Browsing Theses and Dissertations by Subject "Myocardial Infarction"
Now showing items 1-4 of 4
Bone-derived stem cells repair the heart after myocardial infarction through transdifferentiation and paracrine signaling mechanismsRationale: Autologous bone marrow- or cardiac-derived stem cell therapy for heart disease has demonstrated safety and efficacy in clinical trials but has only offered limited functional improvements. Finding the optimal stem cell type best suited for cardiac regeneration remains a key goal toward improving clinical outcomes. Objective: To determine the mechanism by which novel bone-derived stem cells support the injured heart. Methods and Results: Cortical bone stem cells (CBSCs) and cardiac-derived stem cells (CDCs) were isolated from EGFP+ transgenic mice and were shown to express c-kit and Sca-1 as well as 8 paracrine factors involved in cardioprotection, angiogenesis and stem cell function. Wild-type C57BL/6 mice underwent sham operation (n=21) or myocardial infarction (MI) with injection of CBSCs (n=57), CDCs (n=31) or saline (n=57). Cardiac function was monitored using echocardiography with strain analysis. EGFP+ CBSCs in vivo were shown to express only 2/8 factors tested (basic fibroblast growth factor and vascular endothelial growth factor) and this expression was associated with increased neovascularization of the infarct border zone. CBSC and CDC therapy improved survival, cardiac function, attenuated adverse remodeling, and decreased infarct size relative to saline-treated MI controls. CBSC treated animals showed the most pronounced improvements in all parameters. By 6 weeks post-MI, EGFP+ cardiomyocytes, vascular smooth muscle cells and endothelial cells could be identified on histology in CBSC-treated animals but not in CDC-treated animals. EGFP+ myocytes isolated from CBSC-treated animals were smaller, more frequently mononucleated, and demonstrated fractional shortening and calcium currents indistinguishable from EGFP- myocytes from the same hearts. Conclusions: CBSCs improve survival, cardiac function, and attenuate remodeling more so than CDCs and this occurs through two mechanisms: 1) secretion of the proangiogenic factors bFGF and VEGF (which stimulates endogenous neovascularization), and 2) differentiation into functional adult myocytes and vascular cells.
Engineering Nanoparticles for Targeted Delivery of Growth Factors to Prevent Cardiac Remodeling After an MIMyocardial infarction (MI) is a leading cause of death in the United States, claiming the lives of approximately 500,000 people each year. The infarcted heart undergoes a compensatory process called cardiac remodeling, which adversely changes left ventricular (LV) size and function and eventually may lead to heart failure. To date, the only clinical treatments for this condition include surgical restoration of blood flow to the ischemic region (e.g., angioplasty), or pharmacological treatments (e.g., angiotensin converting enzyme inhibitors) which indirectly manage the symptoms of cardiac remodeling. Reperfusion of ischemic heart tissue significantly limits myocardial damage after an MI; however, many MI patients are not candidates for traditional reperfusion surgery. Recently, there has been much interest in non-surgical myocardial reperfusion via pro-angiogenic compounds, specifically vascular endothelial growth factor (VEGF). Although animal studies using therapeutic VEGF have shown promising results, these results have failed to translate into successful clinical trials. This may be due to the short half-life of VEGF in circulation. Increasing the dose of VEGF may increase its availability to the target tissue, but harmful side-effects remain a concert. Encapsulating VEGF and selectively targeting it to the MI border zone may improve vascularization, cardiac function, reduce adverse remodeling associated with MI, and may avoid harmful side effects associated with systemic delivery. Anti-P-selectin conjugated immunoliposomes containing VEGF were developed to target the P-selectin ligand overexpressed in the infarct border zone in a rat MI model. Serial echocardiography and Doppler imaging were used to characterize evolutionary changes in LV geometry and function over a period of four weeks after MI. At four weeks, hearts were excised and stained to measure vascularization and collagen deposition. Targeted VEGF treatment resulted in significant improvements in fractional shortening at four weeks post-infarction (32.9 ± 2.2% for targeted VEGF treated vs. 16.9 ± 1.4% for untreated MI). Functional improvements in treated MI hearts were accompanied by a 74% increase in perfused vessels in the MI border zone, compared to untreated MI hearts. Left ventricular filling dynamics were significantly improved in the targeted VEGF treated group, which resulted in a decrease in LV end diastolic pressure in VEGF treated hearts (23.4 ± 2.9 mm Hg), compared to untreated MIs (81.8 ± 31.8 mm Hg). At four weeks after infarction, hearts treated with targeted VEGF therapy exhibited a 37% reduction in collagen deposition, compared to untreated MI hearts. Targeted VEGF therapy significantly improves vascularization, cardiac function, and moderates adverse cardiac remodeling after an infarction.
