Comparative analysis of uninduced and neuronally-induced human dental pulp stromal cells in a 6-OHDA model of Parkinson's disease.

BACKGROUND: In recent years, dental pulp stromal cells (DPSCs) have emerged as a promising therapeutic approach for Parkinson's disease (PD), owing to their inherent neurogenic potential and the lack of neuroprotective treatments for this condition. However, uncertainties persist regarding the efficacy of these cells in an undifferentiated state versus a neuronally-induced state. This study aims to delineate the distinct therapeutic potential of uninduced and neuronally-induced DPSCs in a rodent model of PD induced by 6-Hydroxydopamine (6-OHDA). METHODS: DPSCs were isolated from human teeth, characterized as mesenchymal stromal cells, and induced to neuronal differentiation. Neuronal markers were assessed before and after induction. DPSCs were transplanted into the substantia nigra pars compacta (SNpc) of rats 7 days following the 6-OHDA lesion. In vivo tracking of the cells, evaluation of locomotor behavior, dopaminergic neuron survival, and the expression of essential proteins within the dopaminergic system were conducted 7 days postgrafting. RESULTS: Isolated DPSCs exhibited typical characteristics of mesenchymal stromal cells and maintained a normal karyotype. DPSCs consistently expressed neuronal markers, exhibiting elevated expression of ßIII-tubulin following neuronal induction. Results from the animal model showed that both DPSC types promoted substantial recovery in dopaminergic neurons, correlating with enhanced locomotion. Additionally, neuronally-induced DPSCs prevented GFAP elevation, while altering DARPP-32 phosphorylation states. Conversely, uninduced DPSCs reduced JUN levels. Both DPSC types mitigated the elevation of glycosylated DAT. CONCLUSIONS: Our results suggested that uninduced DPSCs and neuronally-induced DPSCs exhibit potential in reducing dopaminergic neuron loss and improving locomotor behavior, but their underlying mechanisms differ.

Dental Pulp from Human Exfoliated Deciduous Teeth-derived Stromal Cells Demonstrated Neuronal Potential: In Vivo and In Vitro Studies.

BACKGROUND: Mesenchymal Stromal Cells (MSC) have the potential for self-renewal and differentiation in different tissues, characteristics that encourage their use in regenerative medicine. Dental tissue MSCs are easy to collect, have the same embryonic origin as neurons and have neuronal markers that allow their use in treating neurodegenerative diseases. Human Exfoliated Deciduous teeth (SHED)-derived stromal cells are considered immature and present positive expression of pluripotency and neuronal markers. Studies have shown that after the induction of neuronal differentiation in vitro, SHED increased the expression of neuronal markers, such as ßIIItubulin, nestin, GFAP, NeuN, and NFM, demonstrating the potential use of these cells in preclinical studies. The results of this review reflect the consensus that in diseases such as spinal cord injury, cerebral ischaemia, and Alzheimer's and Parkinson's disease, SHED could function in the suppression of the inflammatory response, neuroprotection, and neuronal replacement. CONCLUSION: For these cells to be used in large-scale clinical trials, standardization of the isolation techniques and theneuronal induction medium are necessary. The potential of SHED to induce neuronal differentiation is evident, demonstrating that this resource is promising and shows great potential for use in future preclinical and clinical trials of neurodegenerative diseases.

Allogenic Adipose Tissue-Derived Stromal/Stem Cells and Vitamin D Supplementation in Patients With Recent-Onset Type 1 Diabetes Mellitus: A 3-Month Follow-Up Pilot Study.

