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Stem Cells

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G. Stephenson on Sep 01, 2009 Says :

Dr.Channon, congratulations for your tremendous job. it is simply a wonderfully made presentation. stem cells ppt are being widely searched. researches on stem cell transplantation are makin new discoveries and developments day to day. stem cell research or heart is what i look for. i have been hearing things about stem cell research controversy.How true is that?

john Bell on Sep 01, 2009 Says :

yes indeed, the presentation is simply the best.i am a part of my research team on stem cells loking for research cadre information on adult stem cells, blood stem cells, bone marrow step cells, cancer stem cells, embryonic and human stem cells. This presentation has helped us a lot in our research. we will be figuring out facts on stem cell nutrition, stem cell preservation, stem cell transplants and treatments.thanks for your help.

KALEEMULLAH on Aug 06, 2009 Says :

BEST EVER

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Notes

Show Notes

Slide 1 :

Stem Cells Keith Channon Department of Cardiovascular Medicine University of Oxford John Radcliffe Hospital, Oxford

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Adult Stem Cells Unique cells that are capable of self-renewal Have the ability to differentiate through a committed lineage Undergo further development within an adult organism v embryo They are multi(pluri)potent v totipotent

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Stem Cells

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N Engl J Med 2003;349:570-82. Phenotypically Characterised Adult Stem Cells

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Why are Stem Cells Relevant to Interventional Cardiology? Understanding stem cell biology challenges and informs our understanding of cardiovascular disease Stem cells may offer new therapeutic approaches in cardiovascular disease

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Multinucleate Negative for Connexin 43 Desmosomes Cadherin No integration Menasché P et al. Myoblast transplantation for heart failure. Lancet 2001 Skeletal Myoblast Cell Transplant in Ischaemic Cardiomyopathy

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Lin- c-kitPOS bone marrow cells from EGFP male mice to myocardium of female C57B6mouse Injected in peri-infarct tissue 3-5hrs after LAD ligation Nature 2001;410:701-705

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Red=Cardiac Myosin a Green=Cell Nuclei c-kit neg c-kit pos

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CD117+ CD90+ CD34– MSCs from BM male rats isolated by adhesion to polystyrene, purified by immunoselection, Transfected with murine Akt by VSV retrovirus Permanent CAL of LAD in female rats 60 mins post CAL MSCs injected 5 peri-infarct sites Nature Medicine 2003;9:1195-1201

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Engraftment does not occur in absence of MI……..

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Conclusions Bone marrow-derived lineage negative progenitors regenerate infarcted murine myocardium Autologous “skeletal lineage” progenitors improve cardiac function and survive in infarction scar

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Bone Marrow Derived Stem Cells : Vascular Injury

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Bone Marrow Derived Stem Cells : Atherosclerosis

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Bone Marrow Derived Stem Cells : Transplant Vasculopathy

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Stem Cells in Human Restenosis ? smc-actin c-kit+ Hibbert et al. Am J Physiol 2004

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Stem Cells in Human Restenosis ? smc-actin c-kit+ Hibbert et al. Am J Physiol 2004

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Nude mice 1 day post femoral artery excision Intracardiac medium, human µvascular ECs or EPCs

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Endothelial Progenitor Cells- Role in Endothelial Maintenance Jonathan Hill, 2004

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J. Hill et al. NEJM 2003; 348:593-600

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Mean ~CK 800 U/L

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TOPCARE-AMI: Late MRI follow up

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TOPCARE-AMI: Late MRI follow up

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The STIMULATE Trial Title Multicenter, randomized controlled study of transplantation of bone marrow-derived progenitor cells into infarct vessels of patients following an acute myocardial infarction, acutely re-vascularised by percutaneous intervention. Principal Investigators Prof. Dr. A. M. Zeiher & J.W. Goethe, University of Frankfurt Sponsor Cardio-Cell, Zutphen, the Netherlands (parent Cryo Cell using subsid MainGen in Frankfurt ) Monitoring CorTrial, Berlin Objective To assess the safety and efficacy of intracoronary therapy with bone marrow-derived autologous progenitor cells with respect to improvement of myocardial function after an acute myocardial infarction treated by PTCA. Design Multi-center,Randomized 1:1 Primary endpoint improvement of left ventricular dysfunction at rest and during Dobutamine stress, assessed by echocardiography at 4 months.

Slide 31 :

THE PRIMATIVE Trial Leicester Percutaneous Randomised Infusion of Marrow Aspirate To Improve Ventricular Efficiency Principal Investigators Tony Gershlick, Nilesh Samani et al. Objective Assess the safety and efficacy of intracoronary therapy with bone marrow-derived autologous progenitor cells delivered at salvage PCI (DES) after acute MI, either early or late. Design Single-center, Randomized, Placebo-Controlled n=150 Primary endpoint improvement of left ventricular function, assessed by echocardiography and cardiac MRI at 4 months, and clinical events, up to 5 years.

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Saline GM-CSF Saline GM-CSF

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EPC Colony-Forming Capacity Following G-CSF J. Hill et al. JACC 2005; in press

Slide 35 :

G-CSF and In-stent Restenosis after MI Kang et al. Lancet 2004 Patients undergoing PCI with stenting of culprit artery following MI (3 days to 9 months) randomized to G-CSF ± apheresis / IC infusion, control No AE’s associated with G-CSF treatment At 6 month F/U, improved treadmill time, LVEF, SPECT perfusion in cell infusion group In-stent restenosis determined in 7/10 G-CSF treated patients, 0/1 control Study terminated

Slide 36 :

Shirota et al. Biomaterials 2003 vWF Flk-1 LDL-Uptake Isolation of EPCs for Stent Delivery

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Stem Cells in Interventional Cardiology

Slide 40 :

Future Directions Circulating or Bone Marrow Progenitor Cells? Harvest or not, which subset? Statins Cytokine stimulation to release- e.g. CXCR4, new drugs Circulating / Bone Marrow progenitor cells clinical trials- need to be blinded, placebo controlled, with hard end points Understanding mechanisms remains critical to evaluating and targeting real benefits

	Medslides_PPT 1 Years ago. Category: Cardiology

Tags:	Cardiology

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