Administration of granulocyte colony-stimulating factor after myocardial infarction enhances the recruitment of hematopoietic stem cell-derived myofibroblasts and contributes to cardiac repair

The administration of granulocyte colony-stimulating factor (G-CSF) after myocardial infarction (MI) improves cardiac function and survival rates in mice. It was also reported recently that bone marrow (BM)-derived c-kit(+) cells or macrophages in the infarcted heart are associated with improvement of cardiac remodeling and function. These observations prompted us to examine whether BM-derived hematopoietic cells mobilized by G-CSF administration after MI play a beneficial role in the infarct region. A single hematopoietic stem cell from green fluorescent protein (GFP)-transgenic mice was used to reconstitute hematopoiesis in each experimental mouse. MI was then induced, and the mice received G-CSF for 10 days. In the acute phase, a number of GFP(+) cells showing the elongated morphology were found in the infarcted area. Most of these cells were positive for vimentin and alpha-smooth muscle actin but negative for CD45, indicating that they were myofibroblasts. The number of these cells was markedly enhanced by G-CSF administration, and the enhanced myofibroblast-rich repair was considered to lead to improvements of cardiac remodeling, function, and survival rate. Next, G-CSF-mobilized monocytes were harvested from the peripheral blood of GFP-transgenic mice and injected intravenously into the infarcted mice. Following this procedure, GFP(+) myofibroblasts were observed in the infarcted myocardium. These results indicate that cardiac myofibroblasts are hematopoietic in origin and could arise from monocytes/macrophages. MI leads to the recruitment of monocytes, which differentiate into myofibroblasts in the infarct region. Administration of G-CSF promotes this recruitment and enhances cardiac protection.     

Bone marrow-derived progenitor cells contribute to lung remodelling after myocardial infarction

BACKGROUND: Congestive heart failure (CHF) causes structural modifications of the lungs that contribute to the functional limitations of affected subjects. We hypothesized that bone marrow-derived progenitor cells could contribute to lung structural remodelling after myocardial infarction (MI). METHODS: Wistar rats were irradiated and received a bone marrow transplant (BMT) from green fluorescent protein (GFP) transgenic rats, followed 5 weeks later by coronary artery ligation or sham operation. Five weeks after MI, lung immunofluorescence studies were performed and GFP expression evaluated by Western immunoblotting. RESULTS: After MI, rats developed lung structural remodelling characterized by myofibroblast (MF) proliferation in the alveolar septa. After BMT, some GFP+ cells were found in the lungs of sham animals. The amount of GFP+ cells in the lungs of MI rats was greatly increased with evidence of differentiation into MFs, as evaluated by co-localization correlation analysis with smooth muscle alpha-actin (P<.01). These cells were particularly abundant in the perivenular regions where they incorporated into the wall of blood vessels. There was a threefold increase in lung GFP protein expression after MI (P=.01). CONCLUSIONS: After MI, bone marrow-derived progenitor differentiates into lung MFs. This novel pathophysiologic process may contribute to the pulmonary manifestations of CHF and could have significant therapeutic implications.     

Nephronectin promotes cardiac repair post myocardial infarction via activating EGFR/JAK2/STAT3 pathway

Background: ECM proteins are instrumental for angiogenesis, which plays momentous roles during development and repair in various organs, including post cardiac insult. After a screening based on an open access RNA-seq database, we identified Nephronectin (NPNT), an extracellular protein, might be involved in cardiac repair post myocardial infarction (MI). However, the specific impact of nephronectin during cardiac repair in MI remains elusive.Methods and Results: In the present study, we established a system overexpressing NPNT locally in mouse heart by utilizing a recombinant adeno-associated virus. One-to-four weeks post MI induction, we observed improved cardiac function, limited infarct size, alleviated cardiac fibrosis, with promoted angiogenesis in infarct border zone in NPNT overexpressed mice. And NPNT treatment enhanced human umbilical vascular endothelial cell (HUVEC) migration and tube formation, putatively through advocating phosphorylation of EGFR/JAK2/STAT3. The migration and capillary-like tube formation events could be readily revoked by EGFR or STAT3 inhibition. Notably, phosphorylation of EGFR, JAK2 and STAT3 were markedly upregulated in AAV2/9-cTnT-NPNT-treated mice with MI.Conclusions: Our study thus identifies the beneficial effects of NPNT on angiogenesis and cardiac repair post MI by enhancing the EGFR/JAK2/STAT3 signaling pathway, implying the potential therapeutic application of NPNT on myocardial dysfunction post MI.     

