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Quantification of the decline of heart muscle cell proliferation and its reversal in pediatric patients

儿科患者心肌细胞增殖下降及其逆转的量化

基本信息

批准号：
10625836
负责人：
Bernhard Kuhn
金额：
$ 41.55万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-15 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10625836
关键词：
Affect Age Anatomy Biology Birth Cardiac Cardiac Myocytes Cell Cycle Cell Cycle Arrest Cell Proliferation Cell division Cells Child Childhood Clinical Clinical Research Congenital Abnormality DNA Data Development Diagnosis Dilated Cardiomyopathy Disease Elements Enrollment Excision Funding Gastrointestinal tract structure Heart Heart Diseases Heart Transplantation Heart failure Human Human body Infant Institutional Review Boards Isotopes Label Life Measures Mechanics Medicine Methods Morbidity - disease rate Myocardium Natural regeneration Neonatal Newborn Infant Observational Study Obstruction Operative Surgical Procedures Organ Pathologist Patients Pattern Population Prevention Proliferating Protocols documentation Publishing Research Research Design Resected Right ventricular structure S phase Scientist Skin Surgeon Testing Tetralogy of Fallot Thymidine Time Tissue Sample Tissues Transplantation Ventricular Visualization Withdrawal Workload age group cardiac regeneration cardiogenesis cell regeneration congenital heart disorder experience first-in-human improved innovation left ventricular assist device mass spectrometric imaging mechanical circulatory support mortality muscle regeneration neonate novel therapeutics offspring pediatric cardiologist pediatric patients postnatal premature prevent prospective regenerative approach regenerative therapy repaired stable isotope

项目摘要

ABSTRACT: Heart failure continues to be a leading cause of mortality and morbidity. Understanding the basic mechanisms of heart regeneration in humans and stimulating them would improve the lives of many patients. Proliferation of heart muscle cells (cardiomyocytes) is essential for heart development and regeneration. After birth, the proliferative potential of cardiomyocytes declines, but neonatal mammalian hearts are thought to maintain the ability to regenerate until cardiomyocytes undergo permanent cell cycle arrest, establishing a barrier for regeneration. Strategies for stimulating cardiomyocyte proliferation are under development and would be most effective when initiated before cardiomyocytes withdraw permanently from the cell cycle. However, the point at which cardiomyocyte proliferation ceases in humans is controversial; some studies place this point before birth, some in the first year after birth, and our data demonstrate cardiomyocyte proliferation extending well into childhood, i.e., the first 10 – 20 years of life. This picture is further complicated by our published and unpublished results suggesting that infants with congenital heart disease (CHD) have decreased cardiomyocyte proliferation. Resolving how age and heart disease alter the temporal pattern of cardiomyocyte cell cycle withdrawal is an essential problem in cardiac biology. Improved understanding of cardiomyocyte proliferation will be critical for developing new regenerative strategies to prevent and treat heart failure in patients with cyanotic CHD, the most common birth defect affecting 0.3% of newborns. We will determine when cardiomyocyte proliferation decreases in pediatric patients by investigating two leading cardiac diseases: tetralogy of Fallot (ToF), the most common form of cyanotic congenital heart disease (CHD), which affects 0.3% of newborns, and dilated cardiomyopathy (DCM), the most common cause for heart transplantation in the pediatric age group. Our central hypothesis is that cardiomyocyte proliferation shows an age- and disease-dependent decline. We will enroll neonates, infants, and children to quantify cardiomyocyte proliferation. We have formed a research team consisting of pediatric cardiologists and cardiac surgeons, pathologists, and basic scientists. The critical element of our approach is the use of a highly innovative method in which we will label patients with innocuous thymidine carrying stable isotope markers (15N-thymidine and 2H- thymidine). Cells in S-phase of the cell cycle incorporate thymidine into their DNA, and their offspring retain the label for at least 6 cell divisions. We will visualize the isotope in post-surgical tissue samples with an innovative method: Multi-isotope imaging mass spectrometry (MIMS) to quantify cardiomyocyte proliferation and differentiation. Preliminary data from our first study patient with ToF provide first-in-human results and validate our approach.

抽象的：心力衰竭仍然是死亡和发病的主要原因。了解基本机制人类心脏再生并刺激它们将改善许多患者的生活。扩散心肌细胞（心肌细胞）对于心脏发育和再生至关重要。出生后，心肌细胞的增殖潜力下降，但新生哺乳动物的心脏被认为可以维持再生能力，直到心肌细胞经历永久性细胞周期停滞，从而建立屏障再生。刺激心肌细胞增殖的策略正在开发中，并且将是最重要的在心肌细胞永久退出细胞周期之前启动时有效。然而，这一点在哪种心肌细胞在人类中停止增殖是有争议的；一些研究将这一点放在出生前，有些是在出生后的第一年，我们的数据表明心肌细胞增殖一直延伸到童年，即生命的最初 10 至 20 年。我们发布的和未发表的结果表明患有先天性心脏病 (CHD) 的婴儿已减少心肌细胞增殖。解决年龄和心脏病如何改变心肌细胞的时间模式细胞周期退出是心脏生物学中的一个重要问题。增进对心肌细胞的了解增殖对于开发新的再生策略来预防和治疗心力衰竭至关重要紫绀型 CHD 患者是最常见的出生缺陷，影响 0.3% 的新生儿。我们将确定通过调查两种主要心脏病，当儿科患者的心肌细胞增殖减少时：法洛四联症 (ToF)，最常见的紫绀型先天性心脏病 (CHD)，影响 0.3% 的新生儿和扩张型心肌病 (DCM) 是心脏移植的最常见原因儿科年龄组。我们的中心假设是心肌细胞增殖表现出年龄和疾病依赖性衰退。我们将招募新生儿、婴儿和儿童来量化心肌细胞增殖。我们组建了一个由儿科心脏病专家和心脏外科医生组成的研究团队，病理学家和基础科学家。我们方法的关键要素是使用高度创新的方法其中我们将用携带稳定同位素标记物（15N-胸苷和 2H- 胸苷）。处于细胞周期 S 期的细胞将胸苷掺入其 DNA 中，并且其后代保留了胸苷至少 6 次细胞分裂的标签。我们将通过创新的方法可视化术后组织样本中的同位素方法：多同位素成像质谱法（MIMS）量化心肌细胞增殖和差异化。我们第一位患有 ToF 的研究患者的初步数据提供了首次在人类中的结果，验证我们的方法。