Abstract

Tissue engineered heart valve constructs (TEHVCs) are thought to be the solution for the increasing needs of heart valve replacements. Using decellularized xenograft valve matrices reseeded with autologous cells seems to fulfill the demands for durability, lack of coagulation and immune reactions, in the same time allowing growth and adaptability. The presently used cell sources are not viable as the TEHVCs frequently exhibit durability issues due to inefficient seeding and subsequent calcification. The natural valve interstitial cells are very heterogeneous, their role is to maintain the extracellular matrix which is responsible for bearing the mechanical and hemodynamic load. We have previously identified, in murine heart valves, a hematopoietic bone marrow-derived progenitor cell population. These progenitor cells are continuously migrating into the heart valves and appear to participate in the normal homeostasis. The heart valve progenitor cells identified in mice seems a good candidate for TEHVCs, but first, their existence must be validated in human heart valves. We used commercially available, paraffin-embedded, human mitral valve sections from 4 different individuals to immunohistochemically identify the hematopoietic-derived progenitor cells. Combination of anti-CD45 (pan hematopoietic marker) and anti-CD133 (progenitor marker) antibodies revealed a double-positive cell population in the proximal region (toward the annulus), atrial side of the mitral leaflets - exactly where we have found the similar cells in the murine system. By further phenotypic experiments, we have excluded the presence of B- and T-lymphocytes, granulocytes and macrophages. In contrast to the mouse findings, the human CD45 + /CD133 + cells are also expressing CD34 which further emphasizes their hematopoietic origin (in mouse the CD34 is not a hematopoietic marker). By co-labeling with CD31 (Pecam-1) markers, we found that the CD45 + /CD133 + cells are never part of the endocardium, although they can be observed closely underneath. In conclusion, we have identified the CD45 + /CD133 + cells, previously identified in mice as progenitor cells, in human mitral valves. Functional characterization of these cells and their use in TEHVCs is the focus of our future work.

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