Intra-renal delivery of mesenchymal stem cells attenuates myocardial injury after reversal of hypertension in porcine renovascular disease

Alfonso Eirin, Xiang Yang Zhu, Christopher M. Ferguson, Scott M. Riester, Andre J van Wijnen, Amir Lerman, Lilach O Lerman

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Introduction: Percutaneous transluminal renal angioplasty (PTRA) fails to fully improve cardiac injury and dysfunction in patients with renovascular hypertension (RVH). Mesenchymal stem cells (MSCs) restore renal function, but their potential for attenuating cardiac injury after reversal of RVH has not been explored. We hypothesized that replenishment of MSCs during PTRA would improve cardiac function and oxygenation, and decrease myocardial injury in porcine RVH. Methods: Pigs were studied after 16 weeks of RVH, RVH treated 4 weeks earlier with PTRA with or without adjunct intra-renal delivery of MSC (10∧6 cells), and controls. Cardiac structure, function (fast-computed tomography (CT)), and myocardial oxygenation (Blood-Oxygen-Level-Dependent- magnetic resonance imaging) were assessed in-vivo. Myocardial microvascular density (micro-CT) and myocardial injury were evaluated ex-vivo. Kidney venous and systemic blood levels of inflammatory markers were measured and their renal release calculated. Results: PTRA normalized blood pressure, yet stenotic-kidney glomerular filtration rate, similarly blunted in RVH and RVH∈+∈PTRA, normalized only in PTRA∈+∈MSC-treated pigs. PTRA attenuated left ventricular remodeling, whereas myocardial oxygenation, subendocardial microvascular density, and diastolic function remained decreased in RVH∈+∈PTRA, but normalized in RVH∈+∈PTRA-MSC. Circulating isoprostane levels and renal release of inflammatory cytokines increased in RVH and RVH∈+∈PTRA, but normalized in RVH∈+∈PTRA-MSC, as did myocardial oxidative stress, inflammation, collagen deposition, and fibrosis. Conclusions: Intra-renal MSC delivery during PTRA preserved stenotic-kidney function, reduced systemic oxidative stress and inflammation, and thereby improved cardiac function, oxygenation, and myocardial injury four weeks after revascularization, suggesting a therapeutic potential for adjunctive MSC delivery to preserve cardiac function and structure after reversal of experimental RVH.

Original languageEnglish (US)
Article number7
JournalStem Cell Research and Therapy
Volume6
Issue number1
DOIs
StatePublished - Jan 19 2015

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Swine Diseases
Stem cells
Mesenchymal Stromal Cells
Renovascular Hypertension
Hypertension
Kidney
Oxygenation
Angioplasty
Wounds and Injuries
Oxidative stress
Blood
Isoprostanes
Blood pressure
Magnetic resonance
Swine
Tomography
Collagen
Cytokines
Oxygen
Imaging techniques

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology (miscellaneous)
  • Molecular Medicine
  • Cell Biology
  • Medicine (miscellaneous)

Cite this

Intra-renal delivery of mesenchymal stem cells attenuates myocardial injury after reversal of hypertension in porcine renovascular disease. / Eirin, Alfonso; Zhu, Xiang Yang; Ferguson, Christopher M.; Riester, Scott M.; van Wijnen, Andre J; Lerman, Amir; Lerman, Lilach O.

In: Stem Cell Research and Therapy, Vol. 6, No. 1, 7, 19.01.2015.

Research output: Contribution to journalArticle

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abstract = "Introduction: Percutaneous transluminal renal angioplasty (PTRA) fails to fully improve cardiac injury and dysfunction in patients with renovascular hypertension (RVH). Mesenchymal stem cells (MSCs) restore renal function, but their potential for attenuating cardiac injury after reversal of RVH has not been explored. We hypothesized that replenishment of MSCs during PTRA would improve cardiac function and oxygenation, and decrease myocardial injury in porcine RVH. Methods: Pigs were studied after 16 weeks of RVH, RVH treated 4 weeks earlier with PTRA with or without adjunct intra-renal delivery of MSC (10∧6 cells), and controls. Cardiac structure, function (fast-computed tomography (CT)), and myocardial oxygenation (Blood-Oxygen-Level-Dependent- magnetic resonance imaging) were assessed in-vivo. Myocardial microvascular density (micro-CT) and myocardial injury were evaluated ex-vivo. Kidney venous and systemic blood levels of inflammatory markers were measured and their renal release calculated. Results: PTRA normalized blood pressure, yet stenotic-kidney glomerular filtration rate, similarly blunted in RVH and RVH∈+∈PTRA, normalized only in PTRA∈+∈MSC-treated pigs. PTRA attenuated left ventricular remodeling, whereas myocardial oxygenation, subendocardial microvascular density, and diastolic function remained decreased in RVH∈+∈PTRA, but normalized in RVH∈+∈PTRA-MSC. Circulating isoprostane levels and renal release of inflammatory cytokines increased in RVH and RVH∈+∈PTRA, but normalized in RVH∈+∈PTRA-MSC, as did myocardial oxidative stress, inflammation, collagen deposition, and fibrosis. Conclusions: Intra-renal MSC delivery during PTRA preserved stenotic-kidney function, reduced systemic oxidative stress and inflammation, and thereby improved cardiac function, oxygenation, and myocardial injury four weeks after revascularization, suggesting a therapeutic potential for adjunctive MSC delivery to preserve cardiac function and structure after reversal of experimental RVH.",
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AU - van Wijnen, Andre J

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AU - Lerman, Lilach O

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N2 - Introduction: Percutaneous transluminal renal angioplasty (PTRA) fails to fully improve cardiac injury and dysfunction in patients with renovascular hypertension (RVH). Mesenchymal stem cells (MSCs) restore renal function, but their potential for attenuating cardiac injury after reversal of RVH has not been explored. We hypothesized that replenishment of MSCs during PTRA would improve cardiac function and oxygenation, and decrease myocardial injury in porcine RVH. Methods: Pigs were studied after 16 weeks of RVH, RVH treated 4 weeks earlier with PTRA with or without adjunct intra-renal delivery of MSC (10∧6 cells), and controls. Cardiac structure, function (fast-computed tomography (CT)), and myocardial oxygenation (Blood-Oxygen-Level-Dependent- magnetic resonance imaging) were assessed in-vivo. Myocardial microvascular density (micro-CT) and myocardial injury were evaluated ex-vivo. Kidney venous and systemic blood levels of inflammatory markers were measured and their renal release calculated. Results: PTRA normalized blood pressure, yet stenotic-kidney glomerular filtration rate, similarly blunted in RVH and RVH∈+∈PTRA, normalized only in PTRA∈+∈MSC-treated pigs. PTRA attenuated left ventricular remodeling, whereas myocardial oxygenation, subendocardial microvascular density, and diastolic function remained decreased in RVH∈+∈PTRA, but normalized in RVH∈+∈PTRA-MSC. Circulating isoprostane levels and renal release of inflammatory cytokines increased in RVH and RVH∈+∈PTRA, but normalized in RVH∈+∈PTRA-MSC, as did myocardial oxidative stress, inflammation, collagen deposition, and fibrosis. Conclusions: Intra-renal MSC delivery during PTRA preserved stenotic-kidney function, reduced systemic oxidative stress and inflammation, and thereby improved cardiac function, oxygenation, and myocardial injury four weeks after revascularization, suggesting a therapeutic potential for adjunctive MSC delivery to preserve cardiac function and structure after reversal of experimental RVH.

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