Safety and Efficacy of the Intravenous Infusion of Umbilical Cord Mesenchymal Stem Cells in Patients With Heart Failure
| Autor: | Pablo Pedreros, Rubén Lamich, Ema Abarzua, Francisca Alcayaga-Miranda, Paz Gonzalez, Fernando J. Verdugo, Jorge Bartolucci, Amit N. Patel, Maroun Khoury, Iván Palma, Gloria Valdivia, Carolina Nazzal, Matthew Brobeck, Jimena Cuenca, Ricardo Larrea, Valentina M. Lopez, Fernando E Figueroa, Carlos Goset, Pamela Rojo |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Physiology Cell- and Tissue-Based Therapy 030204 cardiovascular system & hematology Umbilical cord Umbilical Cord law.invention 0302 clinical medicine Randomized controlled trial Cell Movement law Infusions Intravenous Ejection fraction medicine.diagnostic_test clinical trial Middle Aged Treatment Outcome medicine.anatomical_structure ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Cardiology Female Hepatocyte growth factor mesenchymal stromal cells Cardiology and Cardiovascular Medicine medicine.drug cardiomyopathies medicine.medical_specialty Mesenchymal Stem Cell Transplantation Placebo Article 03 medical and health sciences Double-Blind Method Cardiac magnetic resonance imaging Internal medicine medicine Humans Aged Heart Failure business.industry Mesenchymal Stem Cells medicine.disease Surgery Clinical trial 030104 developmental biology Heart failure Clinical Track business |
| Zdroj: | Circulation Research |
| ISSN: | 1524-4571 0009-7330 |
| DOI: | 10.1161/circresaha.117.310712 |
| Popis: | Supplemental Digital Content is available in the text. Rationale: Umbilical cord–derived mesenchymal stem cells (UC-MSC) are easily accessible and expanded in vitro, possess distinct properties, and improve myocardial remodeling and function in experimental models of cardiovascular disease. Although bone marrow–derived mesenchymal stem cells have been previously assessed for their therapeutic potential in individuals with heart failure and reduced ejection fraction, no clinical trial has evaluated intravenous infusion of UC-MSCs in these patients. Objective: Evaluate the safety and efficacy of the intravenous infusion of UC-MSC in patients with chronic stable heart failure and reduced ejection fraction. Methods and Results: Patients with heart failure and reduced ejection fraction under optimal medical treatment were randomized to intravenous infusion of allogenic UC-MSCs (Cellistem, Cells for Cells S.A., Santiago, Chile; 1×106 cells/kg) or placebo (n=15 per group). UC-MSCs in vitro, compared with bone marrow–derived mesenchymal stem cells, displayed a 55-fold increase in the expression of hepatocyte growth factor, known to be involved in myogenesis, cell migration, and immunoregulation. UC-MSC–treated patients presented no adverse events related to the cell infusion, and none of the patients tested at 0, 15, and 90 days presented alloantibodies to the UC-MSCs (n=7). Only the UC-MSC–treated group exhibited significant improvements in left ventricular ejection fraction at 3, 6, and 12 months of follow-up assessed both through transthoracic echocardiography (P=0.0167 versus baseline) and cardiac MRI (P=0.025 versus baseline). Echocardiographic left ventricular ejection fraction change from baseline to month 12 differed significantly between groups (+7.07±6.22% versus +1.85±5.60%; P=0.028). In addition, at all follow-up time points, UC-MSC–treated patients displayed improvements of New York Heart Association functional class (P=0.0167 versus baseline) and Minnesota Living with Heart Failure Questionnaire (P |
| Databáze: | OpenAIRE |
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