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J Am Coll Cardiol, 2009; 53:1229-1240, doi:10.1016/j.jacc.2008.12.036
© 2009 by the American College of Cardiology Foundation
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PRE-CLINICAL RESEARCH

Imaging Survival and Function of Transplanted Cardiac Resident Stem Cells

Zongjin Li, MD, PhD*, Andrew Lee, BS*, Mei Huang, PhD*, Hyung Chun, MD{dagger}, Jaehoon Chung, MD{dagger}, Pauline Chu, MS§, Grant Hoyt, BS{ddagger}, Phillip Yang, MD, PhD{dagger}, Jarrett Rosenberg, PhD*, Robert C. Robbins, MD{ddagger} and Joseph C. Wu, MD, PhD*,{dagger},*

* Department of Radiology and Molecular Imaging Program (MIPS) Stanford University School of Medicine, Stanford, California
{dagger} Department of Medicine, Division of Cardiology Stanford University School of Medicine, Stanford, California
{ddagger} Department of Cardiothoracic Surgery Stanford University School of Medicine, Stanford, California
§ Department of Comparative Medicine, Stanford University School of Medicine, Stanford, California

Manuscript received September 26, 2008; revised manuscript received December 1, 2008, accepted December 23, 2008.

* Reprint requests and correspondence: Dr. Joseph C. Wu, Stanford University School of Medicine, Edwards Building, R354, Stanford, California 94305-5344. (Email: joewu{at}stanford.edu).

Objectives: The goal of this study is to characterize resident cardiac stem cells (CSCs) and investigate their therapeutic efficacy in myocardial infarction by molecular imaging methods.

Background: CSCs have been isolated and characterized in vitro. These cells offer a provocative method to regenerate the damaged myocardium. However, the survival kinetics and function of transplanted CSCs have not been fully elucidated.

Methods: CSCs were isolated from L2G85 transgenic mice (FVB strain background) that constitutively express both firefly luciferase and enhanced green fluorescence protein reporter gene. CSCs were characterized in vitro and transplanted in vivo into murine infarction models. Multimodality noninvasive imaging techniques were used to assess CSC survival and therapeutic efficacy for restoration of cardiac function.

Results: CSCs can be isolated from L2G85 mice, and fluorescence-activated cell sorting analysis showed expression of resident CSC markers (Sca-1, c-Kit) and mesenchymal stem cell markers (CD90, CD106). Afterwards, 5 x 105 CSCs (n = 30) or phosphate-buffered saline control (n = 15) was injected into the hearts of syngeneic FVB mice undergoing left anterior descending artery ligation. Bioluminescence imaging showed poor donor cell survival by week 8. Echocardiogram, invasive hemodynamic pressure-volume analysis, positron emission tomography imaging with fluorine-18-fluorodeoxyglucose, and cardiac magnetic resonance imaging demonstrated no significant difference in cardiac contractility and viability between the CSC and control group. Finally, postmortem analysis confirmed transplanted CSCs integrated with host cardiomyocytes by immunohistology.

Conclusions: In a mouse myocardial infarction model, Sca-1–positive CSCs provide no long-term engraftment and benefit to cardiac function as determined by multimodality imaging.

Key Words: molecular imaging • cardiac stem cells • ischemic heart disease • differentiation • cell fate

Abbreviations and Acronyms
  BLI = bioluminescence imaging
  BM-MSC = bone marrow-derived mesenchymal stem cell
  CSC = cardiac stem cell(s)
  DAPI = 4'6-diamidino-2-phenylindole
  DiI-ac-LDL = DiI acetylated low-density lipoprotein
  EF = ejection fraction
  eGFP = enhanced green fluorescence protein
  FBS = fetal bovine serum
  Fluc = firefly luciferase
  FS = fractional shortening
  %ID/g = injected dose per gram of heart
  LAD = left anterior descending artery
  LVEDd = left ventricular end-diastolic diameter
  LVESd = left ventricular end-systolic diameter
  MI = myocardial infarction
  MRI = magnetic resonance imaging
  PBS = phosphate-buffered saline
  PET = positron emission tomography
  PV = pressure-volume
  ROI = region of interest
  RT-PCR = reverse transcription-polymerase chain reaction
  [18F]-FDG = fluorine-18-fluorodeoxyglucose


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