Abstract

Adult bone marrow-derived stem cells (BMSCs) have emerged as a promising source for regeneration of tissues including those traditionally considered terminally differentiated, for instance, heart and brain. Chronic heart failure afflicts 4.8 million Americans, for those at the end stage of this disease heart transplantation remains the only and last resort. Acute myocardial infarction (AMI) is a leading cause of heart failure. Increasing evidence suggests that the body has a natural response for cardiac repair by up-regulating stromal cell-derived factor 1 (SDF-1), a stem cell active chemokine, which leads to recruitment of circulating BMSCs to ischemic hearts. However, up-regulation of endogenous SDF-1 is transient and inadequate to induce functionally meaningful heart regeneration. Therefore, the current study aimed to enhance stem cell-initiated cardiac repair by targeting circulating BMSCs to ischemic myocardium through targeted and regulated SDF-1 gene expression. To accomplish this goal, we have developed a regulatable system that consists of a MLC-2v promoter for cardiac selective expression as well as an oxygen-sensitive gene switch based on the oxygen-dependent degradation domain of hypoxia inducible factor 1α. It delivers genes of interest in a cardiac-selective and hypoxia-regulated manner in vitro and in vivo. AMI was surgically induced in adult BALB/c mice. DNA plasmid encoding hypoxia-regulated human SDF-1 was administered via intra-myocardial injection. PKH26 labeled BMSCs (6 × 106) were systemically injected immediately after induction of AMI. hSDF-1 expression was evaluated by Western blot analysis and the efficiency of hSDF-1 to attract implanted BMSCs was assessed by immunofluorescent staining and confocal microscopy. 1 week post AMI, hSDF-1 expression was markedly increased in the ischemic mouse heart, while less or no expression was detected in spleen, liver, lung, kidney and skeletal muscle nor in the heart of non-MI group. Confocal microscopy showed that hSDF-1 was highly expressed in the peri-infarct zone, with PKH26-labeled BMSCs enriched nearby. Furthermore, infarct size and cardiac fibrosis were significantly reduced in mice treated with hSDF-1 plus BMSCs compared to BMSCs alone. Taken together, our results indicate that cardiac-selective and hypoxia-inducible SDF-1 gene transfer activated mobilization of BMSCs to ischemic hearts and facilitated post-ischemic repair. This combined approach of regulated gene transfer and adult stem cells may provide a novel, safe and effective strategy for regenerative medicine, leading to efficient and timely repair of injured tissues.

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