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Zacherl MJ, Todica A, Wängler C, Schirrmacher R, Hajebrahimi MA, Pircher J, Li X, Lindner S, Brendel M, Bartenstein P, Massberg S, Brunner S, Lehner S, Hacker M, Huber BC. Molecular imaging of cardiac CXCR4 expression in a mouse model of acute myocardial infarction using a novel 68Ga-mCXCL12 PET tracer. J Nucl Cardiol 2021; 28:2965-2975. [PMID: 32676914 PMCID: PMC8709820 DOI: 10.1007/s12350-020-02262-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 06/08/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND The chemokine receptor CXCR4 and its ligand CXCL12 have been shown to be a possible imaging and therapeutic target after myocardial infarction (MI). The murine-based and mouse-specific 68Ga-mCXCL12 PET tracer could be suitable for serial in vivo quantification of cardiac CXCR4 expression in a murine model of MI. METHODS AND RESULTS At days 1-6 after MI, mice were intravenously injected with 68Ga-mCXCL12. Autoradiography was performed and the infarct-to-remote ratio (I/R) was determined. In vivo PET imaging with 68Ga-mCXCL12 was conducted on days 1-6 after MI and the percentage of the injected dose (%ID/g) of the tracer uptake in the infarct area was calculated. 18F-FDG-PET was performed for anatomical landmarking. Ex vivo autoradiography identified CXCR4 upregulation in the infarct region with an increasing I/R after 12 hours (1.4 ± 0.3), showing a significant increase until day 2 (4.5 ± 0.6), followed by a plateau phase (day 4) and decrease after 10 days (1.3 ± 1.0). In vivo PET imaging identified similar CXCR4 upregulation in the infarct region which peaked around day 3 post MI (9.7 ± 5.0 %ID/g) and then subsequently decreased by day 6 (2.8 ± 1.0 %ID/g). CONCLUSION Noninvasive molecular imaging of cardiac CXCR4 expression using a novel, murine-based, and specific 68Ga-mCXCL12 tracer is feasible both ex vivo and in vivo.
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Affiliation(s)
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Carmen Wängler
- Biomedical Chemistry, Department of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - Ralf Schirrmacher
- Department of Oncology, Division of Oncological Imaging, University of Alberta, Edmonton, AB, Canada
| | | | - Joachim Pircher
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Xiang Li
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Simon Lindner
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Steffen Massberg
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Stefan Brunner
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Sebastian Lehner
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
- Ambulatory Healthcare Center Dr. Neumaier & Colleagues, Radiology, Nuclear Medicine, Radiation Therapy, Regensburg, Germany
| | - Marcus Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Bruno C Huber
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
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Abstract
PURPOSE The COVID-19 pandemic and the implemented lockdown strongly impact on everyone's daily life. Stressful situations are known to alter eating habits and increase the risk for obesity. In our study, we aimed to investigate the effect of the lockdown measures on nutrition behavior among young adults. METHODS In this cross-sectional study, we enrolled 1964 voluntary participants from Bavarian universities. All participants were asked to complete an online questionnaire, semi-quantitatively evaluating the amount and type of food before and during pandemic lockdown. Study subjects were inquired to give information about acquisition and food procurement. The primary outcome was the change in food amount, secondary outcomes included alterations of food composition and procurement. RESULTS Our study cohort (mean age 23.3 ± 4.0 years, 28.5% male) had a mean body mass index of 22.1 ± 4.5 kg/m2. The overall food amount increased in 31.2% of participants (n = 610) during lockdown and decreased in 16.8% (n = 328). A multinominal regression model revealed that an increased food intake was less likely in male participants (OR, 0.7 [CI 0.6-0.9]) and more likely with increasing BMI (OR, 1.4 [CI 1.3-2.0]), increased sports activity (OR, 1.3 [CI 1.2-1.8]), augmented mental stress (OR 1.4 [1.1-1.7]), and an alteration of alcohol consumption (reduced alcohol amount, OR, 1.4 [CI 1.1-1.7], increased alcohol, OR, 1.9 [CI 1.4-2.5]). Increase in food intake was mainly triggered by consumption of bread (increased in 46.8%, n = 284) and confectionary (increased in 64.4%, n = 389). CONCLUSION The COVID-19 pandemic lockdown significantly affected eating habits in young adults. Further investigation to evaluate long-term effects on weight change and comorbidities are warranted.
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Affiliation(s)
- Bruno C Huber
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Julius Steffen
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany
- Munich Heart Alliance (MHA), Partner Site Munich, DZHK (German Centre for Cardiovascular Research), Marchioninistrasse 15, 81377, Munich, Germany
| | - Jenny Schlichtiger
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany.
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Steffen J, Schlichtiger J, Brunner S, Huber BC. Health promoting behaviour of medical versus non-medical students during COVID-19 pandemic: results from the COLA cross-sectional study. J Transl Med 2021; 19:242. [PMID: 34088328 PMCID: PMC8176269 DOI: 10.1186/s12967-021-02899-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/20/2021] [Indexed: 01/10/2023] Open
Abstract
To investigate the COVID-19 pandemic related alteration of health promoting behaviour during lockdown among medical students compared to other students. In this cross-sectional study, we enrolled 1940 Bavarian students. Participants were asked to complete an online questionnaire 3 weeks after lockdown implementation, evaluating their lifestyle behaviour focusing on self-reported and objectively assessed physical activity. 1154 medical (59.5%) and 786 non-medical (40.5%) students were included (median age 22.0 [IQR, 20.0–25.0], 71.5% female). Physical activity decreased in both groups after lockdown implementation. During lockdown, medical students reported higher physical activity levels compared to non-medical students. This was corroborated by daily step count data assessed by wearables (median steps per day [IQR], 6979 [5218–9348] versus 6581 [4497–8491], p = 0.02). Smoking behaviour during lockdown did not differ between medical and non-medical students (increased in 11.8% vs 13.6%, decreased in 31.9% versus 36.9%). During the COVID-19 pandemic, alteration of lifestyle behaviour among medical students was significantly different compared to non-medical students. This result suggests that medical students are more concerned about health promoting behaviour even in crisis situations.
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Affiliation(s)
- Julius Steffen
- Department of Medicine I, LMU-Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany.
| | - Jenny Schlichtiger
- Department of Medicine I, LMU-Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, LMU-Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Bruno C Huber
- Department of Medicine I, LMU-Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany
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Steffen J, Schlichtiger J, Huber BC, Brunner S. Altered alcohol consumption during COVID-19 pandemic lockdown. Nutr J 2021; 20:44. [PMID: 33975597 PMCID: PMC8112739 DOI: 10.1186/s12937-021-00699-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 04/26/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Since the onset of the COVID-19 pandemic in December 2019, many countries around the world have imposed lockdown measures in order to reduce virus spread. Social isolation is known to have a significant psychological impact, potentially triggering alcohol misuse in adults. In our study, we aimed to investigate the effect of COVID-19 lockdown measures on alcohol consumption in adults in Bavaria. METHODS In this cross-sectional study, we enrolled 2067 participants, with 1961 young adults (mean age 23.3 ± 4.1) and 106 mature adults (mean age 66.7 ± 9.7). Participants were asked to complete a standardized questionnaire, semi-quantitatively evaluating the alcohol drinking behaviour before and during the pandemic lockdown. RESULTS After implementation of lockdown, the alteration of alcohol consumption was significantly different between young and mature adults (p < 0.001). Among young adults, 42% reported unchanged drinking behaviour compared to 76% in the mature adult group; 44% of young adults reported to drink less compared to only 7% of mature adults. An increase in alcohol consumption was only reported by 14% of young adults and 17% of mature adults. Interestingly, in the entire cohort, the change of alcohol intake was most pronounced among moderate drinkers (> 0 to < 5 drinks/week) in both age groups (p < 0.001). Ordinal logistic regression revealed female sex, low BMI and younger age to be associated with a decrease in number of self-reported drinks/week. CONCLUSION The COVID-19 pandemic lockdown significantly affected alcohol drinking behaviour. Further studies exploring long-term effects on potential alcohol misuse and the relevance on public health are warranted. TRIAL REGISTRATION The study was retrospectively registered at ClinicalTrials.gov ( NCT04361877 ) on April 24, 2020.