Early, selective growth hormone administration may ameliorate left ventricular remodeling after myocardial infarction

Left ventricular (LV) remodeling after myocardial infarction (MI) may lead to congestive heart failure, disability and death. It consists of expansion of the infarct zone and dilatation of the non-infarcted myocardium, causing shape distortion and ventricular enlargement. Experimental studies have shown that treatment with growth hormone (GH) stimulates cardiac repair, resulting in increased infarct zone collagen scar formation and possibly enhanced proteinosynthesis. These actions may ameliorate the process of LV remodeling. We hypothesize that these beneficial effects may be more prominent, if GH is delivered selectively in the infarct area, during the early phase of acute MI. Experimental and clinical studies are necessary to validate this hypothesis.     

骨骼肌卫星细胞移植用于治疗心肌梗死的形态学观察

目的探讨冷冻心肌梗死模型的特点以及卫星细胞移植在治疗心梗中的作用。方法将卫星细胞移植到大鼠心梗中央区,用免疫组化、共聚焦免疫荧光双标染色及电镜等多种方法研究移植细胞的增殖分化情况。结果用直径5 mm的铝棒冷冻大鼠左心室前壁15 s,可致左心室重量43%的心肌缺血,17%的心肌梗死,在2周左右可发展成透壁心梗。将卫星细胞移植到大鼠心梗中央区后,细胞大量成活,在早期增殖旺盛,2周后分化形成较多的多核肌管,有的发育成肌纤维,形成了完整的肌节,但移植细胞和宿主心肌细胞之间没有形成缝管连接。结论冷冻心梗模型是研究心肌梗死的良好模型。骨骼肌卫星细胞移植可部分修复心肌梗死区。     

Repair of infarcted myocardium using mesenchymal stem cell seeded small intestinal submucosa in rabbits

Myocardial infarction (MI) remains a common and deadly disease. Using tissue-engineered cardiac grafts to repair infarcted myocrdium is considered to be a therapeutic approach. This study tested the feasibility of using MSCs-seeded SIS to repair chronic myocardial infarction in a rabbit model. MI in rabbits was created by ligation of the left anterior descending artery. BrdU-labeled mesenchymal stem cells (MSCs) were seeded on the small intestinal submucosa and cultured for 5–7 days prior to implantation. Four weeks after myocardial infarction, cardiac grafts were implanted onto the epicardial surface of infarcted myocardium. Four weeks after implantation of the membranes, a serial of tests including echocardiography, hemodynamics, histology and immunohistochemistry were undertaken to evaluate the effect of the implanted grafts on recovery of the infarcted myocardium. It was shown that left ventricular contractile function and dimension, the capillary density of the infarcted region, and myocardial pathological changes were significantly improved in rabbits implanted either SIS or MSCs-seeded SIS. But the MSCs-seeded SIS was more effective. Immunofluorescence staining demonstrated the migration of Brdu-labeled MSCs from the membrane into the infarcted area and their differentiation to cardiomyocytes and smooth muscle cells. Taken together, these results suggest that MSCs-seeded SIS can be used to repair chronic myocardial infarction, which enhances myocardial regeneration.     

Exosomes Mediate the Intercellular Communication after Myocardial Infarction

The mechanisms of cardiac repair after myocardial infarction (MI) are complicated and not well-understood currently. It is known that exosomes are released from most cells, recognized as new candidates with important roles in intercellular and tissue-level communication. Cells can package proteins and RNA messages into exosome and secret to recipient cells, which regulate gene expression in recipient cells. The research on exosomes in cardiovascular disease is just emerging. It is well-known that exosomes from cardiomyocyte can transfect endothelial cells, stem cells, fibroblasts and smooth muscle cells to induce cellular changes. After myocardial infarction (MI), the exosomes play important roles in local and distant microcommunication. Nowadays, exosomal microRNAs transportation has been found to deliver signals to mediate cardiac repair after MI. However, the exosomes quality and quantities are variable under different pathological conditions. Therefore, we speculate that the monitoring of the quality and quantity of exosomes may serve as diagnosis and prognosis biomarkers of MI, and the study of exosomes will provide insights for the new therapeutics to cardiac remodeling after MI.     

