骨髓间充质干细胞体内诱导分化为心肌细胞

观察骨髓间充质干细胞(mesenchymal stem cells,MSCs)植入体内后,在心肌微环境诱导下分化为心肌细胞的能力。无菌条件下取出大鼠双侧股骨及胫骨,冲洗骨髓腔获得细胞,贴壁筛选法纯化MSCs,体外培养、扩增,4,6-二咪基-4-联苯基吲哚(4,6-diamidino-2-phenylindole,DAPI)标记细胞,注入结扎冠脉左前降支所致心肌梗塞模型鼠的心肌组织。在不同时间点处死大鼠,获取心肌组织,采用HE染色和电镜技术对植入MSCs进行形态学观察和超微结构检测,荧光免疫组化检测植入MSCs肌球蛋白重链(MHC)和心肌特异性抗原Cx43的表达,同时应用RT-PCR技术检测心脏早期发育基因NKx2．5、GATA-4的表达。结果发现细胞标记效率为100％,通过连续检测MSCs植入后细胞形态从无规则状态、幼稚细胞表型逐渐向成熟心肌细胞方向转化,植入细胞排列同正常肌纤维方向平行,且植入四周后电镜检测到闰盘的存在;两周出现MHC的表达,后随时间延长表达逐渐增强。四周出现Cx43的表达,以后表达稳定,RT-PCR检测NKx2．5、GATA-4在一天即出现弱表达,两周～三周时表达最强,以后强度逐渐减弱。结果表明MSCs在体内微环境条件下能够转化为心肌细胞。     

贯叶连翘提取物对扩张型心肌病大鼠缝隙连接蛋白Cx43的影响

目的:研究贯叶连翘提取物(HPE)对扩张型心肌病(DCM)大鼠心肌缝隙连接蛋白Cx43表达的作用。方法:以腹腔注射阿霉素建立DCM大鼠模型为基础,分析心肌缝隙连接蛋白(Cx43)表达差异性。结果:治疗组大鼠Cx43蛋白以及Cx43mRNA显著高于模型组。结论:HPE可能通过对Cx43受体敏感性的调节而改变Cx43表达,改善DCM大鼠心功能。     

心肌细胞／胶原复合体移植心梗大鼠梗死周边区的电偶联网络变化

目的应用免疫组化技术和电生理技术记录心肌细胞／胶原复合体对心梗大鼠梗死周边区的有效不应期（ERP）及缝隙连接蛋白43（Cx43）改变,探讨梗死周边区的电偶联网络变化。方法将成年SD大鼠随机分组：假手术组、模型组、移植组。后2组制作心肌梗死动物模型,假手术组仅开胸,不结扎冠状动脉,移植组移植心肌细胞与胶原材料复合组织。结果①左室ERP变化：与假手术组相比,心梗组梗死周边区ERP显著延长（P〈0．01）;移植组梗死周边区ERP延长,但较心梗阻ERP缩短,差异无显著性（P〉0．01）。②Cx43免疫组化结果：移植组Cx43阳性蛋白表达高于心梗组。结论移植的心肌细胞／胶原复合体移植可改善大鼠心肌梗死周边区缝隙连接电偶联网络,进而调控心肌细胞／胶原复合体与宿主心肌同步收缩。     

重组腺病毒Ad5-ADRbeta2-EGFP转染骨髓间充质干细胞移植治疗心衰大鼠的实验研究

目的:重组腺病毒Ad5-ADRbeta2-EGFP转染骨髓间充质干细胞(BMSCs)并植入心衰大鼠心肌,观察其心功能的变化.方法:采用部分缩窄腹主动脉法制备大鼠压力超负荷性慢性心力衰竭模型.分离和培养成年大鼠BMSCs,待细胞传代到第6代,用重组腺病毒Ad5-ADRbeta2-EGFP转染BMSCs48h后将BMSCs移植入心衰大鼠心肌内.实验共分3组:心衰组、移植BMSCs组及移植转染Ad5-ADRbeta2-EGFP的BMSCs组.移植BMSCs(1×104)4周后,检测大鼠血流动力学各指标的变化.结果:荧光显微镜下可见转染BMSCs绿色荧光蛋白表达达到80%以上.移植BMSCs组和移植转染Ad5-ADRbeta2-EGFP的BMSCs组的左心室舒张末压力(LVEDP)低于心衰组,左心室内压变化最大速率(±dp/dt max)和心率均高于心衰组,差异均有统计学意义(P<0.05).移植转染Ad5-ADRbeta2-EGFP的BMSCs组的左心室内压上升最大速率(+dp/dt)高于移植BMSCs组,差异有统计学意义(P<0.05).结论:重组腺病毒Ad5-ADRbeta2-EGFP转染BMSCs并移植入心衰大鼠后,能够改善心衰大鼠的心功能.     

