CAJ | 학술논문

目的探讨脐带间充质干细胞(UC-MSCs)与脐血CD34+ (UCB-CD34+)细胞联合移植对心肌梗死(MI)后心功能的影响.方法成年雌性日本大耳白兔17只,联合移植组和对照组各8只,1只取正常心脏.开胸结扎左心室支(LVB)建立心肌梗死模型,从脐带和脐血中分别分离间充质干细胞(MSCs)和CD34+细胞,于建模后4周二次开胸进行细胞联合移植,单纯磷酸盐缓冲液(PBS)移植作为对照.建模前、后4周及移植后4周行心脏超声心动检查左心室缩短分数(LVFS)变化,处死兔子留取心脏标本,行HE、Masson染色观察心肌纤维化程度,行免疫组织化学染色观察梗死周边血管形成和细胞分化情况.结果两组兔子基线数据差异无统计学意义.建模后两组LVFS差异无统计学意义[(31.63±2.20)％对(32.75±1.16)％,P＞0.05];移植后4周,对照组中LVFS较建模后下降[(32.00±0.76)％对(32.75±1.16)％,P＜0.05],联合移植组中较建模后升高[40.13 ±2.48)％对(31.63±2.20)％,P＜0.01].移植后4周,联合移植组的LVFS显著高于对照组[(40.13±2.48)％对(32.00 ±0.76)％,P＜0.01].HE、Masson染色示梗死区大量心肌细胞坏死,代之以胶原纤维,且联合移植组胶原含量较对照组少;免疫组织化学染色示联合移植组梗死区域可见cTnI(+)及CD31(+)的细胞管状结构,对照组未见阳性细胞存在.结论 UC-MSCs和CD34+细胞联合移植可改善心肌梗死后心功能,可能与梗死周边微血管和心肌细胞形成有关.
목적 탐토제대간충질간세포(UC-MSCs)여제혈CD34+ (UCB-CD34+)세포연합이식대심기경사(MI)후심공능적영향.방법 성년자성일본대이백토17지,연합이식조화대조조각8지,1지취정상심장.개흉결찰좌심실지(LVB)건립심기경사모형,종제대화제혈중분별분리간충질간세포(MSCs)화CD34+세포,우건모후4주이차개흉진행세포연합이식,단순린산염완충액(PBS)이식작위대조.건모전、후4주급이식후4주행심장초성심동검사좌심실축단분수(LVFS)변화,처사토자류취심장표본,행HE、Masson염색관찰심기섬유화정도,행면역조직화학염색관찰경사주변혈관형성화세포분화정황.결과 량조토자기선수거차이무통계학의의.건모후량조LVFS차이무통계학의의[(31.63±2.20)％대(32.75±1.16)％,P＞0.05];이식후4주,대조조중LVFS교건모후하강[(32.00±0.76)％대(32.75±1.16)％,P＜0.05],연합이식조중교건모후승고[40.13 ±2.48)％대(31.63±2.20)％,P＜0.01].이식후4주,연합이식조적LVFS현저고우대조조[(40.13±2.48)％대(32.00 ±0.76)％,P＜0.01].HE、Masson염색시경사구대량심기세포배사,대지이효원섬유,차연합이식조효원함량교대조조소;면역조직화학염색시연합이식조경사구역가견cTnI(+)급CD31(+)적세포관상결구,대조조미견양성세포존재.결론 UC-MSCs화CD34+세포연합이식가개선심기경사후심공능,가능여경사주변미혈관화심기세포형성유관.
Objective To investigate the effect of cotransplantation of umbilical cord mesenchymal stem cells (UC-MSCs) and umbilical cord blood CD34 + (UCB-CD34 +) cells on the heart function after myocardial infarction.Methods Ligating the left ventricular branch (LVB) after median sternotomy to establish a model of myocardial infarction using 17 adult female Japanese white rabbits,dividing into cotransplantation group and PBS group(8 per group),and one is killed for the normal heart.Electrocardiogram (ECG) is measured before and after ligation of LVB and four weeks after ligation.Isolate MSCs from umbilical cord and CD34 + cells from human umbilical cord blood,respectively.Four weeks after the establishment of the model,cotransplantation is administered,and transplantation of PBS alone is as control.Ultrasonic cardiogram is given before and four weeks after the establishment of the model and four weeks after transplantation,and then rabbits are sacrificed.The hearts are taken and cut into slices for HE and Masson's trichrome staining to evaluate the degree of myocardial fibrosis,and immunohistochemical staining to evaluate neovascularization and transdifferentiation in the infarcted area.Results The baseline datas between two groups are not different.And Left ventricular fraction shortening (LVFS) after the establishment of the model have no significant difference between two groups[(31.63 ± 2.20)％ vs (32.75 ±1.16)％,P ＞ 0.05].LVFS after transplantation decreased compared with LVFS before transplantation in control group [32.00 ± 0.76) ％ VS (32.75 ± 1.16) ％,P ＜ 0.05],but increased in cotransplantation group[(40.13 ± 2.48)％ vs (31.63 ± 2.20)％,P ＜ 0.01].After transplantation,LVFS of the cotransplantation group is higher than that of the control group,[(40.13 ±2.48)％ vs (32.00 ±0.76)％,P ＜0.01].As is shown by HE and Masson'strichrome staining,many cardiomyocytes are necrotic and replaced by collagenous fiber in the infarct area,immunohistochemistry staining shows cells with cTnI(+) and tube structures with CD31 (+) in the infarcted area of the cotransplantation group,but not in the control group.Conclusion Cotransplantation of UC-MSCs and UCB-CD34 + cells can ameliorate heart function,and the effect may cause by the neogenesis of the capillaries and cardiomyocytes in the infarcted area.