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Affiliation(s)
- Julius Steffen
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Ziemssenstrasse 1, 80336, Munich, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Marchioninistrasse 15, 81377, Munich, Germany.
| | - Jenny Schlichtiger
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Bruno C Huber
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, Ziemssenstrasse 1, 80336, Munich, Germany
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Brunner S, Huber BC, Kanz G, Bogner-Flatz V. Acute coronary syndrome-related hospital admissions during and after lockdown in Southern Germany. Eur J Intern Med 2021; 87:112-114. [PMID: 33632597 PMCID: PMC7899921 DOI: 10.1016/j.ejim.2021.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/20/2021] [Accepted: 02/06/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Stefan Brunner
- Department of Cardiology, University Hospital Munich, Ludwig Maximilian University, Munich, Germany.
| | - Bruno C Huber
- Department of Cardiology, University Hospital Munich, Ludwig Maximilian University, Munich, Germany
| | - Georg Kanz
- Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Viktoria Bogner-Flatz
- Department of Trauma Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany
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Huber BC, Schlichtiger J, Drey M, Steffen J, Brunner S. Change of the Physical Activity Scale for the Elderly (PASE) score after COVID-19 outbreak. J Sports Med Phys Fitness 2021; 62:593-594. [PMID: 33688710 DOI: 10.23736/s0022-4707.21.12453-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bruno C Huber
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, LMU Munich, Munich, Germany
| | - Jenny Schlichtiger
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, LMU Munich, Munich, Germany
| | - Michael Drey
- Department of Medicine IV, Ludwig-Maximilians-University Munich, University Hospital, LMU Munich, Munich, Germany
| | - Julius Steffen
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, LMU Munich, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital, LMU Munich, Munich, Germany -
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Hamm W, Kassem S, von Stülpnagel L, Maier F, Klemm M, Schüttler D, Grabher F, Weckbach LT, Huber BC, Bauer A, Rizas KD, Brunner S. Deceleration Capacity and Periodic Repolarization Dynamics As Predictors of Acute Mountain Sickness. High Alt Med Biol 2020; 21:417-422. [DOI: 10.1089/ham.2020.0131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wolfgang Hamm
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Berlin, Germany
| | - Sari Kassem
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Lukas von Stülpnagel
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Berlin, Germany
- Department of Medicine III, University Hospital, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Maier
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Mathias Klemm
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Berlin, Germany
| | - Dominik Schüttler
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Felix Grabher
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Ludwig T. Weckbach
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Bruno C. Huber
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Axel Bauer
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Berlin, Germany
- Department of Medicine III, University Hospital, Medical University of Innsbruck, Innsbruck, Austria
| | - Konstantinos D. Rizas
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Berlin, Germany
| | - Stefan Brunner
- Department of Medicine I, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
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8
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Huber BC, Steffen J, Schlichtiger J, Graupe T, Deuster E, Strouvelle VP, Fischer MR, Massberg S, Brunner S. Alteration of physical activity during COVID-19 pandemic lockdown in young adults. J Transl Med 2020; 18:410. [PMID: 33138846 PMCID: PMC7605130 DOI: 10.1186/s12967-020-02591-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bruno C Huber
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital Munich - Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Julius Steffen
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital Munich - Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance (MHA), Partner Site Munich, Munich, Germany
| | - Jenny Schlichtiger
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital Munich - Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Tanja Graupe
- Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Eileen Deuster
- Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Victoria P Strouvelle
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital Munich - Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Martin R Fischer
- Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Steffen Massberg
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital Munich - Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance (MHA), Partner Site Munich, Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, Ludwig-Maximilians-University Munich, University Hospital Munich - Campus Innenstadt, Ziemssenstrasse 1, 80336, Munich, Germany.
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Huber BC, Brunner S, Schlichtiger J, Kanz KG, Bogner-Flatz V. Out-of-hospital cardiac arrest incidence during COVID-19 pandemic in Southern Germany. Resuscitation 2020; 157:121-122. [PMID: 33144091 DOI: 10.1016/j.resuscitation.2020.10.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Bruno C Huber
- Department of Cardiology, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, Germany.
| | - Stefan Brunner
- Department of Cardiology, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Jenny Schlichtiger
- Department of Cardiology, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Karl-Georg Kanz
- Department of Trauma Surgery and Central Emergency Medicine, Klinikum rechts der Isar, Technische Universität Munich, EMS Authority Upper Bavaria
| | - Viktoria Bogner-Flatz
- Department of Trauma Surgery and Emergency Medicine, University Hospital Munich, Ludwig Maximilians-University (LMU), EMS Authority Munich, Munich, Germany
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Schlichtiger J, Brunner S, Steffen J, Huber BC. Mental health impairment triggered by the COVID-19 pandemic in a sample population of German students. J Investig Med 2020; 68:1394-1396. [PMID: 33087426 DOI: 10.1136/jim-2020-001553] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2020] [Indexed: 12/18/2022]
Abstract
Due to the rapid spread of the COVID-19 pandemic, a lockdown including limitation of activity and restrictions of non-essential travel was imposed on March 21, 2020 in the State of Bavaria, Germany. The implementation of activity restrictions not only strongly affects the economy but will possibly also impact the mental and physical health status of the general population. Therefore, the present study aimed to explore psychological effects of the COVID-19 crisis on a sample of Bavarian students.In this cross-sectional study, we enrolled 1943 voluntary subjects from Bavarian universities. All subjects completed an online questionnaire asking for mental health stress, as well as potential factors, influencing the state of mental stress during pandemic lockdown. In our study cohort, 17.3% (n=336) of the students indicated that they experienced less mental stress through COVID-19 pandemic, while 39.6% (n=770) stated that they had an increased psychological burden. The bivariate analysis identified sex and the level of physical activity as potential risk factors for the level of mental stress during the COVID-19 pandemic. Further research is necessary to investigate specific symptoms of mental stress and the overall long-term impact on mental health.