低氧对大鼠右心室肥厚及心肌中缝隙连接蛋白43表达的影响

目的:研究低氧对大鼠右心室肥厚及心肌中缝隙连接蛋白43 (Cx43)表达的影响.方法:40只健康雄性SD大鼠随机分为正常组(control)、低氧3周组、低氧4周组和低氧5周组.除正常组外,其余3组大鼠分别在低氧环境中饲养3周、4周和5周.测定和比较各组大鼠的平均肺动脉压力(mPAP)、右心室收缩压(RVSP)、右心室肥厚度[Rv/(LV+S)％],并通过免疫组化染色法观察各组大鼠左心室心肌细胞中cx43的表达.结果:与正常组相比,低氧3周、4周、5周组大鼠的mPAP、RVSP、右心室肥厚度均显著升高(P均＜0.05),与低氧3周组比较,低氧4周、5周组大鼠的mPAP、RVSP、右心室肥厚度均显著升高(P均＜0.05),而低氧5周组大鼠的mPAP、RVSP、右心室肥厚度均显著高于低氧4周(P均＜0.05).免疫组织化学结果显示:低氧组大鼠Cx43排列紊乱,端-端连接减少,侧面连接增多;随着低氧时间的延长,大鼠心肌细胞中Cx43的表达逐渐减少,差异具有统计学意义(P均＜0.05).结论:低氧可导致右心室肥厚,并随着诱导时间的延长而逐渐加重,这可能与心肌中Cx43的分布紊乱及表达减少有关.     

骨髓基质干细胞移植对扩张型心肌病心衰大鼠心功能改善作用机制的研究

通过对心肌胶原纤维、微血管生成、血管内皮生长因子(VEGF)及其受体表达的研究,探讨骨髓基质干细胞(BMSSCs)心肌内移植对扩张型心肌病心衰大鼠心功能的保护机制．应用阿霉素注射法建立扩张型心肌病心衰大鼠模型,成功建模后移植4', 6-二乙酰基-2-苯基吲哚(DAPI)标记的BMSSCs．分别于术后1、2、3、4周进行血流动力学检测,利用免疫组化、RT-PCR技术分析心肌胶原纤维、血管内皮生长因子(VEGF)及其受体Flt-1、Flk-1表达的改变,以及微血管密度．结果显示,移植细胞于术后4周通过免疫荧光可检测到存活．于术后2周开始,移植组心功能较对照组改善,表现为移植组收缩压(LVSP)、左心室内压最大上升或下降速率(?dp/dt)较对照组显著升高,舒张压(LVDP)显著下降,P < 0.05．移植组心肌胶原纤维沉积减少,光密度值比较P < 0.05．移植组VEGF、Flt-1、Flk-1表达较同期对照组增加,并张且与其受体达峰时间不同步．4周时移植组微血管密度明显高于对照组．上述结果表明,BMSSCs移植后可通过上调受体内VEGF、Flt-1、Flk-1的表达,促进血管新生,减少胶原纤维沉积,从而改善受体心脏的功能．     

心肌肥厚大鼠心肌Cx43的表达及法舒地尔的干预作用

目的：研究腹主动脉缩窄大鼠心肌缝隙连接蛋白Cx43的变化及法舒地尔的干预作用。方法：腹主动脉缩窄建立心肌肥厚大鼠模型,随机分假手术组,腹主动脉缩窄组、腹主动脉缩窄＋10mg／kg法舒地尔（ip,每天1次,8周）组、腹主动脉缩窄＋40mg／kg（ip,每天1次,8周）。病理切片观察心肌组织学变化;免疫组化法检测心肌Cx43蛋白表达。结果：模型组大鼠心肌细胞排列紊乱,肥大,间隙增宽,Cx43蛋白表达量明显低于正常组;Fas治疗后,死亡率下降,cx43蛋白表达量高于模型组,差异具有统计学意义（P〈0．01）。结论：Fas可能通过调高Cx43蛋白表达,治疗大鼠心肌肥厚。     

