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Delayed Intramyocardial Delivery of Stem Cells after Ischemia Reperfusion Injury in a Murine Model
Published on: September 3, 2020
[Effects of autologous bone marrow derived CD34+ stem cells on the left ventricular function following myocardial
László Balogh1, István Czuriga, János Hunyadi
1Debreceni Egyetem, Orvos- és Egészségtudományi Centrum, Altalános Orvostudományi Kar Kardiológiai Intézet, Debrecen Pf. 1. 4004.
Insights
Autologous bone marrow CD34+ stem cells improved heart function after myocardial infarction. This study shows CD34+ cells enhance left ventricular function and viability in heart attack patients.
Area of Science:
- Regenerative Medicine
- Cardiovascular Research
- Stem Cell Therapy
Background:
- Bone marrow cells show potential in healing myocardial infarction.
- Previous trials with bone marrow cells yielded mixed results due to cell population heterogeneity.
- The specific effective cell subpopulation remained unidentified.
Purpose of the Study:
- To investigate the safety and functional effects of autologous bone marrow CD34+ stem cells.
- To assess the impact of intracoronary CD34+ stem cell administration in recent myocardial infarction patients.
- To evaluate changes in left ventricular function and viability post-transplantation.
Main Methods:
- Intracoronary transplantation of autologous bone marrow CD34+ stem cells in 8 patients with recent myocardial infarction and impaired left ventricular function.
- Assessment using 2D-echocardiography, FDG-PET, and MIBI-SPECT before and 6 months after cell therapy.
- Analysis of global left ventricular function, regional viability, and myocardial perfusion.
Main Results:
- Significant improvement in global left ventricular ejection fraction (from 37.3% to 44.8%) six months post-transplantation.
- Significant increase in regional viability and metabolism in the infarct area (17.6%).
- A non-significant trend towards increased myocardial perfusion in the infarct region was observed.
Conclusions:
- Autologous bone marrow CD34+ stem cells are safe and effective for improving left ventricular function and viability after myocardial infarction.
- CD34+ cells represent a promising therapeutic subpopulation for cardiac repair post-myocardial infarction.
- This study provides the first evidence for the efficacy of CD34+ stem cell therapy in this patient group.
Abstract:
Both experimental and human clinical studies executed in the last 5 years suggested that bone marrow derived cells may participate in the healing process after myocardial infarction. A number of small clinical trials indicated mild or moderate beneficial effect of intracoronary administration of bone marrow derived stem cells after myocardial infarction. Most of the studies used mononuclear cell fraction; due to the cellular heterogeneity of this cell population the type of the effective subpopulation was not known. We investigated the safety and functional effects of the autologous bone marrow CD34+ stem cells after intracoronary administration in patients with recent myocardial infarction. 8 patients with impaired left ventricular function were transplanted with CD34+ bone marrow stem cells 12 +/- 1 day after the acute coronary event. 2D-echocardiography, FDG-PET and MIBI-SPECT were performed before transplantation and 6 month later. During the 6-month follow-up the global left ventricular function (basal EF 37.3 +/- 2.9%, after cell therapy 44.8 +/- 4.1%) and regional viability / metabolism increased significantly (17.6 +/- 13.5%). The increase of myocardial perfusion in the infarct region was tendentious but not significant. Our results demonstrate for the first time that the CD34+ subpopulation of bone marrow derived stem cells improves left ventricular function and viability after myocardial infarction.
