CAJ | 학술논문

背景:现已发现心肌梗死后心肌纤维化是心室重构的重要机制,而相关干细胞心肌移植对这一过程的影响报道不多.目的:观察自体骨骼肌卫星细胞移植对心肌梗死大鼠心肌纤维化的影响,并探讨其可能机制.设计、时间及地点:随机对照动物实验,于2007-07/09在解放军第三军医大学大坪医院野战外科研究所第三研究室完成.材料:Wistar 大鼠45只,雌雄各半,体质量150～200 g,其中30只用于制备心肌梗死模型.方法:45只大鼠按随机抽签法分为3组,每组15只.心肌梗死组:结扎冠状动脉左前降支造成心肌梗死,2周后沿梗死区与正常心肌交界处多点注射0.2 mL无血清M199培养液;移植组:造模后将体外培养2周的大鼠自体卫星细胞0.2 mL以注射的方式移植到大鼠梗死区周围.假手术组:不造模,仅在左前降支周围心前壁多点注射0.2 mL生理盐水.主要观察指标:4周后测定各组大鼠缺血心肌血管内皮生长因子mRNA、血管内皮生长因子蛋白质的表达,缺血心肌毛细血管密度变化,苏木精伊红染色观察各组心肌细胞在梗死区的生长、增殖情况.结果:①卫星细胞移植4周后,假手术组和心肌梗死组血管内皮生长因子mRNA和血管内皮生长因子蛋白表达较移植组明显降低(P<0.01);心肌梗死组大鼠毛细血管密度较假手术组升高(P<0.05);移植组大鼠缺血心肌中毛细血管密度较假手术组、心肌梗死组亦明显升高(P<0.01).②苏木精-伊红染色显示假手术组大鼠心肌形态正常,结构清晰,心肌纤维排列整齐有序,肌纤维间无成纤维细胞聚集、增生现象.心肌梗死组大鼠心肌内可见成纤维细胞增生及胶原形成,心肌有序的基本结构发生紊乱.移植组大鼠其梗死区可见较多带有横纹且具有多核的肌细胞存在,组织排列较有序,纤维组织明显少于心肌梗死组.结论:卫星细胞在心肌梗死区中可增殖分化为具有弹性和收缩功能的横纹肌样细胞,并通过自分泌和旁分泌的形式分泌血管内皮生长因子促使缺血心肌毛细血管增生,从而有效地抑制了缺血心肌的纤维化进程. 揹景:現已髮現心肌梗死後心肌纖維化是心室重構的重要機製,而相關榦細胞心肌移植對這一過程的影響報道不多.目的:觀察自體骨骼肌衛星細胞移植對心肌梗死大鼠心肌纖維化的影響,併探討其可能機製.設計、時間及地點:隨機對照動物實驗,于2007-07/09在解放軍第三軍醫大學大坪醫院野戰外科研究所第三研究室完成.材料:Wistar 大鼠45隻,雌雄各半,體質量150～200 g,其中30隻用于製備心肌梗死模型.方法:45隻大鼠按隨機抽籤法分為3組,每組15隻.心肌梗死組:結扎冠狀動脈左前降支造成心肌梗死,2週後沿梗死區與正常心肌交界處多點註射0.2 mL無血清M199培養液;移植組:造模後將體外培養2週的大鼠自體衛星細胞0.2 mL以註射的方式移植到大鼠梗死區週圍.假手術組:不造模,僅在左前降支週圍心前壁多點註射0.2 mL生理鹽水.主要觀察指標:4週後測定各組大鼠缺血心肌血管內皮生長因子mRNA、血管內皮生長因子蛋白質的錶達,缺血心肌毛細血管密度變化,囌木精伊紅染色觀察各組心肌細胞在梗死區的生長、增殖情況.結果:①衛星細胞移植4週後,假手術組和心肌梗死組血管內皮生長因子mRNA和血管內皮生長因子蛋白錶達較移植組明顯降低(P<0.01);心肌梗死組大鼠毛細血管密度較假手術組升高(P<0.05);移植組大鼠缺血心肌中毛細血管密度較假手術組、心肌梗死組亦明顯升高(P<0.01).②囌木精-伊紅染色顯示假手術組大鼠心肌形態正常,結構清晰,心肌纖維排列整齊有序,肌纖維間無成纖維細胞聚集、增生現象.心肌梗死組大鼠心肌內可見成纖維細胞增生及膠原形成,心肌有序的基本結構髮生紊亂.移植組大鼠其梗死區可見較多帶有橫紋且具有多覈的肌細胞存在,組織排列較有序,纖維組織明顯少于心肌梗死組.結論:衛星細胞在心肌梗死區中可增殖分化為具有彈性和收縮功能的橫紋肌樣細胞,併通過自分泌和徬分泌的形式分泌血管內皮生長因子促使缺血心肌毛細血管增生,從而有效地抑製瞭缺血心肌的纖維化進程.