Objective: To evaluate the short term safety and potential therapeutic effect of allogenic adipose tissue-derived stromal/stem cells (ASCs) + cholecalciferol in patients with recent-onset T1D. Methods: Prospective, phase II, open trial, pilot study in which patients with recent onset T1D received ASCs (1 × 106 cells/kg) and cholecalciferol 2000 UI/day for 3 months (group 1) and were compared to controls with standard insulin therapy (group 2). Adverse events, C-peptide (CP), insulin dose, HbA1c, time in range (TIR), glucose variability (continuous glucose monitoring) and frequency of CD4+FoxP3+ T-cells (flow cytometry) were evaluated at baseline (T0) and after 3 months (T3). Results: 13 patients were included (8: group 1; 5: group 2). Their mean age and disease duration were 26.7 ± 6.1 years and 2.9 ± 1.05 months. Adverse events were transient headache (n = 8), mild local reactions (n = 7), tachycardia (n = 4), abdominal cramps (n = 1), thrombophlebitis (n = 4), mild floaters (n = 2), central retinal vein occlusion (n = 1, complete resolution). At T3, group 1 had lower insulin requirement (0.22 ± 0.17 vs. 0.61±0.26IU/Kg; p = 0.01) and HbA1c (6.47 ± 0.86 vs. 7.48 ± 0.52%; p = 0.03) than group 2. In group 1, 2 patients became insulin free (for 4 and 8 weeks) and all were in honeymoon at T3 (vs. none in group 2; p = 0.01). CP variations did not differ between groups (-4.6 ± 29.1% vs. +2.3 ± 59.65%; p = 0.83). Conclusions: Allogenic ASCs + cholecalciferol without immunosuppression was associated with stability of CP and unanticipated mild transient adverse events in patients with recent onset T1D. ClinicalTrials.gov registration: NCT03920397.

The Expression Profile of Dental Pulp-Derived Stromal Cells Supports Their Limited Capacity to Differentiate into Adipogenic Cells.

Mesenchymal stromal cells (MSCs) can self-renew, differentiate into specialised cells and have different embryonic origins-ectodermal for dental pulp-derived MSCs (DPSCs) and mesodermal for adipose tissue-derived MSCs (ADSCs). Data on DPSCs adipogenic differentiation potential and timing vary, and the lack of molecular and genetic information prompted us to gain a better understanding of DPSCs adipogenic differentiation potential and gene expression profile. While DPSCs differentiated readily along osteogenic and chondrogenic pathways, after 21 days in two different types of adipogenic induction media, DPSCs cultures did not contain lipid vacuoles and had low expression levels of the adipogenic genes proliferator-activated receptor gamma (PPARG), lipoprotein lipase (LPL) and CCAAT/enhancer-binding protein alpha (CEBPA). To better understand this limitation in adipogenesis, transcriptome analysis in undifferentiated DPSCs was carried out, with the ADSC transcriptome used as a positive control. In total, 14,871 transcripts were common to DPSCs and ADSCs, some were unique (DPSCs: 471, ADSCs: 1032), and 510 were differentially expressed genes. Detailed analyses of overrepresented transcripts showed that DPSCs express genes that inhibit adipogenic differentiation, revealing the possible mechanism for their limited adipogenesis.

Avaliação sensitiva, motora e cistométrica de cães com lesão medular crônica, submetidos ao transplante de células-tronco mesenquimais derivadas de tecido adiposo / Sensory, motor and cystometric evaluation of dogs with chronic spinal cord injury submitted to mesenchymal stem cell transplantation

A utilização de células-tronco na reparação de lesões tem sido extensivamente investigada. Neste estudo, examinamos os efeitos terapêuticos de dois transplantes (12x106 céls/transplante) de células-tronco mesenquimais alogênicas derivadas do tecido adiposo (CTDAs) em 11 cães com lesões crônicas traumáticas toracolombares da medula espinhal. As CTDAs foram foram cultivadas in vitro, a proliferação e a viabilidade foram avaliadas. As suspensões foram expandidas e administradas no espaço intradural com intervalo de uma semana entre transplantes. Os cães foram submetidos à avaliações clínicas, laboratoriais, radiográficas, tomográficas, sensitivas, motoras e cistométricas. A maioria dos animais não tinha raça definida (63,63%), mesma proporção para o acometimento de fêmeas e foi observada predominância de fratura com subluxação vertebral (81,81%). Na comparação dos cães pré e pós-transplante não foram observadas alterações hematológicas e três animais (27,27%) apresentaram cistite bacteriana. Em relação a sensibilidade, motricidade e cistometria, também não houve alterações significativas dos índices antes e pós transplantes, sendo observado a ausência nociceptiva na maioria dos animais (72,73%), paraplegia e incontinência urinária na mesma proporção. Neste estudo concluiu-se que o protocolo utilizado de transplante de CTDAs, demonstrou ser um tratamento seguro para cães com lesão medular crônica, com melhora discreta da funcionalidade vesical, porém sem melhora clínica significativa.(AU)

