Jun Hong Soon, Rogers Pamela I, Kihlken John, Warfel Jessica, Bull Chris, Deuter-Reinhard Maja, Feng Dongni, Xie Jie, Kyle Aaron, Merfeld-Clauss Stephanie, Johnstone Brian H, Traktuev Dmitry O, Chen Peng-Sheng, Lindner Jonathan R, March Keith L
Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana.
Indiana Center for Vascular Biology and Medicine, Indianapolis, Indiana.
Catheter Cardiovasc Interv. 2015 Aug;86(2):E38-48. doi: 10.1002/ccd.25566. Epub 2015 Apr 24.
The potential for beneficial effects of adipose-derived stem cells (ASCs) on myocardial perfusion and left ventricular dysfunction in myocardial ischemia (MI) has not been tested following intravenous delivery.
Surviving pigs following induction of MI were randomly assigned to 1 of 3 different groups: the placebo group (n = 7), the single bolus group (SB) (n = 7, 15 × 10(7) ASCs), or the divided dose group (DD) (n = 7, 5 × 10(7) ASCs/day for three consecutive days). Myocardial perfusion defect area and coronary flow reserve (CFR) were compared during the 28-day follow-up. Also, serial changes in the absolute number of circulating CD4(+) T and CD8(+) T cells were measured.
The increases in ejection fraction were significantly greater in both the SB and the DD groups compared to the placebo group (5.4 ± 0.9%, 3.7 ± 0.7%, and -0.4 ± 0.6%, respectively), and the decrease in the perfusion defect area was significantly greater in the SB group than the placebo group (-36.3 ± 1.8 and -11.5 ± 2.8). CFR increased to a greater degree in the SB and the DD groups than in the placebo group (0.9 ± 0.2, 0.8 ± 0.1, and 0.2 ± 0.2, respectively). The circulating number of CD8(+) T cells was significantly greater in the SB and DD groups than the placebo group at day 7 (3,687 ± 317/µL, 3,454 ± 787/µL, and 1,928 ± 457/µL, respectively). The numbers of small vessels were significantly greater in the SB and the DD groups than the placebo group in the peri-infarct area.
Both intravenous SB and DD delivery of ASCs are effective modalities for the treatment of MI in swine. Intravenous delivery of ASCs, with its immunomodulatory and angiogenic effects, is an attractive noninvasive approach for myocardial rescue.
脂肪来源干细胞(ASC)经静脉注射给药后,对心肌缺血(MI)时心肌灌注及左心室功能障碍的有益作用尚未得到验证。
诱导MI后存活的猪被随机分为3个不同组中的1组:安慰剂组(n = 7)、单次推注组(SB)(n = 7,15×10⁷个ASC)或分次给药组(DD)(n = 7,连续3天每天给予5×10⁷个ASC)。在28天的随访期间比较心肌灌注缺损面积和冠状动脉血流储备(CFR)。此外,还测量了循环CD4⁺ T细胞和CD8⁺ T细胞绝对数量的系列变化。
与安慰剂组相比,SB组和DD组的射血分数增加均显著更大(分别为5.4±0.9%、3.7±0.7%和 -0.4±0.6%),且SB组灌注缺损面积的减少显著大于安慰剂组(-36.3±1.8和 -11.5±2.8)。SB组和DD组的CFR升高程度大于安慰剂组(分别为0.9±0.2、0.8±0.1和0.2±0.2)。在第7天,SB组和DD组循环CD8⁺ T细胞数量显著多于安慰剂组(分别为3,687±317/µL、3,454±787/µL和1,928±457/µL)。在梗死周边区域,SB组和DD组的小血管数量显著多于安慰剂组。
ASC经静脉单次推注和分次给药都是治疗猪MI的有效方式。ASC经静脉给药具有免疫调节和血管生成作用,是一种有吸引力的心肌挽救非侵入性方法。