title: Adipose stromal cells primed with hypoxia and inflammation enhance cardiomyocyte proliferation rate in vitro through STAT3 and Erk1/2.
abstract: BACKGROUND
  Experimental clinical stem cell therapy has been used for more than a decade to alleviate the adverse aftermath of acute myocardial infarction (aMI). The post-infarcted myocardial microenvironment is characterized by cardiomyocyte death, caused by ischemia and inflammation. These conditions may negatively affect administered stem cells. As postnatal cardiomyocytes have a poor proliferation rate, while induction of proliferation seems even more rare. Thus stimulation of their proliferation rate is essential after aMI. In metaplastic disease, the pro-inflammatory cytokine interleukin-6 (IL-6) has been identified as potent mediators of the proliferation rate. We hypothesized that IL-6 could augment the proliferation rate of (slow-)dividing cardiomyocytes.
  
  
  METHODS
  To mimic the behavior of therapeutic cells in the post-infarct cardiac microenvironment, human Adipose Derived Stromal Cells (ADSC) were cultured under hypoxic (2% O2) and pro-inflammatory conditions (IL-1β) for 24h. Serum-free conditioned medium from ADSC primed with hypoxia and/or IL-1β was added to rat neonatal cardiomyocytes and adult cardiomyocytes (HL-1) to assess paracrine-driven changes in cardiomyocyte proliferation rate and induction of myogenic signaling pathways.
  
  
  RESULTS
  We demonstrate that ADSC enhance the proliferation rate of rat neonatal cardiomyocytes and adult HL-1 cardiomyocytes in a paracrine fashion. ADSC under hypoxia and inflammation in vitro had increased the interleukin-6 (IL-6) gene and protein expression. Similar to conditioned medium of ADSC, treatment of rat neonatal cardiomyocytes and HL-1 with recombinant IL-6 alone also stimulated their proliferation rate. This was corroborated by a strong decrease of cardiomyocyte proliferation after addition of IL-6 neutralizing antibody to conditioned medium of ADSC. The stimulatory effect of ADSC conditioned media or IL-6 was accomplished through activation of both Janus Kinase-Signal Transducer and Activator of Transcription (JAK/STAT) and Mitogen-Activated Protein (MAP) kinases (MAPK) mitogenic signaling pathways.
  
  
  CONCLUSIONS
  ADSC are promising therapeutic cells for cardiac stem cell therapy. The inflammatory and hypoxic host post-MI microenvironment enhances the regenerative potential of ADSC to promote the proliferation rate of cardiomyocytes. This was achieved in paracrine manner, which warrants the development of ADSC conditioned medium as an "of-the-shelf" product for treatment of post-myocardial infarction complications.
authors: University Medical Center Groningen, Department of Pathology and Medical Biology, Cardiovascular Regenerative Medicine Research Group (CAVAREM), Department of Pathology and Medical Biology, University of Groningen, Hanzeplein 1 (EA11), Groningen, GZ 9713, The Netherlands.
authors: Ewa
authors: E
authors: Przybyt
authors: Guido
authors: G
authors: Krenning
authors: Marja G L
authors: MG
authors: Brinker
authors: Martin C
authors: MC
authors: Harmsen
mesh_terms: D000273:Adipose Tissue / Q000166:cytology / Q000201:enzymology / Q000378:metabolism*; D000818:Animals; D001483:Base Sequence; D049109:Cell Proliferation; D018920:Coculture Techniques; D017077:Culture Media, Conditioned; D017931:DNA Primers; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D020935:MAP Kinase Signaling System; D008856:Microscopy, Fluorescence; D032383:Myocytes, Cardiac / Q000166:cytology*; D012333:RNA, Messenger / Q000235:genetics; D051381:Rats; D050796:STAT3 Transcription Factor / Q000378:metabolism*; D017154:Stromal Cells / Q000166:cytology / Q000201:enzymology / Q000378:metabolism*
chemical_list: D017077:Culture Media, Conditioned; D017931:DNA Primers; D015850:Interleukin-6; D012333:RNA, Messenger; D050796:STAT3 Transcription Factor; C494086:STAT3 protein, human