RESUMO
Liver diseases are a major health problem worldwide leading to high mortality rates and causing a considerable economic burden in many countries. Cellular therapies as potential treatments for liver diseases have proven beneficial in most of the conditions. In recent years, studies involving therapy with bone marrow cells have been implemented to promote liver regeneration and to reduce hepatic fibrosis, however identifying the cell population present in the bone marrow that is responsible for hepatic improvement after therapy is still necessary. The aim of the present study was the evaluation of the therapeutic efficacy of monocytes obtained from bone marrow in fibrosis resulting from S. mansoni infection in C57BL/6 mice. Monocytes were isolated by immunomagnetic separation and administered to the infected animals. The effects of treatment were evaluated through morphometric, biochemical, immunological and molecular analyzes. Monocyte therapy promoted reduction of liver fibrosis induced by S. mansoni infection, associated with a decrease in production of inflammatory and pro-fibrogenic mediators. In addition, monocyte infusion caused downregulation of factors associated with the M1 activation profile, as well as upregulation of M2reg markers. The findings altogether reinforce the hypothesis that the predominance of M2reg macrophages, producers of immunosuppressive cytokines, may favor the improvement of hepatic fibrosis in a preclinical model, through fibrous tissue remodeling, modulation of the inflammatory response and fibrogenesis.
Assuntos
Transferência Adotiva/métodos , Terapia Baseada em Transplante de Células e Tecidos/métodos , Cirrose Hepática/terapia , Regeneração Hepática , Monócitos/transplante , Schistosoma mansoni/patogenicidade , Esquistossomose mansoni/terapia , Animais , Células da Medula Óssea/citologia , Células da Medula Óssea/imunologia , Diferenciação Celular , Citocinas/genética , Citocinas/imunologia , Modelos Animais de Doenças , Regulação da Expressão Gênica , Fígado/imunologia , Fígado/parasitologia , Fígado/patologia , Cirrose Hepática/imunologia , Cirrose Hepática/parasitologia , Cirrose Hepática/patologia , Macrófagos/citologia , Macrófagos/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Monócitos/citologia , Monócitos/imunologia , Schistosoma mansoni/crescimento & desenvolvimento , Esquistossomose mansoni/imunologia , Esquistossomose mansoni/parasitologia , Esquistossomose mansoni/patologiaRESUMO
NEW FINDINGS: What is the central question of this study? Can a single bone marrow mononuclear cell (BMMC) transplant into the subcapsular region of kidney improve cellular communication and adhesion, while restoring renal tissue cytoarchitecture and function during renovascular hypertension? What is the main finding and its importance? The BMMC transplantation restored connexin 40 expression and led to recovery of N- and E-cadherin levels within 15 days. It was observed, for the first time, that BMMC transplantation restores expression of nephrin, a component of the glomerular filtration barrier related to podocytes and the glomerular basal membrane. ABSTRACT: Stem cell therapy has emerged as a potential treatment for renal diseases owing to the regenerative potential of stem cells. However, a better understanding of the morphological and functional changes of damaged renal cells in the presence of transplanted stem cells is needed. The aim of this study was to investigate cell-cell communication and adhesion in renal parenchyma, with analysis of fibrosis, to evaluate renal morphology and function after bone marrow mononuclear cell (BMMC) transplantation in two-kidney-one-clip rats. The BMMC therapy significantly decreased blood pressure and renin expression, improved renal morphology and restored the glomerular filtration barrier, with remodelling of podocytes. In addition, there was a reduction in fibrosis, and connexin 40 and nephrin expression were significantly increased after 7 and 15 days of transplantation. Plasma creatinine, urea and total protein levels were restored, and proteinuria was reduced. Furthermore, N- and E-cadherin expression was increased soon after BMMC therapy. Green fluorescent protein-positive BMMCs were found in the renal cortex 24 and 48 h after transplantation into the renal subcapsule, and at 7 and 15 days after transplantation, these cells were observed throughout the renal medulla, indicating cellular migration. Therefore, these data suggest that transplanted BMMCs improve cell-cell communication and adhesion between damaged cells, which is accompanied by a recovery of renal morphology and function.
