Scaffolds and Extracellular Vesicles as a Promising Approach for Cardiac Regeneration after Myocardial Infarction
Abstract
:1. Myocardial Infarction
Clinical Trials Based on Cell Therapy for Cardiac Regeneration
2. Scaffolds for Cardiac Applications
2.1. Biomaterials Used as Therapeutic Scaffolds
2.2. Scaffolds as Cell or GF Carriers
2.3. Scaffolds and GF Combined to Promote Cell Engraftment and Repair
3. Extracellular Vesicles
3.1. Myocardial Repair with Cell-Derived EVs vs. with Cells Alone
3.2. Use of Modified EVs as Therapeutic Agents to Improve Native Beneficial Effects of EVs
3.3. Why Are EVs Not Yet Transferred to the Clinic?
4. EVs Association with Scaffolds as a Future Direction
Funding
Conflicts of Interest
References
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Cell Type | Benefits | Limits | Clinical Trial |
---|---|---|---|
Skeletal myoblasts | Abundant, contractile properties, withstand ischemic insult | Committed to skeletal muscle lineage, high mortality after injection | MAGIC |
Bone Marrow Mononuclear Cells (BMMC), Mesenchymal Stem Cells (MSC), Hematopoietic Stem Cells (HSC) | Easy acquisition, rapid proliferation, multipotency, low immunogenicity, immune-privileged, potential for allogenic use | Heterogeneous cell population, lack of standardized study methodologies, lack of long-term follow-up to determine if benefits will last | BOOST BALANCE BONAMI (NCT00200707) REGENERATE-AMI (NCT00765453) MI3-Trial SWISS-AMI (NCT00355186) REPAIR-AMI SCAMI (NCT00669227) TIME (NCT00684021) LateTIME (NCT00684021) BAMI (NCT01569178) REGENT (NCT00316381) COMPARE-AMI PROCHYMAL (NCT00114452) PROCHYMAL II (NCT00877903) MyStromaCell (NCT01394432) Precise Trial (NCT00426868) RELIEF (NCT01652209) ESTIMATION (NCT01394432) SEESUPIHD (NCT02666391) C-CURE (NCT00810238) CHART (NCT01768702) WJ-MSC-AMI (NCT01291329) |
Cardiac Stem Cells (CSC) | Higher differentiation potency into cardiac lineages | Invasive isolation procedure, high expansion cost, low cell availability, older/autologous donors means lower quality cells | CADUCEUS (NCT00893360) CAREMI NCT02439398) ALLSTAR NCT01458405) SCIPIO (NCT00474461) |
Embryonic Stem Cells (ESC) | Pluripotent | Ethical, political and availability issues | ESCORT (NCT02057900) * |
EV Source | Assay Model | Function and Mechanism | Mechanism | References |
---|---|---|---|---|
MSC | IM rat, intramyocardial injection | Preserve myocardial function | Endogenous miRNA | [108] |
Reduce fibrosis | ||||
Inhibit fibroblast transformation | ||||
Promote cardiomyocyte proliferation | ||||
Human MSC | I/R mouse, intravenous injection | Increase systolic function | Activation of survival pathways | [109] |
Decrease infarct size | Decrease neutrophils and macrophage infiltration | |||
Decrease inflammation | ||||
MSC | MI rat, intramyocardial injection | Promote angiogenesis | miRNA-150, HIF, SHH, PDGFR carrying by EVs | [110] |
Preserve cardiac performance | ||||
MSC | I/R mouse, intravenous injection | Cardioprotective effect | Paracrine effect of EVs, undefined | [111] |
MSC | MI rat, intramyocardial injection | Improve cardiac function | Undefined | [112] |
Decrease fibrosis | ||||
Promote angiogenesis | ||||
iPSC | I/R mouse, intramyocardial injection | Attenuate LV dysfunction and hypertrophy | Protection against oxidative damage | [117] |
Reduction of myocyte apoptosis | ||||
Enhance angiogenesis | ||||
CPCs (murine cardiosphere- derived cells) | I/R mouse, intramyocardial injection | Decrease cardiomyocyte apoptosis | Possibly related to miRNA144 et miRNA451 content in EVs and secretion of soluble factors | [120] |
Human CPCs | IM rat, intramyocardial injection | Improve cardiac function | miRNA carrying by EVs | [119] |
Reduced cardiomyocyte apoptosis | ||||
Enhance angiogenesis | ||||
CPCs (Human cardiosphere-derived cells) | I/R pig, intracoronary injection | Decrease infarct size, collagen content | Undefined | [118] |
Decrease cardiomyocyte hypertrophy | ||||
Increase vessel density | ||||
Embryonic stem cells (ESC) | AMI mouse, intramyocardial injection | Enhance cardiac function | Recruitment of endogenous CPCs (c-kit+ cells) | [115] |
Reduce fibrosis | ||||
Enhance neovascularization | ||||
Enhance cardiomyocyte survival | ||||
Human ESC-derived CPCs | IM mouse, intramyocardial injection | Increase cardiac function | Undefined | [114] |
Decrease fibrosis and cardiomyocyte hypertrophy | ||||
Increase capillary/cardiomyocyte ratio | ||||
Dendritic cells | MI mouse, intravenous injection | Improve cardiac function | Activation LT CD4+ (endocrine mechanism) | [122,123] |
Platelet | MI rat, intramyocardial injection | Increase capillary formation | Action of cytokines (bFGF, PDGF, VEGF) | [124] |
Rat and human plasma | I/R rat, intravenous injection | Decrease infarct size | Activation of HSP70/TLR4 protective pathway | [126] |
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Riaud, M.; Martinez, M.C.; Montero-Menei, C.N. Scaffolds and Extracellular Vesicles as a Promising Approach for Cardiac Regeneration after Myocardial Infarction. Pharmaceutics 2020, 12, 1195. https://doi.org/10.3390/pharmaceutics12121195
Riaud M, Martinez MC, Montero-Menei CN. Scaffolds and Extracellular Vesicles as a Promising Approach for Cardiac Regeneration after Myocardial Infarction. Pharmaceutics. 2020; 12(12):1195. https://doi.org/10.3390/pharmaceutics12121195
Chicago/Turabian StyleRiaud, Melody, M. Carmen Martinez, and Claudia N. Montero-Menei. 2020. "Scaffolds and Extracellular Vesicles as a Promising Approach for Cardiac Regeneration after Myocardial Infarction" Pharmaceutics 12, no. 12: 1195. https://doi.org/10.3390/pharmaceutics12121195