外周血间充质干细胞移植心肌梗死兔新生血管及心功能的变化

背景：药物治疗和支架置入治疗尚不能修复心肌梗死后已坏死的心肌。 目的：观察外周血间充质干细胞移植治疗对心肌梗死兔新生血管及心功能的影响。 方法：随机抽签法将36只大白兔分为假手术组,间充质干细胞移植组和对照组,结扎兔冠状动脉左室支建立心肌梗死模型。 结果与结论：移植后4周,流式细胞仪分析显示绝大部分间充质干细胞表达CD44,极少量细胞表达CD34和CD45。间充质干细胞移植组梗死心肌组织有移植的间充质干细胞存活,超声心动仪示间充质干细胞移植组左心室射血分数及短轴缩短率明显高于对照组(P < 0.01);左心室收缩末内径和舒张末内径明显小于对照组(P < 0.01)。间充质干细胞移植组心肌纤维化程度、心肌梗死面积均明显小于对照组(P < 0.01)。免疫组织化学染色显示间充质干细胞移植组新生毛细血管密度明显高于对照组(P < 0.01)。提示外周血间充质干细胞移植增加了梗死心肌新生血管密度,改善心脏的功能。     

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。     

Intravenously Injected Mesenchymal Stem Cells Home to Infarcted Myocardium Without Altering Cardiac Function

Background： Systemic delivery of mesenchymal stem cells （MSCs） to the infarcted myocardium is an attractive noninvasive strategy, but therapeutic effect of this strategy remain highly controversial. Methods： Myocardial infarction was induced in female Sprague-Dawley rats by transient ligation of the left anterior descending coronary artery for 60 min. Either 2.5 × 106 DiI-labeled MSCs or equivalent saline was injected into the tail vein at 24 h after infarction. Results： Three days later, MSCs localized predominantly in the infarct region of heart rather than in the remote region. MSCs were also observed in spleen, lung and liver. At 4 weeks after infarction, echocardiographic parameters, including ejection fraction, fractional shortening, left ventricular end-diastolic and end-systolic diameters, were not significantly different between MSCs and saline groups. Hemodynamic examination showed that ± dp/dtmax were similar between MSCs and saline-treated animals. Histological evaluation revealed that infarct size and vessel density were not significantly changed by MSCs infusion. Conclusion： Intravenously injected MSCs can home to infarcted myocardium, but plays a limited role in cardiac repair following myocardial infarction.     

大鼠自体骨骼肌卫星细胞向心肌梗死区移植后血液流变特性的改变

目的 了解大鼠自体骨骼肌卫星细胞（SC）梗死心肌移植后血液流变特性的改变及临床意义。方法 45只Wistar大鼠随机分为假手术组（n=15）、对照组（n=15）及移植组（n=15），对照组及移植组大鼠经结扎冠状动脉前降支建立MI模型；假手术组除不结扎左前降支外，其余操作同对照组和移植组。将体外培养2周的大鼠自体SC以注射的方式移植到移植组大鼠梗死区周围，4周后测定大鼠血清VEGF浓度（酶联免疫吸附法）、血液流变学参数的改变以及大鼠缺血心肌中VEGFmRNA（RTPCR法）、VEGF蛋白（免疫组化法）的表达情况，同时病理检测移植细胞在梗死区的生长、增殖情况并探讨它们相互的关系。结果 SC在梗死区中可增殖分化为横纹肌纤维。移植组大鼠血清VEGF浓度及缺血心肌中VEGF mRNA、VEGF蛋白质的表达较之假手术组、对照组明显升高（P〈0．05或0．01或0．001），而某些血液流变学参数明显改善（P〈0．05或0．01）。结论 SC在心肌梗死区中可增殖分化为横纹肌样细胞。并通过自分泌和旁分泌的形式增加VEGF的表达进而提高血清VEGF浓度，由此改善血液流变学参数。     

Cell transplantation into ischemic myocardium using mesenchymal stem cells transfected by vascular endothelial growth factor

