期诱导可以促进心肌梗死后的心肌细胞再生,但这一过程必须与更快的瘢痕形成和不良重塑过程竞争。本研究检验了这样一个假设,即增强干细胞动员/归巢和心肌细胞细胞周期诱导的结合将导致受伤心脏中更多的心肌更新。
通过冠状动脉结扎在成年 MHC-cycD2 转基因小鼠(表现出组成性心肌细胞细胞周期活性)及其非转基因同窝仔鼠中诱导心肌梗死。然后,用生理盐水或粒细胞集落刺激因子(G-CSF)加二肽基肽酶-4(DPP-IV)抑制剂 Diprotin A(DipA)治疗 7 天。与 MHC-cycD2 转基因表达或 G-CSF 加 DipA 单独治疗相比,G-CSF 加 DipA 治疗显著改善了 MHC-cycD2 小鼠的梗死厚度和心肌细胞数量/梗死/切片。超声心动图分析表明,干细胞动员/归巢和心肌细胞细胞周期激活对功能恢复具有相加作用。
这些数据强烈表明,G-CSF 加 DPP-IV 抑制,结合心肌细胞细胞周期激活,可导致心肌梗死后心肌再生增强。这些数据也与改变不良损伤后重塑使心肌对心肌细胞再填充更具宽容性的观点一致。