Abstract

Cell therapy repair strategies using adult mesenchymal stromal cells have shown promising evidence to prevent cardiac deterioration in rodents even in the absence of robust differentiation of the cells into cardiomyocytes. We tested whether increasing doses of porcine adipose-tissue derived mesenchymal stem cells (pASCs) increase cardiac tissue perfusion in pigs post-myocardial infarction (MI) receiving angiotensin-converting-enzyme inhibitor (ACE inhibitors) and Beta-blockers similarly to patients. Female pigs were subjected to MI induction by sponge permanent occlusion of left circumflex coronary artery (LCx) generating approximately 10% of injured LV area with minimum hemodynamic impact. We assessed tissue perfusion by real time myocardial perfusion echocardiography (RTMPE) using commercial microbubbles before and following pASCs treatment. Four weeks after the occlusion of the left circumflex artery, we transplanted placebo or pASCs (1, 2 and 4x106 cells/Kg BW) into the myocardium. The highest dose of pASCs increased myocardial vessel number and blood flow in the border (56% and 3.7-fold, respectively) and in the remote area (54% and 3.9-fold, respectively) while the non-perfused scar area decreased (up to 38%). We also found an increase of immature collagen fibers, although the increase in total tissue collagen and types I and III was similar in all groups. Our results provide evidence that pASCs-induced stimulation of tissue perfusion and accumulation of immature collagen fibers attenuates adverse remodeling post-MI beyond the normal beneficial effects associated with ACE inhibition and beta-blockade.

Highlights

  • A loss of cardiomyocytes combined with fibroblast-derived collagen deposition alter the mechanical properties of the heart after a myocardial infarction (MI) and contributes to the functional deterioration of the organ and high cardiovascular morbidity and mortality [1,2,3,4,5,6,7]

  • The main finding of the present study is that the highest dose of transplanted adipose-derived mesenchymal stromal cells (ASC) into the myocardium (4 million cell/Kg) attenuated the adverse remodeling of the left ventricle (LV) by promoting an increase in vessel density and tissue perfusion accompanied by a pattern of tissue collagen deposition with a predominance of more immature collagen fibers and reduction in scar size regardless of the absence of transplanted cells 30 days after injection

  • Previous data from our lab showed that only 5–7% of bone-marrow (BM) mesenchymal stromal cells therapy (MSC) [13] and ASC [12] remain in the heart of rats 24 hours after a trans-epicardial injection while alternative routes resulted in virtually no cardiac engraftment

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Summary

Introduction

A loss of cardiomyocytes combined with fibroblast-derived collagen deposition alter the mechanical properties of the heart after a myocardial infarction (MI) and contributes to the functional deterioration of the organ and high cardiovascular morbidity and mortality [1,2,3,4,5,6,7]. Cell therapy regenerative strategies using embryonic stem cells (ESCs) [8] induced pluripotent stem cells (iPSCs) [9], and its derived cardiac progenitor cells (CPCs) [10] have all been. R.D. was a recipient of a post-doctoral fellowship from FAPESP

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