Autologous human serum for cell culture avoids the implantation of cardioverter-defibrillators in cellular cardiomyoplasty

Abstract

Background: Current clinical experience with cellular cardiomyoplasty (using serum bovine-cultivated myoblasts) has demonstrated significant malignant ventricular arrhythmias and sudden deaths in patients. In some ongoing clinical trials the implantation of cardioverterdefibrillator is mandatory. We have hypothesized that contact of human cells with fetal bovine serum results after 3-week fixation of animal proteins on the cell surface, representing an antigenic substrate for immunological and inflammatory adverse events.Methods and Results: Autologous myoblasts were transplanted into infarcted LV in 20 patients (90% males, mean age 62±8 years). Cells were cultivated in a complete human medium during 3 weeks, using the patients' own serum obtained from a blood sample or from plasmapheresis. Injections were performed during CABG (2.1 grafts/pt).All patients had an uneventful recovery. At a mean follow-up of 14±5 months without mortality, no malignant cardiac arrhythmias are reported. LV ejection fraction improved from 28±3% to 52:k4.7% (p = 0.03), and regional wall motion score index (WMSI) from 3.1 to 1.4 (p = 0.04) in the cell-treated segments. Myocardial viability tests showed areas of regeneration. Patients moved from mean NYHA class 2.5 to class 1.2.Conclusions: A total autologous cell culture procedure was used in cellular cardiomyoplasty reducing the risk of arrhythmia. Human-autologous-serum cell expansion avoids the risk of prion, viral or zoonoses contamination. Since patients treated with noncultivated bone marrow cells are free of arrhythmia, the bovine-culture medium seems to be responsible for this complication. Cellular cardiomyoplasty may be efficient to avoid progression of ventricular remodeling and subsequent heart failure in ischemic heart disease.

Minimally cultured bone marrow mesenchymal stem cells ameliorate fibrotic lung injury

“…However, the requirement for cell culture processes limits its general applicability for acutely fatal diseases because of the necessity for emergency intervention. In addition, previous studies have highlighted other issues regarding the cultivation of BMMSCs, including laboratory contamination, influence on proliferating, differentiating or homing potential [2][3][4][5], and acquisition of tumorigenic properties [6,7].…”

Do Mesenchymal Stem Cells Have a Role to Play in Cutaneous Wound Healing?

“…83 In addition, life-threatening arrhythmias in cardiomyoplasty with the application of MSCs have been avoided when human autologous serum was used instead of fetal calf serum. 84 Ideally, tissue culture medium should be of sound and reproducible composition, free of animal components allowing production of large homogenic populations of MSCs in a considerably short period of time.…”

Intracoronary Stem Cell Infusion in Heart Transplant Candidates

“…Exciting results of the experimental studies have led to clinical studies which demonstrated benefit of the stem cells on left ventricular functions after acute myocardial infarction or ischemic cardiomyopathy (Chachques et al 2004;Schuster et al 2004;Ince et al 2005). Being accepted as an effective and safe way of performing stem cells into infarcted myocardial region, intracoronary infusion has become a preferable route in particularly acute MI patients (Chen et al 2004;Fernandez-Aviles et al 2004).…”