Wehman Brody, Pietris Nicholas, Bigham Grace, Siddiqui Osama, Mishra Rachana, Li Tieluo, Aiello Emily, Jack Godly, Wang Wendy, Murthi Sarah, Sharma Sudhish, Kaushal Sunjay
Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
Division of Pediatric Cardiology, University of Maryland School of Medicine, Baltimore, Maryland.
Ann Thorac Surg. 2017 Dec;104(6):2045-2053. doi: 10.1016/j.athoracsur.2017.04.058. Epub 2017 Jul 29.
BACKGROUND: C-kit cardiac progenitor cells (CPCs) have been shown to be safe and effective in large-animal models and in an early-phase clinical trial for adult patients with ischemic heart disease. However, CPCs have not yet been evaluated in a preclinical model of right ventricular (RV) dysfunction, which is a salient feature of many forms of congenital heart disease. METHODS: Human c-kit CPCs were generated from right atrial appendage biopsy specimens obtained during routine congenital cardiac operations. Immunosuppressed Yorkshire swine (6 to 9 kg) underwent pulmonary artery banding to induce RV dysfunction. Thirty minutes after banding, pigs received intramyocardial injection into the RV free wall with c-kit CPCs (1 million cells, n = 5) or control (phosphate-buffered saline, n = 5). Pigs were euthanized at 30 days postbanding. RESULTS: Banding was calibrated to a consistent rise in the RV-to-systemic pressure ratio across both groups (postbanding: CPCs = 0.76 ± 0.06, control = 0.75 ± 0.03). At 30 days postbanding, the CPCs group demonstrated less RV dilatation and a significantly greater RV fractional area of change than the control group (p = 0.002). In addition, measures of RV myocardial strain, including global longitudinal strain and strain rate, were significantly greater in the CPCs group at 4 weeks relative to control (p = 0.004 and p = 0.01, respectively). The RV free wall in the CPCs group demonstrated increased arteriole formation (p < 0.0001) and less myocardial fibrosis compared with the control group (p = 0.02). CONCLUSIONS: Intramyocardial injection of c-kit CPCs results in enhanced RV performance relative to control at 30 days postbanding in neonatal pigs. This model is important for further evaluation of c-kit CPCs, including long-term efficacy.
背景:C-kit心脏祖细胞(CPCs)已在大型动物模型以及针对成年缺血性心脏病患者的早期临床试验中被证明是安全有效的。然而,CPCs尚未在右心室(RV)功能障碍的临床前模型中进行评估,而右心室功能障碍是多种先天性心脏病的一个显著特征。 方法:从常规先天性心脏手术期间获取的右心耳活检标本中生成人C-kit CPCs。对免疫抑制的约克夏猪(6至9千克)进行肺动脉环扎以诱导右心室功能障碍。环扎后30分钟,猪接受将C-kit CPCs(100万个细胞,n = 5)或对照(磷酸盐缓冲盐水,n = 5)心肌内注射到右心室游离壁。在环扎后30天对猪实施安乐死。 结果:两组的环扎均校准至右心室与体循环压力比持续升高(环扎后:CPCs组 = 0.76 ± 0.06,对照组 = 0.75 ± 0.03)。在环扎后30天,CPCs组的右心室扩张程度较小,右心室变化分数面积显著大于对照组(p = 0.002)。此外,相对于对照组,CPCs组在4周时的右心室心肌应变测量值,包括整体纵向应变和应变率,均显著更高(分别为p = 0.004和p = 0.01)。与对照组相比,CPCs组的右心室游离壁显示小动脉形成增加(p < 0.0001)且心肌纤维化较少(p = 0.02)。 结论:在新生猪环扎后30天,心肌内注射C-kit CPCs相对于对照可增强右心室功能。该模型对于进一步评估C-kit CPCs(包括长期疗效)具有重要意义。
Am J Physiol Heart Circ Physiol. 2016-6-1
J Thorac Cardiovasc Surg. 2021-9
J Am Heart Assoc. 2019-8-27
J Thorac Cardiovasc Surg. 2011-9-9
Postepy Kardiol Interwencyjnej. 2022-12
Mol Cell Biochem. 2022-2
Int J Environ Res Public Health. 2021-8-5
Stem Cell Res Ther. 2020-11-25
Cardiovasc Diagn Ther. 2020-10
Front Bioeng Biotechnol. 2020-5-13