The use of stem cells in injury repair has been extensively investigated. In this study, we examined the therapeutic effects of two transplants (12x106 cells/transplantation) of allogenic adipose-derived stem cells (ASCs) in 11 dogs with chronic spinal cord injury. ASC were cultured in vitro, proliferation and cell viability were evaluated. Cell suspensions were prepared and administered in the intradural space, with a one-week interval between transplants. The animals were submitted to clinical, laboratory, radiographic, tomographic, sensory, motor and cystometric evaluations. Most of the animals were not a breed defined (63.63%), the same proportion for females affected, predominance of vertebral subluxation fracture was observed (81.81%). Before and after the transplants no hematological changes were observed, three animals (27.27%) presented bacterial cystitis, and in relation to motor, cystometry and sensitivity, no improvement was observed; the rates were maintained before and after transplants, predominance of nociceptive absence in most animals (72.73%), and paraplegia and urinary incontinence in the same proportion. In this study it was concluded that the use of ADSCs for the treatment of dogs with chronic spinal cord injury is safe, with a slight improvement in bladder function, but without significantly clinical improvement.(AU)

Downregulation of the protein synthesis machinery is a major regulatory event during early adipogenic differentiation of human adipose-derived stromal cells.

Commitment of adult stem cells involves the activation of specific gene networks regulated from transcription to protein synthesis. Here, we used ribosome profiling to identify mRNAs regulated at the translational level, through both differential association to polysomes and modulation of their translational rates. We observed that translational regulation during the differentiation of human adipose-derived stromal cells (hASCs, also known as adipose-derived mesenchymal stem cells), a subset of which are stem cells, to adipocytes was a major regulatory event. hASCs showed a significant reduction of whole protein synthesis after adipogenic induction and a downregulation of the expression and translational efficiency of ribosomal proteins. Additionally, focal adhesion and cytoskeletal proteins were downregulated at the translational level. This negative regulation of the essential biological functions of hASCs resulted in a reduction in cell size and the potential of hASCs to migrate. We analyzed whether the inactivation of key translation initiation factors was involved in this observed major repression of translation. We showed that there was an increase in the hypo phosphorylated forms of 4E-BP1, a negative regulator of translation, during early adipogenesis. Our results showed that extensive translational regulation occurred during the early stage of the adipogenic differentiation of hASCs.

Metabolic switches during the first steps of adipogenic stem cells differentiation.

The understanding of metabolism during cell proliferation and commitment provides a greater insight into the basic biology of cells, allowing future applications. Here we evaluated the energy and oxidative changes during the early adipogenic differentiation of human adipose tissue-derived stromal cells (hASCs). hASCs were maintained under differentiation conditions during 3 and 7days. Oxygen consumption, mitochondrial mass and membrane potential, reactive oxygen species (ROS) generation, superoxide dismutase (SOD) and catalase activities, non-protein thiols (NPT) concentration and lipid peroxidation were analyzed. We observed that 7days of adipogenic induction are required to stimulate cells to consume more oxygen and increase mitochondrial activity, indicating organelle maturation and a transition from glycolytic to oxidative energy metabolism. ROS production was only increased after 3days and may be involved in the differentiation commitment. ROS source was not only the mitochondria and we suggest that NOX proteins are related to ROS generation and therefore adipogenic commitment. ROS production did not change after 7days, but an increased activity of catalase and NPT concentration as well as a decreased lipid peroxidation were observed. Thus, a short period of differentiation induction is able to change the energetic and oxidative metabolic profile of hASCs and stimulate cytoprotection processes.

