Abstract P411: Sex-based Differences In A Feline Model Of Hfpef

Rationale: Heart Failure with preserved Ejection Fraction (HFpEF) accounts for approximately 50% of all HF diagnoses with no FDA approved therapies. HFpEF is more prevalent in females versus males, but the mechanisms driving the development of HFpEF as a sex-based disorder are not well understood. We have recently shown that slow progressive pressure overload (PO) in male felines induces a HFpEF phenotype but have not investigated the differences in response to the same physiological stress in females.

Hypothesis: Females will develop a phenotype that is distinct from males in response to PO.

Methods and Results: Male (m) and female (f) domestic short felines (age 2mo) underwent either a sham procedure (m: n=7; f: n=7) or aortic constriction (m: n=11; f: n=10) using a customized pre-shaped band. At baseline (prior to surgery), there was no difference in body weight between groups and echocardiography revealed no significant difference in the ratio of left atrium to aortic root (LA/Ao), LA ejection fraction (LA EF), left ventricle (LV) ejection fraction, LV wall-thickness, and E/A ratio. At 4mo post-surgery, both males and females developed cardiac dysfunction. Females gained significantly less weight than males throughout the study. Despite the size difference, both sexes developed comparable LV wall thickness and changes in E/A ratio vs. sham groups. There was no change in LV EF. Furthermore, there was a decrease in LA EF and increased LA/Ao, indicating LA dysfunction and enlargement. Invasive hemodynamics at 4mo post-surgery showed no differences between sexes for the systolic pressure gradient generated by the aortic banding. Banded males had a significantly higher LV end-diastolic pressure vs. banded females, but there was a trend towards prolongation of tau and lower dp/dt min in banded females, reflective of worse active relaxation. Both sexes had comparable dP/dt max . There were no differences between banded males and females in heart weight to body weight or cardiomyocyte cross-sectional area.

Conclusion: Despite similar pressure gradients as a result of PO and the development of similar cardiac hypertrophy between sexes and a higher LVEDP in males, females had a trend towards worse relaxation. Other causes of HFpEF may have sex-based differences.

Abstract 249: Cortical-bone Derived Stem Cells Improve Cardiac Outcomes After Myocardial Infarction by Modulating the Inflammatory Response

Rationale: Cortical-bone derived stem cells (CBSCs) improve cardiac pump function and reduce scar size after myocardial infarction (MI) compared to Cardiac-Derived and Mesenchymal Stem Cells. However, the mechanism for these improved outcomes is not known. Recent data in a swine model of MI has demonstrated acute changes to the immune response elicited by MI in CBSC treated animals compared to vehicle controls, suggesting that CBSCs may improve post-MI remodeling by modulation of the immune response.

Objective: Identify the changes in the immune response of CBSC-treated animals and determine the role of these changes in cardiac healing and wound repair.

Methods and Results: Using multi-color flow cytometry, we found that murine bone marrow-derived macrophages (BMDMs) cultured and exposed to CBSC conditioned culture medium in vitro express higher levels of the mannose receptor CD206 than controls, indicating alternative “M2” activation. In addition, CD86 expression on BMDMs exposed to the classical (M1) activators interferon-γ (INF-γ) and lipopolysaccharide (LPS) in conditioned CBSC media was significantly lower than cells treated only with INF-γ and LPS. Blocking the IL-4 receptor on the BMDMs with a monoclonal antibody in conditioned media decreased CD206 expression, increased CD86 expression, and failed to mitigate the activation elicited by INF-γ and LPS. Exposing the BMDMs to conditioned media also increased the amount of the anti-inflammatory cytokine IL-1 receptor antagonist (IL1-RA) released compared to controls, matching previous data from a swine-model of MI that showed increased IL-1RA blood levels in CBSC-treated swine 72 hours post-MI. Together these data implicate IL-4 as a possible mechanism through which CBSCs influence the inflammatory response raised to MI.

Conclusion: Soluble factors secreted by CBSCs change the phenotype of immune cells in vitro and in vivo . A possible mechanism for the beneficial effects of CBSCs on cardiac wound healing after MI may come from their ability to modulate the monocyte/macrophage response to preserve cardiac structure and function.

