Recipient Age Determines the Cardiac Functional Improvement Achieved by Skeletal Myoblast Transplantation
Chung-Dann Kan, MD*, ,
Shu-Hong Li, MSc*,
Richard D. Weisel, MD*,
Shun Zhang, BSc* and
Ren-Ke Li, MD, PhD*,*
* Division of Cardiovascular Surgery, Toronto General Research Institute, University of Toronto, Toronto, Ontario, Canada
Department of Surgery, National Cheng Kung University Hospital Institute of Clinical Medicine, Cardiovascular Research Center, Medical College, National Cheng Kung University, Taiwan, Republic of China

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Figure 1 SKMCs in Culture
Light photomicrographs (100x) illustrating the morphology of cultured skeletal myoblast cells (SKMCs) derived from young (A to E) and older (F to J) rats, at passages 1 through 5 (P1 to P5). (K) Growth rate of SKMCs isolated from young and older rats at P1 to P5. Arrows = myotube structures.
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Figure 2 Cell Differentiation and Myotube Formation
Light photomicrographs (100x) showing cultured cells derived from young and older rats, stained for myosin heavy chain (MHC) and desmin at passages 1 (P1) (A to D) and 5 (P5) (E to H). (I) The number of myotubes in cell cultures derived from young and older rats at passages 1 and 5. *p = 0.01 compared with same group at P1.
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Figure 3 Post-Infarction Survival Rates
Survival rates over 5 weeks (35 days) after myocardial infarction (MI) in young rats implanted with young skeletal myoblasts (young SKMC) or culture media (young control), and older rats implanted with young SKMCs (older SKMC) or media (older control), expressed as a percentage of total animals in each group.
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Figure 4 Cardiac Functional Change by Echocardiography
Changes in percent fractional shortening (FS) (A), percent fractional area change (FAC) (B), and percent ejection fraction (EF) (C) measured immediately before cell or media implantation (pre-TX) and 4 weeks after implantation (post-TX), in young rats implanted with young skeletal myoblasts (young SKMC) or culture media (young control), and older rats implanted with young SKMCs (older SKMC) or media (older control). *p < 0.05 compared with older SKMC group; #p < 0.05 compared with corresponding control group; p < 0.05 compared with older control group.
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Figure 5 Histologic Study of Implanted Cells at 4 Weeks After Cell or Media Implantation
(A to D) Light photomicrographs (100x) illustrating cellular density (Masson trichrome staining; arrows = cell clusters) in the central infarcted region of young and older rats implanted with young skeletal myoblasts (SKMCs) or media (controls). (E) Quantification of cellular density in each group: young rats implanted with young SKMCs (young SKMC) or culture media (young control), and older rats implanted with young SKMCs (older SKMC) or media (older control).
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Figure 6 Cell Survival at 4 Weeks After Cell or Media Implantation
(A to D) Light photomicrographs illustrating the localization of bromodeoxyuridine (BrdU) prelabeled skeletal myoblasts (SKMC) (arrows) isolated from young donors, implanted into the central infarcted myocardium of young and older rats. Areas inside black borders in A and B (100x) are shown at higher power (400x) in C and D. (E) Quantification of surviving BrdU+ cells in each group: young rats implanted with young SKMCs (young SKMC), and older rats implanted with young SKMCs (older SKMC).
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Figure 7 Vasculogenesis at 4 Weeks After Cell or Media Implantation
(A to D) Light photomicrographs (100x) illustrating blood vessels (von Willebrand factor staining; arrows) in the peripheral infarcted region of young and older rats implanted with young skeletal myoblasts (SKMCs) or media (control). (E) Quantification of vascular density in each group: young rats implanted with young SKMCs (young SKMC) or culture media (young control), and older rats implanted with young SKMCs (older SKMC) or media (older control).
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Figure 8 Collagen Preservation at 4 Weeks After Cell or Media Implantation
(A to D) Light photomicrographs (100x) illustrating collagen content (Verheoffs Van Geison staining) in the central infarcted region of young and older rats implanted with young skeletal myoblasts (SKMCs) or media (control). (E) Quantification of collagen content (percentage of the total scar area per section stained positive for collagen) in each group: young rats implanted with young SKMCs (young SKMC) or culture media (young control), and older rats implanted with young SKMCs (older SKMC) or media (older control).
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