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Affiliation(s)
- Jenny Schlichtiger
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Stefan Brunner
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Julius Steffen
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Bruno C Huber
- Department of Cardiology, University Hospital of Munich, LMU Munich, Munich, Germany
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11
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Affiliation(s)
- Jenny Schlichtiger
- Department of Medicine I, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Julius Steffen
- Department of Medicine I, Ludwig-Maximilians University (LMU), Munich, Germany.,German Center for Cardiovascular Research, DZHK Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Bruno C Huber
- Department of Medicine I, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, Ludwig-Maximilians University (LMU), Munich, Germany -
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12
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Huber BC, Steffen J, Schlichtiger J, Brunner S. Type of sport activities during COVID-19 crisis among Bavarian students. J Sports Med Phys Fitness 2020; 60:1508-1510. [PMID: 32608940 DOI: 10.23736/s0022-4707.20.11350-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Bruno C Huber
- Department of Medicine I, Munich University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Julius Steffen
- Department of Medicine I, Munich University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Munich, Munich Heart Alliance (MHA), Munich, Germany
| | - Jenny Schlichtiger
- Department of Medicine I, Munich University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, Munich University Hospital, Ludwig-Maximilians University Munich, Munich, Germany -
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13
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Schiopu SRI, Zacherl M, Todica A, Bartenstein P, Milger K, Leuschner G, Munker D, Bauer M, Massberg S, Behr J, Neurohr C, Huber BC, Kneidinger N. Feasibility and accuracy of SPECT myocardial perfusion imaging in end-stage lung disease. J Nucl Cardiol 2020; 27:903-911. [PMID: 31428982 DOI: 10.1007/s12350-019-01851-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 07/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Coronary artery disease (CAD) is associated with increased mortality in patients with chronic lung disease. However, non-invasive diagnostic of CAD is difficult, especially in patients with more advanced disease. Therefore, we aimed to assess the feasibility and accuracy of SPECT-myocardial perfusion imaging (MPI) stress testing with regadenoson in patients with end-stage lung disease (ELD) undergoing assessment of stable CAD. METHODS Between January 2012 and May 2018, 102 patients with ELD, who were referred to our institution for lung transplant evaluation, were assessed retrospectively. All patients underwent both stress SPECT-MPI as well as coronary angiography. RESULTS The mean age in our population was 57±6 years. All patients had severe pulmonary function impairment. During stress SPECT-MPI 14 patients (14%) reported regadenoson-related symptoms, but only 2 patients (2%) required medical treatment. Coronary angiography revealed obstructive CAD in 20 patients (20%). Among those, 5 patients had abnormal SPECT-MPI and PCI was performed in 3 patients accordingly. In 14 patients with obstructive CAD, revascularization was deferred based on normal SPECT-MPI findings. CONCLUSIONS SPECT-MPI using regadenoson is well tolerated in patients with ELD and can help to make decisions about coronary revascularization before lung transplant.
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Affiliation(s)
- Sanziana R I Schiopu
- Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
- Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | - Mathias Zacherl
- Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistrasse. 15, 81377, Munich, Germany
| | - Andrei Todica
- Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistrasse. 15, 81377, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistrasse. 15, 81377, Munich, Germany
| | - Katrin Milger
- Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Gabriela Leuschner
- Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Dieter Munker
- Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Matthäus Bauer
- Medical Controlling Unit, Department for Patient Management, Munich University Hospital (TM), 81366, Munich, Germany
| | - Steffen Massberg
- Medical Department I, Campus Grosshadern and Campus Innenstadt, Ludwig-Maximilians-University, Munich, Marchioninistrasse 15, Munich, Germany
| | - Jürgen Behr
- Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Asklepios Clinic München, Gauting, Germany
| | - Claus Neurohr
- Department for Pneumology and Respiratory Medicine, Robert-Bosch-Hospital, Schillerhöhe Clinic, Solitudestr. 18, 70839, Gerlingen, Germany
| | - Bruno C Huber
- Medical Department I, Campus Grosshadern and Campus Innenstadt, Ludwig-Maximilians-University, Munich, Marchioninistrasse 15, Munich, Germany
| | - Nikolaus Kneidinger
- Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
- Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
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14
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Abstract
PATIENT HISTORY A 33-year old Romanian chef presented with sudden onset of chest pain and chills as well as a significant elevation of myocardial markers and CRP. EXAMS Coronary angiography showed no signs of relevant atherosclerosis. A myocarditis was assumed and later diagnosed on cardiac MRI. DIAGNOSTICS Due to fevers up to 40 °C and occupational history, Q fever was assumed. Serologic findings confirmed the diagnosis. THERAPY AND COURSE OF EVENTS After the start of antibiotic treatment, temperatures remained normal and the patient could be discharged a few days later. Azithromycin was recommended for several weeks to prevent a chronic infection. At the check-up visit one month later the patient appeared to have no signs of chronic heart failure or persistent infection. CONCLUSIONS Myocarditis is a rare manifestation of Q fever, which should not be missed. The diagnostic evaluation with antibody titers is easy. The antibiotic therapy is well tolerated and is a causal treatment that helps to prevent long-term damage.
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Affiliation(s)
- Julius Steffen
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München.,Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Munich Heart Association
| | - Johannes Bogner
- Medizinische Klinik und Poliklinik IV, Abteilung für Infektiologie, Klinikum der Universität München
| | - Bruno C Huber
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München
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15
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Deutsch MA, Brunner S, Grabmaier U, David R, Ott I, Huber BC. Cardioprotective Potential of Human Endothelial-Colony Forming Cells from Diabetic and Nondiabetic Donors. Cells 2020; 9:cells9030588. [PMID: 32131432 PMCID: PMC7140510 DOI: 10.3390/cells9030588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 12/20/2022] Open
Abstract
Objective: The potential therapeutic role of endothelial progenitor cells (EPCs) in ischemic heart disease for myocardial repair and regeneration is subject to intense investigation. The aim of the study was to investigate the proregenerative potential of human endothelial colony-forming cells (huECFCs), a very homogenous and highly proliferative endothelial progenitor cell subpopulation, in a myocardial infarction (MI) model of severe combined immunodeficiency (SCID) mice. Methods: CD34+ peripheral blood mononuclear cells were isolated from patient blood samples using immunomagnetic beads. For generating ECFCs, CD34+ cells were plated on fibronectin-coated dishes and were expanded by culture in endothelial-specific cell medium. Either huECFCs (5 × 105) or control medium were injected into the peri-infarct region after surgical MI induction in SCID/beige mice. Hemodynamic function was assessed invasively by conductance micromanometry 30 days post-MI. Hearts of sacrificed animals were analyzed by immunohistochemistry to assess cell fate, infarct size, and neovascularization (huECFCs n = 15 vs. control n = 10). Flow-cytometric analysis of enzymatically digested whole heart tissue was used to analyze different subsets of migrated CD34+/CD45+ peripheral mononuclear cells as well as CD34−/CD45− cardiac-resident stem cells two days post-MI (huECFCs n = 10 vs. control n = 6). Results: Transplantation of human ECFCs after MI improved left ventricular (LV) function at day 30 post-MI (LVEF: 30.43 ± 1.20% vs. 22.61 ± 1.73%, p < 0.001; ΔP/ΔTmax 5202.28 ± 316.68 mmHg/s vs. 3896.24 ± 534.95 mmHg/s, p < 0.05) when compared to controls. In addition, a significantly reduced infarct size (50.3 ± 4.5% vs. 66.1 ± 4.3%, p < 0.05) was seen in huECFC treated animals compared to controls. Immunohistochemistry failed to show integration and survival of transplanted cells. However, anti-CD31 immunohistochemistry demonstrated an increased vascular density within the infarct border zone (8.6 ± 0.4 CD31+ capillaries per HPF vs. 6.2 ± 0.5 CD31+ capillaries per HPF, p < 0.001). Flow cytometry at day two post-MI showed a trend towards increased myocardial homing of CD45+/CD34+ mononuclear cells (1.1 ± 0.3% vs. 0.7 ± 0.1%, p = 0.2). Interestingly, we detected a significant increase in the population of CD34−/CD45−/Sca1+ cardiac resident stem cells (11.7 ± 1.7% vs. 4.7 ± 1.7%, p < 0.01). In a subgroup analysis no significant differences were seen in the cardioprotective effects of huECFCs derived from diabetic or nondiabetic patients. Conclusions: In a murine model of myocardial infarction in SCID mice, transplantation of huECFCs ameliorated myocardial function by attenuation of adverse post-MI remodeling, presumably through paracrine effects. Cardiac repair is enhanced by increasing myocardial neovascularization and the pool of Sca1+ cardiac resident stem cells. The use of huECFCs for treating ischemic heart disease warrants further investigation.
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Affiliation(s)
- Marcus-André Deutsch
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Georgstr. 11, D-32545 Bad Oeynhausen, Germany;
| | - Stefan Brunner
- Department of Internal Medicine I, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany; (S.B.); (U.G.)
| | - Ulrich Grabmaier
- Department of Internal Medicine I, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany; (S.B.); (U.G.)
| | - Robert David
- Reference- and Translation Center for Cardiac Stem Cell Therapy (RTC), Rostock University Medical Center, Department of Cardiac Surgery, Department Life, Light & Matter (LL&M), 18057 Rostock, Germany;
| | - Ilka Ott
- Department of Internal Medicine, Division of Cardiology, Helios Klinikum Pforzheim, Kanzlerstraße 2-6, D-75175 Pforzheim, Germany;
| | - Bruno C. Huber
- Department of Internal Medicine I, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany; (S.B.); (U.G.)