Assuntos
Transplante de Medula Óssea/métodos , Barreira de Filtração Glomerular/patologia , Hipertensão Renovascular/patologia , Hipertensão Renovascular/terapia , Junções Intercelulares/patologia , Animais , Pressão Sanguínea , Caderinas/metabolismo , Comunicação Celular , Fibrose , Rim/patologia , Córtex Renal/patologia , Masculino , Monócitos/transplante , Podócitos/patologia , Ratos , Ratos Wistar , Renina/biossínteseRESUMO
Systemic lupus erythematosus (SLE) is an autoimmune disease with unrestrained T-cell and B-cell activity towards self-antigens. Evidence shows that apoptotic cells (ApoCells) trigger an autoreactive response against nuclear antigens in susceptible individuals. In this study, we focus on generating and characterizing tolerogenic dendritic cells (tolDCs) to restore tolerance to ApoCells. Monocyte-derived dendritic cells (DCs) from healthy controls and patients with SLE were treated with dexamethasone and rosiglitazone to induce tolDCs. Autologous apoptotic lymphocytes generated by UV irradiation were given to tolDCs as a source of self-antigens. Lipopolysaccharide (LPS) was used as a maturation stimulus to induce the expression of co-stimulatory molecules and secretion of cytokines. TolDCs generated from patients with SLE showed a reduced expression of co-stimulatory molecules after LPS stimulation compared with mature DCs. The same phenomenon was observed in tolDCs treated with ApoCells and LPS. In addition, ApoCell-loaded tolDCs stimulated with LPS secreted lower levels of interleukin-6 (IL-6) and IL-12p70 than mature DCs without differences in IL-10 secretion. The functionality of tolDCs was assessed by their capacity to prime allogeneic T cells. TolDCs displayed suppressor properties as demonstrated by a significantly reduced capacity to induce allogeneic T-cell proliferation and activation. ApoCell-loaded tolDCs generated from SLE monocytes have a stable immature/tolerogenic phenotype that can modulate CD4+ T-cell activation. These properties make them suitable for an antigen-specific immunotherapy for SLE.
Assuntos
Células Dendríticas/transplante , Terapia de Imunossupressão/métodos , Lúpus Eritematoso Sistêmico/terapia , Monócitos/transplante , Doadores de Tecidos , Adulto , Idoso , Autoenxertos , Células Dendríticas/imunologia , Feminino , Humanos , Interleucina-10/imunologia , Interleucina-12/imunologia , Interleucina-6/imunologia , Lipopolissacarídeos/farmacologia , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Monócitos/imunologia , Raios UltravioletaRESUMO
AIM: To evaluate the therapeutic effects of bone marrow-derived CD11b+CD14+ monocytes in a murine model of chronic liver damage. METHODS: Chronic liver damage was induced in C57BL/6 mice by administration of carbon tetrachloride and ethanol for 6 mo. Bone marrow-derived monocytes isolated by immunomagnetic separation were used for therapy. The cell transplantation effects were evaluated by morphometry, biochemical assessment, immunohistochemistry and enzyme-linked immunosorbent assay. RESULTS: CD11b+CD14+ monocyte therapy significantly reduced liver fibrosis and increased hepatic glutathione levels. Levels of pro-inflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-6 and IL-1ß, in addition to pro-fibrotic factors, such as IL-13, transforming growth factor-ß1 and tissue inhibitor of metalloproteinase-1 also decreased, while IL-10 and matrix metalloproteinase-9 increased in the monocyte-treated group. CD11b+CD14+ monocyte transplantation caused significant changes in the hepatic expression of α-smooth muscle actin and osteopontin. CONCLUSION: Monocyte therapy is capable of bringing about improvement of liver fibrosis by reducing oxidative stress and inflammation, as well as increasing anti-fibrogenic factors.
Assuntos
Terapia Baseada em Transplante de Células e Tecidos/métodos , Citocinas/metabolismo , Cirrose Hepática/terapia , Fígado/metabolismo , Monócitos/transplante , Actinas/metabolismo , Animais , Antígeno CD11b/metabolismo , Tetracloreto de Carbono/toxicidade , Separação Celular , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Etanol/toxicidade , Citometria de Fluxo , Glutationa/metabolismo , Humanos , Imuno-Histoquímica , Receptores de Lipopolissacarídeos/metabolismo , Fígado/patologia , Cirrose Hepática/induzido quimicamente , Cirrose Hepática/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Monócitos/metabolismo , Osteopontina/metabolismo , Estresse OxidativoRESUMO
Circulating monocytes (Mo) play an essential role in the host immune response to chronic infections. We previously demonstrated that CD16(pos) Mo were expanded in TB (tuberculosis) patients, correlated with disease severity and were refractory to dendritic cell differentiation. In the present study, we investigated whether human Mo subsets (CD16(neg) and CD16(pos)) differed in their ability to influence the early inflammatory response against Mycobacterium tuberculosis. We first evaluated the capacity of the Mo subsets to migrate and engage a microbicidal response in vitro. Accordingly, CD16(neg) Mo were more prone to migrate in response to different mycobacteria-derived gradients, were more resistant to M. tuberculosis intracellular growth and produced higher reactive oxygen species than their CD16(pos) counterpart. To assess further the functional dichotomy among the human Mo subsets, we carried out an in vivo analysis by adapting a hybrid mouse model (SCID/Beige, where SCID is severe combined immunodeficient) to transfer each Mo subset, track their migratory fate during M. tuberculosis infection, and determine their impact on the host immune response. In M. tuberculosis-infected mice, the adoptively transferred CD16(neg) Mo displayed a higher lung migration index, induced a stronger pulmonary infiltration of murine leucocytes expressing pro- and anti-inflammatory cytokines, and significantly decreased the bacterial burden, in comparison with CD16(pos) Mo. Collectively, our results indicate that human Mo subsets display divergent biological roles in the context of M. tuberculosis infection, a scenario in which CD16(neg) Mo may contribute to the anti-mycobacterial immune response, whereas CD16(pos) Mo might promote microbial resilience, shedding light on a key aspect of the physiopathology of TB disease.