The Current Status of Engineering Myocardial Tissue

Myocardial infarction (MI) remains a common fatal disease all over the world. The adult cardiac myocytes regenerative capability is very limited after infarct injury. Heart transplantation would be the best therapeutic option currently but is restricted due to the lack of donor organs and the serious side effects of immune suppression. The emerging of tissue engineering has evolved to provide solutions to tissue repair and replacement. Engineering myocardial tissue is considered to be a new therapeutic approach to repair infarcted myocardium and ameliorate cardiac function after MI. Engineering myocardial tissue is the combination of biodegradable scaffolds with viable cells and has made much progress in the experimental phase. However, the largest challenge of this field is the revascularization of the engineering constructs to provide oxygen and nutrients for cells. This review will give an overview on the current evolution of engineering myocardial tissue and address a new method to improve the vascularization of myocardium tissue in vivo.     

A PNIPAAm-based thermosensitive hydrogel containing SWCNTs for stem cell transplantation in myocardial repair

Poly (N-isopropylacrylamide) (PNIPAAm) hydrogel was a widely used carrier in therapeutic agent delivery. However, its bioactivities for encapsulated cells were not satisfactory. In the study, we aimed to determine whether modification with single-wall carbon nanotubes (SWCNTs) could improve the bioactivitis, especially supportive adhesion of PNIPAAm to encapsulated cells and favor their efficacy in myocardial repair. A thermosensitive SWCNTs-modified PNIPAAm hydrogel (PNIPAAm/SWCNTs) were prepared by incorporating the SWCNTs into base PNIPAAm hydrogel. The bioactivities of the resulted hydrogel to brown adipose-derived stem cells (BASCs) were evaluated and compared with the base PNIPAAm hydrpgel in vitro. Then, the PNIPAAm-containing hydrogel was used as carrier for imtromyocardial delivery of BASCs in rats with myocardial infarction. The efficacy of PNIPAAm/SWCNTs hydrogel in stem cell-based myocardial repair was systematically evaluated. In vitro study showed that the PNIPAAm/SWCNTs hydrogel demonstrated significantly higher bioactivities to encapsulated BASCs compared with onefold PNIPAAm hydrogel, including promoting cell adhesion and proliferation. When used as carrier for intramyocardial delivery of BASCs after myocardial infarction, the PNIPAAm/SWCNTs hydrogel significantly enhanced the engraftment of seeding cells in infarct myocardium and augmented their therapeutic efficacies in myocardial infarction (MI). The data provided a supportive evidence for the myocardial application of the SWCNTs-modified hydrogel and offered a new perspective in development or improvement of cardiac tissue engineering scaffold.     

Infarct stabilization and cardiac repair with a VEGF-conjugated, injectable hydrogel

Injectable scaffolds made of biodegradable biomaterials can stabilize a myocardial infarct and promote cardiac repair. Here, we describe the synthesis of a new, temperature-sensitive, aliphatic polyester hydrogel (HG) conjugated with vascular endothelial growth factor (VEGF) and evaluate its effects on cardiac recovery after a myocardial infarction (MI). Seven days after coronary ligation in rats, PBS, HG, or HG mixed or conjugated with VEGF (HG + VEGF or HG-VEGF, respectively) was injected around the infarct (n = 8-11/group). Function was evaluated by echocardiography at multiple time points. Pressure-volume measurements were taken and infarct morphometry and blood vessel density were assessed at 35 days after injection. HG-VEGF provided localized, sustained VEGF function. Compared with outcomes in the PBS group, fractional shortening, ventricular volumes, preload recruitable stroke work, and end-systolic elastance were all preserved (p < 0.05) in the HG and HG + VEGF groups, and further preserved in the HG-VEGF group. Conjugated VEGF also produced the highest blood vessel density (p < 0.05). The infarct thinned and dilated after PBS injection, but was smaller and thicker in hearts treated with HG (p < 0.05). Our temperature-sensitive HG attenuated adverse cardiac remodeling and improved ventricular function when injected after an MI. VEGF delivery enhanced these effects when the VEGF was conjugated to the HG.     