Aims: To investigate the effects of mesenchymal stem cells (MSCs) transplantation combining with vascular endothelial growth factor (VEGF) gene therapy on myocardium rebuilding, angiogenesis, and heart function improvement in rats with myocardial infarction. Methods: SD rat MSCs were isolated, cultured in vitro, labeled with BrdU and transfected by Ad.VEGF gene. Four weeks after left anterior descending artery was ligated to create rat myocardial infarction, cardiac function was examined with echocardiography. Rats were randomly divided into four groups (n = 10 in each group): Group I: MSCs/Ad.VEGF implantation; Group II: MSCs implantation; Group III: Ad.VEGF injection; Group IV: Control. MSCs differentiation was observed 4 weeks after transplantation. Immunohistochemistry and angiogenesis were observed. Echocardiography was performed to detect the effects on heart function. Results: MSCs labeled with BrdU could be identified in host hearts in group I and II, most of them positively stained with cTnT antibody. Echocardiography indicated that the improvement of the LVEF value in group I was more significant than that in the other three groups (P < 0.01, respectively). Some cells were incorporated into the coronary capillaries in the infarcted region. The capillary density in group I was higher than that in the other three groups (P < 0.01, respectively). Conclusion: MSCs implantation combining with VEGF gene therapy can obviously repair damaged myocardium and enhance the angiogenesis in ischemic heart tissue.     

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。     

人脐带间充质干细胞分化为心肌细胞的实验研究

目的 探讨人脐带间充质干细胞(MSCs)在体外向心肌细胞分化的能力及移植后对急性心肌梗死大鼠心功能恢复的影响.方法 胶原酶胰酶消化法分离脐带MSCs.取第4-6代脐带干细胞,采用5-氮胞苷诱导,免疫组织化学和免疫荧光法对诱导后细胞进行鉴定.建立大鼠心肌梗死模型,并按完全随机法将其分为2组(n=10):细胞移植组和空白对照组.将培养脐带MSCs移植到大鼠梗死心肌周围,4周后,免疫荧光法鉴定移植细胞,并超声检测心功能改变.结果 体外诱导后,细胞的形态不断发生变化,诱导后的细胞表达心肌特异性α-肌动蛋白、肌球蛋白和肌钙蛋白T,阳性率在50%以上.细胞移植4周后,脐带MSCs在缺血心肌内存活并分化为心肌样细胞,心功能检测显示脐带MSCs移植组大鼠在移植后4周的左心室射血分数[(68.4±15.2)%]比对照组大鼠明显增加[(53.2±13.4)%,P＜0.05].结论 人脐带MSCs能够在体内外分化为心肌样细胞,并能促进心脏功能的恢复.     

A myocardial patch made of collagen membranes loaded with collagen-binding human vascular endothelial growth factor accelerates healing of the injured rabbit heart

Tissue-engineered myocardial patches could be useful in the repair of myocardial injuries. The aim of the present study was to evaluate a collagen targeting delivery system for myocardial repair. A specific peptide collagen-binding domain (CBD) was fused to human vascular endothelial growth factor (VEGF) to enhance the binding of VEGF to collagen. In this study, collagen membranes loaded with CBD-VEGF, natural VEGF, or phosphate-buffered saline are used as cardiac patches to repair the infarcted myocardium in a rabbit model. CBD-VEGF/collagen group could effectively induce more cells to penetrate into the collagen membrane after 4 weeks and promote more vascularization in infarcted myocardium after 12 weeks compared with the other two control groups. Echocardiography and hemodynamic studies both show cardiac function improvement in the CBD-VEGF/collagen group. These results reveal that implantation of CBD-VEGF collagen membrane patch into the infarcted myocardium could effectively improve left ventricle cardiac function and increase the vascular density.     

Monocyte chemotactic protein 1 increases homing of mesenchymal stem cell to injured myocardium and neovascularization following myocardial infarction

