Key result
Whole bone-marrow cell therapy improves post-MI LVEF by ~6% vs control, unlike fractionated formulations.
Why the study?
Clinical trials of bone-marrow-derived cells for therapy after acute myocardial infarction have been controversial, with uncertainty about the efficacy of fractionated versus whole bone marrow cells.
BACKGROUND AND OBJECTIVES: Clinical trials of bone-marrow (BM)-derived cells for therapy after acute myocardial infarct (MI) have been controversial. The most commonly used cells for these trials have been mononuclear cells (MNC), obtained by fractionation of BM cells (BMCs) via different protocols. In this study, we performed a head-to-head comparison of: 1) whole BMC; 2) fractionated BM (fBM) using the commonly used Ficoll protocol; 3) the extract derived from the fBM (fBM extract) versus 4) saline (HBSS) control for treatment of acute MI. METHODS: In total, 155 male C57BL/6J (10-12-week old) mice were included. Echocardiography was performed at baseline and 2 days after permanent ligation of the left anterior descending artery to induce MI. Echocardiography and histology were employed to measure outcome at 28 days post-MI. RESULTS: Whole BMC therapy improved left ventricular ejection fraction (LVEF) post-MI, but fBM or fBM extract was not beneficial compared to control (change of LVEF of 4.9% ±4.6% (P = 0.02), -0.4% ±5.8% (P = 0.86), -2.0% ±6.2% (P = 0.97) versus -1.4% ±5.3%, respectively). The histological infarct size or numbers of arterioles or capillaries at infarct or border zone did not differ between the groups. CONCLUSIONS: Clinical studies should be performed to test whether whole BMC therapy translates into better outcome also after human MI.
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Koskenvuo et al. (2012) studied Acute myocardial infarction (n=155). Whole bone-marrow cells (BMC) vs. Fractionated BM (fBM), fBM extract, or saline control was evaluated on Change in left ventricular ejection fraction (LVEF) (p=0.02). Whole bone-marrow cell therapy improved LVEF post-MI compared to saline control (change of 4.9% vs -1.4%, P=0.02), whereas fractionated BM and extract showed no benefit.
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