Project Summary
Mechanisms involved in wound healing and heart function are essential for the survival of mammalian species. The treatment of ischaemic heart disease and myocardial tissue regeneration remains poorly understood. Mesenchymal stem cells possess the ability to differentiate into various tissue types, including hematopoiesis, cardiogenesis, vasculogenesis, and neuronal development, as well as endothelial progenitor cells. In addition to its multipotent capability, the mesenchymal stem cell (MSC) can secrete and supply a large amount of vascular endothelial growth factor (VEGF) (Tang J et al., 2009). This response can be overexpressed, resulting in tumor formation. The stromal-derived factor-1 alpha (SDF-1α) plays an important
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Primary research for this proposal suggests SDF-1α and VEGF play a key role in stem cell recruitment and myocardial regeneration. Increased expression of of SDF-1α through Ad-SDF-1alpha (adenoviral vector containing human SDF-1alpha gene under the control of the rous sarcoma virus (RSV) promoter) through injection into myocardial tissue promotes angiogenesis in damaged tissue. It is suggested that SDF-1 gene expression is regulated by the transcription factor hypoxia-inducible factor-1 (HIF-1) in endothelial cells, resulting in selective in vivo expression of SDF-1 in ischemic tissue in direct proportion to reduced oxygen tension (Ceradini DJ, 2004). VEGF secreted by MSC’s is thought to enhance expression of SDF-1α. Increased expression of SDF-1α in the presence of transplanted MSC’s could potentially promote differentiation of MSC’s into myocytes, leading to regeneration of myocardial tissue leading to improved heart function.
Specific Aims
The aim of this research is to investigate if and how co-transplantation of mesenchymal stem cells, varying in quantity transplanted, in combination with overexpression of VEGF, SDF-1α, enhance differentiation and recruitment leading to cardiac repair in LAD occluded rats.
The hypothesis of the following paper proposes that
This new research uses the scaffolding technique combined with stem cells to grow a heart. The new breakthrough was made using poor quality donated hearts. There were first stripped of heart tissue, leaving only the scaffolding of the heart. All of the tissue must be gone so that a potential patient won't risk rejection.
Stem cells have made significant promise to help people understand and treat a broad range of injuries, diseases, and other health-related issues. This type of treatment has saved the lives of many people with leukemia and can also be used for tissue grafts to treat conditions with the skin, bone and surface of the eye ("Nine Things to Know about Stem Cell Treatments"). Dilated cardiomyopathy (DMC) is a disease characterized by expansion of the left ventricular chamber and it is usually associated with systolic dysfunction. The presentations of the condition include heart failure, myocardial infarction, and arrhythmia and as a refractory life-threatening condition which can cause heart failure, transplantation remains the ultimate therapy for
A few individuals with coronary illness and diabetes have gotten trial medications taking into account foundational cells disconnected from grown-up tissue, frequently from bone marrow, with shifting degrees of achievement. These mesenchymal stem cells, or MSCs, can develop into a few tissues including muscle, bone, ligament and fat yet there is no ensure that they will develop into heart muscle. This will left us with the answer to many people around the world why and how stem cells are stored.
Another study by Dedkov et al demonstrated that mice with STEMI when treated with Ivabradine had improved ejection fraction, coronary reserve and the amount of interstitial and periarteriolar collagen indicating that this agent might be useful in preventing remodeling of heart (46). A pilot study of 124 patients investigating the role of Ivabradine in successfully reperfused STEMI patients demonstrated promising results with a smaller increase in LV end-diastolic volume index (p=0.04), and significant improvement in LV ejection fraction compared with the control group (p=0.04)
Antioxidants and stem cells for coronary heart disease entails various methods of research on the effects of antioxidants and stem cells for coronary heart disease. The book is written in a simplified form to make it easy to read and understand. This book is relevant to heart disease due to the two treatment options which have been researched and tested. The information being used in the research paper is the possibility of treatment for coronary heart disease (Philip,
Because of their ability to differentiate into specialized cells, embryonic stem cells can have the potential of treating a wide range of diseases. Some of these diseases include heart disease, Parkinson 's disease, and diabetes (Kelly 5). The regenerative properties of stem cells allow scientists to potentially restore damaged muscle, and perhaps even damaged nerve tissue. The discovery of embryonic stem cells is so important that it opened up a new field of medicine called regenerative medicine. Although embryonic stem cells are not the answer to all diseases known to man, other types of stem cells are being used to effectively treat
Despite many new advances in patient care, drug therapy and cardiac assist devices, the prognosis for chronic heart failure remains very poor. One year mortality figures are 50-60% for patients diagnosed with severe heart failure, 15-30% in mild to moderate failure, and about 10% in mild or asymptomatic failure. With gene therapies, and cell implantation/regeneration just on the horizon, the prognosis for heart failure patients is much more promising than just 20 years ago.