Intratracheal therapy with autologous bone marrow-derived mononuclear cells reduces airway inflammation in horses with recurrent airway obstruction.

This research evaluated the effects of bone marrow-derived mononuclear cells (BMMCs) on the inflammatory process in the equine recurrent airway obstruction (RAO). Eight horses in RAO clinical score were divided into cell therapy group (Gcel) treated with a single intratracheal dose of BMMCs, and dexamethasone group (Gdex) treated with 21days of oral dexamethasone. The horses were clinically revaluated on days 7 and 21, together with cytological evaluation of the BALF, and detection of inflammatory markers (interleukins [IL]-10, -4, and -17, and interferon γ and α). There were decreases in respiratory effort and clinical score on days 7 and 21(p<0.05) for both groups. The percentage of neutrophils decreased and macrophages increased on days 7 and 21 (p<0.005) in both groups. IL-10 levels increased in the Gcel group on day 21 compared to days 0 and 7 (p<0.05), but this was not observed in the Gdex group. The quantification of IL-4, IL-17, IFN-γ, and IFN-α did not change between evaluations in both groups. These preliminary results suggest that BMMCs may ameliorate the inflammatory response of RAO.

Direct intracardiac injection of umbilical cord-derived stromal cells and umbilical cord blood-derived endothelial cells for the treatment of ischemic cardiomyopathy.

The development of new therapeutic strategies is necessary to reduce the worldwide social and economic impact of cardiovascular disease, which produces high rates of morbidity and mortality. A therapeutic option that has emerged in the last decade is cell therapy. The aim of this study was to compare the effect of transplanting human umbilical cord-derived stromal cells (UCSCs), human umbilical cord blood-derived endothelial cells (UCBECs) or a combination of these two cell types for the treatment of ischemic cardiomyopathy (IC) in a Wistar rat model. IC was induced by left coronary artery ligation, and baseline echocardiography was performed seven days later. Animals with a left ventricular ejection fraction (LVEF) of ≤40% were selected for the study. On the ninth day after IC was induced, the animals were randomized into the following experimental groups: UCSCs, UCBECs, UCSCs plus UCBECs, or vehicle (control). Thirty days after treatment, an echocardiographic analysis was performed, followed by euthanasia. The animals in all of the cell therapy groups, regardless of the cell type transplanted, had less collagen deposition in their heart tissue and demonstrated a significant improvement in myocardial function after IC. Furthermore, there was a trend of increasing numbers of blood vessels in the infarcted area. The median value of LVEF increased by 7.19% to 11.77%, whereas the control group decreased by 0.24%. These results suggest that UCSCs and UCBECs are promising cells for cellular cardiomyoplasty and can be an effective therapy for improving cardiac function following IC.

Morphology and morphometry of feline bone marrow-derived mesenchymal stem cells in culture / Morfologia e morfometria das células-tronco mesenquimais isoladas de medula óssea de gato