- Correspondence: ; Tel.: +49-89-44-000
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16
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Affiliation(s)
- Wolfgang Hamm
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany
- German Cardiovascular Research Center (DZHK), Partner Site: Munich Heart Alliance, Munich, Germany
| | - Viktoria Bogner-Flatz
- Department of Trauma Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany
| | - Lukas von Stülpnagel
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany
- German Cardiovascular Research Center (DZHK), Partner Site: Munich Heart Alliance, Munich, Germany
| | - Mathias Klemm
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany
- German Cardiovascular Research Center (DZHK), Partner Site: Munich Heart Alliance, Munich, Germany
| | - Bruno C Huber
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany
| | - Konstantinos D Rizas
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany
- German Cardiovascular Research Center (DZHK), Partner Site: Munich Heart Alliance, Munich, Germany
| | - Karl-Georg Kanz
- Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Axel Bauer
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany
- German Cardiovascular Research Center (DZHK), Partner Site: Munich Heart Alliance, Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, University Hospital Munich, Ludwig Maximilian University, Campus Innenstadt, Ziemssenstrasse 1, Munich, Germany
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17
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Ebert AD, Kodo K, Liang P, Wu H, Huber BC, Riegler J, Churko J, Lee J, de Almeida P, Lan F, Diecke S, Burridge PW, Gold JD, Mochly-Rosen D, Wu JC. Characterization of the molecular mechanisms underlying increased ischemic damage in the aldehyde dehydrogenase 2 genetic polymorphism using a human induced pluripotent stem cell model system. Sci Transl Med 2016; 6:255ra130. [PMID: 25253673 DOI: 10.1126/scitranslmed.3009027] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nearly 8% of the human population carries an inactivating point mutation in the gene that encodes the cardioprotective enzyme aldehyde dehydrogenase 2 (ALDH2). This genetic polymorphism (ALDH2*2) is linked to more severe outcomes from ischemic heart damage and an increased risk of coronary artery disease (CAD), but the underlying molecular bases are unknown. We investigated the ALDH2*2 mechanisms in a human model system of induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) generated from individuals carrying the most common heterozygous form of the ALDH2*2 genotype. We showed that the ALDH2*2 mutation gave rise to elevated amounts of reactive oxygen species and toxic aldehydes, thereby inducing cell cycle arrest and activation of apoptotic signaling pathways, especially during ischemic injury. We established that ALDH2 controls cell survival decisions by modulating oxidative stress levels and that this regulatory circuitry was dysfunctional in the loss-of-function ALDH2*2 genotype, causing up-regulation of apoptosis in cardiomyocytes after ischemic insult. These results reveal a new function for the metabolic enzyme ALDH2 in modulation of cell survival decisions. Insight into the molecular mechanisms that mediate ALDH2*2-related increased ischemic damage is important for the development of specific diagnostic methods and improved risk management of CAD and may lead to patient-specific cardiac therapies.
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Affiliation(s)
- Antje D Ebert
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kazuki Kodo
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Ping Liang
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Haodi Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Bruno C Huber
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Johannes Riegler
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jared Churko
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jaecheol Lee
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Patricia de Almeida
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Feng Lan
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sebastian Diecke
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Paul W Burridge
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Joseph D Gold
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Daria Mochly-Rosen
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA. Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA. Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
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18
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Ong SG, Huber BC, Lee WH, Kodo K, Ebert AD, Ma Y, Nguyen PK, Diecke S, Chen WY, Wu JC. Microfluidic Single-Cell Analysis of Transplanted Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes After Acute Myocardial Infarction. Circulation 2015; 132:762-771. [PMID: 26304668 DOI: 10.1161/circulationaha.114.015231] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Human induced pluripotent stem cells (iPSCs) are attractive candidates for therapeutic use, with the potential to replace deficient cells and to improve functional recovery in injury or disease settings. Here, we test the hypothesis that human iPSC-derived cardiomyocytes (iPSC-CMs) can secrete cytokines as a molecular basis to attenuate adverse cardiac remodeling after myocardial infarction. METHODS AND RESULTS Human iPSCs were generated from skin fibroblasts and differentiated in vitro with a small molecule-based protocol. Troponin(+) iPSC-CMs were confirmed by immunohistochemistry, quantitative polymerase chain reaction, fluorescence-activated cell sorting, and electrophysiological measurements. Afterward, 2×10(6) iPSC-CMs derived from a cell line transduced with a vector expressing firefly luciferase and green fluorescent protein were transplanted into adult NOD/SCID mice with acute left anterior descending artery ligation. Control animals received PBS injection. Bioluminescence imaging showed limited engraftment on transplantation into ischemic myocardium. However, magnetic resonance imaging of animals transplanted with iPSC-CMs showed significant functional improvement and attenuated cardiac remodeling compared with PBS-treated control animals. To understand the underlying molecular mechanism, microfluidic single-cell profiling of harvested iPSC-CMs, laser capture microdissection of host myocardium, and in vitro ischemia stimulation were used to demonstrate that the iPSC-CMs could release significant levels of proangiogenic and antiapoptotic factors in the ischemic microenvironment. CONCLUSIONS Transplantation of human iPSC-CMs into an acute mouse myocardial infarction model can improve left ventricular function and attenuate cardiac remodeling. Because of limited engraftment, most of the effects are possibly explained by paracrine activity of these cells.
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Affiliation(s)
- Sang-Ging Ong
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA.,Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA
| | - Bruno C Huber
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA.,Ludwig-Maximilians-University, Medical Department I, Campus Grosshadern, Munich, Germany
| | - Won Hee Lee
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA
| | - Kazuki Kodo
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA
| | - Antje D Ebert
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA
| | - Yu Ma
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA
| | - Patricia K Nguyen
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA
| | - Sebastian Diecke
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA
| | - Wen-Yi Chen
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA.,Depts of Medicine and Radiology, Stanford University School of Medicine, Stanford, CA.,Institute of Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA
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19
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Grabmaier U, Rottstegge I, Offers M, Ziegler T, Brenner C, Huber BC, Seissler J. Isolation and expansion of cytokeratin positive progenitor cells from adult murine pancreatic ducts expressing Pdx-1, Nestin, Sox9, MafA and hepatic nuclear factors. MINERVA ENDOCRINOL 2015; 42:30-40. [PMID: 26337491 DOI: 10.23736/s0391-1977.16.02351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Recent studies suggest that stem cells may represent a putative source for the generation of beta cells. However, the identity and characteristics of stem cells from adult pancreas and conditions for their large scale expansion are still poorly defined. METHODS DPC were isolated from adult pancreatic ducts of C57Bl/6 mice. Expression profile was investigated by PCR, FACS and immunohistochemistry. RESULTS DPC express a panel of stem cell associated markers such as Pdx-1, cytokeratin-19 (CK19), nestin, Sox9 together with the transcription factor MafA and hepatic nuclear factors HNF1β, HNF3β, HNF4α und HNF6. This gene expression profile is suggesting that DPC might be a promising tool for endocrine differentiation. After stimulation with picolinic acid and hypoxia, DPC expressed the endocrine differentiation marker Ngn3. Nevertheless, insulin production was not observed. CONCLUSIONS We here describe a protocol for the isolation end expansion of murine pancreatic ductal progenitor cells (DPC) displaying high self-renewal, spheroid- and colony-forming capacity. Further studies are required to elucidate the conditions for differentiation into mature pancreatic endocrine cell lineages.
