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

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.

• Authors: Alfonso Eirin, Xiang-Yang Zhu, Christopher M Ferguson, Scott M Riester, Andre J van Wijnen, Amir Lerman, Lilach O Lerman
• Journal: Stem cell research & therapy (Stem Cell Res Ther) Vol. 6 Pg. 7 (Jan 19 2015) ISSN: 1757-6512 [Electronic] England
• PMID: 25599803 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Cytokines
• Isoprostanes
• Collagen

Topics

• Angioplasty
• Animals
• Blood Pressure
• Collagen (metabolism)
• Cytokines (metabolism)
• Female
• Fibrosis
• Glomerular Filtration Rate
• Heart (diagnostic imaging)
• Heart Injuries (pathology)
• Hemodynamics
• Hypertension, Renovascular (therapy)
• Inflammation
• Isoprostanes (blood)
• Kidney (cytology, physiology)
• Mesenchymal Stem Cell Transplantation
• Mesenchymal Stem Cells (cytology, metabolism)
• Microvessels (physiology)
• Myocardium (metabolism)
• Oxidative Stress
• Swine
• Tomography, X-Ray Computed