Mesenchymal stem cells (MSC) are increasingly being proposed as a therapeutic option for treatment of a variety of different diseases in human and veterinary medicine. Stem cells have been isolated from feline bone marrow, however, very few data exist about the morphology of these cells and no data were found about the morphometry of feline bone marrow-derived MSCs (BM-MSCs). The objectives of this study were the isolation, growth evaluation, differentiation potential and characterization of feline BM-MSCs by their morphological and morphometric characteristics. in vitro differentiation assays were conducted to confirm the multipotency of feline MSC, as assessed by their ability to differentiate into three cell lineages (osteoblasts, chondrocytes, and adipocytes). To evaluate morphological and morphometric characteristics the cells are maintained in culture. Cells were observed with light microscope, with association of dyes, and they were measured at 24, 48, 72 and 120h of culture (P1 and P3). The non-parametric ANOVA test for independent samples was performed and the means were compared by Tukey's test. On average, the number of mononuclear cells obtained was 12.29 (±6.05x106) cells/mL of bone marrow. Morphologically, BM-MSCs were long and fusiforms, and squamous with abundant cytoplasm. In the morphometric study of the cells, it was observed a significant increase in average length of cells during the first passage. The cell lengths were 106.97±38.16µm and 177.91±71.61µm, respectively, at first and third passages (24 h). The cell widths were 30.79±16.75 µm and 40.18±20.46µm, respectively, at first and third passages (24 h).The nucleus length of the feline BM-MSCs at P1 increased from 16.28µm (24h) to 21.29µm (120h). However, at P3, the nucleus length was 26.35µm (24h) and 25.22µm (120h). This information could be important for future application and use of feline BM-MSCs.(AU)

As células tronco mesenquimais são utilizadas na terapia de várias doenças na medicina humana e veterinária. As células tronco foram isoladas da medula óssea de gato, entretanto, existem poucos dados referentes a morfologia e não existem informações sobre a morfometria das células tronco isoladas da medula óssea. Os objetivos do presente estudo foram o isolamento, avaliação do crescimento, potencial de diferenciação e caracterização morfológica e morfométrica das células mesenquimais de gato isoladas de medula óssea. A diferenciação in vitro foi realizada para confirmar a multipotencialidade das células mesenquimais de gato (diferenciação em osteoblastos, condrócitos, adipócitos). As células mesenquimais foram mantidas em cultivo para avaliações morfológica e morfométrica. As células foram coradas e observadas em microscopia ótica. As mensurações foram realizadas com 24, 48, 72 e 120h de cultura (primeira e terceira passagens). O teste não paramétrico ANOVA foi utilizado e as médias foram comparadas pelo teste de Tukey. O número médio de células mononucleares obtido foi de 12,29 (±6,05x106) células/mL de medula óssea. As células mesenquimais são longas e fusiformes, e escamosas com citoplasma abundante. No estudo morfométrico, observou-se aumento no comprimento médio das células durante a primeira passagem. As medidas de comprimento das células foram: 106,97±38,16µm e 177,91±71,61µm, respectivamente, na primeira e terceira passagens (24 horas). As medidas de largura das células foram: 30,79±16,75 µm e 40,18±20,46 µm, respectivamente, na primeira e terceira passagens (24 horas). O comprimento do núcleo na primeira passagem aumentou de 16,28µm (24h) para 21,29µm (120h) e na terceira passagem foi de 26,35µm (24h) para 25,22µm (120h). As informações são importantes para futuras aplicações e uso da célula mesenquimal de gato.(AU)

Polysome profiling shows the identity of human adipose-derived stromal/stem cells in detail and clearly distinguishes them from dermal fibroblasts.

Although fibroblasts and multipotent stromal/stem cells, including adipose-derived stromal cells (ADSCs), have been extensively studied, they cannot be clearly distinguished from each other. We, therefore, investigated the cellular and molecular characteristics of ADSCs and fibroblasts. ADSCs and fibroblasts share several morphological similarities and surface markers, but were clearly found to be different types of cells. Contrary to previous reports, fibroblasts were not able to differentiate into adipocytes, osteoblasts, or chondrocytes. Polysome-bound mRNA profiling revealed that ∼ 1,547 genes were differentially expressed (DE) in the two cell types; the genes were related to cell adhesion, the extracellular matrix, differentiation, and proliferation. These findings were confirmed by functional analyses showing that ADSCs had a greater adhesion capacity than fibroblasts; the proliferation rate of fibroblasts was also higher than that of ADSCs. Importantly, 185 DE genes were integral to the plasma membrane and, thus, candidate markers for ADSC isolation and manipulation. We also observed that an established marker of fibroblasts and ADSCs, CD105, was overexpressed in ADSCs at both mRNA and protein levels. CD105 expression seemed to be related to differentiation capacity, at least for adipogenesis. This study shows that ADSCs and fibroblasts are distinct cell types. These findings should be taken into account when using these two cell types in basic and therapeutic studies.

