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三维 PLLA 基质引导的心肌梗死后心脏内注射 VEGF 和心脏干细胞促进心脏再生和血管生成。

Epicardial delivery of VEGF and cardiac stem cells guided by 3-dimensional PLLA mat enhancing cardiac regeneration and angiogenesis in acute myocardial infarction.

机构信息

Department of Pharmacy, College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, 11-1 Daehyun-dong, Seodaemun-gu, Seoul 120-750, Republic of Korea.

Paik Institute for Clinical Research, Inje University College of Medicine, Busan 614-735, Republic of Korea.

出版信息

J Control Release. 2015 May 10;205:218-30. doi: 10.1016/j.jconrel.2015.02.013. Epub 2015 Feb 11.

Abstract

Congestive heart failure is mostly resulted in a consequence of the limited myocardial regeneration capacity after acute myocardial infarction. Targeted delivery of proangiogenic factors and/or stem cells to the ischemic myocardium is a promising strategy for enhancing their local and sustained therapeutic effects. Herein, we designed an epicardial delivery system of vascular endothelial growth factor (VEGF) and cardiac stem cells (CSCs) using poly(l-lactic acid) (PLLA) mat applied to the acutely infarcted myocardium. The fibrous VEGF-loaded PLLA mat was fabricated by an electrospinning method using PLLA solution emulsified VEGF. This mat not only allowed for sustained release of VEGF for 4weeks but boosted migration and proliferation of both endothelial cells and CSCs in vitro. Furthermore, sustained release of VEGF showed a positive effect on in vitro capillary-like network formation of endothelial cells compared with bolus treatment of VEGF. PLLA mat provided a permissive 3-dimensional (3D) substratum that led to spontaneous cardiomyogenic differentiation of CSCs in vitro. Notably, sustained stimulation by VEGF-loaded PLLA mat resulted in a substantial increase in the expression of proangiogenic mRNAs of CSCs in vitro. The epicardially implanted VEGF-loaded PLLA mat showed modest effects on angiogenesis and cardiomyogenesis in the acutely infarcted hearts. However, co-implantation of VEGF and CSCs using the PLLA mat showed meaningful therapeutic effects on angiogenesis and cardiomyogenesis compared with controls, leading to reduced cardiac remodeling and enhanced global cardiac function. Collectively, the PLLA mat allowed a smart cargo that enabled the sustained release of VEGF and the delivery of CSCs, thereby synergistically inducing angiogenesis and cardiomyogenesis in acute myocardial infarction.

摘要

充血性心力衰竭主要是由于急性心肌梗死后心肌再生能力有限所致。将促血管生成因子和/或干细胞靶向递送至缺血心肌是增强其局部和持续治疗效果的一种有前途的策略。在此,我们使用聚(L-丙交酯)(PLLA)基质设计了一种血管内皮生长因子(VEGF)和心脏干细胞(CSC)的心外膜递药系统,应用于急性梗死的心肌。纤维状负载 VEGF 的 PLLA 基质是通过将 PLLA 溶液乳化 VEGF 的电纺方法制成的。该基质不仅允许 VEGF 持续释放 4 周,而且还能促进体外内皮细胞和 CSC 的迁移和增殖。此外,与 VEGF 一次性给药相比,VEGF 的持续释放对体外内皮细胞毛细血管样网络形成有积极影响。PLLA 基质提供了一个允许的 3D 基质,导致 CSC 在体外自发进行心肌生成分化。值得注意的是,负载 VEGF 的 PLLA 基质的持续刺激导致 CSC 的促血管生成 mRNA 的表达显著增加。心外膜植入的负载 VEGF 的 PLLA 基质对急性梗死心脏的血管生成和心肌生成仅有适度影响。然而,与对照组相比,使用 PLLA 基质共植入 VEGF 和 CSC 对血管生成和心肌生成具有有意义的治疗作用,导致心脏重构减少和整体心功能增强。总之,PLLA 基质允许智能载体持续释放 VEGF 和递送 CSC,从而协同诱导急性心肌梗死后的血管生成和心肌生成。

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