title: Repair of impaired myocardium by means of implantation of engineered autologous myoblast sheets.
abstract: OBJECTIVE
  Autologous skeletal myoblast cell transplantation by means of the injection method is subject to the loss of intercellular communication, extracellular matrix, and cell numbers. We hypothesize that the implantation of skeletal myoblast cell sheets might be more advantageous in repairing the impaired heart by providing uniform and stable cell delivery with less cell loss and without disrupting the cell-cell microenvironment.
  
  
  METHODS
  Left anterior descending coronary artery-ligated Lewis rat hearts (2 weeks, total n = 173) received 1 x 10(7) autologous skeletal myoblasts by means of cell transplantation either through myoblast injection or implantation of 2 monolayer-constructed myoblast sheets (5 x 10(6) cells per sheet) or through medium injection. Myoblast sheets were constructed with temperature-responsive, polymer-grafted cell-culture dishes, which release the confluent cells from the dish surface at less than 20 degrees C.
  
  
  RESULTS
  Echocardiographic results indicated higher improvement of cardiac performance in the myoblast sheet group than among the other groups until 8 weeks after cell transplantation. Histologic comparison revealed greater cellularity and abundant widespread neocapillaries within the noticeable uniform thickened wall in myoblast sheet group hearts only. Fibrosis was substantially reduced with skeletal myoblast sheet implantation compared with skeletal myoblast cell injection. Obviously higher numbers of hematopoietic stem cells (c-kit, stem cell antigen 1, and CD34) were observed in the myoblast sheet group infarct heart region. Reverse transcription-polymerase chain reaction results showed expression of stromal-derived factor 1, hepatocyte growth factor, and vascular endothelial growth factor as follows: myoblast sheets > myoblast injection > control.
  
  
  CONCLUSIONS
  Myoblast sheets repaired the impaired myocardium, reduced fibrosis, and prevented remodeling in association with recruitment of hematopoietic stem cells through the release of stromal-derived factor 1 and other growth factors. Our experiment indicates a therapy for patients with severe heart failure.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. i.memon@victorchang.unsw.edu.au
authors.forename: Imran A
authors.initials: IA
authors.lastname: Memon
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
authors.forename: Norihide
authors.initials: N
authors.lastname: Fukushima
authors.forename: Goro
authors.initials: G
authors.lastname: Matsumiya
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyagawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Taketani
authors.forename: Satoru K
authors.initials: SK
authors.lastname: Sakakida
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kondoh
authors.forename: Alexey N
authors.initials: AN
authors.lastname: Aleshin
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Teruo
authors.initials: T
authors.lastname: Okano
authors.forename: Hikaru
authors.initials: H
authors.lastname: Matsuda
mesh_terms: D000818:Animals; D032386:Myoblasts, Cardiac / Q000637:transplantation*; D009203:Myocardial Infarction / Q000473:pathology / Q000601:surgery*; D051381:Rats; D011917:Rats, Inbred Lew; D013997:Time Factors; D023822:Tissue Engineering