Polysome profiling shows extensive posttranscriptional regulation during human adipocyte stem cell differentiation into adipocytes.

Adipocyte stem cells (hASCs) can proliferate and self-renew and, due to their multipotent nature, they can differentiate into several tissue-specific lineages, making them ideal candidates for use in cell therapy. Most attempts to determine the mRNA profile of self-renewing or differentiating stem cells have made use of total RNA for gene expression analysis. Several lines of evidence suggest that self-renewal and differentiation are also dependent on the control of protein synthesis by posttranscriptional mechanisms. We used adipogenic differentiation as a model, to investigate the extent to which posttranscriptional regulation controlled gene expression in hASCs. We focused on the initial steps of differentiation and isolated both the total mRNA fraction and the subpopulation of mRNAs associated with translating ribosomes. We observed that adipogenesis is committed in the first days of induction and three days appears as the minimum time of induction necessary for efficient differentiation. RNA-seq analysis showed that a significant percentage of regulated mRNAs were posttranscriptionally controlled. Part of this regulation involves massive changes in transcript untranslated regions (UTR) length, with differential extension/reduction of the 3'UTR after induction. A slight correlation can be observed between the expression levels of differentially expressed genes and the 3'UTR length. When we considered association to polysomes, this correlation values increased. Changes in the half lives were related to the extension of the 3'UTR, with longer UTRs mainly stabilizing the transcripts. Thus, changes in the length of these extensions may be associated with changes in the ability to associate with polysomes or in half-life.

Are purified or expanded cord blood-derived CD133+ cells better at improving cardiac function?

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.

Expansão de células-tronco da medula óssea e do sangue de cordão umbilical humano / Expansion of stem cells from bone marrow and human umbilical cord blood

Células-tronco/progenitoras frequentemente não estão disponíveis em quantidade suficiente para restauração de órgãos e tecidos danificados, sendo necessária sua expansão in vitro. Instalações físicas adequadas, pessoal técnico qualificado, reagentes de grau clínico e protocolos bem definidos de acordo com as condições de boas práticas de fabricação são imprescindíveis para assegurar a qualidade e segurança das células infundidas no paciente. A medula óssea e o sangue de cordão umbilical ainda são as fontes de células mais utilizadas em terapias. Protocolos bem sucedidos de expansão utilizando células-tronco hematopoéticas, células-tronco mesenquimais e células progenitoras endoteliais já têm sido empregados em estudos pré-clínicos e clínicos. A escolha do tipo celular adequado deve ser direcionada pelo tamanho da lesão ou natureza do tecido tratado e pelo efeito terapêutico desejado. Estudos recentes têm demonstrado que propriedades de diferentes células expandidas in vitro podem ser combinadas para obtenção de um resultado melhor no tratamento de algumas doenças. Células em culturas de longo termo precisam ser acompanhadas por meio de diversas técnicas de citogenética clássica e molecular para demonstrar que não há evidências de transformação espontânea ou sinais de imortalização. Ensaios utilizando a infusão de células expandidas através da barreira alogeneica e xenogeneica, apresentaram melhora funcional e foram alcançados sem imunossupressão e sem evidências de infiltrados celulares que indicariam resposta imune. Porém, mais estudos precisam ser realizados para avaliar a imunogenicidade destas células e garantir a segurança da terapia celular alogênica permitindo sua consolidação no uso clínico. Aqui apresentamos uma atualização sobre expansão celular associada com seu uso clínico.

