This study analyzed the regenerative ability of cardiac muscle in the rat. Normal cardiac muscle from the rat was minced into one mm 3 fragments and homotransplanted into a gastrocnemius cavity of a non-sibling rat. At 45 days post surgery the regenerated tissue was removed and histological characteristics and oxidative capacity of the tissue were regenerate revealed the presence of myofibers. These myofibers of the cardiac regenerate typically exhibited centrally located, large, oval nuclei and branching. Both of these histological characteristics are typical of normal cardiac muscle. The absence of definitive intercalated discs though precluded conclusive identification of the myofibers of the cardiac regenerate as cardiac myofibers. The oxidative data showed that the cardiac regenerate consumed oxygen at a rate of 2.69X103 ± 2.96X102 (SE)y1 02/g X hr-1 this was found to be 4.9 times lower than normal cardiac tissue. The reason for this diminution is attributed to the observatiBall State UniversityMuncie, IN 47306

Mesenchymal stem cell (MSC) transplantation has achieved only modest success in the treatment of ischemic heart disease due to poor cell viability in the diseased microenvironment. Genetic manipulation on the MSCs holds promising prospects in enhancing cell tolerance against adverse environmental conditions. Recent studies demonstrate that the activation of the NRG1 (neuregulin 1) - ERBB4 (v-erb-b2 avian erythroblastic leukemia viral oncogene homolog 4) pathway can enhance pro-survival signaling, stimulate mature cardiomyocyte cell cycle re-entry and cell division. In this study, I aimed to determine whether activating NRG1-ERBB4 in MSCs can enhance their cardioprotective effects following myocardial infarction. In chapter 3, I determined that MSC endogenously expresses NRG1, but not ERBB4. Considering the absence of ERBB4 in the MSCs might lead to mute response to its ligand NRG1, I exogenously manipulated ERBB4 into MSCs. In chapter 4, MSCs, with or without ERBB4 overexpression were transplanted into mice following myocardial infarction. The transplantation of MSCs with ERBB4 expression considerably improved left ventricular ejection fraction and reduced infarctsize, compared to unmodified MSCs and direct NRG1 injection. ERBB4 overexpression induced greater MSC survival following infarction. The transduction of ERBB4 in MSCs increased cell mobility and apoptotic resistance via a PI3K/Akt pathway under hypoxic conditions in the presence of NRG1. The transplantation of MSCs with ERBB4 expression induced cardiomyocyte division and protected them against apoptosis during early phase of infarction. In chapter 5, a novel autocrine loop regarding to NRG1-ERBB4-NRG1 signaling was identified. MSCs with ERBB4 overexpression in turn increased NRG1 synthesis and secretion. Conditioned medium of ERBB4-expressing MSCs containing elevated NRG1, promoted cardiomyocyte growth, division and anti-senescence, whereas neutralization of NRG1 blunted these effects. Injecting ERBB4-expressing MSCs restored NRG1 in the infarcted myocardium to a level comparable with that of the normal myocardium. These findings collectively suggest overexpressing ERBB4 in MSCs enhances the effectiveness of MSCtherapy following myocardial in farction through potentiating MSC survival and revitalizing endogenous repair and regeneration. The combination of ERBB4 and MSC is more efficient than naïve MSC or solely recombinant NRG1 injection, emerging as potential target for developing novel strategy in treating myocardial diseases. / published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / Medicine / Doctoral / Doctor of Philosophy

Cardiovascular diseases are the leading cause of death throughout the world and various estimates predict that heart disease will remain the number one killer in the world. Pharmacotherapies have not shown significant long term survival benefits to the patients, therefore alternate therapeutic strategies such as bioactive agent delivery and cell therapy based approaches are being investigated. One of the major causes of heart failure is the disease progression after an ischemic event and any successful therapy will be needed over the course of several days/weeks. Oxidative stress is greatly increased in the myocardium following infarction. This plays a significant role in cardiac disease progression and it has also been implicated in the failure of implanted cell therapy. Therefore, reducing oxidative stress in damaged tissue using antioxidants may have broad clinical implications for both the treatment of cardiac dysfunction and for cardiac regeneration applications. This dissertation work examines the effect of sustained delivery of endogenous antioxidant superoxide dismutase (SOD) to the rat myocardium following ischemia/reperfusion (IR) using polyketal polymers as drug carriers. The second major objective of this dissertation is to examine the effects of oxidative stress on cardiac progenitor cells - a promising endogenous adult stem cell in cardiac cell therapy applications

