While cell therapy is emerging as a promising option for patients with ischemic cardiomyopathy (ICM), the influence of advanced donor age and a history of ischemic injury on the reparative performance of these cells are not well defined. As such, intrinsic changes that result from advanced donor age and ischemia are explored in hopes of identifying a molecular candidate capable of restoring the lost reparative potency of heart explant-derived cells (EDCs) used in cell therapy. EDCs were cultured from myocardial biopsies obtained from young or old mice 4 weeks after randomization to experimental myocardial infarction or no intervention. Advanced donor age reduces cell yield while increasing cell senescence and the secretion of senescence-associated cytokines. A history of ischemic injury magnifies these effects as cells are more senescent and have lower antioxidant reserves. Consistent with these effects, intramyocardial injection of EDCs from aged ischemic donors provided less cell-mediated cardiac repair. A transcriptome comparison of ICM EDCs shows aging modifies many of the pathways responsible for effective cell cycle control and DNA damage/repair. Over-expression of the barely explored antisenescent transcription factor, Mybl2, in EDCs from aged ICM donors reduces cell senescence while conferring salutary effects on antioxidant activity and paracrine production. In vivo, we observed an increase in cell retention and vasculogenesis after treatment with Mybl2-over-expressing EDCs which improved heart function in infarcted recipient hearts. In conclusion, Mybl2 over-expression rejuvenates senescent EDCs sourced from aged ICM donors to confer cell-mediated effects comparable to cells from young nonischemic donors.

译文

尽管细胞治疗已成为缺血性心肌病 (ICM) 患者的有希望的选择,但晚期供体年龄和缺血性损伤史对这些细胞修复性能的影响尚不明确。因此,探索了由晚期供体年龄和缺血引起的内在变化,以期找到能够恢复细胞治疗中使用的心脏外植体衍生细胞 (edc) 丧失的修复能力的分子候选者。随机分组至实验性心肌梗死或无干预4周后,从年轻或老年小鼠获得的心肌活检中培养edc。晚期供体年龄降低细胞产量,同时增加细胞衰老和衰老相关细胞因子的分泌。缺血性损伤的历史会放大这些作用,因为细胞更衰老且抗氧化剂储备较低。与这些作用一致,从老年缺血供体的心肌内注射EDCs可提供较少的细胞介导的心脏修复。ICM edc的转录组比较显示,衰老修饰了许多负责有效细胞周期控制和DNA损伤/修复的途径。在来自老年ICM供体的edc中,几乎未探索的抗衰老转录因子Mybl2的过度表达可减少细胞衰老,同时对抗氧化活性和旁分泌产生有益的作用。在体内,我们观察到用Mybl2-over-expressing EDCs治疗后细胞保留和血管生成的增加,这改善了梗塞受体心脏的心脏功能。总之,Mybl2过表达可使来自老年ICM供体的衰老edc恢复活力,从而赋予细胞介导的作用,与年轻的非缺血供体的细胞相当。

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