Transplantation of bone marrow-derived very small embryonic-like stem cells attenuates left ventricular dysfunction and remodeling after myocardial infarction

Adult bone marrow (BM) contains Sca-1+/Lin-/CD45- very small embryonic-like stem cells (VSELs) that express markers of several lineages, including cardiac markers, and differentiate into cardiomyocytes in vitro. We examined whether BM-derived VSELs promote myocardial repair after a reperfused myocardial infarction (MI). Mice underwent a 30-minute coronary occlusion followed by reperfusion and received intramyocardial injection of vehicle (n= 11), 1 x 10(5) Sca-1+/Lin-/CD45+ enhanced green fluorescent protein (EGFP)-labeled hematopoietic stem cells (n= 13 [cell control group]), or 1 x 10(4) Sca-1+/Lin-/CD45- EGFP-labeled cells (n= 14 [VSEL-treated group]) at 48 hours after MI. At 35 days after MI, VSEL-treated mice exhibited improved global and regional left ventricular (LV) systolic function (echocardiography) and attenuated myocyte hypertrophy in surviving tissue (histology and echocardiography) compared with vehicle-treated controls. In contrast, transplantation of Sca-1+/Lin-/CD45+ cells failed to confer any functional or structural benefits. Scattered EGFP+ myocytes and capillaries were present in the infarct region in VSEL-treated mice, but their numbers were very small. These results indicate that transplantation of a relatively small number of CD45- VSELs is sufficient to improve LV function and alleviate myocyte hypertrophy after MI, supporting the potential therapeutic utility of these cells for cardiac repair. Disclosure of potential conflicts of interest is found at the end of this article.     

心肌梗死局部注射壳聚糖水凝胶材料的存留和降解

背景：研究发现壳聚糖水凝胶可促进受损组织新生血管生成,修复损伤细胞和组织。 目的：观察心肌梗死部位局部注射壳聚糖水凝胶材料的存留和降解及其对心脏功能的保护作用。 方法：结扎Wistar大鼠冠状动脉左前降支致心肌梗死30 min 后,随机抽签法分为壳聚糖水凝胶注射组、心肌梗死模型组、PBS注射组。术后1,2,4 周使大鼠心脏停留在舒张期行心肌组织学检查,术后4周进行心电图、心脏超声检测,并进行大鼠颈动脉插管,检测心脏功能和心室内压。 结果与结论：壳聚糖水凝胶注射1,2 周后在心肌组织中有明显存留,4 周后已降解吸收,无明显残留。注射4周后心脏超声、心室血流动力学及心室内压检测结果表明,壳聚糖水凝胶注射组心脏功能明显好于心肌梗死模型组、PBS 注射组,而心肌梗死模型组和PBS 注射组之间没有明显的区别。说明以壳聚糖为支架材料,应用配制的可注射性液态支架进行心肌梗死局部注射治疗,注射4周后无明显残留,保护和改善了心脏功能,适宜作为可注射性组织工程化心肌的支架材料。     

Sca-1-Positive Cardiac Stem Cell migration in a Cardiac Infarction Model

Adult myocardium has the capacity for repair and regeneration, which is derived from cardiac stem cells (CSCs). In this study, we assessed the migration and changes in numbers of Sca-1-positive CSCs after myocardial infarction (MI) in vivo and in vitro. In this study, we showed that in a rat MI model the CSCs emerged around the vessels near the peri-infarct zone and in the epicardium of the infarcted area. Four weeks after infarction, no differences in the expression of connexin 43 (Cx43) were observed in the peri-infarct and infarct zones. In vitro, we mimicked tissue ischemia and hypoxia by using a culture environment of 5 % O₂ and a wound healing assay to monitor the migration of CSCs. In conclusion, under hypoxic conditions, the CSCs, conveyed by blood vessels, migrated from the niche to the infarct zone for repairing the damaged myocytes. The number of endogenous migrating CSCs was proportionate to the repair time after infarction, rather than the degree of infarction. Four weeks after MI, the expression of Cx43 was not altered in migratory CSCs, namely no enhanced gap-junctional communication with cardiomyocytes was seen in the CSCs. Further studies are necessary to delineate the molecular mechanisms that drive the migration of CSCs after MI.     

