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Ann Thorac Surg 2009;87:794-801. doi:10.1016/j.athoracsur.2008.11.057
© 2009 The Society of Thoracic Surgeons

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Joseph H. Gorman, III
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Original Articles: Adult Cardiac

Allogeneic Mesenchymal Precursor Cell Therapy to Limit Remodeling After Myocardial Infarction: The Effect of Cell Dosage

Hirotsugu Hamamoto, MDa, Joseph H. Gorman, III, MDa, Liam P. Ryan, MDa, Robin Hinmon, MSa, Timothy P. Martens, MDb, Michael D. Schuster, MSb, Theodore Plappert, CVTc, Matti Kiupel, DVM, PhDd, Martin G. St. John-Sutton, MBBSc, Silviu Itescu, MDb, Robert C. Gorman, MDa,*

a Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
c Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
b Angioblast Systems Inc, New York, New York
d Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan

Accepted for publication November 19, 2008.

* Address correspondence to Dr Robert C. Gorman, Gorman Cardiovascular Research Group, Glenolden Research Laboratory, University of Pennsylvania, 500 S Ridgeway Ave, Glenolden, PA 19036 (Email: gormanr{at}uphs.upenn.edu).

Background: This experiment assessed the dose-dependent effect of a unique allogeneic STRO-3–positive mesenchymal precursor cell (MPC) on postinfarction left ventricular (LV) remodeling. The MPCs were administered in a manner that would simulate an off-the-self, early postinfarction, preventative approach to cardiac cell therapy in a sheep transmural myocardial infarct (MI) model.

Methods: Allogeneic MPCs were isolated from male crossbred sheep. Forty-six female sheep underwent coronary ligation to produce a transmural LV anteroapical infarction. One hour after infarction, the borderzone myocardium received an injection of 25, 75, 225, or 450 x 106 MPCs, or cell medium. Echocardiography was performed at 4 and 8 weeks after MI to quantify LV end-diastolic (LVEDV) and end-systolic volumes (LVESV), ejection fraction (EF), and infarct expansion. CD31 and smooth muscle actin (SMA) immunohistochemical staining was performed on infarct and borderzone specimens to quantify vascular density.

Results: Compared with controls, low-dose (25 and 75 x 106 cells) MPC treatment significantly attenuated infarct expansion and increases in LVEDV and LVESV. EF was improved at all cell doses. CD31 and SMA immunohistochemical staining demonstrated increased vascular density in the borderzone only at the lower cell doses. There was no evidence of myocardial regeneration within the infarct.

Conclusion: Allogeneic STRO-3 positive MPCs attenuate the remodeling response to transmural MI in a clinically relevant large-animal model. This effect is associated with vasculogenesis and arteriogenesis within the borderzone and infarct and is most pronounced at lower cell doses.




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