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Affiliation(s)
- Ulrich Grabmaier
- IV Medical Department, Ludwig Maximilians University, Munich, Germany - .,I Medical Department, Ludwig Maximilians University, Munich, Germany -
| | | | - Monika Offers
- IV Medical Department, Ludwig Maximilians University, Munich, Germany
| | - Tilmann Ziegler
- I Medical Department, Ludwig Maximilians University, Munich, Germany.,Department of Molecular Medicine, Max Planck Institute of Biochemistry, Munich, Germany
| | - Christoph Brenner
- I Medical Department, Ludwig Maximilians University, Munich, Germany
| | - Bruno C Huber
- I Medical Department, Ludwig Maximilians University, Munich, Germany
| | - Jochen Seissler
- IV Medical Department, Ludwig Maximilians University, Munich, Germany
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20
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Abstract
Parathyroid hormone (PTH) is the predominant regulator of calcium/phosphate homeostasis in the human body. Beside this classical function, preclinical and clinical studies indicated a relevant role for PTH in mobilisation of bone marrow-derived cells into peripheral blood. In addition, recombinant PTH (teriparatide) was recently approved for the treatment of severe osteoporosis. Therefore, it was the aim of the present study to investigate the dynamics of haemopoietic stem cells and corresponding in peripheral blood of 13 patients with osteoporosis during treatment with teriparatide. We were able to show that administration of teriparatide is sufficient to mobilise haemopoietic stem cells into the bloodstream accompanied by an alteration of mobilising cytokines. In conclusion, teriparatide might be a useful tool in the context of stem cell mobilisation.
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Affiliation(s)
- U Grabmaier
- Medical Department I, Campus Innenstadt and Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - B C Huber
- Medical Department I, Campus Innenstadt and Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - W-M Franz
- Department of Internal Medicine III (Cardiology & Angiology), Medical University of Innsbruck, Innsbruck, Austria
| | - E Koch
- Medical Department II, Campus Grosshadern, Ludwig-Maximilians-University, Munich, Germany
| | - S Brunner
- Medical Department I, Campus Innenstadt and Grosshadern, Ludwig-Maximilians-University, Munich, Germany
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21
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Huber BC, Beetz NL, Laskowski A, Ziegler T, Grabmaier U, Kupatt C, Herbach N, Wanke R, Franz WM, Massberg S, Brunner S. Attenuation of cardiac hypertrophy by G-CSF is associated with enhanced migration of bone marrow-derived cells. J Cell Mol Med 2015; 19:1033-41. [PMID: 25754690 PMCID: PMC4420605 DOI: 10.1111/jcmm.12494] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/20/2014] [Indexed: 12/16/2022] Open
Abstract
Granulocyte-colony stimulating factor (G-CSF) has been shown to promote mobilization of bone marrow-derived stem cells (BMCs) into the bloodstream associated with improved survival and cardiac function after myocardial infarction. Therefore, the aim of the present study was to investigate whether G-CSF is able to attenuate cardiac remodelling in a mouse model of pressure-induced LV hypertrophy focusing on mobilization and migration of BMCs. LV hypertrophy was induced by transverse aortic constriction (TAC) in C57BL/6J mice. Four weeks after TAC procedure. Mice were treated with G-CSF (100 μg/kg/day; Amgen Biologicals) for 2 weeks. The number of migrated BMCs in the heart was analysed by flow cytometry. mRNA expression and protein level of different growth factors in the myocardium were investigated by RT-PCR and ELISA. Functional analyses assessed by echocardiography and immunohistochemical analysis were performed 8 weeks after TAC procedure. G-CSF-treated animals revealed enhanced homing of VLA-4+ and c-kit+ BMCs associated with increased mRNA expression and protein level of the corresponding homing factors Vascular cell adhesion protein 1 and Stem cell factor in the hypertrophic myocardium. Functionally, G-CSF significantly preserved LV function after TAC procedure, which was associated with a significantly reduced area of fibrosis compared to control animals. Furthermore, G-CSF-treated animals revealed a significant improvement of survival after TAC procedure. In summary, G-CSF treatment preserves cardiac function and is able to diminish cardiac fibrosis after induction of LV hypertrophy associated with increased homing of VLA-4+ and c-kit+ BMCs and enhanced expression of their respective homing factors VCAM-1 and SCF.
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Affiliation(s)
- Bruno C Huber
- Medical Department I, Campus Grosshadern and Campus Innenstadt, Ludwig-Maximilians-University, Munich, Germany
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22
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Huber BC, Grabmaier U, Brunner S. Impact of parathyroid hormone on bone marrow-derived stem cell mobilization and migration. World J Stem Cells 2014; 6:637-643. [PMID: 25426261 PMCID: PMC4178264 DOI: 10.4252/wjsc.v6.i5.637] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/05/2014] [Accepted: 09/17/2014] [Indexed: 02/06/2023] Open
Abstract
Parathyroid hormone (PTH) is well-known as the principal regulator of calcium homeostasis in the human body and controls bone metabolism via actions on the survival and activation of osteoblasts. The intermittent administration of PTH has been shown to stimulate bone production in mice and men and therefore PTH administration has been recently approved for the treatment of osteoporosis. Besides to its physiological role in bone remodelling PTH has been demonstrated to influence and expand the bone marrow stem cell niche where hematopoietic stem cells, capable of both self-renewal and differentiation, reside. Moreover, intermittent PTH treatment is capable to induce mobilization of progenitor cells from the bone marrow into the bloodstream. This novel function of PTH on modulating the activity of the stem cell niche in the bone marrow as well as on mobilization and regeneration of bone marrow-derived stem cells offers new therapeutic options in bone marrow and stem cell transplantation as well as in the field of ischemic disorders.
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23
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Huber BC, Ransohoff JD, Ransohoff KJ, Riegler J, Ebert A, Kodo K, Gong Y, Sanchez-Freire V, Dey D, Kooreman NG, Diecke S, Zhang WY, Odegaard J, Hu S, Gold JD, Robbins RC, Wu JC. Costimulation-adhesion blockade is superior to cyclosporine A and prednisone immunosuppressive therapy for preventing rejection of differentiated human embryonic stem cells following transplantation. Stem Cells 2014; 31:2354-63. [PMID: 24038578 DOI: 10.1002/stem.1501] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 06/05/2013] [Accepted: 07/07/2013] [Indexed: 12/19/2022]
Abstract
RATIONALE Human embryonic stem cell (hESC) derivatives are attractive candidates for therapeutic use. The engraftment and survival of hESC derivatives as xenografts or allografts require effective immunosuppression to prevent immune cell infiltration and graft destruction. OBJECTIVE To test the hypothesis that a short-course, dual-agent regimen of two costimulation-adhesion blockade agents can induce better engraftment of hESC derivatives compared to current immunosuppressive agents. METHODS AND RESULTS We transduced hESCs with a double fusion reporter gene construct expressing firefly luciferase (Fluc) and enhanced green fluorescent protein, and differentiated these cells to endothelial cells (hESC-ECs). Reporter gene expression enabled longitudinal assessment of cell engraftment by bioluminescence imaging. Costimulation-adhesion therapy resulted in superior hESC-EC and mouse EC engraftment compared to cyclosporine therapy in a hind limb model. Costimulation-adhesion therapy also promoted robust hESC-EC and hESC-derived cardiomyocyte survival in an ischemic myocardial injury model. Improved hESC-EC engraftment had a cardioprotective effect after myocardial injury, as assessed by magnetic resonance imaging. Mechanistically, costimulation-adhesion therapy is associated with systemic and intragraft upregulation of T-cell immunoglobulin and mucin domain 3 (TIM3) and a reduced proinflammatory cytokine profile. CONCLUSIONS Costimulation-adhesion therapy is a superior alternative to current clinical immunosuppressive strategies for preventing the post-transplant rejection of hESC derivatives. By extending the window for cellular engraftment, costimulation-adhesion therapy enhances functional preservation following ischemic injury. This regimen may function through a TIM3-dependent mechanism.