电刺激提高分化心肌细胞成熟度并改善心肌梗死大鼠心脏功能

该研究探讨了电刺激对诱导多能干细胞的心脏分化影响,并评估了分化心肌细胞对心肌梗死的治疗效果。电刺激和非电刺激促进诱导多能干细胞分化出功能性心肌细胞;qRT-PCR和细胞免疫荧光检测分化心肌细胞中心源性基因和功能成熟基因表达情况;建立心肌梗死模型SD大鼠并将其随机分为心肌梗死组、电刺激组和对照组,每组10只。心肌梗死组只结扎冠状动脉,电刺激组和对照组分别在心肌梗死边界注射电刺激和无电刺激预处理的分化心肌细胞。超声心动图和有创血流动力学检测心功能;Masson染色评估梗死面积,免疫组化检测梗死边缘区毛细血管密度。结果表明,电刺激可提高分化心肌细胞的自发搏动,并上调分化心肌细胞中心源性基因(Nkx2-5、GATA4、α-MHC和CX-43)和功能成熟基因(α-actinin和RYR2)的表达(P0.05)。电刺激明显改善心肌梗死大鼠心功能,减小梗死面积和增加梗死边缘区毛细血管密度(P0.05)。以上结果表明,电刺激可提高诱导多能干细胞的心脏分化效率并促进分化心肌细胞的成熟;经电刺激预处理的分化心肌细胞可明显改善心肌梗死大鼠心功能。     

自体内皮前体细胞移植对急性心肌梗死大鼠微血管新生及心功能的影响

目的探讨外周血来源的内皮前体细胞自体移植,对大鼠急性心肌梗死后微血管新生与心功能的影响。方法抽取SD大鼠外周动脉血,应用Ficoll密度梯度离心法获取单个核细胞。应用含有VEGF和bFGF的特定培养基体外培养,得到内皮前体细胞;结扎SD大鼠冠状动脉左前降支,建立急性心肌梗死模型;然后将得到的自体内皮前体细胞植入缺血心肌局部区域。对照组动物注入细胞培养液。结果与对照组比较,细胞移植组大鼠心功能明显改善,心肌收缩力显著优于对照组;梗死心肌微血管新生更为明显。结论急性心肌梗死心肌局部移植外周血来源的自体内皮前体细胞,能够促进血管新生;对局部梗死心肌组织结构有一定的保护作用,并可在不同时点不同程度恢复心肌收缩力,显著改善心功能。     

PKC βII特异性抑制剂LY333531减缓心肌梗死后心肌纤维化

目的:探讨蛋白激酶CβⅡ(PKCβⅡ)特异性抑制剂LY333531对心梗后大鼠心功能和心肌纤维化的保护作用。方法:利用左冠状动脉降支(LAD)结扎制备大鼠心梗模型,将手术4周后出现心衰的大鼠分为模型组(MF+NS)和治疗组(MF+LY333531),分别给予生理盐水和LY333531(10 mg/kg/d)处理6周,检测各组大鼠体重和各项心功能指标,利用HE染色观察各组大鼠心肌组织形态变化,利用天狼星红染色观察心肌组织胶原沉积情况。结果:相对于模型组,LY333531处理组大鼠左心室缩短率(FS)明显改善(从21%到35%)。HE染色显示LY333531能够部分逆转心衰大鼠心室壁肥厚和心肌细胞宽度,天狼星红染色显示治疗组胶原蛋白沉积降低150%。结论:使用LY333531选择性抑制PKCβⅡ能够改善心梗后心力衰竭模型大鼠心脏功能和抑制心肌纤维化。     

Intravenous administration of mesenchymal stem cells improves cardiac function in rats with acute myocardial infarction through angiogenesis and myogenesis

