Abstract 5376: Evidence of Mobilization of Pluripotent and Very Small Embryonic-Like (VSEL) Stem Cells in Patients with Myocardial Ischemia- A Potential Therapeutic Target
Studies have shown that predestined bone marrow-derived stem cells are mobilized in acute myocardial infarction (MI). In contrast, the mobilization of pluripotent stem cells (PSCs), including Very Small Embryonic-Like stem cells (VSELs), in MI and other ischemic conditions has not been demonstrated. In this study, we sought to investigate whether PSCs such as VSELs are mobilized into peripheral blood (PB) in various clinical conditions of myocardial ischemia using a multidimensional approach employing flow cytometric, ImageStream system (ISS), and RQ-PCR analyses. PB was collected from patients with: chronic ischemic heart disease (IHD), non ST-segment elevation MI (NSTEMI), ST-segment elevation MI (STEMI), and controls. By flow cytometry, PSCs, hematopoetic stem cells and VSELs’ content was lowest in controls and highest in patients with STEMI particularly at the time of presentation (BSL) (Fig.1A⇓). A similar pattern of expression of the pluripotency marker Oct-4 was observed by ISS (Fig. 1A and 1B⇓). By RQ-PCR analyses, the expression of pluripotency markers (Oct-4 and Nanog), cardiac markers (Nkx-2.5 and GATA-4), endothelial markers (vWF and VE-Cadherin), and CXCR-4 was highest at BSL in STEMI patients (Fig. 1C⇓). Mobilization of PSCs correlated positively with the extent of myocardial injury as estimated by cardiac enzymes (R=0.72, P=0.02) and negatively with age (R= −0.64, P=0.046). This is the first comprehensive and systematic report that demonstrates that PSCs are mobilized in patients with ischemic heart disease. Mobilization of PSCs with cardiogenic potential in myocardial ischemia suggests that these cells may play a role in repair of infarcted myocardium.