Regenerative concepts in cardiovascular research: novel hybrid therapy for remodeling ischemic cardiomyopathy

Rao, Prashant; Skaria, Rinku; Khalpey, Zain

doi:10.21037/jtd.2018.01.83

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Given positive results in animal model in this study, employing HPAC grafts during coronary artery bypass graft procedures would temper the inflammatory effects, thereby promoting long‐term benefit and better clinical outcomes. (Khalpey et al., 2015 ; Marsh et al., 2017 ; Rao et al., 2018 ) Although it is likely that the underlying mechanism can be attributed to HPAC being immunologically privileged and retaining the endogenous properties of the natural tissue, the specific cellular and molecular pathways remain undefined. (Khalpey et al., 2015 ; Marsh et al., 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Epicardial placement of human placental membrane protects from heart injury in a swine model of myocardial infarction

Skaria,

Lopez‐Pier,

Kathuria

et al. 2023

Physiological Reports

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Cardiac ischemic reperfusion injury (IRI) is paradoxically instigated by reestablishing blood‐flow to ischemic myocardium typically from a myocardial infarction (MI). Although revascularization following MI remains the standard of care, effective strategies remain limited to prevent or attenuate IRI. We hypothesized that epicardial placement of human placental amnion/chorion (HPAC) grafts will protect against IRI. Using a clinically relevant model of IRI, swine were subjected to 45 min percutaneous ischemia followed with (MI + HPAC, n = 3) or without (MI only, n = 3) HPAC. Cardiac function was assessed by echocardiography, and regional punch biopsies were collected 14 days post‐operatively. A deep phenotyping approach was implemented by using histological interrogation and incorporating global proteomics and transcriptomics in nonischemic, ischemic, and border zone biopsies. Our results established HPAC limited the extent of cardiac injury by 50% (11.0 ± 2.0% vs. 22.0 ± 3.0%, p = 0.039) and preserved ejection fraction in HPAC‐treated swine (46.8 ± 2.7% vs. 35.8 ± 4.5%, p = 0.014). We present comprehensive transcriptome and proteome profiles of infarct (IZ), border (BZ), and remote (RZ) zone punch biopsies from swine myocardium during the proliferative cardiac repair phase 14 days post‐MI. Both HPAC‐treated and untreated tissues showed regional dynamic responses, whereas only HPAC‐treated IZ revealed active immune and extracellular matrix remodeling. Decreased endoplasmic reticulum (ER)‐dependent protein secretion and increased antiapoptotic and anti‐inflammatory responses were measured in HPAC‐treated biopsies. We provide quantitative evidence HPAC reduced cardiac injury from MI in a preclinical swine model, establishing a potential new therapeutic strategy for IRI. Minimizing the impact of MI remains a central clinical challenge. We present a new strategy to attenuate post‐MI cardiac injury using HPAC in a swine model of IRI. Placement of HPAC membrane on the heart following MI minimizes ischemic damage, preserves cardiac function, and promotes anti‐inflammatory signaling pathways.

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