Assuntos
Pulmão/imunologia , Monócitos/imunologia , Mycobacterium tuberculosis/imunologia , Tuberculose Pulmonar/imunologia , Animais , Carga Bacteriana , Células Cultivadas , Quimiotaxia de Leucócito , Modelos Animais de Doenças , Proteínas Ligadas por GPI/imunologia , Proteínas Ligadas por GPI/metabolismo , Interações Hospedeiro-Patógeno , Humanos , Pulmão/metabolismo , Pulmão/microbiologia , Camundongos SCID , Monócitos/classificação , Monócitos/metabolismo , Monócitos/microbiologia , Monócitos/transplante , Mycobacterium tuberculosis/crescimento & desenvolvimento , Mycobacterium tuberculosis/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Receptores de IgG/imunologia , Receptores de IgG/metabolismo , Explosão Respiratória , Fatores de Tempo , Tuberculose Pulmonar/sangue , Tuberculose Pulmonar/microbiologiaRESUMO
OBJECTIVE: Recent studies have demonstrated the therapeutic effects of bone marrow-derived cells in tissue regeneration. The aim of this study was to investigate the effects of bone marrow mononuclear cell (BMMC) transplantation in a mouse model of acute renal failure (ARF) induced by mercuric chloride. METHODS: BMMC was isolated from male BALB/c mice and injected into female mice treated with a lethal dose (LD90) of mercuric chloride. Survival rate, histopathological analysis, and assessment of urea, creatinine, sodium, potassium, and mercury levels were carried out. RESULTS: Cellular therapy with BMMC significantly reduced the mortality induced by mercuric chloride (p < 0.05). This finding correlated with a decrease in serum levels of urea (p = 0.04) and potassium (p < 0.01). However, no differences in renal morphology were observed when BMMC-treated and control group were compared. CONCLUSION: Transplanted BMMC improve renal function and reduce mortality and, therefore, may represent a new therapeutic alternative to treat ARF.
Assuntos
Injúria Renal Aguda/terapia , Transplante de Medula Óssea , Monócitos/transplante , Injúria Renal Aguda/induzido quimicamente , Animais , Modelos Animais de Doenças , Feminino , Masculino , Cloreto de Mercúrio , Camundongos , Camundongos Endogâmicos BALB CRESUMO
OBJETIVO: Avaliar o efeito da associação terapêutica entre o transplante autólogo de células-tronco e o exercício físico aquático, sobre a fração de ejeção do ventrículo esquerdo (FEVE) de ratos com disfunção ventricular pós-infarto agudo do miocárdio (IAM). MÉTODOS: Foram induzidos ao IAM, por ligadura da artéria coronária esquerda, 21 ratos Wistar. Os animais foram submetidos à ecocardiografia para avaliação da FEVE (%) e dos volumes diastólico e sistólico finais do ventrículo esquerdo (VDF, VSF, ml), randomizados e ao transplante das células-tronco mononucleares. Os animais foram divididos em quatro grupos: grupo sedentário sem células (n=5), sedentário com células (n=5), treinado sem células (n=5) e treinado com células (n=6). O treinamento físico foi iniciado 30 dias após o IAM e realizado em piscina adaptada durante 30 dias. No início e no final do protocolo de treinamento físico, foram realizadas dosagens de lactato. Os animais foram submetidos a nova ecocardiografia após 60 dias do IAM. RESULTADOS: Comparação dos valores de FEVE 30 dias e 60 dias pós-IAM, respectivamente: sedentário sem (35,20 ± 7,64% vs. 22,39 ± 4,56% P=0,026), com células (25,18 ± 7,73% vs. 23,85 ± 9,51% P=0,860) e no treinado sem (21,49 ± 2,70% vs. 20,71 ± 7,14% P=0,792), treinado com células (28,86 ± 6,68 vs. 38,43 ±7,56% P=0,062). Identificou-se a diminuição de fibras colágenas, nas regiões de fibrose miocárdica no grupo treinado com e sem células. CONCLUSÃO: A associação terapêutica entre exercício físico e o transplante autólogo de células-tronco foi benéfica contra as ações do remodelamento ventricular.
