Granulocyte‐colony stimulating factor administration after myocardial infarction in a porcine ischemia‐reperfusion model: Functional and pathological effects of dose timing

Background: Acute MI results in cardiomyocyte death, left ventricular (LV) dysfunction and adverse remodeling. The use of growth factors may prevent this. The aim of this study was to assess early and delayed administration of granulocyte colony‐stimulating factor (G‐CSF) in a porcine model of myocardial infarction (MI) and reperfusion.Methods: MI was induced by balloon occlusion followed by reperfusion. There were 3 groups: Control (n = 11), Early (n = 17), and Delayed treatment (n = 8). The Early group received G‐CSF 10 μg/kg/d every other day for 20 days beginning immediately. The Delayed group received G‐CSF 10 μg/kg/d daily for 10 days beginning on day 5. Magnetic resonance imaging was performed on days 5 and 56. LV end‐diastolic volumes (EDV), end‐systolic volumes, ejection fraction, expansion index, sphericity index, thinning ratio, and infarct mass were calculated. Histology was analyzed at 56 days. Results: At 56 days the change in EDV was 53% less in the Early (p = 0.005) and 24% greater in the Delayed (p = NS) group versus Control. The Delayed group also showed a 60% increase in normalized infarct mass (p = 0.055) and an 88% increase in expansion index (p = 0.003). Both groups had significantly less capillary density in the infarct border zone. The Delayed also had decreased arteriolar density in the mid scar. Conclusions: Early treatment with G‐CSF after MI decreases ventricular dilatation, while delayed treatment has a deleterious effect on LV remodeling. This may be related to changes in myocardial vascularity. The effects of G‐CSF therapy and its dose timing help to elucidate the results of recent human trials. © 2006 Wiley‐Liss, Inc.

[1]  Katherine C. Wu,et al.  Quantification and time course of microvascular obstruction by contrast-enhanced echocardiography and magnetic resonance imaging following acute myocardial infarction and reperfusion. , 1998, Journal of the American College of Cardiology.

[2]  P. Merlet,et al.  Influence of mobilized stem cells on myocardial infarct repair in a nonhuman primate model. , 2003, Blood.

[3]  M. Schwaiger,et al.  Stem cell mobilization by granulocyte colony-stimulating factor in patients with acute myocardial infarction: a randomized controlled trial. , 2006, JAMA.

[4]  Emmanuel Messas,et al.  Transplantation of cardiac-committed mouse embryonic stem cells to infarcted sheep myocardium: a preclinical study , 2005, The Lancet.

[5]  C. Nienaber,et al.  Preservation From Left Ventricular Remodeling by Front-Integrated Revascularization and Stem Cell Liberation in Evolving Acute Myocardial Infarction by Use of Granulocyte-Colony–Stimulating Factor (FIRSTLINE-AMI) , 2005, Circulation.

[6]  R. Kim,et al.  Early Assessment of Myocardial Salvage by Contrast-Enhanced Magnetic Resonance Imaging , 2000, Circulation.

[7]  M. Entman,et al.  Regeneration of ischemic cardiac muscle and vascular endothelium by adult stem cells. , 2001, The Journal of clinical investigation.

[8]  M. Pfeffer,et al.  Ventricular Remodeling After Myocardial Infarction: Experimental Observations and Clinical Implications , 1990, Circulation.

[9]  Gusto Angiographic Investigators The effects of tissue plasminogen activator, streptokinase, or both on coronary-artery patency, ventricular function, and survival after acute myocardial infarction. , 1993, The New England journal of medicine.

[10]  James T. Willerson,et al.  Transdifferentiation of Human Peripheral Blood CD34+-Enriched Cell Population Into Cardiomyocytes, Endothelial Cells, and Smooth Muscle Cells In Vivo , 2003, Circulation.

[11]  R. Kloner,et al.  Granulocyte colony-stimulating factor and stem cell factor improve contractile reserve of the infarcted left ventricle independent of restoring muscle mass. , 2005, Journal of the American College of Cardiology.

[12]  M. Harmsen,et al.  Signaling factors in stem cell-mediated repair of infarcted myocardium. , 2005, Journal of molecular and cellular cardiology.

[13]  Michael Lill,et al.  Stem cell transplantation for myocardial infarction? , 2004, Reviews in cardiovascular medicine.

[14]  Winfried Brenner,et al.  Assessment of the Tissue Distribution of Transplanted Human Endothelial Progenitor Cells by Radioactive Labeling , 2003, Circulation.

[15]  I. Komuro,et al.  Cytokine therapy prevents left ventricular remodeling and dysfunction after myocardial infarction through neovascularization , 2004, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[16]  L. Tavazzi,et al.  Heterogeneity of left ventricular remodeling after acute myocardial infarction: results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-3 Echo Substudy. , 2001, American heart journal.

