Cell Therapy for Improving Cardiac Function

改善心脏功能的细胞疗法

• 批准号: 7212901
• 负责人: Douglas E Vaughan
• 金额: $ 55.41万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-01-01 至 2011-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7212901
• 关键词: Acute myocardial infarction; Address; Adenosine; Admission activity; Aftercare; Age; Beds; Blood Vessels; Bone Marrow; Bone Marrow Cells; Cardiac; Cardiomyopathies; Catheters; Cell Adhesion; Cell Therapy; Cell-Matrix Junction; Cells; Cessation of life; Chronic; Clinical; Clinical Investigator; Clinical Protocols; Clinical Research; Clinical Research Protocols; Congestive Heart Failure; Consent; Coronary; Coronary Artery Bypass; Coronary Circulation; Coronary heart disease; Coronary sinus structure; Development; Diagnosis; Dilated Cardiomyopathy; Disease; EFRAC; Engraftment; Enrollment; Experimental Models; Ficoll; Fostering; Future; Harvest; Healed; Heart; Heart Diseases; Heart Transplantation; Heart failure; Homing; Hospitalization; Hospitals; Infarction; Infusion procedures; Left Ventricular Dysfunction; Left Ventricular Ejection Fraction; Left Ventricular Function; Magnetic Resonance Imaging; Mediating; Medical; Medicare; Mesenchymal; Mesenchymal Stem Cells; Mononuclear; Muscle Cells; Myocardial; Myocardial Infarction; Myocardium; Natural regeneration; Numbers; Operative Surgical Procedures; Organ; Patients; Placebos; Population; Preparation; Prevention; Procedures; Process; Property; Randomized; Reporting; Research; Research Personnel; Residual state; Role; Skeletal system; Staging; Standards of Weights and Measures; Stem cells; Structure; Testing; Time; Tissues; Training; Treatment Efficacy; United States; Upper arm; Ventricular Function; Viral; Week; Work; Wound Healing; abstracting; angiogenesis; cell preparation; cell type; cytokine; day; design; experience; healing; heart function; improved; indexing; paracrine; placebo controlled study; prevent; programs; prospective; skills

DESCRIPTION (provided by applicant): Heart Failure is the most common reason for admission to hospitals in the United States, especially in the Medicare population. A majority of patients with HF have poor left ventricular function, with 60-70% due to chronic ischemic coronary disease. The remainder of patients experience HF due to a variety of other causes, including idiopathic and viral cardiomyopathies, and are classified as dilated non-ischemic cardiomyopathies. Stem cells (endothelial, mesenchymal, skeletal or from bone marrow), injected directly into the myocardium or delivered to the coronary circulation, can improve cardiac function in chronic ischemic cardiomyopathy or following an acute myocardial infarction. While there is evidence that cell therapy can improve cardiac function, the exact mechanisms through which cell therapy exerts beneficial effects remain unclear. We and others have demonstrated that the cardioprotective effects of endothelial progenitor cells (EPCs) following myocardial infarction are mediated, in part, by multiple cytokines secreted by stem cells, which can favorably enhance myocardial survival. We postulate that an enriched, mixed, stem cell population may offer an advantage over a single cell type. It is also evident from our studies that active interaction between stem cells and the vascular wall during systemic delivery is necessary for efficient grafting to occur. This proposal describes two clinical protocols to use bone marrow-derived cells for the treatment of left ventricular dysfunction. The first will test the hypothesis that expansion of bone marrow cells to yield high levels of endothelial and mesenchymal progenitor cells will produce a greater improvement in cardiac function compared to freshly harvested bone marrow cells. The second will investigate the role of cell therapy in dilated non-ischemic cardiomyopathy and test the hypothesis that adenosine pretreatment will enhance cell homing potentiating the beneficial effects of cell therapy. To foster future research, a Clinical Research Skills Development Core will train new clinical investigators in cardiac cell-therapy. The two clinical protocols will determine the efficacy of different cell preparations and the role of modulating stem cell engraftment in target tissue to restore ventricular function opening the way for feasible, easily applied strategies to capture the healing properties of bone marrow-derived cells. (End of Abstract)

描述（由申请人提供）： 心力衰竭是美国入院的最常见原因，尤其是在医疗保险人群中。大多数心力衰竭患者左心室功能较差，其中60-70%是由于慢性缺血性冠状动脉疾病所致。其余患者因各种其他原因（包括特发性和病毒性心肌病）而出现心力衰竭，并被归类为扩张型非缺血性心肌病。 干细胞（内皮干细胞、间充质干细胞、骨骼干细胞或骨髓干细胞）直接注射到心肌中或输送到冠状循环中，可以改善慢性缺血性心肌病或急性心肌梗死后的心脏功能。虽然有证据表明细胞疗法可以改善心脏功能，但细胞疗法发挥有益作用的确切机制仍不清楚。我们和其他人已经证明，心肌梗死后内皮祖细胞（EPC）的心脏保护作用部分是由干细胞分泌的多种细胞因子介导的，这可以有利地提高心肌存活率。我们假设富集的混合干细胞群可能比单一细胞类型具有优势。从我们的研究中还可以明显看出，在全身输送过程中干细胞和血管壁之间的积极相互作用对于有效移植的发生是必要的。 该提案描述了使用骨髓来源细胞治疗左心室功能障碍的两种临床方案。第一个将检验这样的假设：与新鲜收获的骨髓细胞相比，扩增骨髓细胞以产生高水平的内皮和间充质祖细胞将产生更大的心脏功能改善。第二部分将研究细胞疗法在扩张型非缺血性心肌病中的作用，并检验腺苷预处理将增强细胞归巢从而增强细胞疗法的有益效果的假设。为了促进未来的研究，临床研究技能发展核心将培训心脏细胞治疗方面的新​​临床研究人员。 这两个临床方案将确定不同细胞制剂的功效以及调节干细胞在目标组织中植入以恢复心室功能的作用，为可行、易于应用的策略来捕获骨髓来源细胞的愈合特性开辟了道路。 （摘要完）