title: Stem-cell therapy in an experimental model of pulmonary hypertension and right heart failure: role of paracrine and neurohormonal milieu in the remodeling process.
abstract: BACKGROUND
  In this study we investigated the effect of human amniotic fluid stem (hAFS) cells and rat adipose tissue stromal vascular fraction GFP-positive cell (rSVC-GFP) therapy and the contribution of the paracrine and neurohormonal milieu to cardiac and pulmonary vascular remodeling in a rat model of pulmonary hypertension (PH) and right heart failure (RHF).
  
  
  METHODS
  Sprague-Dawley rats were injected with monocrotaline (MCT). Four million hAFS or rSVC-GFP cells were injected via the tail vein 3 weeks after MCT. RHF was confirmed by RV hypertrophy/dilation and by brain natriuretic peptide (BNP) level. Cytokine profile was assessed by Multiplex array. Stem cell (SC) differentiation was studied by immunofluorescence.
  
  
  RESULTS
  MCT rats showed eccentric RV hypertrophy with increased RV dilation (measured as right ventricular mass/right ventricular volume [RVM/RVV]: MCT, 1.46 ± 0.12; control, 2.33 ± 0.24; p = 0.01), and increased RV hypertrophy (measured as LVM/RVM: MCT, 1.58 ± 0.06; control, 2.83 ± 0.1; p < 0.00001), increased BNP (MCT, 5.2 ± 1.2; control, 1.5 ± 0.1; p < 0.001) and both pro- and anti-inflammatory cytokines. SC produced a fall of BNP (hAFS, 2.1 ± 0.7; rSVC-GFP, 1.98 ± 1.3; p < 0.001) and pro-inflammatory cytokines. Positive RV remodeling with decreased RV dilation (RVM/RVV: hAFS, 1.87 ± 0.44; rSVC-GFP, 2.12 ± 0.24; p < 0.03 and p < 0.05 vs MCT) and regression of RV hypertrophy (LVM/RVM: hAFS, 2.06 ± 0.08; rSVC-GFP, 2.16 ± 0.08; p < 0.00001 vs MCT) was seen together with a decrease in medial wall thickness of pulmonary arterioles (hAFS, 35.33 ± 2.78%; rSVC-GFP, 37.15 ± 2.92%; p = 0.0001 vs MCT).
  
  
  CONCLUSIONS
  SC engrafted in the lung, heart and skeletal muscle modulated the pro- and anti-inflammatory cytokine milieu, and produced a positive neurohormonal response. This was accompanied by positive cardiac and pulmonary vascular remodeling, with formation mainly of new vascular cells.
authors: Department of Medico-Diagnostic Sciences and Special Therapies, University of Padua, Italy. annalisa.angelini@unipd.it
authors: Annalisa
authors: A
authors: Angelini
authors: Chiara
authors: C
authors: Castellani
authors: Barbara
authors: B
authors: Ravara
authors: Chiara
authors: C
authors: Franzin
authors: Michela
authors: M
authors: Pozzobon
authors: Regina
authors: R
authors: Tavano
authors: Luciano Dalla
authors: LD
authors: Libera
authors: Emanuele
authors: E
authors: Papini
authors: Roberto
authors: R
authors: Vettor
authors: Paolo
authors: P
authors: De Coppi
authors: Gaetano
authors: G
authors: Thiene
authors: Giorgio
authors: G
authors: Vescovo
mesh_terms: D000818:Animals; D016207:Cytokines / Q000378:metabolism; D004195:Disease Models, Animal; D005434:Flow Cytometry; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles / Q000378:metabolism / Q000473:pathology; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D017380:Hypertrophy, Right Ventricular / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D007150:Immunohistochemistry; D008297:Male; D018377:Neurotransmitter Agents / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D033581:Stem Cell Transplantation / Q000379:methods*; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D016207:Cytokines; D018377:Neurotransmitter Agents