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Affiliation(s)
- Bruno C Huber
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA; Department of Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Radiology, Stanford University School of Medicine, Stanford, California, USA
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24
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Grabmaier U, Brandl L, Kreiner J, Negele T, Huber BC, Rimmbach C, David R, Brunner S. Increased numbers of bone marrow-derived cells in parathyroid adenoma. Eur J Clin Invest 2014; 44:833-9. [PMID: 25047264 DOI: 10.1111/eci.12302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 07/17/2014] [Indexed: 12/26/2022]
Abstract
BACKGROUND In primary hyperparathyroidism (PHPT), the increased levels of parathyroid hormone (PTH) result in mobilisation of bone-marrow-derived cells (BMCs) into peripheral blood. However, the fate of these cells is still unknown. MATERIALS AND METHODS In this study, we sought to investigate cells with typical surface markers of BMCs within parathyroid adenomas (PA) of patients with primary hyperparathyroidism. We therefore investigated PA and normal parathyroid glands (NPG) of 15 patients with PHPT by immunohistochemistry and PCR. RESULTS mRNA levels for CD31, CD34 and CD45 were significantly increased in PA compared to NPG. Immunohistochemical staining for CD31 and CD34 revealed a significantly higher vessel density in PA. Furthermore, scattered single cells expressing CD31, CD34 or CD45 were significantly augmented compared to normal parathyroid glands and directly correlated with vessel density. mRNA levels of SDF-1 was increased whereas its major inhibitor dipeptidylpeptidase IV (DPP IV) is decreased in PA, suggesting that the SDF-1 axis plays a role in the migration of BMCs into PA. CONCLUSION These data indicate a possible role of BMCs in the pathophysiology of PA of patients with PHPT.
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Affiliation(s)
- Ulrich Grabmaier
- Medical Department I, Ludwig-Maximilians-University, Campus Innenstadt and Grosshadern, Munich, Germany
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Gu M, Nguyen PK, Lee AS, Xu D, Hu S, Plews JR, Han L, Huber BC, Lee WH, Gong Y, de Almeida PE, Lyons J, Ikeno F, Pacharinsak C, Connolly AJ, Gambhir SS, Robbins RC, Longaker MT, Wu JC. Microfluidic single-cell analysis shows that porcine induced pluripotent stem cell-derived endothelial cells improve myocardial function by paracrine activation. Circ Res 2012; 111:882-93. [PMID: 22821929 DOI: 10.1161/circresaha.112.269001] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
RATIONALE Induced pluripotent stem cells (iPSCs) hold great promise for the development of patient-specific therapies for cardiovascular disease. However, clinical translation will require preclinical optimization and validation of large-animal iPSC models. OBJECTIVE To successfully derive endothelial cells from porcine iPSCs and demonstrate their potential utility for the treatment of myocardial ischemia. METHODS AND RESULTS Porcine adipose stromal cells were reprogrammed to generate porcine iPSCs (piPSCs). Immunohistochemistry, quantitative PCR, microarray hybridization, and angiogenic assays confirmed that piPSC-derived endothelial cells (piPSC-ECs) shared similar morphological and functional properties as endothelial cells isolated from the autologous pig aorta. To demonstrate their therapeutic potential, piPSC-ECs were transplanted into mice with myocardial infarction. Compared with control, animals transplanted with piPSC-ECs showed significant functional improvement measured by echocardiography (fractional shortening at week 4: 27.2±1.3% versus 22.3±1.1%; P<0.001) and MRI (ejection fraction at week 4: 45.8±1.3% versus 42.3±0.9%; P<0.05). Quantitative protein assays and microfluidic single-cell PCR profiling showed that piPSC-ECs released proangiogenic and antiapoptotic factors in the ischemic microenvironment, which promoted neovascularization and cardiomyocyte survival, respectively. Release of paracrine factors varied significantly among subpopulations of transplanted cells, suggesting that transplantation of specific cell populations may result in greater functional recovery. CONCLUSIONS In summary, this is the first study to successfully differentiate piPSCs-ECs from piPSCs and demonstrate that transplantation of piPSC-ECs improved cardiac function after myocardial infarction via paracrine activation. Further development of these large animal iPSC models will yield significant insights into their therapeutic potential and accelerate the clinical translation of autologous iPSC-based therapy.
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Affiliation(s)
- Mingxia Gu
- Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, CA 94305, USA
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Brunner S, Huber BC, Weinberger T, Vallaster M, Wollenweber T, Gerbitz A, Hacker M, Franz WM. Migration of bone marrow-derived cells and improved perfusion after treatment with erythropoietin in a murine model of myocardial infarction. J Cell Mol Med 2012; 16:152-9. [PMID: 21362129 PMCID: PMC3823101 DOI: 10.1111/j.1582-4934.2011.01286.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Erythropoietin (EPO) was shown to have protective effects after myocardial infarction (MI) by neovascularization and antiapoptotic mechanisms. Beside direct receptor-dependent mechanisms, mobilization and homing of bone marrow-derived cells (BMCs) may play a pivotal role in this regard. In this study, we intended to track different subpopulations of BMCs and to assess serially myocardial perfusion changes in EPO-treated mice after MI. To allow tracking of BMCs, we used a chimeric mouse model. Therefore, mice (C57BL/6J) were sublethally irradiated, and bone marrow (BM) from green fluorescent protein transgenic mice was transplanted. Ten weeks later coronary artery ligation was performed to induce MI. EPO was injected for 3 days with a total dose of 5000 IU/kg. Subpopulations (CD31, c-kit, CXCR-4 and Sca-1) of EGFP+ cells were studied in peripheral blood, bone marrow and hearts by flow cytometry. Myocardial perfusion was serially investigated in vivo by pinhole single-photon emission computed tomography (SPECT) at days 6 and 30 after MI. EPO-treated animals revealed an enhanced mobilization of BMCs into peripheral blood. The numbers of these cells in BM remained unchanged. Homing of all BMCs subpopulations to the ischaemic myocardium was significantly increased in EPO-treated mice. Among the investigated subpopulations, EPO predominantly affected migration of CXCR-4+ (4.3-fold increase). Repetitively SPECT analyses revealed a reduction of perfusion defects after EPO treatment over time. Our study shows that EPO treatment after MI enhances the migration capacity of BMCs into ischaemic tissue, which may attribute to an improved perfusion and reduced size of infarction, respectively.
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Affiliation(s)
- Stefan Brunner
- Medical Department I, Klinikum der Universität München, Munich, Germany
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Brunner S, Weinberger T, Huber BC, Segeth A, Zaruba MM, Theiss HD, Assmann G, Herbach N, Wanke R, Mueller-Hoecker J, Franz WM. The cardioprotective effects of parathyroid hormone are independent of endogenous granulocyte-colony stimulating factor release. Cardiovasc Res 2011; 93:330-9. [PMID: 22080594 DOI: 10.1093/cvr/cvr303] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIMS Parathyroid hormone (PTH) administration after myocardial infarction (MI) is known to attenuate ischaemic cardiomyopathy. This effect mainly resulted from an increase in mobilization and homing of CD34+/CD45+ cells into the ischaemic myocardium. PTH-related stem cell mobilization was shown to be related to endogenous granulocyte-colony stimulating factor (G-CSF) release. The aim of our study is to determine the role of G-CSF on the cardioprotective effects of PTH. METHODS AND RESULTS G-CSF +/+ (C57BL/6) and G-CSF -/- mice were treated with PTH for 6 days after inducing a MI. The myocardial homing factor stromal cell-derived factor-1 (SDF-1) was analysed on day 2 with enzyme-linked immunosorbent assay. Stem cell populations in peripheral blood and hearts were examined by FACS on days 6 and 2, respectively. Cardiac function and immunohistochemistry were investigated on day 6 and day 30. PTH treatment resulted in a significant increase in CD45+/CD34+ cells in peripheral blood in G-CSF +/+ but not in G-CSF -/- mice. However, a significant increase in SDF-1 and enhanced migration of CD45+/CD34+ cells into the ischaemic myocardium was revealed after PTH administration in both G-CSF +/+ and G-CSF -/- mice. Enhanced stem cell homing was associated with improved cardiac function and post-MI survival after PTH treatment. Furthermore, infarct size, wall thickness, and neovascularization showed a significant improvement in both groups 30 days after MI. CONCLUSION The cardioprotective effects of PTH were shown to be independent of endogenous G-CSF release and therefore from stem cell mobilization. This puts more emphasis on the role of stem cell homing into ischaemic myocardium.