Objective:To investigate the effect of MCP-1 on mesenchymal stem cells(MSCs) homing to injured myocardium in a rat myocardial infarction(MI) model. Methods:Rat myocardial infarction model was established by permanent left anterior descending branch ligation. Mesenchymal stem cells from donor rats were cultured in IMDM and labeled with BrdU. The Rats were divided into two groups. Monocyte chemotactic protein 1(MCP-1) expression were measured by in situ hybridization and immunohistochemistry in the sham operated or infarcted hearts at 1,2, 4,7,14 and 28 days post operation in MCP-1 detection group. The rats were injected with MCP-1, anti-MCP-1 antibody or saline 4 days after myocardial infarction in intervention group. Then, a total of 5 × 106 cells in 2.5 ml of PBS were injected through the tail vein. The number of the labeled MSCs in the infarcted hearts was counted 3 days post injection. Cardiac function and blood vessel density were assessed 28 days post injection. Results:Self-generating MCP-1 expression was increased at the first day, peaked at the 7th day and decreased thereafter post MI and remained unchanged in sham operated hearts. The MSCs enrichment in the host hearts were more abundant in the MI groups than that in the non-Mi group(P = 0.000), the MSCs enrichment in the host hearts were more abundant in the MCP-1 injected group than that in the anti-MCP-1 antibody and saline injected groups (P = 0.000). Cardiac function was improved more in MCP-1 injected group than anti-MCP-1 antibody and saline injected groups(P= 0.000). Neovascularization in MCP-1 injected group significantly increased compared with that of other groups(P = 0.000). Conclusion: Myocardial MCP-1 expression was increased only in the early phase post MI. MCP-1 may enhance MSCs homing to the injured heart and improve cardiac function by promoting neovascularization.     

Reactive oxygen species promote angiogenesis in the infarcted rat heart

The purpose of this study was to determine whether reactive oxygen species (ROS) promote cardiac angiogenesis following myocardial infarction (MI) and contribute to cardiac repair. Rats with MI were treated with or without antioxidants, tempol and apocynin. Hearts of these rats were collected at days 2, 4, 7 and 14 post‐MI. We examined the spatial and temporal relationship between oxidative stress and angiogenesis as well as the potential regulation of ROS in cardiac angiogenesis. We found: (i) following MI, gp91^phox, a subunit of NADPH oxidase, a key enzyme for ROS production, was significantly increased in the border zone at day 2, followed by the infarcted myocardium at day 4, peaked at day 7 and declined at day 14, while superoxide dismutase was significantly reduced; (ii) malondialdehyde, a marker of oxidative stress, was significantly increased in the infarcted myocardium at day 7; (iii) pre‐existing blood vessels in the infarcted myocardium underwent necrosis post‐MI, whereas newly formed vessels appeared at the border zone at day 4, and then extended into the infarcted myocardium, where microvascular density peaked at day 7 and (iv) antioxidant treatment significantly reduced microvascular density in the infarcted myocardium at day 7. These observations suggest that following MI, angiogenesis is mostly active in the infarcted myocardium in the first week, which is temporally and spatially coincident with enhanced ROS. Suppression of angiogenesis by antioxidants indicates that ROS promote angiogenesis in the infarcted myocardium and contribute to cardiac repair. Further studies are required to determine the mechanisms responsible for ROS‐mediated cardiac angiogenesis.     

Implantation of bone marrow mononuclear cells using injectable fibrin matrix enhances neovascularization in infarcted myocardium

Neovascularization may improve cardiac function and prevent further scar tissue formation in infarcted myocardium. A number of studies have demonstrated that bone marrow-derived cells have the potential to induce neovascularization in ischemic tissues. In this study, we hypothesized that implantation of bone marrow mononuclear cells (BMMNCs) using injectable fibrin matrix further enhances neovascularization in infarcted myocardium compared to BMMNC implantation without matrix. To test this hypothesis, infarction was induced in rat myocardium by cryoinjury. Three weeks later, rat BMMNCs were mixed with fibrin matrix and injected into the infarcted myocardium. Injection of either BMMNCs or medium alone into infarcted myocardium served as controls. Eight weeks after the treatments, histological analyses indicated that implantation of BMMNCs using fibrin matrix resulted in more extensive tissue regeneration in the infarcted myocardium compared to BMMNC implantation without matrix. Examination with fluorescence microscopy revealed that cells labeled with a fluorescent dye prior to implantation survived in the infarcted myocardium at 8 weeks of implantation. Importantly, implantation of BMMNCs using fibrin matrix resulted in much more extensive neovascularization in infarcted myocardium than BMMNC implantation without matrix. The microvessel density in infarcted myocardium was significantly higher (p < 0.05) when BMMNCs were implanted using fibrin matrix (350 +/- 22 microvessels/mm2) compared to BMMNC implantation without matrix (262 +/- 13 microvessels/mm2) and medium injection (76 +/- 9 microvessels/mm2). In addition, average internal diameter of microvessels was significantly larger (p < 0.05) in BMMNC implantation with fibrin matrix group (14.6 +/- 1.2 microm) than BMMNC implantation without matrix group (10.2 +/- 0.7 microm) and medium injection group (7.3 +/- 0.5 microm). These results suggest that fibrin matrix could serve as a cell implantation matrix that enhances neovascularization efficacy for myocardial infarction treatment.     

