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CD133+Exosome Treatment Improves Cardiac Function after Stroke in Type 2 Diabetic Mice
Poornima Venkat1, Chengcheng Cui1, Zhili Chen1
1Department of Neurology, Henry Ford Hospital, Detroit, MI, 48202, USA.
Insights
Exosomes from CD133+ cells (CD133+Exo) improve cardiac function in type 2 diabetes mellitus (T2DM) stroke mice by reducing inflammation and fibrosis. This therapy shows promise for managing post-stroke cardiac complications in diabetic patients.
Area of Science:
- Cardiovascular Research
- Regenerative Medicine
- Diabetes Complications
Background:
- Cardiac complications are frequent after stroke, with diabetes mellitus (T2DM) worsening cardiac injury.
- Existing treatments for post-stroke cardiac dysfunction in diabetic individuals are limited.
- Exosomes derived from specific stem cell populations are being investigated for therapeutic potential.
Purpose of the Study:
- To evaluate the efficacy of exosomes from human umbilical cord blood CD133+ cells (CD133+Exo) in improving cardiac function in a mouse model of type 2 diabetes mellitus (T2DM) with stroke.
- To investigate the underlying mechanisms of CD133+Exo's cardioprotective effects, including microRNA-126 (miR-126) expression, capillary density, and inflammatory markers.
Main Methods:
- Type 2 diabetes mellitus (T2DM) and non-diabetic mice underwent photothrombotic stroke or sham procedures.
- T2DM-stroke mice received intravenous injections of phosphate-buffered saline (PBS) or CD133+Exo.
- Cardiac function (echocardiography), cardiac histology (hypertrophy, fibrosis, capillary density), inflammatory markers, oxidative stress, and miR-126 expression were assessed 28 days post-stroke.
Main Results:
- CD133+Exo treatment significantly improved cardiac function in T2DM-stroke mice, evidenced by increased left ventricular ejection fraction (LVEF) and decreased left ventricular diastolic dimension (LVDD).
- Treatment reduced cardiac hypertrophy, interstitial fibrosis, M1 macrophage infiltration, and oxidative stress markers in T2DM-stroke mice.
- CD133+Exo treatment increased myocardial capillary density and upregulated miR-126 expression in the heart, while decreasing its target genes (Spred-1, VCAM, MCP1).
Conclusions:
- Exosomes derived from CD133+ cells (CD133+Exo) demonstrate significant cardioprotective effects in a mouse model of type 2 diabetes mellitus with stroke.
- The therapeutic benefits are likely mediated by increased miR-126 expression, enhanced myocardial capillary density, and reduced cardiac inflammation and fibrosis.
- CD133+Exo therapy represents a promising strategy for mitigating cardiac injury following stroke in diabetic patients.
Abstract:
Cardiac complications post-stroke are common, and diabetes exacerbates post-stroke cardiac injury. In this study, we tested whether treatment with exosomes harvested from human umbilical cord blood derived CD133+ cells (CD133+Exo) improves cardiac function in type 2 diabetes mellitus (T2DM) stroke mice. Adult (3-4 m), male, BKS.Cg-m+/+Leprdb/J (db/db, T2DM) and non-DM (db+) mice were randomized to sham or photothrombotic stroke groups. T2DM-stroke mice were treated with phosphate-buffered saline (PBS) or CD133+Exo (20 μg, i.v.) at 3 days after stroke. T2DM sham and T2DM+CD133+Exo treatment groups were included as controls. Echocardiography was performed, and mice were sacrificed at 28 days after stroke. Cardiomyocyte hypertrophy, myocardial capillary density, interstitial fibrosis, and inflammatory factor expression were measured in the heart. MicroRNA-126 expression and its target gene expression were measured in the heart. T2DM mice exhibit significant cardiac deficits such as decreased left ventricular ejection fraction (LVEF) and shortening fraction (LVSF), increased left ventricular diastolic dimension (LVDD), and reduced heart rate compared to non-DM mice. Stroke in non-DM and T2DM mice significantly decreases LVEF compared to non-DM and T2DM-sham, respectively. Cardiac dysfunction is worse in T2DM-stroke mice compared to non-DM-stroke mice. CD133+Exo treatment of T2DM-stroke mice significantly improves cardiac function identified by increased LVEF and decreased LVDD compared to PBS treated T2DM-stroke mice. In addition, CD133+Exo treatment significantly decreases body weight and blood glucose but does not decrease lesion volume in T2DM-stroke mice. CD133+Exo treatment of T2DM mice significantly decreases body weight and blood glucose but does not improve cardiac function. CD133+Exo treatment in T2DM-stroke mice significantly decreases myocardial cross-sectional area, interstitial fibrosis, transforming growth factor beta (TGF-β), numbers of M1 macrophages, and oxidative stress markers 4-HNE (4-hydroxynonenal) and NADPH oxidase 2 (NOX2) in heart tissue. CD133+Exo treatment increases myocardial capillary density in T2DM-stroke mice as well as upregulates endothelial cell capillary tube formation in vitro. MiR-126 is highly expressed in CD133+Exo compared to exosomes derived from endothelial cells. Compared to PBS treatment, CD133+Exo treatment significantly increases miR-126 expression in the heart and decreases its target gene expression such as Sprouty-related, EVH1 domain-containing protein 1 (Spred-1), vascular cell adhesion protein (VCAM), and monocyte chemoattractant protein 1 (MCP1) in the heart of T2DM-stroke mice. CD133+Exo treatment significantly improves cardiac function in T2DM-stroke mice. The cardio-protective effects of CD133+Exo in T2DM-stroke mice may be attributed at least in part to increasing miR-126 expression and decreasing its target protein expression in the heart, increased myocardial capillary density and decreased cardiac inflammatory factor expression.
