Evidence that human cardiac myocytes divide after myocardial infarction (Publication with Expression of Concern. See vol. 379, pg. 1870, 2018)
Evidence that human cardiac myocytes divide after myocardial infarction (Publication with Expression of Concern. See vol. 379, pg. 1870, 2018)
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DOI：
10.1056/nejm200106073442303
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发表时间：
2001-06-07
影响因子：
158.5
通讯作者：
Anversa, P
中科院分区：
文献类型：
--
作者：
Beltrami, AP;Urbanek, K;Anversa, P
背景：心肌梗死引起的心脏疤痕被解释为心脏由不能分裂的心肌细胞组成的证据。然而，最近的观察提供了成年人心脏中心肌细胞增殖的证据。因此，我们对人类心肌梗死后心肌细胞有丝分裂的程度进行了研究。方法从心肌梗死后4~12天死亡的13例患者的梗死灶边缘和远离梗死区的心肌组织中采集标本。10例正常心脏作为对照。通过标记与细胞分裂相关的核抗原Ki-67来测量进入细胞周期为细胞分裂做准备的肌细胞。测定正在进行有丝分裂的心肌细胞核的比例，并计算有丝分裂指数(进行有丝分裂的核数与未有丝分裂的核数之比)。结果心肌梗死后，4%的心肌细胞核有Ki-67表达，而远区心肌细胞核有1%的Ki-67表达。心肌细胞重新进入细胞周期后，在邻近和远离梗死区的有丝分裂指数分别为0.08%和0.33%。细胞分裂的特征事件-有丝分裂纺锤体的形成、收缩环的形成、核分裂和胞质分裂-这些特征表明心肌梗死后存在心肌细胞的增殖。结论我们的结果挑战了成人心脏是有丝分裂后器官的教条，并提高了心肌细胞再生可能有助于心肌肌肉质量增加的可能性。(N Engl J Med 2001；344：1750-7)版权所有(C)2001年马萨诸塞州医学会。
Background The scarring of the heart that results from myocardial infarction has been interpreted as evidence that the heart is composed of myocytes that are unable to divide. However, recent observations have provided evidence of proliferation of myocytes in the adult heart. Therefore, we studied the extent of mitosis among myocytes after myocardial infarction in humans.Methods Samples from the border of the infarct and from areas of the myocardium distant from the infarct were obtained from 13 patients who had died 4 to 12 days after infarction. Ten normal hearts were used as controls. Myocytes that had entered the cell cycle in preparation for cell division were measured by labeling of the nuclear antigen Ki-67, which is associated with cell division. The fraction of myocyte nuclei that were undergoing mitosis was determined, and the mitotic index (the ratio of the number of nuclei undergoing mitosis to the number not undergoing mitosis) was calculated. The presence of mitotic spindles, contractile rings, karyokinesis, and cytokinesis was also recorded.Results In the infarcted hearts, Ki-67 expression was detected in 4 percent of myocyte nuclei in the regions adjacent to the infarcts and in 1 percent of those in regions distant from the infarcts. The reentry of myocytes into the cell cycle resulted in mitotic indexes of 0.08 percent and 0.33 percent, respectively, in the zones adjacent to and distant from the infarcts. Events characteristic of cell division - the formation of the mitotic spindles, the formation of contractile rings, karyokinesis, and cytokinesis - were identified; these features demonstrated that there was myocyte proliferation after myocardial infarction.Conclusions Our results challenge the dogma that the adult heart is a postmitotic organ and raise the possibility that the regeneration of myocytes may contribute to the increase in muscle mass of the myocardium. (N Engl J Med 2001;344:1750-7.) Copyright (C) 2001 Massachusetts Medical Society.