Francois Haddad1, Matjaz Sever2, Gregor Poglajen3, Luka Lezaic4, Philip Yang5, Holden Maecker5, Mark Davis5, Tatiana Kuznetsova6, Joseph C Wu5, Bojan Vrtovec7. 1. Stanford University School of Medicine, Stanford Cardiovascular Institute, Stanford, California; Advanced Heart Failure and Transplantation Center, University Medical Center, Ljubljana, Slovenia. 2. Department of Hematology, University Medical Center, Ljubljana, Slovenia. 3. Advanced Heart Failure and Transplantation Center, University Medical Center, Ljubljana, Slovenia. 4. Department of Nuclear Medicine, University Medical Center, Ljubljana, Slovenia. 5. Stanford University School of Medicine, Stanford Cardiovascular Institute, Stanford, California. 6. Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium. 7. Stanford University School of Medicine, Stanford Cardiovascular Institute, Stanford, California; Advanced Heart Failure and Transplantation Center, University Medical Center, Ljubljana, Slovenia. Electronic address: bvrtovec@stanford.edu.
Abstract
BACKGROUND: Although stem cell therapy (SCT) is emerging as a potential treatment for patients with dilated cardiomyopathy (DCM), clinical response remains variable. Our objective was to determine whether baseline differences in circulating immunologic and nonimmunologic biomarkers may help to identify patients more likely to respond to intramyocardial injection of CD34(+)-based SCT. METHODS AND RESULTS: We enrolled from January 3, 2011 to March 5, 2012 37 patients with longstanding DCM (left ventricular ejection fraction [LVEF] <40%, New York Heart Association functional class III) who underwent peripheral CD34(+) stem cell mobilization with granulocyte colony-stimulating factor (G-CSF) and collection by means of apheresis. CD34(+) cells were labeled with (99m)Tc-hexamethylpropyleneamine oxime to allow assessment of stem cell retention at 18 hours. Response to SCT was predefined as an increase in LVEF of ≥5% at 3 months. The majority (84%) of patients were male with an overall mean LVEF of 27 ± 7% and a median N-terminal pro-B-type natriuretic peptide (NT-proBNP) level of 2,774 pg/mL. Nineteen patients (51%) were responders to SCT. There was no significant difference between responders and nonresponders regarding to age, sex, baseline LVEF, NT-proBNP levels, or 6-minute walking distance. With the use of a partial least squares (PLS) predictive model, we identified 9 baseline factors that were associated with both stem cell response and stem cell retention (mechanistic validation). Among the baseline factors positively associated with both clinical response and stem cell retention were G-CSF, SDF-1, LIF, MCP-1, and MCP-3. Among baseline factors negatively associated with both clinical response and retention were IL-12p70, FASL, ICAM-1, and GGT. A decrease in G-CSF at 3-month follow-up was also observed in responders compared with nonresponders (P = .02). CONCLUSIONS: If further validated, baseline immunologic and nonimmunologic biomarkers may help to identify patients with DCM who are more likely to respond to CD34(+)-based SCT.
BACKGROUND: Although stem cell therapy (SCT) is emerging as a potential treatment for patients with dilated cardiomyopathy (DCM), clinical response remains variable. Our objective was to determine whether baseline differences in circulating immunologic and nonimmunologic biomarkers may help to identify patients more likely to respond to intramyocardial injection of CD34(+)-based SCT. METHODS AND RESULTS: We enrolled from January 3, 2011 to March 5, 2012 37 patients with longstanding DCM (left ventricular ejection fraction [LVEF] <40%, New York Heart Association functional class III) who underwent peripheral CD34(+) stem cell mobilization with granulocyte colony-stimulating factor (G-CSF) and collection by means of apheresis. CD34(+) cells were labeled with (99m)Tc-hexamethylpropyleneamine oxime to allow assessment of stem cell retention at 18 hours. Response to SCT was predefined as an increase in LVEF of ≥5% at 3 months. The majority (84%) of patients were male with an overall mean LVEF of 27 ± 7% and a median N-terminal pro-B-type natriuretic peptide (NT-proBNP) level of 2,774 pg/mL. Nineteen patients (51%) were responders to SCT. There was no significant difference between responders and nonresponders regarding to age, sex, baseline LVEF, NT-proBNP levels, or 6-minute walking distance. With the use of a partial least squares (PLS) predictive model, we identified 9 baseline factors that were associated with both stem cell response and stem cell retention (mechanistic validation). Among the baseline factors positively associated with both clinical response and stem cell retention were G-CSF, SDF-1, LIF, MCP-1, and MCP-3. Among baseline factors negatively associated with both clinical response and retention were IL-12p70, FASL, ICAM-1, and GGT. A decrease in G-CSF at 3-month follow-up was also observed in responders compared with nonresponders (P = .02). CONCLUSIONS: If further validated, baseline immunologic and nonimmunologic biomarkers may help to identify patients with DCM who are more likely to respond to CD34(+)-based SCT.
Authors: Jesse V Jokerst; Nicholas Cauwenberghs; Tatiana Kuznetsova; Francois Haddad; Timothy Sweeney; Jiayi Hou; Yael Rosenberg-Hasson; Eric Zhao; Robert Schutt; Roberto Bolli; Jay H Traverse; Carl J Pepine; Timothy D Henry; Ivonne H Schulman; Lem Moyé; Doris A Taylor; Phillip C Yang Journal: Sci Rep Date: 2017-06-30 Impact factor: 4.379
Authors: Mayra Lorena Moreira; Priscylla da Costa Medeiros; Sergio Augusto Lopes de Souza; Bianca Gutfilen; Paulo Henrique Rosado-de-Castro Journal: Stem Cells Int Date: 2016-01-12 Impact factor: 5.443