Therapeutic potential of human induced pluripotent stem cell-derived cardiac tissue in an ischemic model with unloaded condition mimicking left ventricular assist device

Daisuke Heima; Masafumi Takeda; Yasuhiko Tabata; Kenji Minatoya; Jun K Yamashita; Hidetoshi Masumoto

doi:10.1016/j.jtcvs.2023.11.019

Therapeutic potential of human induced pluripotent stem cell-derived cardiac tissue in an ischemic model with unloaded condition mimicking left ventricular assist device

J Thorac Cardiovasc Surg. 2023 Nov 21:S0022-5223(23)01095-4. doi: 10.1016/j.jtcvs.2023.11.019. Online ahead of print.

Authors

Daisuke Heima¹, Masafumi Takeda², Yasuhiko Tabata³, Kenji Minatoya⁴, Jun K Yamashita⁵, Hidetoshi Masumoto⁶

Affiliations

¹ Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan.
² Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan.
³ Department of Biomaterials, Institute for Life and Medical Sciences, Kyoto University, Kyoto, Japan.
⁴ Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁵ Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan. Electronic address: juny@m.u-tokyo.ac.jp.
⁶ Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Clinical Translational Research Program, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan. Electronic address: masumoto@kuhp.kyoto-u.ac.jp.

PMID: 37981100
DOI: 10.1016/j.jtcvs.2023.11.019

Abstract

Objective: This study aimed to explore the therapeutic potential of human induced pluripotent stem cell (hiPSC)-derived cardiac tissues (HiCTs) in the emerging approach of bridge to recovery for severe heart failure with ventricular assist devices. We used a rat model of heterotopic heart transplantation (HTx) to mimic ventricular assist device support and heart unloading.

Methods: HiCTs were created by inserting gelatin hydrogel microspheres between cell sheets made from hiPSC-derived cardiovascular cells. Male athymic nude rats underwent myocardial infarction (MI) and were divided into the following groups: MI (loaded, untreated control), MI + HTx (unloaded, untreated control), MI + HTx + HiCT (unloaded, treated), and MI + HiCT (loaded, treated). HiCTs were placed on the epicardium of the heart in treated groups. We evaluated HiCT engraftment, fibrosis, and neovascularization using histologic analysis.

Results: After 4 weeks, HiCTs successfully engrafted in 5 of 6 rats in the MI + HTx + HiCT group (83.3%). The engrafted HiCT area was greater under unloaded conditions (MI + HTx + HiCT) than loaded conditions (MI + HiCT) (P < .05). MI + HTx + HiCT had a significantly smaller infarct area compared with MI and MI + HTx. The MI + HTx + MiCT group exhibited greater vascular density in the border zone than MI and MI + HTx. HiCT treatment suppressed cardiomyocyte atrophy due to left ventricular unloading (P = .001). The protein level of muscle-specific RING finger 1, an atrophy-related ubiquitin ligase, was lower in the MI + HTx + HiCT group than in MI + HTx (P = .036).

Conclusions: Transplanting HiCTs into ischemic hearts under unloaded conditions promoted engraftment, neovascularization, attenuated infarct remodeling, and suppressed myocyte atrophy. These results suggest that HiCT treatment could contribute to future advancements in bridge to recovery.

Keywords: bridge to recovery; stem cell; ventricular assist device.