Published online before print November 8, 2004, doi: 10.1161/01.CIR.0000147609.39780.02
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(Circulation. 2004;110:3213-3220.)
© 2004 American Heart Association, Inc.
Genetics |
Mobilization of CD34/CXCR4+, CD34/CD117+, c-met+ Stem Cells, and Mononuclear Cells Expressing Early Cardiac, Muscle, and Endothelial Markers Into Peripheral Blood in Patients With Acute Myocardial Infarction
Tendera, MD, PhD, FESCowska, MD
lankiewicz, MD Wyderka, MDa, MD, PhDFrom the Third Division of Cardiology, Silesian School of Medicine, Katowice (W.W., M.T., K.M., R.W., A.O.), and the Department of Transplantology, Polish-American Children’s Hospital, Medical College, Jagiellonian University, Kraków (A.M., M.M., M.Z.R.), Poland; and the Stem Cell Biology Program at James Graham Brown Cancer Center and Department of Medicine, University of Louisville, Louisville, Ky (M.K., M.Z.R.).
Correspondence to Wojciech Wojakowski, MD, PhD, Third Division of Cardiology, Silesian School of Medicine, 45-47 Zioowa St, 40-635 Katowice, Poland. E-mail wojwoj{at}mp.pl
Received June 21, 2004; revision received August 18, 2004; accepted September 8, 2004.
Background— Adult stem cells can contribute to myocardial regeneration after ischemic injury. Bone marrow and skeletal muscles contain a population of CXCR4+ cells expressing genes specific for muscle progenitor cells that can be mobilized into the peripheral blood. The aims of the study were (1) to confirm the presence of early tissue-committed cells expressing cardiac, muscle, and endothelial markers in populations of mononuclear cells in peripheral blood and (2) to assess the dynamics and magnitude of the mobilization of CD34+, CD117+, CXCR4+, c-met+, CD34/CD117+, and CD34/CXCR4+ stem cells into peripheral blood in relation to inflammatory and hematopoietic cytokines in patients with ST-segment–elevation acute myocardial infarction (STEMI).
Methods and Results— Fifty-six patients with STEMI (<12 hours), 39 with stable angina, and 20 healthy control subjects were enrolled. Real-time reverse transcription–polymerase chain reaction (RT-PCR) was used for detection of tissue-specific markers. The number of the cells was assessed by use of a flow cytometer on admission, after 24 hours, and after 7 days. RT-PCR revealed increased expression of mRNA (up to 3.5-fold increase) for specific cardiac (GATA4, MEF2C, Nkx2.5/Csx), muscle (Myf5, Myogenin, MyoD), and endothelial (VE-cadherin, von Willebrand factor) markers in peripheral blood mononuclear cells. The number of CD34/CXCR4+ and CD34/CD117+ and c-met+ stem cells in peripheral blood was significantly higher in STEMI patients than in stable angina and healthy subjects, peaking on admission, without further significant increase after 24 hours and 7 days.
Conclusions— The study demonstrates in the setting of STEMI a marked mobilization of mononuclear cells expressing specific cardiac, muscle, and endothelial markers as well as CD34/CXCR4+ and CD34/CD117+ and c-met+ stem cells and shows that stromal cell–derived factor-1 is an important factor influencing the mobilization.
Key Words: blood cells • myocardial infarction • inflammation • molecular biology • genetics
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Circulation 2004 110: 3158-3160.
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