EphB/ephrin-B interaction mediates adult stem cell attachment, spreading, and migration: implications for dental tissue repair

Human adult dental pulp stem cells (DPSCs) reside predominantly within the perivascular niche of dental pulp and are thought to originate from migrating neural crest cells during development. The Eph family of receptor tyrosine kinases and their ligands, the ephrin molecules, play an essential role in the migration of neural crest cells during development and stem cell niche maintenance. The present study examined the expression and function of the B-subclass Eph/ephrin molecules on DPSCs. Multiple receptors were primarily identified on DPSCs within the perivascular niche, whereas ephrin-B1 and ephrin-B3 were expressed by the surrounding pulp tissue. EphB/ephrin-B bidirectional signaling inhibited cell attachment and spreading, predominately via the mitogen-activated protein kinase (MAPK) pathway for forward signaling and phosphorylation of Src family tyrosine kinases via reverse ephrin-B signaling. DPSC migration was restricted through unidirectional ephrin-B1-activated EphB forward signaling, primarily signaling through the MAPK pathway. Furthermore, we observed that ephrin-B1 was downregulated in diseased adult teeth compared with paired uninjured controls. Collectively, these studies suggest that EphB/ephrin-B molecules play a role in restricting DPSC attachment and migration to maintain DPSCs within their stem cell niche under steady-state conditions. These results may have implications for dental pulp development and regeneration.     

Intracardiac fibroblasts, but not bone marrow derived cells, are the origin of myofibroblasts in myocardial infarct repair.

SUMMARY: Origin of myofibroblasts in infarcted myocardium was examined by using rats in which bone marrow of green fluorescent protein (GFP)-transgenic mice had been transplanted. GFP was not detected in myofibroblasts at either 3 or 7 days after infarction, suggesting that proliferating myofibroblasts in infarcted myocardium are derived from resident fibroblasts rather than circulating precursor cells of bone marrow origin. BACKGROUND: Myofibroblasts play important roles in the repair process of myocardial infarct, and their origin has been assumed to be interstitial fibroblasts in the heart. However, bone marrow-derived myofibroblasts have recently been identified in pathological fibrosis in extracardiac tissues. In this study, we aimed to determine whether some of the myofibroblasts in infarcted myocardium are derived from circulating precursor cells of bone marrow origin. METHODS AND RESULTS: Bone marrow (BM) of GFP-transgenic mice was transplanted into nude rats, and their coronary arteries were occluded for 60 min and reperfused for 3 or 7 days. Non-BM-transplanted rats served as controls. At 3 days after infarction, some endothelial cells were GFP-positive, indicating that they were of bone marrow origin. Predominant cells in infarcted regions were macrophages and neutrophils, and there were only a small number of vimentin-positive cells and fewer myofibroblasts, both of which were GFP-negative. At 7 days after infarction, there were numerous myofibroblasts in granulation tissue replacing necrotic myocytes, and none of them showed GFP signals, whereas some cells were positive for both GFP and vimentin. Appearance of myofibroblasts and extent of the infarct repair in BM-transplanted and those in non-transplanted rats were similar. CONCLUSIONS: The findings in this study suggest that proliferating myofibroblasts in infarcted myocardium are derived from resident fibroblasts rather than circulating precursor cells of bone marrow origin.     