OBJECTIVE: To analyze the functional and anatomical-pathological effect of transplantation of bone marrow mononuclear cells associated to aquatic physical activity after myocardial infarction in rats. METHODS: Twenty-one rats were induced by myocardial infarction, through left coronary artery ligation. After a week, the animals were subjected to echocardiography for evaluation of left ventricle ejection fraction (LVEF, %) and dyastolic and end systolic volume of the left ventricle (EDV, ESV, ml), randomized and the transplantation of mononuclear stem cells. The animals were divided into four groups: sedentary group without cells (n=5), sedentary with cells (n=5), trained without cells (n=5) and trained with cells (n=6). The physical training was started 30 days after infarction and held in swimming during 30 days. At the beginning and at the end of the physical training protocol were held assay of lactate. The animals have been subjected to new echocardiography after 60 days of myocardial infarction. RESULTS: Two months after the transplant, were observed decrease in FE in the control group (35.2 to 23.54 P=0.022) and addition of LVEF and stabilization of ventricular remodeling in the group trained with cells (29.85 to 33.43% P=0.062 and 0.71 to 0.73 ml, P=0.776, respectively). Identified the reduction of collagen fibers, myocardial fibrosis regions in the group trained with and without cells. CONCLUSION: The group trained with cells improves ventricular function compared to the control group, suggesting the benefit of associated cell therapy will physical activity.
Assuntos
Animais , Masculino , Ratos , Transplante de Medula Óssea/fisiologia , Monócitos/transplante , Infarto do Miocárdio/cirurgia , Condicionamento Físico Animal/fisiologia , Disfunção Ventricular Esquerda/reabilitação , Remodelação Ventricular/fisiologia , Análise de Variância , Transplante de Medula Óssea/métodos , Colágeno/metabolismo , Modelos Animais de Doenças , Ácido Láctico/sangue , Infarto do Miocárdio/reabilitação , Distribuição Aleatória , Ratos Wistar , Natação/fisiologia , Transplante Autólogo , Disfunção Ventricular Esquerda/fisiopatologia , Disfunção Ventricular EsquerdaRESUMO
OBJECTIVE: To analyze the functional and anatomical-pathological effect of transplantation of bone marrow mononuclear cells associated to aquatic physical activity after myocardial infarction in rats. METHODS: Twenty-one rats were induced by myocardial infarction, through left coronary artery ligation. After a week, the animals were subjected to echocardiography for evaluation of left ventricle ejection fraction (LVEF, %) and dyastolic and end systolic volume of the left ventricle (EDV, ESV, ml), randomized and the transplantation of mononuclear stem cells. The animals were divided into four groups: sedentary group without cells (n=5), sedentary with cells (n=5), trained without cells (n=5) and trained with cells (n=6). The physical training was started 30 days after infarction and held in swimming during 30 days. At the beginning and at the end of the physical training protocol were held assay of lactate. The animals have been subjected to new echocardiography after 60 days of myocardial infarction. RESULTS: Two months after the transplant, were observed decrease in FE in the control group (35.2 to 23.54 P=0.022) and addition of LVEF and stabilization of ventricular remodeling in the group trained with cells (29.85 to 33.43% P=0.062 and 0.71 to 0.73 ml, P=0.776, respectively). Identified the reduction of collagen fibers, myocardial fibrosis regions in the group trained with and without cells. CONCLUSION: The group trained with cells improves ventricular function compared to the control group, suggesting the benefit of associated cell therapy will physical activity.
Assuntos
Transplante de Medula Óssea/fisiologia , Monócitos/transplante , Infarto do Miocárdio/cirurgia , Condicionamento Físico Animal/fisiologia , Disfunção Ventricular Esquerda/reabilitação , Remodelação Ventricular/fisiologia , Análise de Variância , Animais , Transplante de Medula Óssea/métodos , Colágeno/metabolismo , Modelos Animais de Doenças , Ácido Láctico/sangue , Masculino , Infarto do Miocárdio/reabilitação , Distribuição Aleatória , Ratos , Ratos Wistar , Natação/fisiologia , Transplante Autólogo , Ultrassonografia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
Two major subsets of human Mo are identified based on CD14 and CD16 expression: the classical CD16(-) Mo and the minor CD14(+)CD16(+) Mo. In vitro studies suggested distinct function and differentiation potential for each cell population. However, the in vivo relevance of these findings remains unclear. To evaluate the development and function of human Mo in an in vivo model, we transferred both Mo subpopulations into the peritoneum of immunocompromised mice in homeostatic or inflammatory conditions. Inflammation was induced with soluble LPS or particulate zymosan. CD16(+) were more phagocytic and produced higher amounts of TNF and IL-6 than CD16(-) Mo early after transfer with zymosan. They also produced higher levels of ß2-defensin in any condition evaluated, which could represent a new marker for this subpopulation. In contrast, differentiating CD16(-) Mo (24 h after transfer) acquired greater APC capacity in LPS-induced peritonitis, whereas none of the Mo subsets attained this ability with zymosan. CX(3)CL1 supported the survival of both Mo subsets in vivo. Similar Mo subpopulations were present in human peritonitis. These results support the idea of specialized roles of the Mo subset, where CD16(+) might act in an immediate innate immune response, whereas CD16(-) could have a major role as APCs.