Tissue transglutaminase is essential for integrin-mediated survival of bone marrow-derived mesenchymal stem cells

Autologous mesenchymal stem cell (MSC) transplantation therapy for repair of myocardial injury has inherent limitations due to the poor viability of the stem cells after cell transplantation. Adhesion is a prerequisite for cell survival and also a key factor for the differentiation of MSCs. As a novel prosurvival modification strategy, we genetically engineered MSCs to overexpress tissue transglutaminase (tTG), with intention to enhance adhesion and ultimately cell survival after implantation. tTG-transfected MSCs (tTG-MSCs) showed a 2.7-fold and greater than a twofold increase of tTG expression and surface tTG activity, respectively, leading to a 20% increased adhesion of MSCs on fibronectin (Fn). Spreading and migration of tTG-MSCs were increased 4.75% and 2.52%, respectively. Adhesion of tTG-MSCs on cardiogel, a cardiac fibroblast-derived three-dimensional matrix, showed a 33.1% increase. Downregulation of tTG by transfection of small interfering RNA specific to the tTG resulted in markedly decreased adhesion and spread of MSCs on Fn or cardiogel. tTG-MSCs on Fn significantly increased phosphorylation of focal adhesion related kinases FAK, Src, and PI3K. tTG-MSCs showed significant retention in infarcted myocardium by forming a focal adhesion complex and developed into cardiac myocyte-like cells by the expression of cardiac-specific proteins. Transplantation of 1 x 10(6) MSCs transduced with tTG into the ischemic rat myocardium restored normalized systolic and diastolic cardiac function. tTG-MSCs further restored cardiac function of infarcted myocardium as compared with MSC transplantation alone. These findings suggested that tTG may play an important role in integrin-mediated adhesion of MSCs in implanted tissues. Disclosure of potential conflicts of interest is found at the end of this article.     

Stem cell-loaded nanofibrous patch promotes the regeneration of infarcted myocardium with functional improvement in rat model

Myocardial infarction (MI) leads to the loss of cardiomyocytes, followed by left ventricular (LV) remodeling and cardiac dysfunction. The authors hypothesize that an elastic, biodegradable nanofibrous cardiac patch loaded with mesenchymal stem cells (MSC) could restrain LV remodeling and improve cardiac function after MI. Poly(ε-caprolactone)/gelatin (PG) nanofibers were fabricated by electrospinning, and the nanofibers displayed a porous and uniform nanofibrous structure with a diameter of 244 ± 51 nm. An MI model was established by ligation of the left anterior descending coronary artery of female Sprague–Dawley rats. The PG nanofibrous patch seeded with MSC, isolated from rat bone marrow, was implanted on the epicardium of the infarcted region of the LV wall of the heart. After transplantation, the PG–cell patch restricted the expansion of the LV wall effectively and reduced the scar size, and the density of the microvessels increased. Cells within the patch were able to migrate towards the scar tissue, and promoted new blood vessel formation at the infarct site. Angiogenesis and the cardiac functions improved significantly after 4 weeks of implantation. The MSC-seeded PG nanofibrous patches are demonstrated to provide sufficient mechanical support, to induce angiogenesis and to accelerate cardiac repair in a rat model of MI. The study highlights the positive impact of implantation of an MSC-seeded PG nanofibrous patch as a novel constituent for MI repair.     