Cardiac oxidative stress and remodeling following infarction: role of NADPH oxidase

BackgroundThere is growing recognition that oxidative stress plays a role in the pathogeneses of myocardial repair/remodeling following myocardial infarction (MI). Nicotinamide adenine denucleotide phosphate (NADPH) oxidase is a major source for cardiac reactive oxygen species production. Herein, we studied the importance of NADPH oxidase in development of cardiac oxidative stress and its induced molecular and cellular changes related to myocardial repair/remodeling.MethodsMI was created by coronary artery ligation in C57/BL (wild type) and NADPH oxidase (gp91^phox) knockout mice. Cardiac oxidative stress, inflammatory/fibrogenic responses, apoptosis, and hypertrophy were detected by in situ hybridization, immunohistochemistry, terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL), picrosirius red staining, and image analysis, respectively, at different stages post MI.ResultsIn wild-type mice with MI, and compared to sham-operated animals, we observed significantly increased gp91^phox and 3-nitrotyrosine, a marker of oxidative stress, in the infarcted myocardium; accumulated macrophages and myofibroblasts at the infarct site; abundant apoptotic myocytes primarily at border zones on Day 3; and numerous apoptotic inflammatory/myofibroblasts in the later stages. In addition, we detected significantly increased transforming growth factor β1, tissue inhibitor of metalloprotease 2, and type 1 collagen gene expression; continuously increasing collagen volume in the infarcted myocardium; and hypertrophy in noninfarcted myocardium. Compared to wild-type mice with MI, we did not observe significant difference in infarct size/thickness, cardiac hypertrophy, myocyte apoptosis, inflammatory/fibrogenic responses, as well as cardiac oxidative stress in gp91^phox knockout mice.ConclusionOur findings indicate that during NADPH oxidase deficiency, superoxide production can be compensated by other sources, which leads to cardiac oxidative stress and its related molecular/cellular events in the infarcted heart.     

参术冠心颗粒对心肌梗死大鼠冠脉微循环的影响*

 目的：探讨参术冠心颗粒（SSGX）对大鼠心肌梗死(MI)模型冠脉微循环作用。方法：健康SPF级SD大鼠50只,随机分成假手术(sham)组、MI组、SSGX高剂量、中剂量和低剂量治疗组,每组10只。后4组结扎冠状动脉建立MI大鼠模型,假手术组只穿线不进行结扎。造模3 d后超声检查淘汰不合格大鼠,药物干预4周,测定4周后各组大鼠血清心肌损伤标志物、梗死区中小血管平均血管面密度（MVC值）、梗死边缘区血小板内皮细胞黏附分子1(PECAM-1)和血管内皮生长因子(VEGF)表达。结果：MI组与sham组比较,光学显微镜见MI组死亡的心肌纤维间空隙变宽,密集的中型多形核白细胞浸润,肉芽组织增生,坏死心肌纤维被致密的胶原纤维取代。超声可见MI组左室室璧活动异常,射血分数减低。心肌钙蛋白T（cTnT）、MVC、PECAM-1和VEGF各指标与sham组比较均有显著差异（P<0.01）,证明造模成功。大鼠心肌梗死区中小血管的MVC、梗死边缘区PECAM-1及VEGF的表达,SSGX各剂量组与MI组相比表达明显增加,差异有统计学意义（P<0.01）,呈量效关系。但各SSGX组大鼠和MI组大鼠之间,心肌标志物差异无统计学意义（P>0.05）。结论:参术冠心颗粒能改善心肌梗死大鼠冠脉微循环状态,其机制可能与增加PECAM-1和VEGF表达、促进中小血管新生有关。     

Bone marrow-derived CXCR4+ cells mobilized by macrophage colony-stimulating factor participate in the reduction of infarct area and improvement of cardiac remodeling after myocardial infarction in mice