Assuntos
Mediadores da Inflamação/fisiologia , Monócitos/imunologia , Monócitos/patologia , Receptores de IgG/biossíntese , Transferência Adotiva , Animais , Proteínas Ligadas por GPI/biossíntese , Proteínas Ligadas por GPI/metabolismo , Humanos , Imunidade Inata , Inflamação/imunologia , Inflamação/metabolismo , Inflamação/patologia , Lipopolissacarídeos/farmacologia , Camundongos , Camundongos SCID , Monócitos/transplante , Peritonite/imunologia , Peritonite/metabolismo , Peritonite/patologia , Receptores de IgG/metabolismo , Zimosan/farmacologiaRESUMO
AIMS: Epilepsy affects 0.5-1% of the world's population, and approximately a third of these patients are refractory to current medication. Given their ability to proliferate, differentiate and regenerate tissues, stem cells could restore neural circuits lost during the course of the disease and reestablish the physiological excitability of neurons. This study verified the therapeutic potential of bone marrow mononuclear cells (BMMCs) on seizure control and cognitive impairment caused by experimentally induced epilepsy. MAIN METHODS: Status epilepticus (SE) was induced by lithium-pilocarpine injection and controlled with diazepam 90 min after SE onset. Lithium-pilocarpine-treated rats were intravenously transplanted 22 days after SE with BMMCs obtained from enhanced green fluorescent protein (eGFP) transgenic C57BL/6 mice. Control epileptic animals were given an equivalent volume of saline or fibroblast injections. Animals were video-monitored for the presence of spontaneous recurrent seizures prior to and following the cell administration procedure. In addition, rats underwent cognitive evaluation using a Morris water maze. KEY FINDINGS: Our data show that BMMCs reduced the frequency of seizures and improved the learning and long-term spatial memory impairments of epileptic rats. EGFP-positive cells were detected in the brains of transplanted animals by PCR analysis. SIGNIFICANCE: The positive behavioral effects observed in our study indicate that BMMCs could represent a promising therapeutic option in the management of chronic temporal lobe epilepsy.
Assuntos
Transplante de Células , Transtornos Cognitivos/prevenção & controle , Epilepsia/terapia , Transtornos da Memória/prevenção & controle , Monócitos/citologia , Convulsões/prevenção & controle , Animais , Células da Medula Óssea/citologia , Doença Crônica , Transtornos Cognitivos/induzido quimicamente , Diazepam/farmacologia , Modelos Animais de Doenças , Epilepsia/complicações , Lítio/farmacologia , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Transtornos da Memória/induzido quimicamente , Camundongos , Camundongos Endogâmicos C57BL , Monócitos/transplante , Pilocarpina/farmacologia , Ratos , Ratos Wistar , Convulsões/induzido quimicamente , NataçãoRESUMO
This study tests the hypothesis that bone marrow-derived mononuclear cell (BMDMC) therapy may reduce lung inflammation and fibrosis leading to an improvement in respiratory mechanics in a murine model of silicosis. 52 female C57BL/6 mice were randomly assigned into four groups. In the silica group (SIL), silica suspension (20 mg/50 µL in saline) was intratracheally instilled. In the control animals, 50 µL saline was administered intratracheally. At 1 h, the control and SIL groups were further randomised, receiving BMDMC (2×106 i.v. control-cell and SIL-cell) or saline (50 µL i.v. control and SIL). BMDMC were obtained from male donor mice. At day 15, lung mechanics, histology, and the presence of Y chromosome, interleukin (IL)-1ß, IL-1α, IL-1 receptor antagonist (IL-1RN), IL-1 receptor type 1, transforming growth factor (TGF)-ß and caspase-3 mRNA expressions in lung tissue were analysed. In the SIL-cell group, the fraction area of granuloma, the number of macrophages and the collagen fibre content were reduced, yielding improved lung mechanics. The presence of male donor cells in lung tissue was not confirmed using detection of Y chromosome DNA. Nevertheless, caspase-3, IL-1ß, IL-1α, IL-1RN and TGF-ß mRNA expression diminished after cell therapy. In conclusion, BMDMC acted on inflammatory and fibrogenic processes improving lung function through paracrine effects.