INCREASING MYOCYTE CONTRACTILITY EXACERBATES CARDIAC INJURY AND PUMP DYSFUNCTION AND ABLATION OF PHOSPHORYLATIONMyocardial infarction (MI) leads to heart failure (HF) and premature death. The respective roles of myocyte death and depressed myocyte contractility in the induction of HF after MI have not been clearly defined. Cardiac ryanodine receptor (RyR2) has been linked to cardiac arrhythmias and HF. It has been controversial that protein kinase A (PKA) hyperphosphorylation of the RyR2 at a single residue, Ser-2808 is a critical mediator of progressive cardiac dysfunction after MI. We developed two mouse models. In one model with beta2a (LTCC subunit) overexpression we could prevent depressed myocyte contractility after MI and use it to test the idea that preventing depression of myocyte Ca2+ handling defects could avert post MI cardiac pump dysfunction. In the other model, mice with Ser2808 in RyR2 replaced by alanine (S2808A) to prevent the phosphorylation at this site were used to determine whether loss of functional PKA phosphorylation site at Ser2808 could protect against cardiac dysfunction progression after MI. beta2a myocytes had increased Ca2+ current; contraction and Ca2+ transients (versus controls) and beta2a hearts had increased performance before MI. After MI, ventricular dilation, myocyte hypertrophy, and depressed cardiac pump function was greater in beta2a versus control hearts. There was also an increased rate of myocyte death in beta2a hearts after MI and survival was significantly reduced in these animals. We concluded that maintaining myocyte contractility after MI, by increasing Ca2+ influx, depresses rather than improves cardiac pump function. Baseline cardiac function was similar in wild type (WT) and RyR-S2808A mice before MI. After MI, there was no significant difference between WT and RyR-S2808A mice in EF and FS at 4 weeks. ICa-L € in WT and RyR-S2808A myocytes was not significantly different. There were significant ISO responses in all myocytes, and no appreciable differences in responsiveness were found. Contractions and Ca2+ transients were not significantly different in WT and RyR-S2808A myocytes after MI. In conclusion, preventing PKA phosphorylation of RyR at Ser2808 after MI does not protect the heart or its myocytes. The role of RyR phosphorylation at other sites on abnormal Ca2+ handling in diseased hearts is yet to be defined.
INFLAMMATORY PROTEASES AND CARDIAC REPAIR POST MYOCARDIAL ISCHEMIANeutrophils are thought to orchestrate myocardial remodeling during the early progression to cardiac failure through the release of reactive oxygen species, antimicrobial peptides, and proteases. Although neutrophil activation may be beneficial at early stages of disease, excessive neutrophil infiltration detrimentally leads to cardiomyocyte death and tissue damage. The neutrophil-derived serine protease cathepsin G (CG) has been shown to induce neonatal rat cardiomyocyte detachment and apoptosis by anoikis1. However the role of inflammatory serine proteases in cardiac remodeling and cardiac regeneration in-vivo is still unknown. We showed that cardiac injection of neutrophil derived protease led to early cardiac dilatation and dysfunction characterized by an increase in matrix metalloprotease (MMP) activation and extracellular matrix degradation along with an increase in myocyte death by apoptosis. To assess the role of these serine proteases, we used mice lacking dipeptidyl peptidase I (DPPI), an enzyme involved in major inflammatory protease activation. DPPI deficient mice demonstrated a more robust functional recovery after ischemia reperfusion (IR) and myocardial infarction (MI) injury, as well as significantly reduced myocyte apoptosis, cardiac dilatation, infarct size and mortality rate. Meanwhile, our data showed increased groups of cardiac stem cells and proliferating cardiac cells in the MI 7-days DPPI knockout mice. We also found enhanced DPPI expression in response to pathological stress stimuli in mice. These findings reveal an unrecognized role of DPPI as a key mediator of post-ischemia cardiac injury and show that inflammatory derived proteases may contribute to the pathological cardiac remodeling and cardiac regeneration, and may be considered as novel target for future therapies.