Homing miocárdico após infusão intrapericárdica de Células Mononucleares de Medula Óssea

Abstract

Bone Marrow Sampling & Cell Separation and Labeling Animals were pre-medicated with intramuscular chloridrate of ketamine (5mg/kg) and midazolam (0.5 mg/kg). Induction was performed with intravenous propofol (5mg/kg) followed by maintenance with isofluorane. A 60-ml bone marrow aspirate was obtained using a bone puncture needle introduced in iliac crest.

Regenerative therapy and tissue engineering for the treatment of end-stage cardiac failure

“…It is also reported that although the patients with heart failure have normal concentrations of SERCA II and phospholamban, the myocardial calcium uptake and calcium ATPase activity within sarcoplasmic reticulum are reduced. 33,34 This results in a weak contractile force. In short, the sarcoplasmic reticulum is unable to release enough calcium during systole as a result of insufficient calcium uptake during the previous diastole.…”

Access routes, devices and guidance methods for intrapericardial delivery in cardiac conditions

“…An epicardial introducer needle containing g contrast medium is inserted and punctures the pericardium contrast medium is then injected into the pericardial space. [7,65] The access of pericardium is confirmed with tenting at the needle site [38] and a sluggish layering of contrast medium diffusing inferiorly (downwards) observed, [38,65,66] A guidewire is then introduced into the pericardial space in exchange for the introducer needle. [65] Sosa et al performed pericardial puncture in patients using an epicardial introducer needle (Tuohy-17G) via the subxiphoid route with fluoroscopic guidance.…”

“…Branco et al also utilised the same approach, but without the continuous positive pressure, for delivery of bone marrow mononuclear cells (BMMC) in swine models. [7] The entry of the needle into pericardial space was both confirmed by injection of diluted contrast media under fluoroscopy. A floppy-tipped guidewire was then inserted into the pericardium, allowing the needle in exchange for a drug infusion catheter.…”

“…Drugs or cells that have been delivered into the intrapericardial space have been shown to diffuse across epicardium into the endocardium, penetrate the myocardium spread from the atrium to ventricle [5,6] and achieve localized and targeted action on the heart. [5][6][7][8] Moreover, owing to the slow clearance of the pericardial fluid, [9] the pericardial escape of drug is low and thus the pericardium can act as a reservoir for the drug and prolong the half-life in the heart, [10] and reduce peripheral side effects. [11] Furthermore, desired drug concentration in the myocardial tissue can be achieved with a lower dose compared with other routes, such as oral, intravenous or intracoronary delivery.…”

Intracoronary delivery of bone-marrow-derived stem cells

“…However, migration of cells across the visceral pericardium into the myocardium is necessary. Small preclinical studies suggest that such delivered BMCs home to the infarct site [24]. Little is known about the efficiency and efficacy of cells delivered via this approach and future studies will be needed to clarify its usefulness.…”