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(Circulation. 2006;113:1275-1277.)
© 2006 American Heart Association, Inc.

Editorial

You Can’t Judge a Book by Its Cover

Philippe Menasché, MD, PhD

From Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Cardiovascular Surgery, INSERM U 633, University Paris-Descartes, Faculty of Medicine, Paris, France.

Correspondence to Dr Philippe Menasché, Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France.

Key Words: Editorials • heart failure • cells • myocardial infarction • stem cells

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The current issue of Circulation reports 2 apparently conflicting studies^1,2 pertaining to the highly controversial issue of transdifferentiation of bone marrow–derived cells into cardiomyocytes. The study by Iwasaki et al¹ entailed intramyocardial injections of human CD34⁺ progenitors 20 minutes after the creation of a myocardial infarction in sex-mismatched, immunodeficient athymic mice. The results, assessed 28 days after transplantation, demonstrate a dose-dependent improvement in regional and global left ventricular function, a limitation of remodeling, and an increase in capillary density. These functional benefits are associated with a cardiac differentiation of the engrafted CD34⁺ cells demonstrated by a double immunofluorescent staining for human- and cardiac-specific markers. Expression of cardiac genes unraveled by real-time polymerase chain reaction is also taken as additional evidence for the cardiomyocytic conversion of the CD34⁺ progenitor cells, although this conclusion is compounded by the concomitant observation of fusion events between human and mouse cells demonstrated by fluorescent hybridization in situ, using probes specific for these 2 species. Differentiation of the CD34⁺ progenitors into smooth muscle and endothelial cells is also reported on the basis of similar double-staining immunofluorescent patterns. In contrast, the second article, by Gruh et al,² does not demonstrate any conversion of human endothelial progenitor cells cocultured with neonatal rat cardiomyocytes. This study has carefully deciphered the potential causes of artifacts that may arise from the use of flow cytometry and conventional 2-dimensional immunofluorescence microscopy and lead to misinterpretations of phenotypic changes incurred by transplanted cells. Indeed, even 3-dimensional confocal microscopy failed to provide a conclusive . . . [Full Text of this Article]

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