Children's National Heart Institute, Children's National Hospital, Washington, DC; Center for Neuroscience Research, Children's National Hospital, Washington, DC.
George Washington University School of Medicine and Health Science, Washington, DC.
Ann Thorac Surg. 2020 Apr;109(4):1274-1281. doi: 10.1016/j.athoracsur.2019.08.036. Epub 2019 Sep 26.
Neurodevelopmental impairment is an important challenge for survivors after neonatal surgery with cardiopulmonary bypass (CPB). The subventricular zone, where most neural stem/progenitors originate, plays a critical role in cortical maturation of the frontal lobe. Promoting neurogenesis in the subventricular zone is therefore a potential therapeutic target for preserving cortical growth. Mesenchymal stromal cells (MSCs) promote endogenous regeneration in the rodent brain. We investigated the impact of MSC delivery through CPB on neural stem/progenitor cells and neuroblasts (ie, young neurons) in the piglet subventricular zone.
Two-week-old piglets (n = 12) were randomly assigned to one of three groups: (1) control, (2) deep hypothermic circulatory arrest, and (3) circulatory arrest, followed by MSC administration. MSCs (10 × 10 per kg) were delivered through CPB during the rewarming period. Neural stem/progenitors, proliferating cells, and neuroblasts were identified with immunohistochemistry at 3 hours after CPB.
CPB-induced insults caused an increased proliferation of neural stem/progenitors (P < .05). MSC delivery reduced the acute proliferation. MSC treatment increased the number of neuroblasts in the outer region of the subventricular zone (P < .05) where they form migrating chains toward the frontal lobe. Conversely, the thickness of the neuroblast-dense band along the lateral ventricle was reduced after treatment (P < .05). These findings suggest that MSC treatment changes neuroblast distribution within the subventricular zone.
MSC delivery through CPB has the potential to mitigate effects of CPB on neural stem/progenitor cells and to promote migration of neuroblasts. Further investigation is necessary to determine the long-term effect of MSC treatment during CPB on postnatal neurogenesis.
心肺转流术(CPB)后新生儿手术的神经发育障碍是一个重要挑战。室下区是大多数神经干细胞/祖细胞的起源地,在额叶皮质成熟中起着关键作用。因此,促进室下区的神经发生是保留皮质生长的潜在治疗靶点。间充质基质细胞(MSCs)促进啮齿动物大脑内源性再生。我们研究了通过 CPB 输送 MSC 对猪仔室下区神经干细胞/祖细胞和神经母细胞(即年轻神经元)的影响。
将 2 周龄的小猪(n=12)随机分为三组:(1)对照组;(2)深低温停循环;(3)停循环后 MSC 给药。MSC(10×10 个/kg)在复温期通过 CPB 输送。CPB 后 3 小时,通过免疫组织化学鉴定神经干细胞/祖细胞、增殖细胞和神经母细胞。
CPB 引起的损伤导致神经干细胞/祖细胞增殖增加(P<0.05)。MSC 输送减少了急性增殖。MSC 治疗增加了室下区外层神经母细胞的数量(P<0.05),它们形成向额叶迁移的链。相反,治疗后沿侧脑室的神经母细胞密集带变薄(P<0.05)。这些发现表明,MSC 治疗改变了室下区神经母细胞的分布。
CPB 期间通过 CPB 输送 MSC 有可能减轻 CPB 对神经干细胞/祖细胞的影响,并促进神经母细胞的迁移。需要进一步研究确定 CPB 期间 MSC 治疗对产后神经发生的长期影响。