Mesenchymal stem cells (MSCs) are pluripotent cells that differentiate into a variety of cells, including cardiomyocytes and endothelial cells. However, little information is available regarding the therapeutic potency of systemically delivered MSCs for myocardial infarction. Accordingly, we investigated whether intravenously transplanted MSCs induce angiogenesis and myogenesis and improve cardiac function in rats with acute myocardial infarction. MSCs were isolated from bone marrow aspirates of isogenic adult rats and expanded ex vivo. At 3 h after coronary ligation, 5 x 10(6) MSCs (MSC group, n=12) or vehicle (control group, n=12) was intravenously administered to Lewis rats. Transplanted MSCs were preferentially attracted to the infarcted, but not the noninfarcted, myocardium. The engrafted MSCs were positive for cardiac markers: desmin, cardiac troponin T, and connexin43. On the other hand, some of the transplanted MSCs were positive for von Willebrand factor and formed vascular structures. Capillary density was markedly increased after MSC transplantation. Cardiac infarct size was significantly smaller in the MSC than in the control group (24 +/- 2 vs. 33 +/- 2%, P <0.05). MSC transplantation decreased left ventricular end-diastolic pressure and increased left ventricular maximum dP/dt (both P <0.05 vs. control). These results suggest that intravenous administration of MSCs improves cardiac function after acute myocardial infarction through enhancement of angiogenesis and myogenesis in the ischemic myocardium.     

Xenogenic cardiomyocytes transplantation for the treatment of curing acute myocardial infarction

The autogenic cardiomyocytes transplantation presents numerous challenges in clinical application, such as the difficulty to obtain the autogenic cells, etc. Therefore, it is necessary to investigate allogenic or xenogenic cardiomyocytes transplantation. In this study, the experimental rabbits with acute infarcted myocardium were randomly divided into 3 groups: the 7-day cultured cardiomyocytes group, the 2-day cultured cardiomyocytes group and the control group. Neonate rat cardiomyocytes were labeled by DAPI and then injected into the acute infarcted myocardium of rabbits. After transplantation, results showed that, compared to the control group, the survival number of grafted cardiomyocytes in the cultured group is significantly larger (P < 0.05), with the implanted cardiomyocytes parallel to the host myocardium in an aligning direction. However, compared to the control group, the ventricular wall of the two experimental groups is thicker and the condition of myocardial fibrosis is better, especially to 7-day cultured cardiomyocytes group. These results suggested that the transplantation of xenogenic cardiomyocytes into curing acute ischemic heart of animal model is possible.     

Reduced atrial connexin43 expression after pediatric heart surgery

Myocardial dysfunction and arrhythmias may be induced by congenital heart defects, but also be the result of heart surgery with cardiopulmonary bypass (CPB), potentially caused by differential expression of connexin40 (Cx40) and connexin43 (Cx43). In 16 pediatric patients undergoing corrective heart surgery, connexin mRNA expression was studied in volume overloaded (VO group, n=8) and not overloaded (NO group, n=8) right atrial myocardium, excised before and after CPB. Additionally, in eight of these patients ventricular specimens were investigated. The atrial Cx43 expression decreased during CPB, which was restricted to the VO group (p=0.008). In contrast, atrial Cx40 mRNA did not change during CPB. In ventricular myocardium compared to atrial mRNA levels, Cx40 was lower (p=0.006) and Cx43 higher (p=0.017) expressed, without significant change during CPB. This study revealed a significant influence of CPB and the underlying heart defect on Cx43 expression.     

Transplantation of embryonic stem cells improves cardiac function in postinfarcted rats.

Massive loss of cardiac myocytes after myocardial infarction (MI) is a common cause of heart failure. The present study was designed to investigate the improvement of cardiac function in MI rats after embryonic stem (ES) cell transplantation. MI in rats was induced by ligation of the left anterior descending coronary artery. Cultured ES cells used for cell transplantation were transfected with the marker green fluorescent protein (GFP). Animals in the treated group received intramyocardial injection of ES cells in injured myocardium. Compared with the MI control group injected with an equivalent volume of the cell-free medium, cardiac function in ES cell-implanted MI animals was significantly improved 6 wk after cell transplantation. The characteristic phenotype of engrafted ES cells was identified in implanted myocardium by strong positive staining to sarcomeric alpha-actin, cardiac alpha-myosin heavy chain, and troponin I. GFP-positive cells in myocardium sectioned from MI hearts confirmed the survival and differentiation of engrafted cells. In addition, single cells isolated from cell-transplanted MI hearts showed rod-shaped GFP-positive myocytes with typical striations. The present data demonstrate that ES cell transplantation is a feasible and novel approach to improve ventricular function in infarcted failing hearts.     

