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Updated: May 24, 2026
Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Effect of autologous bone marrow mononuclear cells transplantation in diabetic patients with ST-segment elevation
Dongdong Sun1, Kazim Narsinh, Haichang Wang
1Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
Insights
Bone marrow mononuclear cell transplantation shows less benefit for diabetic patients with ST-segment elevation myocardial infarction (STEMI). This is linked to reduced cell function in diabetics, impacting stem cell self-renewal and myocardial repair.
Area of Science:
- Cardiovascular Medicine
- Regenerative Medicine
- Diabetes Mellitus Research
Background:
- Investigating the efficacy of bone marrow mononuclear cells (BMMNCs) transplantation in ST-segment elevation myocardial infarction (STEMI) patients.
- Comparing outcomes between diabetic and non-diabetic STEMI patients receiving BMMNCs.
Purpose of the Study:
- To evaluate the effectiveness of BMMNCs transplantation in STEMI patients.
- To explore the underlying mechanisms of BMMNCs efficacy in diabetic versus non-diabetic individuals.
Main Methods:
- 116 STEMI patients undergoing percutaneous coronary intervention (PCI) received intracoronary BMMNCs.
- Patients were stratified into diabetic (n=51) and non-diabetic (n=65) groups.
- Echocardiography, SPECT imaging, and clinical assessments were used for follow-up.
Main Results:
- Diabetes down-regulated key growth factors and stem cell-related genes (IGF-1, VEGF, Bmi-1, etc.).
- Non-diabetic patients showed significantly better improvements in LVEF, WMSI, myocardial perfusion, and reduced infarct size.
- Non-diabetic group experienced reduced anginal symptoms and greater improvement in 6-minute walk distance.
Conclusions:
- BMMNCs transplantation offers less benefit for diabetic STEMI patients compared to non-diabetic counterparts.
- The diminished efficacy in diabetics is associated with impaired BMMNCs function and altered gene expression.
- Findings highlight the impact of diabetes on stem cell therapy outcomes in myocardial infarction.
Background:
To investigate the efficacy and proposed mechanism of bone marrow mononuclear cells (BMMNCs) transplantation for diabetic and non-diabetic patients with ST-segment elevation myocardial infarction (STEMI).
Methods:
One hundred and sixteen patients with STEMI who had successfully undergone percutaneous coronary intervention (PCI) were divided into a diabetic group (n=51) and non-diabetic group (n=65). All of the patients received intracoronary injection of BMMNCs.
Results:
Diabetes down-regulated IGF-1, IGFBP-5, VEGF, SDF-1, IL-6, IL-1α and TNF-α expression and affected the expression of Bmi-1, Gfi1, Tel and Hox-B4 which could prevent premature senescence and maintain the self-renewal capacity of stem cells. Event-free survival rates were not statistically different between the diabetic and non-diabetic group (80% vs. 72.5%, p=0.382). LV ejection fraction (LVEF) and wall motion score index (WMSI) were evaluated by echocardiography and found to be significantly improved in the non-diabetic group compared to the diabetic group over the 4-year follow-up period. Improved myocardial perfusion and reduced infarct size in the non-diabetic group compared to the diabetic group was verified using single-photon emission computed tomographic (SPECT) imaging. The non-diabetic group also had reduced anginal symptoms as assessed by changes in their Seattle Angina Questionnaire scores and Canadian Cardiovascular Society (CCS) Functional Angina classification. An improvement of 6-minute walk distance (6MWD) was also noted to be higher in the non-diabetic group during the follow-up period.
Conclusion:
This study indicates that the beneficial effect of BMMNCs transplantation for STEMI is less pronounced in diabetic patients. The mechanism is associated with decreased BMMNCs function in diabetic patients.
