静脉移植骨髓间充质干细胞对心肌病心力衰竭心功能的影响

Effect of bone marrow mesenchymal stem cells via intravenous transplantation on cardiac function in heart failure induced by cardiomyopathies

背景:骨髓间充质干细胞移植可以有效改善心力衰竭所致心功能下降,但关于心肌病所致心力衰竭,相关移植效果及其对心功能的影响等问题,相关的研究较少。目的:探讨静脉移植骨髓间充质干细胞对心肌病心力衰竭心功能的影响。方法:取40只SD大鼠,其中10只进行骨髓间充质干细胞分离与培养,其余30只随机分为3组(n=10),分别为正常组、模型组以及干细胞移植组。模型组以及干细胞移植组腹腔注射盐酸阿霉素建立心肌病心力衰竭模型,模型制备后7 d干细胞移植组静脉移植骨髓间充质干细胞,对照组予以等量DMEM培养基。移植后4周,对3组大鼠进行心功能检测,免疫荧光检测移植干细胞的存活与分化情况。结果与结论:(1)移植后4周,与正常组和干细胞移植组比较,模型组的左心室收缩压、左室内压最大上升速率、左室内压最大下降速率均出现显著下降,左心室舒张末压显著上升,差异有显著性意义(P<0.05)。正常组与干细胞移植组比较,差异无显著性意义(P>0.05);(2)经免疫荧光检测,骨髓间充质干细胞移植即刻,在宿主心肌内可观察到较高的荧光强度。移植后4周,荧光强度较移植后即刻出现一定的减弱,密度下降,但可观察到细胞迁移现象,部分细胞表达肌钙蛋白T;(3)实验结果表明,骨髓间充质干细胞静脉移植可以显著改善心肌病心力衰竭大鼠心功能,移植细胞可在宿主体内存活,并向心肌样细胞发生分化。

BACKGROUND： Bone marrow mesenchymal stem cell transplantation can effectively improve decreased cardiac function caused by heart failure, but there is a lack of research about the effect in bone marrow mesenchymal stem cell transplantation on cardiac function in heart failure induced by cardiomyopathies. OBJECTIVE： To explore the effect of bone marrow mesenchymal stem cell transplantation on cardiac function in patients with cardiomyopathies accompanied by heart failure. METHODS： Totally 40 Sprague-Dawley rats were enrolled, and bone marrow mesenchymal stem cells were isolated from 10 rats, and the remaining rats were equivalently randomized into normal, model and stem cell transplantation groups. Then rats in the model and stem cell transplantation groups were given intraperitoneal injection of hydrochloric acid doxorubicin to prepare cardiomyopathy-induced heart failure models. At 7 days after modeling, the stem cell transplantation group was treated with bone marrow mesenchymal stem cells through intravenous transplantation, and the model group was treated with equal amount of DMEM medium. Four weeks later, cardiac function of each rat was detected, and the cell survival and differentiation were observed by immunofluorescence method. RESULTS AND CONCLUSION： At 4 weeks after transplantation, compared with normal and stem cell transplantation groups, the left ventricular systolic pressure and maximum rise/fall rate of left ventricular pressure were significantly decreased, but the left ventricular end diastolic pressure significantly increased in the model group（P〈0.05）. And there was no significant difference between the normal group and the stem cell transplantation group（P〈0.05）. High and dense fluorescence intensity was observed in the host myocardium immediately after transplantation. Subsequently, the fluorescence intensity and density decreased at 4 weeks, but the cell migration could be found, and some cells expressed cardiac troponin T. These results show that intravenous transplantation of bone marrow mesenchymal stem cells can improve cardiac function in rats with heart failure due to cardiomyopathies. Besides, the transplanted cells can survive in the host, and differentiate into cardiomyocyte-like cells.