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Affiliation(s)
- Stefan Brunner
- Department of Internal Medicine I, Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
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Sheikh AY, Huber BC, Narsinh KH, Spin JM, van der Bogt K, de Almeida PE, Ransohoff KJ, Kraft DL, Fajardo G, Ardigo D, Ransohoff J, Bernstein D, Fischbein MP, Robbins RC, Wu JC. In vivo functional and transcriptional profiling of bone marrow stem cells after transplantation into ischemic myocardium. Arterioscler Thromb Vasc Biol 2011; 32:92-102. [PMID: 22034515 DOI: 10.1161/atvbaha.111.238618] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Clinical trials of bone marrow-derived stem cell therapy for the heart have yielded variable results. The basic mechanism(s) that underlies their potential efficacy remains unknown. In the present study, we evaluated the survival kinetics, transcriptional response, and functional outcome of intramyocardial bone marrow mononuclear cell (BMMC) transplantation for cardiac repair in a murine myocardial infarction model. METHODS AND RESULTS We used bioluminescence imaging and high-throughput transcriptional profiling to evaluate the in vivo survival kinetics and gene expression changes of transplanted BMMCs after their engraftment into ischemic myocardium. Our results demonstrate short-lived survival of cells following transplant, with less than 1% of cells surviving by 6 weeks posttransplantation. Moreover, transcriptomic analysis of BMMCs revealed nonspecific upregulation of various cell regulatory genes, with a marked downregulation of cell differentiation and maturation pathways. BMMC therapy caused limited improvement of heart function as assessed by echocardiography, invasive hemodynamics, and positron emission tomography. Histological evaluation of cell fate further confirmed findings of the in vivo cell tracking and transcriptomic analysis. CONCLUSIONS Collectively, these data suggest that BMMC therapy, in its present iteration, may be less efficacious than once thought. Additional refinement of existing cell delivery protocols should be considered to induce better therapeutic efficacy.
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Affiliation(s)
- Ahmad Y Sheikh
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Huber BC, von Ziegler F, Bamberg F, Franz WM, Becker A. Cardiac arrest associated with sildenafil ingestion in a patient with an abnormal origin of the left coronary artery: case report. BMC Cardiovasc Disord 2011; 11:49. [PMID: 21824399 PMCID: PMC3166914 DOI: 10.1186/1471-2261-11-49] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 08/08/2011] [Indexed: 11/11/2022] Open
Abstract
Background Left coronary artery arising from the right sinus of Valsalva is an uncommon congenital coro-nary anomaly that seems to be associated with sudden death in young patients. Case presentation We report a case of cardiac arrest in a 59-year-old patient after sexual intercourse and Silde-nafil ingestion. A coronary arteriography and an angiographic computed tomography scan subsequently revealed a LCA origin from the right aortic sinus along with an intramural course of the left main stem. In addition a distal stenosis of the right coronary artery was detected. After successful resuscitation without neurological deficits coronary artery bypass surgery was performed. Conclusion To our knowledge, this is the first report demonstrating sudden cardiac arrest associated with Sildenafil ingestion in a patient with this type of coronary anomaly. The question arises, whether a cardiac screening is necessary before a Sildenafil therapy is initiated.
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Affiliation(s)
- Bruno C Huber
- Department of Internal Medicine I, Ludwig-Maximilians-University, Campus Grosshadern, Munich, Germany
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Huber BC, Brunner S, Segeth A, Nathan P, Fischer R, Zaruba MM, Vallaster M, Theiss HD, David R, Gerbitz A, Franz WM. Parathyroid hormone is a DPP-IV inhibitor and increases SDF-1-driven homing of CXCR4(+) stem cells into the ischaemic heart. Cardiovasc Res 2011; 90:529-37. [PMID: 21245057 DOI: 10.1093/cvr/cvr014] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
AIMS Parathyroid hormone (PTH) has been shown to promote stem cell mobilization into peripheral blood. Moreover, PTH treatment after myocardial infarction (MI) improved survival and myocardial function associated with enhanced homing of bone marrow-derived stem cells (BMCs). To unravel the molecular mechanisms of PTH-mediated stem cell trafficking, we analysed wild-type (wt) and green fluorescent protein (GFP)-transgenic mice after MI with respect to the pivotal stromal cell-derived factor-1 (SDF-1)/chemokine receptor type 4 (CXCR4) axis. METHODS AND RESULTS WT and GFP-transgenic mice (C57BL/6J) were infarcted by coronary artery ligation and PTH (80 μg/kg/day) was injected for 6 days afterwards. Number of BMCs was analysed by flow cytometry. SDF-1 protein levels and activity of dipeptidyl peptidase-IV (DPP-IV) were investigated by ELISA and activity assay. Functional analyses were performed at day 30 after MI. PTH-treated animals revealed an enhanced homing of CXCR4(+) BMCs associated with an increased protein level of the corresponding homing factor SDF-1 in the ischaemic heart. In vitro and in vivo, PTH inhibited the activity of DPP-IV, which cleaves and inactivates SDF-1. Functionally, PTH significantly improved myocardial function after MI. Both stem cell homing as well as functional recovery were reversed by the CXCR4 antagonist AMD3100. CONCLUSION In summary, PTH is a DPP-IV inhibitor leading to an increased cardiac SDF-1 level, which enhances recruitment of CXCR4(+) BMCs into the ischaemic heart associated with attenuated ischaemic cardiomyopathy. Since PTH is already clinically used our findings may have direct impact on the initiation of studies in patients with ischaemic disorders.
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Affiliation(s)
- Bruno C Huber
- Department of Internal Medicine I, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninistr. 15, D-81377 Munich, Germany
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Huber BC, Fischer R, Brunner S, Groebner M, Rischpler C, Segeth A, Zaruba MM, Wollenweber T, Hacker M, Franz WM. Comparison of parathyroid hormone and G-CSF treatment after myocardial infarction on perfusion and stem cell homing. Am J Physiol Heart Circ Physiol 2010; 298:H1466-71. [PMID: 20207820 DOI: 10.1152/ajpheart.00033.2010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mobilization of stem cells by granulocyte colony-stimulating factor (G-CSF) was shown to have protective effects after myocardial infarction (MI); however, clinical trials failed to be effective. In search for alternative cytokines, parathyroid hormone (PTH) was recently shown to promote cardiac repair by enhanced neovascularization and cell survival. To compare the impact of the two cytokines G-CSF and PTH on myocardial perfusion, mice were noninvasively and repetitively investigated by pinhole single-photon emission computed tomography (SPECT) after MI. Mobilization and homing of bone marrow-derived stem cells (BMCs) was analyzed by fluorescence-activated cell sorter (FACS) analysis. Mice (C57BL/6J) were infarcted by left anterior descending artery ligation. PTH (80 mug/kg) and G-CSF (100 mug/kg) were injected for 5 days. Perfusion defects were determined by (99m)Tc-sestamibi SPECT at days 6 and 30 after MI. The number of BMCs characterized by Lin(-)/Sca-1(+)/c-kit(+) cells in peripheral blood and heart was analyzed by FACS. Both G-CSF and PTH treatment resulted in an augmented mobilization of BMCs in the peripheral blood. Contrary to G-CSF and controls, PTH and the combination showed significant migration of BMCs in ischemic myocardium associated with a significant reduction of perfusion defects from day 6 to day 30. A combination of both cytokines had no additional effects on migration and perfusion. In our preclinical model, SPECT analyses revealed the functional potential of PTH reducing size of infarction together with an enhanced homing of BMCs to the myocardium in contrast to G-CSF. A combination of both cytokines did not improve the functional outcome, suggesting clinical applications of PTH in ischemic heart diseases.
