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背景:细胞凋亡与心肌梗死后的心室重构之间互为因果,形成恶性循环,如何减少心肌梗死后的凋亡事件是挽救心功能的关键之一。目的:观察脐血间充质干细胞移植对犬急性心肌梗死后残存心肌细胞的影响。设计:随机对照观察。单位:上海交通大学附属新华医院心胸外科。材料:实验于2005-10/2007-05在上海交通大学附属新华医院中心实验室完成。选用36只成年杂种犬,雌雄各半,由上海交通大学附属新华医院动物实验中心提供。方法:采用随机数字表法将36只犬分为细胞移植组和对照组,每组18只。自近足月的妊娠杂种犬脐血中提取、培养、扩增间充质干细胞,Laz基因标记,经5-氮胞苷体外诱导后移植入细胞移植组急性心梗模型犬,对照组同法注射生理盐水。移植后1,4,8周后麻醉处死各组实验犬,获取心肌标本。主要观察指标:①TUNEL检测残存凋亡指数。②共聚焦显微镜检测心肌细胞体积及组织形态学检测。③苏木精-碱性复红-苦味酸染色检测心脏胶原网络的组织学变化。结果:纳入实验犬36只,均进入结果分析。①细胞移植后1,4,8周移植组的凋亡指数均低于对照组,差异有显著性意义(P<0.05)。②移植组移植后1,4,8周心肌细胞体积均高于对照组,差异有显著性意义(P<0.05)。③移植组心肌组织内胶原纤维排列整齐、规律,对照组排列较紊乱、无规律,部分发生融合。结论:脐血间充质干细胞移植后可通过减少心肌细胞凋亡,促使残存心肌细胞肥大,调节心肌胶原网络从而改善心功能。
Background: Apoptosis and ventricular remodeling after myocardial infarction cause and effect a vicious circle. How to reduce the apoptotic events after myocardial infarction is one of the keys to save heart function. Objective: To observe the effect of cord blood derived mesenchymal stem cell transplantation on survived cardiomyocytes in dogs with acute myocardial infarction. Design: Randomized controlled observation. SETTING: Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University. Materials: The experiment was performed at the Central Laboratory of Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2005 to May 2007. 36 adult mongrel dogs were selected, male and female, and were provided by the Animal Experiment Center of Xinhua Hospital Affiliated to Shanghai Jiaotong University. Methods: 36 dogs were divided into cell transplantation group and control group using random number table method, with 18 in each group. The cord blood of pregnant mongrel dogs were collected, cultured, expanded and labeled with Laz gene. The cells were induced by 5-azacytidine and then transplanted into acute myocardial infarction model group. The control group Injection of saline. After 1, 4, and 8 weeks after transplantation, dogs in each group were anesthetized and sacrificed to obtain myocardial samples. MAIN OUTCOME MEASURES: ① TUNEL detection of residual apoptotic index. ② Confocal microscopy was used to detect the myocardial cell volume and histomorphology. ③ hematoxylin - alkaline complex red - picric acid staining cardiac collagen network histological changes. Results: Into the experimental dogs 36, are involved in the results analysis. ①Apoptosis index in the transplantation group at 1, 4, 8 weeks after cell transplantation was lower than that in the control group, the difference was significant (P <0.05). ② At 1, 4 and 8 weeks after transplantation, the volume of myocardial cells in the transplantation group was significantly higher than that in the control group (P <0.05). ③ The collagen fibers in the myocardial grafts in the transplantation group were arranged neatly and regularly. The control group was more disorderly and irregularly arranged, and some fusion occurred. Conclusion: Umbilical cord blood-derived mesenchymal stem cells can improve cardiac function by reducing cardiomyocyte apoptosis, inducing cardiomyocyte hypertrophy, regulating myocardial collagen network.