[17]  M. Arai,et al.  Acceleration of the Healing Process and Myocardial Regeneration May Be Important as a Mechanism of Improvement of Cardiac Function and Remodeling by Postinfarction Granulocyte Colony–Stimulating Factor Treatment , 2004, Circulation.

[18]  Hyun-Jai Cho,et al.  Effects of intracoronary infusion of peripheral blood stem-cells mobilised with granulocyte-colony stimulating factor on left ventricular systolic function and restenosis after coronary stenting in myocardial infarction: the MAGIC cell randomised clinical trial , 2004, The Lancet.

[19]  J. Ottervanger,et al.  Long-term benefit of primary angioplasty compared to thrombolytic therapy for acute myocardial infarction. , 2000, European heart journal.

[20]  I. Komuro,et al.  Cardioprotective effects of granulocyte colony-stimulating factor in swine with chronic myocardial ischemia. , 2006, Journal of the American College of Cardiology.

[21]  Eric J Topol,et al.  Effect of stromal-cell-derived factor 1 on stem-cell homing and tissue regeneration in ischaemic cardiomyopathy , 2003, The Lancet.

[22]  The effects of tissue plasminogen activator, streptokinase, or both on coronary-artery patency, ventricular function, and survival after acute myocardial infarction. , 1993, The New England journal of medicine.

[23]  A. Neskovic,et al.  Left Ventricular Remodeling After Primary Coronary Angioplasty: Patterns of Left Ventricular Dilation and Long-Term Prognostic Implications , 2002, Circulation.

[24]  M. Entman,et al.  The inflammatory response in myocardial infarction. , 2002, Cardiovascular research.

[25]  H. Tillmanns,et al.  Long-term follow-up after direct percutaneous transluminal coronary angioplasty for acute myocardial infarction. , 1998, Journal of the American College of Cardiology.

[26]  R. Kim,et al.  Contrast-enhanced magnetic resonance imaging of myocardium at risk: distinction between reversible and irreversible injury throughout infarct healing. , 2000, Journal of the American College of Cardiology.

[27]  J. Finn,et al.  Heart failure: evaluation of cardiopulmonary transit times with time-resolved MR angiography. , 2003, Radiology.

[28]  C. Nienaber,et al.  Prevention of Left Ventricular Remodeling With Granulocyte Colony-Stimulating Factor After Acute Myocardial Infarction: Final 1-year Results of the Front-Integrated Revascularization and Stem Cell Liberation in Evolving Acute Myocardial Infarction by Granulocyte Colony-Stimulating Factor (FIRSTLINE- , 2005, Circulation.

[29]  Wolfgang G Rehwald,et al.  Infarct resorption, compensatory hypertrophy, and differing patterns of ventricular remodeling following myocardial infarctions of varying size. , 2004, Journal of the American College of Cardiology.

[30]  S. Kajigaya,et al.  Effects of recombinant murine granulocyte colony-stimulating factor on granulocyte-macrophage and blast colony formation. , 1987, Experimental hematology.

[31]  I. Komuro,et al.  G-CSF prevents cardiac remodeling after myocardial infarction by activating the Jak-Stat pathway in cardiomyocytes , 2005, Nature Medicine.

[32]  T. Murohara,et al.  Mobilization of Endothelial Progenitor Cells in Patients With Acute Myocardial Infarction , 2001, Circulation.

[33]  H. Johnsen,et al.  Stem Cell Mobilization Induced by Subcutaneous Granulocyte-Colony Stimulating Factor to Improve Cardiac Regeneration After Acute ST-Elevation Myocardial Infarction: Result of the Double-Blind, Randomized, Placebo-Controlled Stem Cells in Myocardial Infarction (STEMMI) Trial , 2006, Circulation.

[34]  I. Komuro,et al.  Effects of G-CSF on cardiac remodeling after acute myocardial infarction in swine. , 2004, Biochemical and biophysical research communications.

[35]  O. Simonetti,et al.  Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. , 1999, Circulation.

[36]  J. Lévesque,et al.  Disruption of the CXCR4/CXCL12 chemotactic interaction during hematopoietic stem cell mobilization induced by GCSF or cyclophosphamide. , 2003, The Journal of clinical investigation.

[37]  A. Neskovic,et al.  Left Ventricular Remodeling After Primary Coronary Angioplasty , 2002 .

[38]  P. Doevendans,et al.  Transplantation of cells for cardiac repair. , 2003, Journal of the American College of Cardiology.

[39]  S. Singhal,et al.  Comparison of marrow and blood cell yields from the same donors in a double-blind, randomized study of allogeneic marrow vs blood stem cell transplantation , 2000, Bone Marrow Transplantation.

[40]  S. Ogawa,et al.  Granulocyte colony-stimulating factor attenuates early ventricular expansion after experimental myocardial infarction. , 2005, Cardiovascular research.