Injection of autologous bone marrow cells in hyaluronan hydrogel improves cardiac performance after infarction in pigs

Am J Physiol Heart Circ Physiol. 2014 Apr 1;306(7):H1078-86. doi: 10.1152/ajpheart.00801.2013. Epub 2014 Feb 7.

Abstract

Intramyocardial injection of bone marrow mononuclear cells (MNCs) with hyaluronan (HA) hydrogel is beneficial to the ischemic heart in a rat model of myocardial infarction (MI). However, the therapeutic efficacy and safety must be addressed in large animals before moving onto a clinical trial. Therefore, the effect of combined treatment on MI was investigated in pigs. Coronary artery ligation was performed in minipigs to induce MI followed by an intramyocardial injection of normal saline (n = 7), HA (n = 7), normal saline with 1 × 10(8) freshly isolated MNCs (n = 8), or HA with 1 × 10(8) MNCs (HA-MNC; n = 7), with a sham-operated group serving as a control (n = 7). The response of each experimental group was estimated by echocardiography, ventricular catheterization, and histological analysis. Although injection of HA or MNCs slightly elevated left ventricular ejection fraction, the combined HA-MNC injection showed a significant increase in left ventricular ejection fraction, contractility, infarct size, and neovascularization. Importantly, injection of MNCs with HA also promoted MNC retention and MNC differentiation into vascular lineage cells in pigs. Therefore, this study not only provides evidence but also raises the possibility of using a combined HA-MNC injection as a promising therapy for heart repair.

Keywords: cell therapy; hyaluronan; large animal model; myocardial infarction; neovascularization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Marrow Transplantation*
  • Cell Differentiation
  • Collagen / metabolism
  • Coronary Vessels / drug effects
  • Coronary Vessels / pathology
  • Coronary Vessels / physiopathology
  • Disease Models, Animal
  • Hemodynamics / drug effects
  • Hyaluronic Acid / administration & dosage*
  • Hydrogels
  • Injections, Intramuscular
  • Myocardial Contraction / drug effects
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / metabolism
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Myocardium / metabolism
  • Myocardium / pathology
  • Neovascularization, Physiologic / drug effects
  • Recovery of Function
  • Regeneration
  • Stroke Volume / drug effects
  • Swine
  • Swine, Miniature
  • Time Factors
  • Transplantation, Autologous
  • Ventricular Function, Left / drug effects*
  • Ventricular Remodeling / drug effects

Substances

  • Hydrogels
  • Hyaluronic Acid
  • Collagen