Cortical Bone Stem Cell Therapy Preserves Cardiac Structure and Function After Myocardial Infarction

RATIONALE

Cortical bone stem cells (CBSCs) have been shown to reduce ventricular remodeling and improve cardiac function in a murine myocardial infarction (MI) model. These effects were superior to other stem cell types that have been used in recent early-stage clinical trials. However, CBSC efficacy has not been tested in a preclinical large animal model using approaches that could be applied to patients.

OBJECTIVE

To determine whether post-MI transendocardial injection of allogeneic CBSCs reduces pathological structural and functional remodeling and prevents the development of heart failure in a swine MI model.

METHODS AND RESULTS

Female Göttingen swine underwent left anterior descending coronary artery occlusion, followed by reperfusion (ischemia-reperfusion MI). Animals received, in a randomized, blinded manner, 1:1 ratio, CBSCs (n=9; 2×10⁷ cells total) or placebo (vehicle; n=9) through NOGA-guided transendocardial injections. 5-ethynyl-2'deoxyuridine (EdU)-a thymidine analog-containing minipumps were inserted at the time of MI induction. At 72 hours (n=8), initial injury and cell retention were assessed. At 3 months post-MI, cardiac structure and function were evaluated by serial echocardiography and terminal invasive hemodynamics. CBSCs were present in the MI border zone and proliferating at 72 hours post-MI but had no effect on initial cardiac injury or structure. At 3 months, CBSC-treated hearts had significantly reduced scar size, smaller myocytes, and increased myocyte nuclear density. Noninvasive echocardiographic measurements showed that left ventricular volumes and ejection fraction were significantly more preserved in CBSC-treated hearts, and invasive hemodynamic measurements documented improved cardiac structure and functional reserve. The number of EdU⁺ cardiac myocytes was increased in CBSC- versus vehicle- treated animals.

CONCLUSIONS

CBSC administration into the MI border zone reduces pathological cardiac structural and functional remodeling and improves left ventricular functional reserve. These effects reduce those processes that can lead to heart failure with reduced ejection fraction.

Ethanol consumption in the Sprague-Dawley rat increases sensitivity of the dorsal raphe nucleus to 5,7-dihydroxytryptamine

Alcoholism afflicts 1 in 13 US adults, and comorbidity with depression is common. Levels of serotonin (5-HT) metabolites in alcoholic or depressed humans and rat strains are lower compared to healthy counterparts. Rats bred for ethanol (EtOH) preference are common in EtOH studies, however out-bred strains better model the range of EtOH consumption in humans. We examined voluntary EtOH consumption in out-bred Sprague-Dawley (SD) rats placed in the 20% EtOH intermittent access drinking paradigm (IA). Acquisition of 20% EtOH consumption (g EtOH/kg/24h) was assessed during the first 6-8 weeks of IA. Rats naturally separated into two groups (Drinkers or Non-drinkers) based on EtOH intake above or below 0.5 g/kg/24h prior to treatment intervention. We examined the effect of central 5-HT depletion on EtOH consumption by infusing 5,7-dihyroxytryptamine (5,7-DHT; i.c.v., 200-300 μg) or vehicle and measured EtOH consumption for 4 weeks post-operatively in IA. Compared to baseline, there was no effect of vehicle or 5,7-DHT on EtOH consumption during the post-operative period. Quantification of 5-HT depletion in the dorsal raphe nucleus (DRN) using tryptophan hydroxylase-2 (TPH2) immunohistochemistry resulted in a 76% decrease in staining with 5,7-DHT treatment. Interestingly, preservation of the ventromedial (VM) sub-regions was evident in all animals treated with 5,7-DHT, regardless of drinking behavior. In addition, Drinkers treated with 5,7-DHT had significantly more TPH2 depletion in the DRN compared to Non-drinkers. Our findings indicate that out-bred SD rats exhibit a natural EtOH consumption behavior (Drinker or Non-drinker) that is stable across time and independent of 5-HT depletion in the CNS. In addition, rats that regularly consumed >0.5 g EtOH/kg had greater sensitivity to 5,7-DHT in the DRN, indicating an interaction between EtOH and sensitivity of DRN 5-HT cells to neurotoxic substances. This may contribute to the dysfunctionality of the 5-HT system in alcoholic humans and lead to a better understanding of current pharmacological treatments for this addiction.