Functional characterization of human umbilical cord-derived mesenchymal stem cells for treatment of systolic heart failure

Abstract

Congestive heart failure (HF) is a leading cause of morbidity and mortality worldwide. Although advances in medical therapy, mechanical support and heart transplantation have been made, almost half of all patients with HF succumb to the disease within five years of the initial diagnosis. Therefore, treatment methods need to be identified to restore the structure and function of cardiac muscle. Three patients with HF caused by ischemic cardiomyopathy received human umbilical cord-derived mesenchymal stem cell (HUC-MSC) intravenous infusion were included in the present study. Two patients demonstrated a 65.1% increase in left ventricular ejection fraction (LVEF) at the end of 3 months, which was maintained increasing 47.8% at the end of 12 months post-HUC-MSC intravenous infusion. LVEF of patient 1 decreased slowly in the observation period. This LVEF improvement was associated with significant improvements in the clinical parameters of the New York Heart Association class, and six-minute walk test in the coupled time. The third patient showed significant improvement in the six-minute walk test at the end of 12 months, while the other parameters did not change obviously. There were no severe adverse events during and post-HUC-MSC transplantation. During follow-up, no other immunosuppressive drugs were used. In conclusion, HUC-MSC therapy is a reasonable salvage treatment in HF. Future large-scale randomized clinical trials are likely to be designed to elucidate the efficacy of the HUC-MSC transplantation therapy on HF.

Extracellular vesicles derived from human Wharton’s jelly mesenchymal stem cells protect hippocampal neurons from oxidative stress and synapse damage induced by amyloid-β oligomers

“…MSCs can be obtained from a variety of tissues, including the umbilical cord [52], adipose tissue [53], dental pulp [54], and bone marrow [55]. In the current study, we successfully isolated adherent cells with MSC characteristics from human Wharton’s jelly [52, 56–58]. These cells had fibroblast-like morphology, expressed mesenchymal but not hematopoietic surface markers, and effectively differentiated into adipogenic and chondrogenic lineages (Additional file 1: Figure S1).…”

What is the impact of human umbilical cord mesenchymal stem cell transplantation on clinical treatment?

“…These cells promote cardiac tissue regeneration and angiogenesis, inhibit inflammation [ 61 ], and significantly reduce infarct size and mortality. Also, transplantation of HUC-MSCs improves the New York Heart Association functional class and the results of the Minnesota Living with Heart Failure Questionnaire and 6-min walk test, significantly improving patients’ quality of life [ 62 , 63 ]. The mechanism of HUC-MSCs’ effects on the heart is not fully understood yet, but previous studies documented that HUC-MSCs can have an anti-apoptotic function by increasing the expression of anti-apoptotic protein Bcl-2 and decreasing the expression of pro-apoptotic proteins Bax and pro-caspase-9 [ 64 ].…”

“…In this manner, the transplanted cells enhance the local contractile function of the myocardium, reduce the necrotic infracted area, and increase ejection fraction. The long-term follow-up found that the induction of blood vessel formation was also an essential part of heart repair after injury [ 63 , 64 ]. Importantly, HUC-MSCs can secrete HGF to exert anti-inflammatory effects [ 62 ].…”

Cell-Based Therapies for Cardiac Regeneration: A Comprehensive Review of Past and Ongoing Strategies

“…Based on these encouraging results, the use of umbilical cord-derived stem cells was also tested in humans to develop a possible new clinical application for cardiac regeneration. The main scope of these trials was first the safety of the allogeneic transplant of the UC-MSCs: interestingly, no severe adverse effects were observed [ 133 , 134 , 135 ]. Then, four clinical trials included a control group in order to assess a potential therapeutic effect of the UC-MSCs ( Table 7 ).…”