Plasma-functionalized electrospun matrix for biograft development and cardiac function stabilization

Cardiac tissue engineering approaches can deliver large numbers of cells to the damaged myocardium and have thus increasingly been considered as a possible curative treatment to counteract the high prevalence of progressive heart failure after myocardial infarction (MI). Optimal scaffold architecture and mechanical and chemical properties, as well as immune- and bio-compatibility, need to be addressed. We demonstrated that radio-frequency plasma surface functionalized electrospun poly(ɛ-caprolactone) (PCL) fibres provide a suitable matrix for bone-marrow-derived mesenchymal stem cell (MSC) cardiac implantation. Using a rat model of chronic MI, we showed that MSC-seeded plasma-coated PCL grafts stabilized cardiac function and attenuated dilatation. Significant relative decreases of 13% of the ejection fraction (EF) and 15% of the fractional shortening (FS) were observed in sham treated animals; respective decreases of 20% and 25% were measured 4 weeks after acellular patch implantation, whereas a steadied function was observed 4 weeks after MSC-patch implantation (relative decreases of 6% for both EF and FS).     

血管内皮生长因子基因转染骨髓间充质干细胞同种异体移植治疗大鼠急性心肌梗死

目的探讨同种异体血管内皮生长因子(VEGF)基因转染的骨髓间充质干细胞(MSCs)在大鼠梗死心脏局部存活、分化及对心功能的影响;明确同种异体干细胞及VEGF基因转染干细胞移植治疗急性心肌梗死(AMI)的可行性及效果。方法雄性SD大鼠30只,随机分为单纯注射培养基对照组、MSCs治疗组及VEGF基因转染MSCs治疗组。分离纯化雄性Wistar大鼠骨髓间充质干细胞(rMSCs),于左冠状动脉前降支结扎1h后植入到SD大鼠心组织,移植4周后检测心功能并取心脏行组织染色检查。结果异体大鼠MSCs可在梗死心组织定居、生存;免疫组化检测MSCs转化为心肌细胞及血管内皮细胞;与对照组比较VEGF基因转染异体细胞移植组左室射血分数升高(P<0.05),梗死边缘区心肌面毛细血管数目明显增加(P<0.05)。结论同种异体VEGF基因转染MSCs移植治疗AMI可行、有效。     

骨髓间充质干细胞和心脏Sca1阳性细胞移植治疗心肌梗死的效果比较及其机制研究

目的探讨骨髓来源的间充质干细胞(MSCs)和心脏来源的Sca1阳性干细胞移植对小鼠急性心肌梗死后的心功能恢复的影响。方法分别从成年C57BL/C小鼠的骨髓分离获取骨髓间充质干细胞,从心脏利用流式分选获取Sca1阳性干细胞,并在体外进行培养、扩增。C57BL/C小鼠雄性小鼠24只,按照以下方式分组,每组6只,假手术组,生理盐水对照组,MSCs治疗组和Sca1阳性细胞治疗组。小鼠麻醉后开胸,利用结扎心脏冠状动脉的左前降支建立急性心肌梗死模型,建模成功后分别在梗死区周围心肌内注射上述细胞或者生理盐水,假手术组小鼠不结扎冠状动脉。4周后,利用心脏超声观察小鼠左心室射血分数(LVEF)以及左心室舒张末期容积,以此评估心功能改变。细胞培养至第4代,采用荧光半定量PCR的方式分析细胞表达血管内皮生长因子(VEGFa和VEGFb)的情况。结果分离培养的骨髓MSCs贴壁生长,呈梭形;Sca1阳性干细胞在心脏组织的阳性率约为18%,培养后细胞贴壁生长,成短梭形,形态较MSCs更饱满。在细胞移植治疗后,与Sca1阳性干细胞治疗相比,MSCs治疗可以增加心梗后小鼠的存活率。细胞移植治疗4周后,骨髓来源MSCs治疗组的LVEF明显高于心脏来源Sca1阳性干细胞,且更有利于减少心梗后左心室舒张末期容积的扩大,改善心肌重塑。骨髓来源的MSCs表达VEGFa和VEGFb明显高于Sca1阳性细胞。结论心脏来源的Sca1阳性干细胞和骨髓来源的MSCs均可提高LVEF,促进心功能的恢复,且后者优于前者,这可能与MSCs高表达VEGF有关。     

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.     