Assuntos
Monócitos/transplante , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/terapia , Silicose/terapia , Animais , Caspase 3/análise , Feminino , Interleucina-1alfa/análise , Interleucina-1beta/análise , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Receptores de Interleucina-1/análise , Dióxido de Silício/toxicidade , Fator de Crescimento Transformador beta/análise , Cromossomo YRESUMO
BACKGROUND: Several studies have been published on the effect of bone-marrow stem cells on the left ventricle when acting on post- acute myocardial infarction remodeling. However, the results have been controversial. OBJECTIVE: To carry out an echocardiographic analysis of the systolic function of patients with acute myocardial infarction after autologous mononuclear bone marrow cell transplantation (AMBMCT) as performed via the intracoronary and intravenous routes. METHODS: This is an open-label, prospective, randomized study. INCLUSION CRITERIA: patients admitted for ST-elevation acute myocardial infarction (MI) who had undergone mechanical or chemical reperfusion within 24 hours of the onset of symptoms and whose echocardiogram showed decreased segmental wall motion and fixed perfusion defect related to the culprit artery. Autologous bone marrow was aspirated from the posterior iliac crest under sedation and analgesia of the patients randomly assigned for the treatment group. After laboratory manipulation, intracoronary or intravenous injection of 100 x 106 mononuclear cells was performed. Echocardiography (Vivid 7) was used to assess ventricular function before and three and six months after cell infusion. RESULTS: A total of 30 patients were included, 14 in the arterial group (AG), 10 in the venous group (VG), and six in the control group (CG). No statistical difference was found between the groups for the echocardiographic parameters studied. CONCLUSION: Autologous mononuclear bone marrow cell transplantation did not improve the echocardiographic parameters of systolic function.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Monócitos/transplante , Infarto do Miocárdio/cirurgia , Disfunção Ventricular Esquerda/fisiopatologia , Transplante de Medula Óssea/métodos , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sístole/fisiologia , Transplante Autólogo , Resultado do Tratamento , Ultrassonografia , Disfunção Ventricular Esquerda/diagnóstico por imagemRESUMO
FUNDAMENTO: Diversos estudos foram publicados sobre a ação de células tronco da medula óssea no ventrículo esquerdo, ao atuarem no remodelamento pós-infarto agudo do miocárdio. Os resultados, no entanto, têm se mostrado controversos. OBJETIVO: Avaliar através do ecocardiograma a função sistólica de pacientes com infarto agudo do miocárdio após o Transplante Autólogo de Células Mononucleares da Medula Óssea (TACMMO) através de duas vias injeção: intracoronariana e intravenosa. MÉTODOS: Estudo aberto, prospectivo, randomizado. Foram incluídos pacientes admitidos por infarto agudo do miocárdio (IAM) com supradesnivelamento do segmento ST e submetidos à reperfusão mecânica ou química, dentro de 24 horas após o início dos sintomas, que apresentavam ao ecocardiograma redução da contratilidade segmentar e defeito fixo da perfusão relacionada à artéria culpada pelo IAM. A medula óssea autóloga foi aspirada da crista ilíaca posterior sob sedação e analgesia, nos pacientes randomizados para o grupo tratado. Após manipulação laboratorial, 100 milhões de células mononucleares foram injetadas por via intracoronariana ou intravenosa. Utilizamos o ecocardiograma (Vivid 7) para avaliar a função ventricular antes e após três e seis meses da infusão de células. RESULTADOS: Foram incluídos trinta pacientes, 14 no grupo arterial (GA), dez no grupo venoso (GV) e seis no grupo controle (GC). Não houve diferença estatística dos parâmetros ecocardiográficos estudados entre os grupos. CONCLUSÃO: O transplante autólogo de células mononucleares da medula óssea não demonstrou melhora dos parâmetros ecocardiográficos da função sistólica.
