Comparative Efficacy of Intracoronary Allogeneic Mesenchymal Stem Cells and Cardiosphere-Derived Cells in Swine with Hibernating Myocardium.
BACKGROUND
Allogeneic bone marrow-derived mesenchymal stem cells (MSCs) and cardiosphere-derived cells (CDCs) have each entered clinical trials, but a direct comparison of these cell types has not been performed in a large animal model of hibernating myocardium.


OBJECTIVE
Using completely blinded methodology, we compared the efficacy of global intracoronary allogeneic MSCs (icMSCs, ≈35×10(6)) and CDCs (icCDCs, ≈35×10(6)) versus vehicle in cyclosporine-immunosuppressed swine with a chronic left anterior descending coronary artery stenosis (n=26).


RESULTS
Studies began 3 months after instrumentation when wall thickening was reduced (left anterior descending coronary artery % wall thickening [mean±SD], 38±11% versus 83±26% in remote; P<0.01) and similar among groups. Four weeks after treatment, left anterior descending coronary artery % wall thickening increased similarly after icCDCs and icMSCs, whereas it remained depressed in vehicle-treated controls (icMSCs, 51±13%; icCDCs, 51±17%; vehicle, 34±3%, treatments P<0.05 versus vehicle). There was no change in myocardial perfusion. Both icMSCs and icCDCs increased left anterior descending coronary artery myocyte nuclear density (icMSCs, 1601±279 nuclei/mm(2); icCDCs, 1569±294 nuclei/mm(2); vehicle, 973±181 nuclei/mm(2); treatments P<0.05 versus vehicle) and reduced myocyte diameter (icMSCs, 16.4±1.5 μm; icCDCs, 16.8±1.2 μm; vehicle, 20.2±3.7 μm; treatments P<0.05 versus vehicle) to the same extent. Similar changes in myocyte nuclear density and diameter were observed in the remote region of cell-treated animals. Cell fate analysis using Y-chromosome fluorescent in situ hybridization demonstrated rare cells from sex-mismatched donors.


CONCLUSIONS
Allogeneic icMSCs and icCDCs exhibit comparable therapeutic efficacy in a large animal model of hibernating myocardium. Both cell types produced equivalent increases in regional function and stimulated myocyte regeneration in ischemic and remote myocardium. The activation of endogenous myocyte proliferation and regression of myocyte cellular hypertrophy support a common mechanism of cardiac repair.
From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY.
Brian R
BR
Weil
From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY.
Gen
G
Suzuki
From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY.
Merced M
MM
Leiker
From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY.
James A
JA
Fallavollita
From the Departments of Medicine, Physiology and Biophysics and Biomedical Engineering, and the Clinical and Translational Research Center, University at Buffalo and the VA WNY Health Care System, NY. canty@buffalo.edu.
John M
JM
Canty
D000818:Animals; D049109:Cell Proliferation / Q000502:physiology; D003331:Coronary Vessels / Q000473:pathology; D007269:Injections, Intra-Arterial; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D017682:Myocardial Stunning / Q000473:pathology / Q000628:therapy*; D032383:Myocytes, Cardiac / Q000637:transplantation*; D013552:Swine; D014184:Transplantation, Homologous; D016896:Treatment Outcome
bone marrow; cell- and tissue-based therapy; coronary stenosis; in situ hybridization, fluorescence; mesenchymal stromal cells; myocardial ischemia