Phagocytes secrete inflammatory molecules in response to chemicals released by damaged tissue cells, and activate B and T lymphocytes. These changes result in the activation and differentiation of MSCs into the injury site. Alongside inflammatory molecules, MSCs will then produce growth factors. These growth factors then activate endothelial cells and fibroblasts that enhance angiogenesis, inhibit leukocytes, and stimulate further stem cell differentiation. This secretion of growth factors may be the root of the regenerative abilities of MSCs, even if they do not differentiate. (Van de Walle,
“Through the isolation and manipulation of cells, scientists are finding ways to identify young, regenerating ones that can be used to replace damaged of dead cells in diseased organs. This therapy is similar to the process of organ transplant, only the treatment consists of the transplantation of cells rather than organs. The cells that have shown by far the most promise of supplying diseased organs with healthy cells are called stem cells.” (Chapter Preface)
After a heart attack, the heart is unable to regenerate cardiac muscle cells known as myocytes which diminishes the heart’s pump function. The heart tries to heal itself by changing the damaged or dead heart muscle cells into scar tissue. However, the scar tissue cannot function as a muscle so it does not contribute to the cardiac contractile force. Overtime, this leads to a greater burden on the remaining viable heart muscle which eventually leads to heart failure. Current treatments such as autologous grafting and commercially available fillers incur donor-site morbidity and volume loss over time. Other transplantation therapies do not directly address the loss of cardiac myocytes, which leads to the drive for more research in cardiac regeneration.
It was originally believed that cardiac stem cells can be transplanted into the infarcted region of a failing heart so that they can proliferate and differentiate into cardiomyocytes to improve the heart’s ability to pump blood. While transplanted cardiac stem cells were shown improve cardiac function in animal trials and clinical trials, it was later discovered that they did so with the release of paracrine factors, not through differentiation. As a result, interest in the use of paracrine factors to promote endogenous cardiac regeneration has increased. A proposed therapy to take advantage of the regenerative properties of paracrine factors is to upregulate, through genetic engineering, a cardiac stem cell’s release of factors SCF and IGF-1.
According to some researches, stem cell-based therapies have the potential to dramatically transform the treatment and prognosis of HF by achieving what would have been unthinkable only a few years ago. They also asserted that for the first time since cardiac transplantation, a therapy is being developed to eliminate the underlying cause of HF, not just to achieve damage control. In 2001, the first study of bone marrow cells in experimental myocardial infarction (MI) was published,9 within a year, this therapy had been applied in patients.10 In the setting of HF, it took only three years from the first use of stem cells (skeletal myoblasts) in an animal model to the first use of these cells in
One of the major obstacles in progressing to large-scale clinical trials of cardiac stem cell therapy is the ongoing debate regarding the mechanism of action by which stem cell therapy leads to cardiac repair. The classic idea that provided the primary motivation for stem cell therapy is that delivery of the appropriate stem cells would repair a damaged heart via active myocardial regeneration resulting from transdifferentiation of the administered stem cells.19
Heart is the first organ that develops and functions in mammalian embryo (Moorman et al., 2003). In mouse, it was reported to starting differentiation at E7.25 embryo. Twenty four hours later, a primitive heart tube was formed from the precardiac mesoderm, and start beating at E8 in mouse compared to about 3 weeks of gestation in human (Brand, 2003; Sissman, 1970). In mice, Roche et al., (2013) reported that the heart is considered a unique structure as it is derived from a four distinct pools of progenitors: the cardiac crescent, the second heart field (SHF), the proepicardial organ, and the cardiac neural crest. These progenitors were tracked into the different cell types namely, cardiomyocytes, fibroblasts, smooth muscle cells, endothelial cells, and the conduction system described in adult heart (Roche, Czubryt, & Wigle, 2013).
Stem cells are undifferentiated cells that can proliferate and differentiate into many types of cells like blood cells, neuron cells or muscle cells. This ability to differentiate makes them ideal to be used in a field like regenerative medicine, where scientists look for ways to replace damaged tissues or