BACKGROUND: Several studies have been published on the effect of bone-marrow stem cells on the left ventricle when acting on post- acute myocardial infarction remodeling. However, the results have been controversial. OBJECTIVE: To carry out an echocardiographic analysis of the systolic function of patients with acute myocardial infarction after autologous mononuclear bone marrow cell transplantation (AMBMCT) as performed via the intracoronary and intravenous routes. METHODS: This is an open-label, prospective, randomized study. Inclusion criteria: patients admitted for ST-elevation acute myocardial infarction (MI) who had undergone mechanical or chemical reperfusion within 24 hours of the onset of symptoms and whose echocardiogram showed decreased segmental wall motion and fixed perfusion defect related to the culprit artery. Autologous bone marrow was aspirated from the posterior iliac crest under sedation and analgesia of the patients randomly assigned for the treatment group. After laboratory manipulation, intracoronary or intravenous injection of 100 x 106 mononuclear cells was performed. Echocardiography (Vivid 7) was used to assess ventricular function before and three and six months after cell infusion. RESULTS: A total of 30 patients were included, 14 in the arterial group (AG), 10 in the venous group (VG), and six in the control group (CG). No statistical difference was found between the groups for the echocardiographic parameters studied. CONCLUSION: Autologous mononuclear bone marrow cell transplantation did not improve the echocardiographic parameters of systolic function.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Medula Óssea/efeitos adversos , Monócitos/transplante , Infarto do Miocárdio/cirurgia , Disfunção Ventricular Esquerda/fisiopatologia , Transplante de Medula Óssea/métodos , Métodos Epidemiológicos , Sístole/fisiologia , Transplante Autólogo , Resultado do Tratamento , Disfunção Ventricular EsquerdaRESUMO
Autologous bone marrow mononuclear cell (BMMC) transplantation has emerged as a potential therapeutic option for refractory angina patients. Previous studies have shown conflicting myocardium reperfusion results. The present study evaluated safety and efficacy of CellPraxis Refractory Angina Cell Therapy Protocol (ReACT), in which a specific BMMC formulation was administered as the sole therapy for these patients. The phase I/IIa noncontrolled, open label, clinical trial, involved eight patients with refractory angina and viable ischemic myocardium, without left ventricular dysfunction and who were not suitable for conventional myocardial revascularization. ReACT is a surgical procedure involving a single series of multiple injections (40-90 injections, 0.2 ml each) into ischemic areas of the left ventricle. Primary endpoints were Canadian Cardiovascular Society Angina Classification (CCSAC) improvement at 18 months follow-up and myocardium ischemic area reduction (assessed by scintigraphic analysis) at 12 months follow-up, in correlation with a specific BMMC formulation. Almost all patients presented progressive improvement in angina classification beginning 3 months (p = 0.008) postprocedure, which was sustained at 18 months follow-up (p = 0.004), as well as objective myocardium ischemic area reduction at 12 months (decrease of 84.4%, p < 0.004). A positive correlation was found between monocyte concentration and CCSAC improvement (r = -0.759, p < 0.05). Improvement in CCSAC, followed by correlated reduction in scintigraphic myocardium ischemic area, strongly suggests neoangiogenesis as the main stem cell action mechanism. The significant correlation between number of monocytes and improvement strongly supports a cell-related effect of ReACT. ReACT appeared safe and effective.
Assuntos
Angina Pectoris/terapia , Células da Medula Óssea/citologia , Monócitos/transplante , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplante Autólogo , Disfunção Ventricular Esquerda/diagnóstico , Função Ventricular EsquerdaRESUMO
We investigated red cell (RBC) alloantibodies in 125 sickle cell anemia (SCA) patients using tube indirect antiglobulin test (PEG, LISS or enzyme) and gel centrifugation test (LISS or enzyme). Prediction of clinical significance of alloantibodies was evaluated by the monocyte monolayer assay (MMA) and the chemiluminescence test (CLT) using autologous monocytes. The alloimmunization rate was 20.8% and the gel test detected a higher number of alloantibodies than the tube test (26 v 21, p = 0.02). We observed 58.3% and 69.2% positive MMA and CLT results, respectively. Eighteen (69.2%) antibodies exhibited clinical relevance, 14 (58.3%) antibodies reacted by both MMA and CLT, while 4 (15.4%) antibodies reacted only by CLT. In conclusion, the application of phagocytic cellular assays using autologous monocytes defined clinical significance of about 70% of RBC alloantibodies detected in SCA patients. The data also suggest that the CLT may be more valuable than the MMA as a noninvasive test for predicting hemolysis after transfusion of incompatible blood in SCA patients.
