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Heart 93:1278-1284 doi:10.1136/hrt.2006.093161
  • Original research
  • Basic research

Human embryonic stem cell transplantation to repair the infarcted myocardium

  1. Jonathan Leor1,
  2. Sharon Gerecht2,
  3. Smadar Cohen3,
  4. Liron Miller1,
  5. Radka Holbova1,
  6. Anna Ziskind2,
  7. Michal Shachar3,
  8. Micha S Feinberg1,
  9. Esther Guetta4,
  10. Joseph Itskovitz-Eldor2
  1. 1
    Neufeld Cardiac Research Institute, Sheba Medical Centre, Tel-Aviv University, Tel-Hashomer, Israel
  2. 2
    Faculty of Medicine, Technion, Department of Obstetrics and Gynaecology, Rambam Medical Centre, Haifa, Israel
  3. 3
    Department of Biotechnology Engineering and the Institute for Applied Biosciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
  4. 4
    Danek Gertner Institute of Human Genetics, Sheba Medical Centre, Tel-Aviv University, Tel-Hashomer, Israel
  1. Dr J Leor, Neufeld Cardiac Research Institute, Sheba Medical Centre, Tel-Hashomer 52621, Israel; leorj{at}post.tau.ac.il
  • Accepted 21 November 2006
  • Published Online First 12 June 2007

Abstract

Objective: To test the hypothesis that human embryonic stem cells (hESCs) can be guided to form new myocardium by transplantation into the normal or infarcted heart, and to assess the influence of hESC-derived cardiomyocytes (hESCMs) on cardiac function in a rat model of myocardial infarction (MI).

Methods: Undifferentiated hESCs (0.5–1×106), human embryoid bodies (hEBs) (4–8 days; 0.5–1×106), 0.1 mm pieces of embryonic stem-derived beating myocardial tissue, and phosphate-buffered saline (control) were injected into the normal or infarcted myocardium of athymic nude rats (n = 58) by direct injection into the muscle or into preimplanted three-dimensional alginate scaffold. By 2–4 weeks after transplantation, heart sections were examined to detect the human cells and differentiation with fluorescent in situ hybridisation, using DNA probes specific for human sex chromosomes and HLA-DR or HLA-ABC immunostaining.

Results: Microscopic examination showed transplanted human cells in the normal, and to a lesser extent in the infarcted myocardium (7/7 vs 2/6; p<0.05). The transplanted hESCs and hEBs rarely created new vessels and did not form new myocardium. Transplantation of hESCM tissue into normal heart produced islands of disorganised myofibres, fibrosis and, in a single case, a teratoma. However, transplantation of hESCMs into the infarcted myocardium did prevent post-MI dysfunction and scar thinning.

Conclusions: Undifferentiated hESCs and hEBs are not directed to form new myocardium after transplantation into normal or infarcted heart and may create teratoma. Nevertheless, this study shows that hESC-derived cardiomyocyte transplantation can attenuate post-MI scar thinning and left ventricular dysfunction.

Footnotes

  • Conflict of interest: None declared.

  • Abbreviations:
    ES
    embryonic stem
    FISH
    fluorescent in situ hybridisation
    hEBs
    human embryoid bodies
    hESCs
    human embryonic stem cells
    hESCMs
    hESC-derived cardiomyocytes
    LV
    left ventricular
    MI
    myocardial infarction
    MHC
    myosin heavy chain
    PBS
    phosphate-buffered saline