Institute of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, PR China.
Int J Cardiol. 2013 Sep 10;167(6):2524-32. doi: 10.1016/j.ijcard.2012.06.052. Epub 2012 Sep 13.
Cell transplantation and gene therapy have been demonstrated to have beneficial effects after a myocardial infarction (MI). Here, we used a large animal model of MI to investigate the beneficial effects of mesenchymal stem cells (MSCs) transfected with hepatocyte growth factor (HGF) or vascular endothelial growth factor (VEGF) genes.
A porcine MI model was created by balloon occlusion of the distal left anterior descending artery for 90 min followed by reperfusion. At 1 week after MI, the pigs were infused via the coronary vein with saline (n=8), MSCs + AdNull(n=8), MSC+VEGF(n=10), or MSC+HGF(n=10). Cardiac function and myocardial perfusion were evaluated by using echocardiography and gated cardiac perfusion imaging before and 4 weeks after transplantation. Morphometric and histological analyses were performed.
All cell-implanted groups had better cardiac function than the saline control group. There were further functional improvements in the MSC+HGF group, accompanied by smaller infarct sizes, increased cell survival, and less collagen deposition. Blood vessel densities in the damaged area and cardiac perfusion were significantly greater in the MSC+AdNull group than in the saline control group, and further increased in the MSC+VEGF/HGF groups. Tissue fibrosis was significantly less extensive in the MSC and MSC+VEGF groups than in the saline control group and was most reduced in the MSC+HGF group.
MSCs (alone or transfected with VEGF/HGF) delivered into the infarcted porcine heart via the coronary vein improved cardiac function and perfusion, probably by increasing angiogenesis and reducing fibrosis. MSC+HGF was superior to MSC+VEGF, possibly owing to its enhanced antifibrotic effect.
细胞移植和基因治疗已被证明在心肌梗死(MI)后具有有益作用。在这里,我们使用 MI 的大型动物模型来研究转染肝细胞生长因子(HGF)或血管内皮生长因子(VEGF)基因的间充质干细胞(MSCs)的有益作用。
通过球囊闭塞远端左前降支 90 分钟,然后再灌注,创建猪 MI 模型。在 MI 后 1 周,通过冠状静脉将盐水(n=8)、MSCs+AdNull(n=8)、MSC+VEGF(n=10)或 MSC+HGF(n=10)输注到猪体内。在移植前和 4 周后,使用超声心动图和门控心脏灌注成像评估心功能和心肌灌注。进行形态计量学和组织学分析。
所有细胞植入组的心脏功能均优于盐水对照组。MSC+HGF 组的心脏功能进一步改善,伴有梗死面积减小、细胞存活率增加和胶原沉积减少。损伤区域的血管密度和心脏灌注在 MSC+AdNull 组比盐水对照组显著增加,并且在 MSC+VEGF/HGF 组进一步增加。与盐水对照组相比,MSC 和 MSC+VEGF 组的组织纤维化程度明显降低,而 MSC+HGF 组的组织纤维化程度降低最为明显。
通过冠状静脉将 MSCs(单独或转染 VEGF/HGF)递送到梗死的猪心脏中,改善了心脏功能和灌注,可能是通过增加血管生成和减少纤维化。MSC+HGF 优于 MSC+VEGF,可能是由于其增强的抗纤维化作用。