Assuntos
Anemia Falciforme/sangue , Anemia Falciforme/terapia , Eritrócitos/imunologia , Isoanticorpos/sangue , Transfusão de Leucócitos , Monócitos/transplante , Fagócitos/transplante , Adolescente , Adulto , Criança , Humanos , Pessoa de Meia-Idade , Monócitos/imunologia , Fagócitos/imunologia , Transplante Autólogo/imunologiaRESUMO
We studied the effect of peripheral blood mononuclear cells (PBMNC) from insulin-dependent diabetic (IDDM) children on the insulin secretion pattern of the pancreas from recipient athymic mice. PBMNC from healthy controls or IDDM patients in different stages of disease were injected into athymic mice. PBMNC from newly diagnosed IDDM children elicited basal nonfasting hyperglycemia and in vitro inhibition of the first and second phases of glucose-stimulated insulin secretion in recipient mice. Animals injected with cells from chronically IDDM children showed normoglycemia, abnormal tolerance to glucose, and inhibition of first-phase insulin secretion. Mitomycin C treatment of MNC from IDDM patients abolished insulin secretion inhibition in recipient mice. PBMNC from newly diagnosed and chronically IDDM patients showed positive anti-beta-cell cellular immune aggression. Mice injected with cells from patients during the remission period showed normoglycemia and no alteration of insulin secretion patterns. When relapsed to their former clinical stage, injection of the cells significantly inhibited first-phase glucose-induced insulin secretion in recipients. PBMNC from newly diagnosed IDDM patients were found to migrate to the pancreas of recipient mice preferably as compared with cells from controls. Cells from chronically IDDM patients cultured with concanavalin A (Con A) increased insulin secretion inhibition; despite this, cells from children during the remission period cultured with Con A failed to modify insulin secretion in recipients. These results show that injection of PBMNC from diabetic patients leads to insulin secretion impairment in recipient mice pancreas, and provide a basis for the study of mechanisms involved in the onset and modulation of anti-beta-cell cellular immune aggression induced by human PBMNC.
Assuntos
Diabetes Mellitus Tipo 1/metabolismo , Insulina/metabolismo , Monócitos/fisiologia , Monócitos/transplante , Pâncreas/metabolismo , Adolescente , Animais , Antibióticos Antineoplásicos/farmacologia , Transplante de Células , Células Cultivadas , Criança , Pré-Escolar , Concanavalina A/farmacologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/fisiopatologia , Feminino , Humanos , Insulina/sangue , Secreção de Insulina , Ilhotas Pancreáticas/citologia , Ilhotas Pancreáticas/metabolismo , Ilhotas Pancreáticas/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Mitomicina/farmacologia , Monócitos/efeitos dos fármacos , Pâncreas/citologia , Pâncreas/fisiologia , Radioimunoensaio , Ratos , Ratos WistarRESUMO
The present paper describes a mechanism responsible for the induction of inducer-phase suppressor cells effective to suppress the autoimmune response to rat male accessory glands (RAG). In fact, we reported here that marked suppression of delayed type hypersensitivity (DTH) reaction and humoral response to chemically modified rat male accessory glands (MRAG) can be obtained when previously to be immunized with MRAG in complete Freund's adjuvant (CFA) syngeneic rats were pretreated with peritoneal cells (PC) coupled with a purified fraction of RAG (containing the autoantigen). The involvement of MRAG-specific inducer-phase suppressor cells was demonstrated by adoptive transfer experiments of spleen mononuclear cells from unresponsive donors to normal syngeneic rats 24 h prior to immunization of the recipients with MRAG-CFA. The PC used to treat the animals show a large proportion of non-specific-esterase positive, Ox-41 bearing macrophage-like cells. Moreover, the antigen-coupled PC able to trigger the suppressor cells showed the presence of the autoantigen of RAG on their surface. The role of the antigen presenting cells in the induction of MRAG-specific inducer-phase suppressor cells is discussed.
Assuntos
Células Apresentadoras de Antígenos/imunologia , Autoantígenos/imunologia , Autoimunidade/fisiologia , Genitália Masculina/imunologia , Tolerância Imunológica , Macrófagos/fisiologia , Linfócitos T Reguladores/imunologia , Animais , Hipersensibilidade Tardia/imunologia , Imunização , Imunoterapia Adotiva , Masculino , Monócitos/imunologia , Monócitos/transplante , Ratos , Ratos Endogâmicos/imunologiaRESUMO
Splenocytes from Junin-virus-persistently-infected euthymic mice taken at 45 days postinfection seemed unable to induce overt signs of disease, to cause death, or to modify brain viral levels when transferred to athymic Junin-virus-infected mice. Findings differed sharply when the same recipients were transferred with splenocytes taken at 6 or 30 days postinfection from immunocompetent mice infected in adult life, since mortality reached 80 or 50%, respectively, and brain viral titers were significantly lowered. Furthermore, splenocytes taken at 6 days postinfection from whole adult mice proved harmless to persistently infected euthymic mice. These findings strongly suggest the existence of an immune system alteration in the immunocompetent mouse, attributable to Junin virus persistence. This premise is based on the fact that splenocytes from persistently infected mice were unable to recognize viral antigen expressed on recipient-infected cells. The absence or impairment of a specific cytotoxic T cell population is hereby postulated.