Repeated Administrations of Cardiac Progenitor Cells Are Markedly More Effective Than a Single Administration: A New Paradigm in Cell Therapy

Circ Res. 2016 Aug 19;119(5):635-51. doi: 10.1161/CIRCRESAHA.116.308937. Epub 2016 Jun 30.

Abstract

Rationale: The effects of c-kit(POS) cardiac progenitor cells (CPCs, and adult cell therapy in general) on left ventricular (LV) function have been regarded as modest or inconsistent.

Objective: To determine whether 3 CPC infusions have greater efficacy than 1 infusion.

Methods and results: Rats with a 30-day-old myocardial infarction received 1 or 3 CPC infusions into the LV cavity, 35 days apart. Compared with vehicle-treated rats, the single-dose group exhibited improved LV function after the first infusion (consisting of CPCs) but not after the second and third (vehicle). In contrast, in the multiple-dose group, regional and global LV function improved by a similar degree after each CPC infusion, resulting in greater cumulative effects. For example, the total increase in LV ejection fraction was approximately triple in the multiple-dose group versus the single-dose group (P<0.01). The multiple-dose group also exhibited more viable tissue and less scar, less collagen in the risk and noninfarcted regions, and greater myocyte density in the risk region.

Conclusions: This is the first demonstration that repeated CPC administrations are markedly more effective than a single administration. The concept that the full effects of CPCs require repeated doses has significant implications for both preclinical and clinical studies; it suggests that the benefits of cell therapy may be underestimated or even overlooked if they are measured after a single dose, and that repeated administrations are necessary to evaluate the effectiveness of a cell product properly. In addition, we describe a new method that enables studies of repeated cell administrations in rodents.

Keywords: cardiac progenitor cells; cell therapy; collagen; left ventricular function; myocardial infarction; reperfusion injury; ventricular remodeling.

MeSH terms

  • Animals
  • Cell Survival / physiology
  • Cell- and Tissue-Based Therapy / methods
  • Cell- and Tissue-Based Therapy / trends
  • Female
  • Male
  • Myocardial Infarction / pathology
  • Myocardial Infarction / therapy*
  • Myocytes, Cardiac / physiology*
  • Rats
  • Rats, Inbred F344
  • Stem Cell Transplantation / methods*
  • Stem Cell Transplantation / trends
  • Stem Cells / physiology*
  • Ventricular Function, Left / physiology