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Affiliation(s)
- Bruno C Huber
- Department of Internal Medicine I, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninistrasse 15, Munich, Germany
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Brunner S, Winogradow J, Huber BC, Zaruba MM, Fischer R, David R, Assmann G, Herbach N, Wanke R, Mueller-Hoecker J, Franz WM. Erythropoietin administration after myocardial infarction in mice attenuates ischemic cardiomyopathy associated with enhanced homing of bone marrow-derived progenitor cells via the CXCR-4/SDF-1 axis. FASEB J 2008; 23:351-61. [PMID: 18827024 DOI: 10.1096/fj.08-109462] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Mobilization of bone marrow-derived stem cells (BMCs) was shown to have protective effects after myocardial infarction (MI). However, the classical mobilizing agent, granulocyte-colony stimulating factor (G-CSF) relapsed after revealing an impaired homing capacity. In the search for superior cytokines, erythropoietin (EPO) appears to be a promising agent. Therefore, we analyzed in a murine model of surgically induced MI the influence of EPO treatment on survival and functional parameters as well as BMC mobilization, homing, and effect on resident cardiac stem cells (CSCs). Human EPO was injected intraperitoneally after ligation of the left anterior descendens (LAD) for 3 days with a total dose of 5000 IU/kg 6 and 30 days after MI, and pressure volume relationships were investigated in vivo. Cardiac tissues were analyzed by histology. To show the effect on BMCs and CSCs, FACS analyses were performed. Homing factors were analyzed by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and ELISA. EPO-treated animals showed a significant improvement of survival post-MI (62 vs. 36%). At days 6 and 30, all hemodynamic parameters associated with attenuated remodeling, enhanced neovascularization, and diminished apoptotic cells in the peri-infarct area were improved. BMC subpopulations (CD31(+), c-kit(+), and Sca-1(+) cells) were mobilized, and homing of Sca-1(+) and CXCR4(+) BMCs toward an SDF-1 gradient into the ischemic myocardium was enhanced. However, there was no beneficial effect on CSCs. We have shown that EPO application after MI shows cardioprotective effects. This may be explained by mobilization of BMCs, which are homing via the CXCR-4/SDF-1 axis. However, EPO has no beneficial effects on resident CSCs. Therefore, new treatment regimes using EPO together with other agents may combine complementary beneficial effects preventing ischemic cardiomyopathy.
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Affiliation(s)
- Stefan Brunner
- Klinikum Grosshadern, Medical Department I, Munich, Germany
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Brunner S, Huber BC, Fischer R, Groebner M, Hacker M, David R, Zaruba MM, Vallaster M, Rischpler C, Wilke A, Gerbitz A, Franz WM. G-CSF treatment after myocardial infarction: impact on bone marrow-derived vs cardiac progenitor cells. Exp Hematol 2008; 36:695-702. [PMID: 18346841 DOI: 10.1016/j.exphem.2008.01.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2007] [Revised: 10/31/2007] [Accepted: 01/23/2008] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Besides its classical function in the field of autologous and allogenic stem cell transplantation, granulocyte colony-stimulating factor (G-CSF) was shown to have protective effects after myocardial infarction (MI) by mobilization of bone marrow-derived progenitor cells (BMCs) and in addition by activation of multiple signaling pathways. In the present study, we focused on the impact of G-CSF on migration of BMCs and the impact on resident cardiac cells after MI. MATERIALS AND METHODS Mice (C57BL/6J) were sublethally irradiated, and BM from green fluorescent protein (GFP)-transgenic mice was transplanted. Coronary artery ligation was performed 10 weeks later. G-CSF (100 microg/kg) was daily injected for 6 days. Subpopulations of enhanced GFP(+) cells in peripheral blood, bone marrow, and heart were characterized by flow cytometry. Growth factor expression in the heart was analyzed by quantitative real-time polymerase chain reaction. Perfusion was investigated in vivo by gated single photon emission computed tomography (SPECT). RESULTS G-CSF-treated animals revealed a reduced migration of c-kit(+) and CXCR-4(+) BMCs associated with decreased expression levels of the corresponding growth factors, namely stem cell factor and stromal-derived factor-1 alpha in ischemic myocardium. In contrast, the number of resident cardiac Sca-1(+) cells was significantly increased. However, SPECT-perfusion showed no differences in infarct size between G-CSF-treated and control animals 6 days after MI. CONCLUSION Our study shows that G-CSF treatment after MI reduces migration capacity of BMCs into ischemic tissue, but increases the number of resident cardiac cells. To optimize homing capacity a combination of G-CSF with other agents may optimize cytokine therapy after MI.
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Affiliation(s)
- Stefan Brunner
- Ludwig-Maximilians-University, Klinikum Grosshadern, Medical Department I, Munich, Germany
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Zaruba MM, Huber BC, Brunner S, Deindl E, David R, Fischer R, Assmann G, Herbach N, Grundmann S, Wanke R, Mueller-Hoecker J, Franz WM. Parathyroid hormone treatment after myocardial infarction promotes cardiac repair by enhanced neovascularization and cell survival. Cardiovasc Res 2007; 77:722-31. [PMID: 18055578 DOI: 10.1093/cvr/cvm080] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS An ongoing concept is that stem cells have the potential to regenerate the injured myocardium. In addition to direct vasorelaxing effects on the vasculature, which are mediated by an increased cAMP production leading to a decreased calcium influx in smooth muscle cells, parathyroid hormone (PTH) was recently shown to facilitate stem cell mobilization. Therefore, we analysed in a murine model of experimental myocardial infarction (MI) the influence of PTH treatment on survival, functional parameters, stem cell migration, and expression of vascular endothelial growth factor A (VEGF-A). METHODS AND RESULTS Mice (C57BL/6) were treated with PTH (80 microg/kg/d) for up to 14 days after coronary artery ligation. Functional and immunohistochemical analyses were performed at days 6 and 30 after MI. Stem cells and VEGF expression in the myocardium were analysed by FACS and qRT-PCR at day 2 after MI. PTH-treated animals revealed a significant improvement of post-MI survival and myocardial function that was related to a subsequent reduction of left ventricular wall thinning and scar extension. Infarcted hearts of PTH-treated mice revealed increased numbers of CD45(+)/CD34(+) progenitor cells as well as an upregulation of VEGF-A mRNA associated with increased neovascularization and cell survival. CONCLUSIONS PTH application after MI increases migration of angiogenic CD45(+)/CD34(+) progenitor cells to the ischaemic heart, which may attenuate ischaemic cardiomyopathy. As PTH is already used in patients with osteoporosis, our findings may have a direct impact on the initiation of clinical studies in patients with ischaemic heart disease.
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Affiliation(s)
- Marc-Michael Zaruba
- Klinikum der Ludwig-Maximilians-Universität München Grosshadern, Med Klinik und Poliklinik I, Marchioninistr 15, Munich, Germany
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