Transplantation of embryonic stem cell-derived cardiomyocytes improves cardiac function in infarcted rat hearts

BACKGROUND: Post-infarct congestive heart failure is one of the leading causes of morbidity and mortality in industrialized countries. The main purpose of this study was to investigate whether transplantation of embryonic stem cell-derived cardiomyocytes (ESCM) directly into the infarcted myocardium could improve cardiac function in rats. METHODS: Cell culture medium with or without ESCM was injected into the borders of cardiac scar tissue 1 week after experimental infarction. Cardiac performance was evaluated 4 weeks later by means of echocardiography after ESCM (n=16) or medium (n=12) injection. RESULTS: ESCM implantation significantly improved fractional shortening (31.5+/-3. 8%) compared with medium-treated hearts (21.3+/-5.2%; P<0.05) and preserved left ventricular structure. Co-localization of 4',6-diamidino-2-phenylindole-labeled nuclei of transplanted cells with cardiomyocyte markers for cardiac troponin T and connexin-43, as detected by immunofluorescent microscopy, indicated the regeneration of damaged myocardium and the formation of gap junctions between grafted and host cells. However, intra-myocardial teratomas were observed in the hearts of two of the 16 grafted animals, at the fourth week after ESCM transplantation. DISCUSSION: Our results suggest that, although ESCM implantation can improve the function of infarcted myocardium, strategies to prevent tumorigenesis should be developed.     

Stem cell engineering for treatment of heart diseases: Potentials and challenges

Heart disorders are a major health concern worldwide responsible for millions of deaths every year. Among the many disorders of the heart, myocardial infarction, which can lead to the development of congestive heart failure, arrhythmias, or even death, has the most severe social and economic ramifications. Lack of sufficient available donor hearts for heart transplantation, the only currently viable treatment for heart failure other than medical management options (ACE inhibition, beta blockade, use of AICDs, etc.) that improve the survival of patients with heart failure emphasises the need for alternative therapies. One promising alternative replaces cardiac muscle damaged by myocardial infarction with new contractile cardiomyocytes and vessels obtained through stem cell-based regeneration.We report on the state of the art of recovery of cardiac functions by using stem cell engineering. Current research focuses on (a) inducing stem cells into becoming cardiac cells before or after injection into a host, (b) growing replacement heart tissue in vitro, and (c) stimulating the proliferation of the post-mitotic cardiomyocytes in situ. The most promising treatment option for patients is the engineering of new heart tissue that can be implanted into damaged areas. Engineering of cardiac tissue currently employs the use of co-culture of stem cells with scaffold microenvironments engineered to improve tissue survival and enhance differentiation. Growth of heart tissue in vitro using scaffolds, soluble collagen, and cell sheets has unique advantages. To compensate for the loss of ventricular mass and contractility of the injured cardiomyocytes, different stem cell populations have been extensively studied as potential sources of new cells to ameliorate the injured myocardium and eventually restore cardiac function. Unresolved issues including insufficient cell generation survival, growth, and differentiation have led to mixed results in preclinical and clinical studies. Addressing these limitations should ensure the successful production of replacement heart tissue to benefit cardiac patients.     

Age- and myopathy-dependent changes in connexins of normal and cardiomyopathic Syrian hamster ventricular myocardium

The conduction of cardiac action potentials depends on the flow of excitation through gap junctions, which are hexameric protein associations of connexins (Cxs). The major Cx reported in the heart is Cx43, although some Cx40 and Cx45 are also present. There is some evidence for altered Cx content in heart failure. In heart failure, conduction is depressed and slowed conduction may contribute to arrhythmogenesis and (or) the maintenance of arrhythmia. Cx content and distribution were determined in ventricular tissues from normal and cardiomyopathic Syrian hamsters, an animal model of heart failure which has reproducible age-specific cardiomyopathy resulting in heart failure and age-matched controls in three groups: young (3-5 weeks), adult (13-18 weeks), and old (>45 weeks). Frozen, unfixed sections of ventricular tissues were immunofluorescently stained using antibodies against Cx43, Cx40, and Cx45. Cx43 was the predominant Cx detected in all samples. In normal hamsters, Cx43 was localized predominantly at the intercalated disc region, while in myopathic myocytes, it was scattered. In Western blots, Cx43 content of normal hamster hearts was highest in the adult hearts compared with young and old hamster hearts. In contrast, Cx43 content was significantly lower in adult cardiomyopathic hamster hearts compared with all other groups. The alterations of content and distribution of gap junction Cx43 may contribute to diminished conduction, pump function, and arrhythmogenesis in heart failure.