Division of Cardiology, Department of Medicine III, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Eur Heart J. 2012 Aug;33(15):1911-9. doi: 10.1093/eurheartj/ehr388. Epub 2011 Dec 15.
We aimed to characterize the influence of acute myocardial infarction (AMI) on the metabolic activity of the bone marrow (BM) and on the composition and functional activity of BM-derived mononuclear cells (BMC). Acute ischaemia or other stressors induce the mobilization of progenitor cells from the BM stem cell niche. The effect of AMI on the numbers and functional activity of cells within the BM is unknown.
In patients of the REPAIR-AMI trial as well as in mice, the number and functionality of BMC was compared with respect to the time interval from AMI. Activation of Wnt signalling was assessed after AMI induction in TOP-GAL transgenic reporter mice, carrying a β-galactosidase gene driven by an LEF/TCF/β-catenin responsive promoter. The metabolic activity of the BM, as determined by F-18-fluorodeoxyglucose-positron emission tomography, was significantly higher in patients with AMI compared with patients with chronic post-ischaemic heart failure. Moreover, the number of haematopoietic CD34(+) (P < 0.05) and CD133(+) (P < 0.05) cells in the BM aspirates was significantly increased in patients within 7 days after AMI. In order to confirm these clinical data, we induced AMI in mice, which time-dependently increased the number of c-kit + Sca-1 + lin- cells and colony-forming units in the BM. Activation of the BM by AMI induced a significant increase in Wnt signalling, which is known to induce proliferation of haematopoietic stem cells, and demonstrated increased levels of the Wnt target Axin-2 in BM-derived cells on Day 7 (P < 0.01 vs. control).
Acute myocardial infarction is associated with an increased metabolic activity and increased levels of progenitor cells within days after AMI. These findings document an activation of the stem cell niche within the BM following AMI, which may have important implications for the optimal timing of cell aspirations used for therapeutic application in patients with AMI.
本研究旨在探讨急性心肌梗死(AMI)对骨髓(BM)代谢活性以及骨髓源性单核细胞(BMC)组成和功能活性的影响。急性缺血或其他应激源会诱导祖细胞从 BM 干细胞龛中动员。AMI 对 BM 内细胞数量和功能活性的影响尚不清楚。
在 REPAIR-AMI 试验的患者以及小鼠中,根据 AMI 发生后的时间间隔,比较了 BMC 的数量和功能。在携带由 LEF/TCF/β-连环蛋白反应性启动子驱动的β-半乳糖苷酶基因的 TOP-GAL 转基因报告小鼠中,评估了 AMI 诱导后的 Wnt 信号激活。与患有慢性缺血性心力衰竭的患者相比,患有 AMI 的患者的 BM 代谢活性通过 F-18-氟脱氧葡萄糖正电子发射断层扫描(F-18-fluorodeoxyglucose-positron emission tomography)明显更高。此外,在 AMI 发生后 7 天内的患者中,BM 抽吸物中的造血 CD34+(P < 0.05)和 CD133+(P < 0.05)细胞数量显著增加。为了证实这些临床数据,我们在小鼠中诱导 AMI,结果显示时间依赖性地增加了 BM 中的 c-kit+Sca-1+lin-细胞和集落形成单位的数量。AMI 对 BM 的激活诱导了 Wnt 信号的显著增加,已知 Wnt 信号会诱导造血干细胞增殖,并在第 7 天(P < 0.01 与对照组相比)在 BM 来源的细胞中显示出 Wnt 靶标 Axin-2 的水平增加。
AMI 后数天内,与代谢活性增加和祖细胞水平升高相关。这些发现证明了 AMI 后 BM 中的干细胞龛被激活,这可能对 AMI 患者进行治疗性细胞抽吸的最佳时机具有重要意义。