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1.
Pediatr Res ; 76(4): 341-6, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25000348

RESUMO

BACKGROUND: Tetralogy of Fallot patients with pulmonary atresia (TOF/PA) present a pulmonary blood supply directly from aortic collateral arteries. Major aorto-pulmonary collateral arteries (MAPCAs) present substantial clinical and surgical management challenges. Surgical operations to reestablish and promote further development of a pulmonary arterial connection preferentially utilize MAPCAs for reconstruction of central pulmonary arteries. However, the propensity of some MAPCAs to develop stenosis rather than growth may impair the response to reconstructions. METHODS: Probe sets prepared from MAPCAs, PA, and aorta mRNA were used to interrogate human genome microarrays. We compared expression differences between pairs of the three vessels to determine whether MAPCAs display distinct expression patterns. RESULTS: Functional clustering analysis identified differences in gene expression, which were further analyzed by gene ontology classification. A subset of highly regulated genes was validated using quantitative PCR. Expression differences among vessel types were observed for multiple gene classes. Of note, we observed that MAPCAs differentially express several genes at much higher levels than either PA or aorta. CONCLUSION: MAPCAs differ from PA or aorta by significantly altered levels in gene expression, suggesting a transcriptional basis for their physiology that will guide a further understanding of the pathobiology of MAPCAs and TOF.


Assuntos
Aorta/metabolismo , Circulação Colateral , Artéria Pulmonar/metabolismo , Tetralogia de Fallot/genética , Transcriptoma , Análise por Conglomerados , Perfilação da Expressão Gênica , Humanos , Reação em Cadeia da Polimerase em Tempo Real , Tetralogia de Fallot/cirurgia
2.
World J Pediatr Congenit Heart Surg ; 4(3): 253-61, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24327492

RESUMO

BACKGROUND: Development of a subaortic membrane is not fully understood. Recurrence after surgical removal continues to be high. We sought to assess the differences in aorto-septal angles (AoSA) to possibly explain alterations within the left ventricular outflow tract, hence in subaortic membrane formation. METHODS: A total of 113 patients who underwent subaortic membrane resection were matched by age and sex with 113 controls. The subaortic membrane resection group included isolated subaortic membranes (n = 34, group I), associated with ventricular septal defect (n = 29, group II), or patent ductus arteriosus (n = 50, group III). RESULTS: Mean (± standard deviation) AoSA (in degrees) were not different between subaortic membrane groups I, II, and III but were steeper than their control groups (126.2 ± 9.2 vs 138.6 ± 7.0, 129.2 ± 9.9 vs 137.7 ± 10.0, and 126.2 ± 8.1 vs 135 ± 8.5, respectively; all Ps < .05). Additionally, group II had lower preoperative gradients (28.8 ± 20.7 mm Hg) compared to groups I and III (67.0 ± 32.9 and 66.2 ± 33.1 mm Hg, respectively, P < .001). Follow-up ranged from 3 to 132 months. In 22 (32%) patients, a subaortic membrane recurred. Early postoperative residual gradients and development of aortic regurgutation were associated with the need for reoperation (P < .05). CONCLUSIONS: These findings suggest a contributing role of the AoSA in the development of subaortic membrane. Further rheological experiments are warranted. Whether the steeper the angle the higher the risk of recurrence may be revealed by longer follow-up periods.


Assuntos
Aorta Torácica/patologia , Estenose Subaórtica Fixa/patologia , Cardiopatias Congênitas/patologia , Septos Cardíacos/patologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Estenose Subaórtica Fixa/diagnóstico por imagem , Estenose Subaórtica Fixa/cirurgia , Ecocardiografia , Feminino , Seguimentos , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/cirurgia , Humanos , Cuidados Intraoperatórios/métodos , Masculino , Recidiva , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
3.
Ann Thorac Surg ; 93(4): 1311-5, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22450088

RESUMO

In this case report, we evaluated cellular structure and the growth potential of a porcine small intestinal submucosal patch used for pulmonary artery augmentation in a 20-day-old newborn with pulmonary atresia. The patch was resected 2 months postoperatively due to apparent abnormal wall thickening and evaluated by histologic and immunohistologic staining.


Assuntos
Intestino Delgado/transplante , Artéria Pulmonar/cirurgia , Atresia Pulmonar/cirurgia , Animais , Remoção de Dispositivo , Matriz Extracelular/patologia , Matriz Extracelular/transplante , Feminino , Cardiopatias Congênitas/cirurgia , Humanos , Recém-Nascido , Intestino Delgado/patologia , Mucosa/transplante , Artéria Pulmonar/patologia , Procedimentos de Cirurgia Plástica , Reoperação , Suínos
4.
Exp Biol Med (Maywood) ; 235(1): 119-29, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20404026

RESUMO

Endothelial progenitor cells (EPCs), which express the CD133 marker, can differentiate into mature endothelial cells (ECs) and create new blood vessels. Normal angiogenesis is unable to repair the injured tissues that result from myocardial infarction (MI). Patients who have high cardiovascular risks have fewer EPCs and their EPCs exhibit greater in vitro senescence. Human umbilical cord blood (HUCB)-derived EPCs could be an alternative to rescue impaired stem cell function in the sick and elderly. The aim of this study was to purify HUCB-derived CD133(+) cells, expand them in vitro and evaluate the efficacy of the purified and expanded cells in treating MI in rats. CD133(+) cells were selected for using CD133-coupled magnetic microbeads. Purified cells stained positive for EPC markers. The cells were expanded and differentiated in media supplemented with fetal calf serum and basic fibroblast growth factor, insulin-like growth factor-I and vascular endothelial growth factor (VEGF). Differentiation was confirmed by lack of staining for EPC markers. These expanded cells exhibited increased expression of mature EC markers and formed tubule-like structures in vitro. Only the expanded cells expressed VEGF mRNA. Cells were expanded up to 70-fold during 60 days of culture, and they retained their functional activity. Finally, we evaluated the therapeutic potential of purified and expanded CD133(+) cells in treating MI by intramyocardially injecting them into a rat model of MI. Rats were divided into three groups: A (purified CD133(+) cells-injected); B (expanded CD133(+) cells-injected) and C (saline buffer-injected). We observed a significant improvement in left ventricular ejection fraction for groups A and B. In summary, CD133(+) cells can be purified from HUCB, expanded in vitro without loosing their biological activity, and both purified and expanded cells show promising results for use in cellular cardiomyoplasty. However, further pre-clinical testing should be performed to determine whether expanded CD133(+) cells have any clinical advantages over purified CD133(+) cells.


Assuntos
Antígenos CD/metabolismo , Sangue Fetal/citologia , Glicoproteínas/metabolismo , Infarto do Miocárdio/terapia , Peptídeos/metabolismo , Transplante de Células-Tronco , Antígeno AC133 , Animais , Sequência de Bases , Capilares/crescimento & desenvolvimento , Diferenciação Celular , Proliferação de Células , Primers do DNA/genética , Células Endoteliais/citologia , Células Endoteliais/imunologia , Células Endoteliais/metabolismo , Sangue Fetal/imunologia , Sangue Fetal/metabolismo , Humanos , Separação Imunomagnética , Técnicas In Vitro , Recém-Nascido , Masculino , Infarto do Miocárdio/fisiopatologia , Neovascularização Fisiológica , Fenótipo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Transplante Heterólogo , Fator A de Crescimento do Endotélio Vascular/genética , Função Ventricular Esquerda
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