MicroRNA-23a is involved in tumor necrosis factor-α induced apoptosis in mesenchymal stem cells and myocardial infarction

Cell therapy has emerged as an attractive therapeutic modality to treat myocardial infarction (MI) via repairing damaged myocardium, and mesenchymal stem cells (MSCs) are an appealing therapeutic approach for cardiac regeneration. However, the clinical application of MSC-based therapy is restricted because of the poor survival of implanted cells, and this poor survival remains poorly understood. Using a tumor necrosis factor (TNF)-α-induced bone marrow (BM)-MSC injury model in vitro and a rat MI model in vivo, we showed in the current study that miR-23a was involved in TNF-α-induced BM-MSC apoptosis through regulating caspase-7 and that the injection of BM-MSCs overexpressing miR-23a could improve left ventricular (LV) function and reduce infarct size in the rat MI model. Our findings elucidate the etiology of MI and provide an alternative treatment strategy for patients with heart failure caused by MI who are not optimal candidates for surgical treatment.     

Mesenchymal stem cell-based repair of articular cartilage with polyglycolic acid-hydroxyapatite biphasic scaffold

This study investigates the capacity of a composite scaffold composed of polyglycolic acid-hydroxyapatite (PGA-HA) and autologous mesenchymal stem cells (MSCs) to promote repair of osteochondral defects. MSCs from culture-expanded rabbits were seeded onto a PGA and HA scaffold. After a 72-hour co-culture period, the cell-adhered PGA and HA were joined together, forming an MSCs-PGA-HA composite. Full-thickness cartilage defects in the intercondylar fossa of the femur were then implanted with the MSC-PGA-HA composite, the PGA-HA scaffold only, or they were left empty (n=20). Animals were sacrificed 16 or 32 weeks after surgery and the gross appearance of the defects was evaluated. The specimens were examined histologically for morphologic features, and stained immunohistochemically for type 2 collagen. Specimens of the MSCs-PGA-HA composite implantation group demonstrated hyaline cartilage and a complete subchondral bone formation. At 16 weeks post-implantation, significant integration of the newly formed tissue with surrounding normal cartilage and subchondral bone was observed when compared to the two control groups. At 32 weeks, no sign of progressive degeneration of the newly formed tissue was found. A significant difference in histological grading score was found compared with the control groups. The novel MSCs-seeded, PGA-HA biphasic graft facilitated both articular cartilage and subchondral bone regeneration in an animal model and might serve as a new approach for clinical applications.     

Coronary vein infusion of multipotent stromal cells from bone marrow preserves cardiac function in swine ischemic cardiomyopathy via enhanced neovascularization

Few reports have examined the effects of adult bone marrow multipotent stromal cells (MSCs) on large animals, and no useful method has been established for MSC implantation. In this study, we investigate the effects of MSC infusion from the coronary vein in a swine model of chronic myocardial infarction (MI). MI was induced in domestic swine by placing beads in the left coronary artery. Bone marrow cells were aspirated and then cultured to isolate the MSCs. At 4 weeks after MI, MSCs labeled with dye (n=8) or vehicle (n=5) were infused retrogradely from the anterior interventricular vein without any complications. Left ventriculography (LVG) was performed just before and at 4 weeks after cell infusion. The ejection fraction (EF) assessed by LVG significantly decreased from baseline up to a follow-up at 4 weeks in the control group (P<0.05), whereas the cardiac function was preserved in the MSC group. The difference in the EF between baseline and follow-up was significantly greater in the MSC group than in the control group (P<0.05). The MSC administration significantly promoted neovascularization in the border areas compared with the controls (P<0.0005), though it had no affect on cardiac fibrosis. A few MSCs expressed von Willebrand factor in a differentiation assay, but none of them expressed troponin T. In quantitative gene expression analysis, basic fibroblast growth factor and vascular endothelial growth factor (VEGF) levels were significantly higher in the MSC-treated hearts than in the controls (P<0.05, respectively). Immunohistochemical staining revealed VEGF production in the engrafted MSCs. In vitro experiment demonstrated that MSCs significantly stimulated endothelial capillary network formation compared with the VEGF protein (P<0.0001). MSC infusion via the coronary vein prevented the progression of cardiac dysfunction in chronic MI. This favorable effect appeared to derive not from cell differentiation, but from enhanced neovascularization by angiogenic factors secreted from the MSCs.