배경:현이발현심기경사후심기섬유화시심실중구적중요궤제,이상관간세포심기이식대저일과정적영향보도불다.목적:관찰자체골격기위성세포이식대심기경사대서심기섬유화적영향,병탐토기가능궤제.설계、시간급지점:수궤대조동물실험,우2007-07/09재해방군제삼군의대학대평의원야전외과연구소제삼연구실완성.재료:Wistar 대서45지,자웅각반,체질량150～200 g,기중30지용우제비심기경사모형.방법:45지대서안수궤추첨법분위3조,매조15지.심기경사조:결찰관상동맥좌전강지조성심기경사,2주후연경사구여정상심기교계처다점주사0.2 mL무혈청M199배양액;이식조:조모후장체외배양2주적대서자체위성세포0.2 mL이주사적방식이식도대서경사구주위.가수술조:불조모,부재좌전강지주위심전벽다점주사0.2 mL생리염수.주요관찰지표:4주후측정각조대서결혈심기혈관내피생장인자mRNA、혈관내피생장인자단백질적표체,결혈심기모세혈관밀도변화,소목정이홍염색관찰각조심기세포재경사구적생장、증식정황.결과:①위성세포이식4주후,가수술조화심기경사조혈관내피생장인자mRNA화혈관내피생장인자단백표체교이식조명현강저(P<0.01);심기경사조대서모세혈관밀도교가수술조승고(P<0.05);이식조대서결혈심기중모세혈관밀도교가수술조、심기경사조역명현승고(P<0.01).②소목정-이홍염색현시가수술조대서심기형태정상,결구청석,심기섬유배렬정제유서,기섬유간무성섬유세포취집、증생현상.심기경사조대서심기내가견성섬유세포증생급효원형성,심기유서적기본결구발생문란.이식조대서기경사구가견교다대유횡문차구유다핵적기세포존재,조직배렬교유서,섬유조직명현소우심기경사조.결론:위성세포재심기경사구중가증식분화위구유탄성화수축공능적횡문기양세포,병통과자분비화방분비적형식분비혈관내피생장인자촉사결혈심기모세혈관증생,종이유효지억제료결혈심기적섬유화진정.
BACKGROUND:Myocardial fibrosis following myocardial infarction is an important mechanism of ventricle reconstitution. However, there are few reports concerning effects of myocardial transplantation related to stern cells on this process. OBJECTIVE: To investigate the effects of auto-skeletal muscle satellite cells implanted into ischemic myocardium on myocardial fibrosis in rats with myocardial infarction and their mechanisms.DESIGN, TIME AND SETTING: The randomized controlled animal study was performed at the Third Research Room, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA from July to September 2007. MATERIALS: A total of 45 Wistar rats, of both genders, weighing 150-200 g, were used in this study. Of them, 30 rats were used to establish models of myocardial infarction.METHODS: A total of 45 rats were assigned to 3 groups (n=15). Rats in the myocardial infarction group received ligation of the left anterior descending coronary artery to induce myocardial infarction. 2 weeks later, 0.2 mL serum-free M199 medium was infused into the juncture between infarct region and normal myocardium through multiple points. In the transplantation group, following model induction, 0.2 mL auto-skeletal muscle satellite cells in rats after 2-weeks in vitro culture were transplanted into the surrounding of infarct region. Rats in the sham operation group were not induced to create models, only injected with 0.2 mL saline in the heart anterior wall surrounding the left anterior descending branch through multiple points. MAIN OUTCOME MEASURES: Four weeks after injection, vascular endothelial growth factor mRNA and vascular endothelial growth factor protein expression in the ischemic myocardium was demonstrated. Capillary density changes in the ischemic myocardium were detected. Growth and proliferation of myocardial cells in the infarct region were observed using hematoxylin-eosin staining.RESULTS: Vascular endothelial growth factor mRNA and vascular endothelial growth factor protein expression was significantly decreased in the sham operation and myocardial infarction groups compared with the transplantation group at 4 weeks following satellite cell transplantation (P<0.01). Capillary density was greater in the myocardial infarction group compared with the sham operation group (P<0.05). Capillary density was significantly higher in the rat ischemic myocardium in the transplantation group compared with the sham operation and myocardial infarction groups (P<0.01). Hematoxylin-eosin staining demonstrated that myocardial morphology was normal in rats of the sham operation group, with clear structure, orderly myocardial fibrosis. There were no fibroblastaggregation and hyperplasia among myocardial fibrosis. Fibroblast hyperplasia and collagent formation were found in the rat myocardium in the myocardial infarction group, with disorderly myocardial structure. Myocardial cells with transverse striation and many nuclei were observed in the rat infarct region of the transplantation group, with orderly arrangement. Fibrous tissue was significantly less in the transplantation group compared with the myocardial infarction group.CONCLUSION: Satellite cells can proliferate and differentiate into striated muscle-like cells with flexible and systolic functions in the infarct region. Satellite cells secrete vascular endothelial growth factor and promote blood capillary hyperplasia in ischemic myocardium by autocrine and paracrine, which finally effectively inhibits fibrosis progress in the ischomic myocardium.