Inflammatory responses after intracoronary injection of autologous mononuclear bone marrow cells in patients with acute myocardial infarction.
BACKGROUND
Inflammatory responses after intracoronary injection of autologous mononuclear bone marrow cells (mBMC) are not clarified. The aim of this study was to investigate the influence of intracoronary injection of mBMC on inflammatory mediators in patients with acute myocardial infarction (AMI).


METHODS
Patients with AMI in the ASTAMI trial (N = 100) treated with percutaneous coronary intervention were randomized to intracoronary injections of mBMC or control. Fasting blood samples were drawn the day before stem cell transplantation (baseline 4-5 days after AMI) and 1 day, 3 days, 2 to 3 weeks, and 3 months after transplantation for determination of circulating levels of selected inflammatory markers and mRNA levels in whole blood samples.


RESULTS
From baseline to day 1, the levels of interleukin 6 and the expression of tumor necrosis factor alpha mRNA increased significantly in the mBMC group compared to the control group (P < .05 for both). The decrease in interleukin 6 levels from baseline to 2 to 3 weeks in the mBMC group was less pronounced than in the controls (P < .05), as was also the decrease in C-reactive protein levels from baseline to day 1 and day 3 in the mBMC group (P < .05). However, from baseline to 3 months the levels of tumor necrosis factor alpha and monocyte chemoattractant protein 1 increased less in the mBMC group (P < .05 for both).


CONCLUSIONS
Intracoronary injection of mBMC in patients with AMI induces a marked short-term inflammatory response, but a slightly reduced inflammation after 3 months which may have implications for the timing of stem cell transplantation in AMI.
Solheim
Svein
S
Department of Cardiology, Ullevål University Hospital, Oslo, Norway. s-solh@online.com
Seljeflot
Ingebjørg
I
Lunde
Ketil
K
Aukrust
Pål
P
Yndestad
Arne
A
Grøgaard
Haakon Kiil
HK
Aakhus
Svend
S
Forfang
Kolbjørn
K
Arnesen
Harald
H
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001854:Bone Marrow Cells; D017690:Cell Transplantation / Q000379:methods*; D017023:Coronary Angiography; D004562:Electrocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011336:Probability; D012333:RNA, Messenger / Q000032:analysis; D012016:Reference Values; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D018836:Inflammation Mediators; D012333:RNA, Messenger