Heart failure is the leading cause of death worldwide. In 2013, the American Heart Association estimated that one American will die of cardiovascular disease every 39 seconds. While heart transplantation is the most viable treatment option, the limited availability of donor hearts has necessitated the search for treatment alternatives such as the use of adult stem cells for cardiac repair and regeneration. Following myocardial infarction (MI), the inflammatory cardiac microenvironment, limited survival of stem/progenitor cells, myocardial scarring and fibrosis affect cardiac regeneration. This dissertation examines adult stem cell based approaches for cardiac regeneration by studying the effect of i) H₂O₂- mediated oxidative stress on mesenchymal stem cells, ii) Notch1 activation in cardiac progenitor cells using a self-assembling peptide hydrogel containing the Notch1 ligand mimic RJ in vitro and functional consequences in a rat model of MI. Through these approaches, the central hypothesis that modulation of stem cell response using cues such as oxidative stress and activation of Notch1 signaling can improve functional outcome following myocardial infarction has been studied.

Thesis (PhD (Physiology (Human and animal))-- University of Stellenbosch, 2007. / Definition: Stem cells are unspecialised cells with the capacity for long-term self-renewal and the ability to differentiate into multiple cell-lineages. The potential for the application of stem cells in clinical settings has had a profound effect on the future of regenerative medicine. However, to be of greater therapeutic use, selection of the most appropriate cell type, as well as optimisation of stem cell incorporation into the damaged tissue is required. In adult skeletal muscle, satellite cells are the primary stem cell population which mediate postnatal muscle growth. Following injury or in diseased conditions, these cells are activated and recruited for new muscle formation. In contrast, the potential of resident adult stem cell incorporation into the myocardium has been challenged and the response of cardiac tissue, especially to ischaemic injury, is scar formation. Following muscle damage, various growth factors and cytokines are released in the afflicted area which influences the recruitment and incorporation of stem cells into the injured tissue. Transforming Growth Factor-β (TGF-β) is a member of the TGF-β-superfamily of cytokines and has at least three isoforms, TGF-β1, -β2, and -β3, which play essential roles in the regulation of cell growth and regeneration following activation and stimulation of receptor-signalling pathways. By improving the understanding of how TGF-β affects these processes, it is possible to gain insight into how the intercellular environment can be manipulated to improve stem cell-mediated repair following muscle injury. Therefore, the main aims of this thesis were to determine the effect of the three TGF-β isoforms on proliferation, differentiation, migration and fusion of muscle progenitor cells (skeletal and cardiac) and relate this to possible improved mechanisms for muscle repair. The effect of short- and long-term treatment with all three TGF-β isoforms were investigated on muscle progenitor cell proliferation and differentiation using the C2C12 skeletal muscle satellite and P19 multipotent embryonal carcinoma cell-lineages as in vitro model systems. Cells were treated with 5 ng/mℓ TGF-β isoforms unless where stated otherwise. In C2C12 cells, proliferating cell nuclear antigen (PCNA) expression and localisation were analysed, and together with total nuclear counts, used to assess the effect of TGF-β on myoblast proliferation (Chapter 5). The myogenic regulatory factors MyoD and myogenin, and structural protein myosin heavy chain (MHC) were used as protein markers to assess early and terminal differentiation, respectively. To establish possible mechanisms by which TGF-β isoforms regulate differentiation, further analysis included determination of MyoD localisation and the rate of MyoD degradation in C2C12 cells. To assess the effect of TGF-β isoforms on P19 cell differentiation, protein expression levels of connexin-43 and MHC were analysed, together with the determination of embryoid body numbers in differentiating P19 cells (Chapter 6). Furthermore, assays were developed to analyse the effect of TGF-β isoforms on both C2C12 and P19 cell migration (Chapter 7), as well as fusion of C2C12 cells (Chapter 8). Whereas all three isoforms of TGF-β significantly increased proliferation of C2C12 cells, differentiation results, however, indicated that especially following long-term incubation, TGF-β isoforms delayed both early and terminal differentiation of C2C12 cells into myotubes. Similarly, myocyte migration and fusion were also negatively regulated following TGF-β treatment. In the P19 cell-lineage, results demonstrated that isoform-specific treatment with TGF-β1 could potentially enhance differentiation. Further research is however required in this area, especially since migration was greatly reduced in these cells. Taken together, results demonstrated variable effects following TGF-β treatment depending on the cell type and the duration of TGF-β application. Circulating and/or treatment concentrations of this growth factor could therefore be manipulated depending on the area of injury to improve regenerative processes. Alternatively, when selecting appropriate stem or progenitor cells for therapeutic application, the effect of the immediate environment and subsequent interaction between the two should be taken into consideration for optimal beneficial results.