Stem/progenitor cells are not frequently available in large enough amounts to repair damaged tissues and organs and so in vitro expansion is necessary. Appropriate facilities, qualified technicians, clinical-grade reagents and well defined protocols relating to good manufacturing products are essential to assure the quality and security of the cells injected in the patient. Bone marrow and human umbilical cord blood are still the best sources of cells for therapies. Successful expansion protocols using hematopoietic stem cells, mesenchymal stem cells and endothelial progenitor cells have already been used in clinical and pre-clinical trials. Adequate cell choice should consider the extent of injury or nature of the damaged tissue and the desired therapeutic effect. Recent studies have demonstrated that properties of different in vitro expanded cells can be combined aiming to improve the outcome of the treatment of some diseases. Long-term cell cultures need to be followed up by classical and molecular cytogenetic techniques to demonstrate that there is no evidence of spontaneous transformation or signs of immortalization. Assays using expanded cell infusions across both xenogeneic and allogeneic transplant barriers showed functional improvement and were achieved without immunosuppression and without evidence of a cellular infiltrate that would indicate an immune response. However, more research needs to be performed to evaluate the immunogenicity of these cells and to guarantee the safety of allogeneic cell therapy, allowing consolidation of their clinical use. Here, we present an update regarding cellular expansion associated with their clinical use.

Six-minute walk test and quality-of-life in heart failure: a correlative study with a Brazilian sample / Test de la caminata de seis minutos y calidad de vida en insuficiencia cardíaca: un estudio correlativo con una muestra brasileña / Teste de caminhada de seis minutes e qualidade de vida na insuficiência cardíaca: Um estudo correlativo com uma amostra brasileira

Background. Quality-of-life and functional capacity in heart failure are, actually, between the most investigated topics in the scientific community. Patient's self perceptions and exercise capacity can help health professionals with prognosis and decisions in heart failure treatment. Specifically in Brazil, the research on quality-of-life still needs to focus on the differences in the multifactor aspects of heart failure. The aim of this study is to investigate the correlation between quality-of-life and functional capacity in a sample of Brazilian heart failure patients. Methods. 30 male heart failure patients were included in the study. Quality-of-life was assessed by the Brazilian version of the Minnesota Living with Heart Failure Questionnaire and the functional capacity through the six-minute walk test. Differences in quality-of-life among the functional classes were evaluated through the analysis of variance and the association between the variables was assessed through Pearson's coefficient. Results. Quality-of-life decreased significantly according to functional class (functional class I= 20±11, class II= 35.9±18 and class III= 58.3±24) and correlated significantly to the distance (r=-0.62, p=0.004). Conclusions. Longer distances obtained in the six-minute walk test can be interpreted as a better quality-of-life in Brazilian heart failure patients.

Fundamentação. Qualidade-de-vida e capacidade funcional na insuficiência cardíaca estão, atualmente, entre os tópicos mais investigados na comunidade científica. As autopercepções e a capacidade de exercício dos pacientes podem ajudar as profissionais de saúde com o prognóstico e as decisões no tratamento da insuficiência cardíaca. Especificamente no Brasil, a pesquisa em qualidade-de-vida ainda precisa focar nas diferenças nos aspectos multifatoriais da insuficiência cardíaca. O objetivo deste estudo foi investigar a correlação entre qualidade-de-vida e capacidade funcional em uma amostra brasileira de pacientes com insuficiência cardíaca. Métodos. Foram incluídos no estudo trinta pacientes masculinos com insuficiência cardíaca. A qualidade-de-vida foi avaliada pela versão brasileira do Questionário Minnesota Living With Heart Failure e a capacidade funcional pelo teste de caminhada de seis minutos. Foram avaliadas diferenças em qualidade-de-vida entre as classes funcionais pela análise de variância, e a associação entre as variáveis foi avaliada pelo coeficiente de Pearson. Resultados. A qualidade-de-vida diminuiu significativamente de acordo com classe funcional (classe funcional I=20±11, classe II=35,9±18 e classe III=58,3±24) e correlacionou-se significativamente com a distância (r=0,62, p=0,004). Conclusões. Distâncias mais longas obtidas no Teste de caminhada de seis minutos podem ser interpretadas como uma qualidade-de-vida melhor em pacientes de parada cardíaca brasileiros.