The monocyte/macrophage lineage might affect the healing process after myocardial infarction (MI). Because macrophage colony-stimulating factor (M-CSF) stimulates differentiation and proliferation of this lineage, we examined the effect of M-CSF treatment on infarct size and left ventricular (LV) remodeling after MI. MI was induced in C57BL/6J mice by ligation of the left coronary artery. Either recombinant human M-CSF or saline was administered for 5 consecutive days after MI induction. M-CSF treatment significantly reduced the infarct size (P < 0.05) and scar formation (P < 0.05) and improved the LV dysfunction (percent fractional shortening, P < 0.001) after the MI. Immunohistochemistry revealed that M-CSF increased macrophage infiltration (F4/80) and neovascularization (CD31) of the infarct myocardium but did not increase myofibroblast accumulation (alpha-smooth muscle actin). M-CSF mobilized CXCR4(+) cells into peripheral circulation, and the mobilized CXCR4(+) cells were then recruited into the infarct area in which SDF-1 showed marked expression. The CXCR4 antagonist AMD3100 deteriorated the infarction and LV function after the MI in the M-CSF-treated mice. In conclusion, M-CSF reduced infarct area and improved LV remodeling after MI through the recruitment of CXCR4(+) cells into the infarct myocardium by the SDF-1-CXCR4 axis activation; this suggests that the SDF-1-CXCR4 axis is as a potential target for the treatment of MI.     

Intracoronary delivery of DNAzymes targeting human EGR-1 reduces infarct size following myocardial ischaemia reperfusion

Despite improvements in treatment, myocardial infarction (MI) remains an important cause of morbidity and mortality. Inflammation arising from ischaemic and reperfusion injury is a key mechanism which underpins myocardial damage and impairment of cardiac function. Early growth response-1 (Egr-1) is an early immediate gene and a master regulator that has been implicated in the pathogenesis of ischaemia-reperfusion (IR) injury. This study sought to examine the effect of selective inhibition of Egr-1 using catalytic deoxyribonucleic acid molecules (DNAzymes, DZs) delivered via the clinically relevant coronary route in a large animal model of myocardial IR. It was hypothesized that Egr-1 inhibition with intracoronary DZ would reduce infarction size by modulating its downstream effector molecules. Egr-1 DZs inhibited the adherence of THP-1 monocytes to IL-1β-activated endothelial cells in vitro and retained its catalytic activity up to 225 min after in vivo administration. In a porcine model of myocardial IR (45 min ischaemia/3 h reperfusion), DZ was taken up in the cytoplasm and nuclei of cardiomyocytes and endothelial cells in the myocardium after intracoronary delivery. Egr-1 DZs reduced infarct size and improved cardiac functional recovery following intracoronary delivery at the initiation of IR in this large animal model of MI. This was associated with inhibition of pro-inflammatory Egr-1 and ICAM-1 expression, and the reduced expression of TNF-α, PAI-1, TF, and myocardial MPO activity in tissue derived from the border zone of the infarct. Taken together, these data suggest that strategies targeting Egr-1 via the intracoronary route after IR injury in pigs have potential therapeutic implications in human MI.     

The role of the sca-1+/CD31- cardiac progenitor cell population in postinfarction left ventricular remodeling

Cardiac stem cell-like populations exist in adult hearts, and their roles in cardiac repair remain to be defined. Sca-1 is an important surface marker for cardiac and other somatic stem cells. We hypothesized that heart-derived Sca-1(+)/CD31(-) cells may play a role in myocardial infarction-induced cardiac repair/remodeling. Mouse heart-derived Sca-1(+)/CD31(-) cells cultured in vitro could be induced to express both endothelial cell and cardiomyocyte markers. Immunofluorescence staining and fluorescence-activated cell sorting analysis indicated that endogenous Sca-1(+)/CD31(-) cells were significantly increased in the mouse heart 7 days after myocardial infarction (MI). Western blotting confirmed elevated Sca-1 protein expression in myocardium 7 days after MI. Transplantation of Sca-1(+)/CD31(-) cells into the acutely infarcted mouse heart attenuated the functional decline and adverse structural remodeling initiated by MI as evidenced by an increased left ventricular (LV) ejection fraction, a decreased LV end-diastolic dimension, a decreased LV end-systolic dimension, a significant increase of myocardial neovascularization, and modest cardiomyocyte regeneration. Attenuation of LV remodeling was accompanied by remarkably improved myocardial bioenergetic characteristics. The beneficial effects of cell transplantation appear to primarily depend on paracrine effects of the transplanted cells on new vessel formation and native cardiomyocyte function. Sca-1(+)/CD31(-) cells may hold therapeutic possibilities with regard to the treatment of ischemic heart disease.