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Chachques, J.C. et al.

Chachques, Herreros, Trainini, Juffe, Rendal, Prosper, Genovese,

Autologous human serum for cell culture avoids the implantation of cardioverter-defibrillators in cellular cardiomyoplasty.

BACKGROUND: Current clinical experience with cellular cardiomyoplasty (using serum bovine-cultivated myoblasts) has demonstrated significant malignant ventricular arrhythmias and sudden deaths in patients. In some ongoing clinical trials the implantation of cardioverter-defibrillator is mandatory. We have hypothesized that contact of human cells with fetal bovine serum results after 3-week fixation of animal proteins on the cell surface, representing an antigenic substrate for immunological and inflammatory adverse events. METHODS AND RESULTS: Autologous myoblasts were transplanted into infarcted LV in 20 patients (90% males, mean age 62+/-8 years). Cells were cultivated in a complete human medium during 3 weeks, using the patients' own serum obtained from a blood sample or from plasmapheresis. Injections were performed during CABG (2.1 grafts/pt). All patients had an uneventful recovery. At a mean follow-up of 14 +/- 5 months without mortality, no malignant cardiac arrhythmias are reported. LV ejection fraction improved from 28 +/- 3% to 52 +/- 4.7% (p = 0.03), and regional wall motion score index (WMSI) from 3.1 to 1.4 (p = 0.04) in the cell-treated segments. Myocardial viability tests showed areas of regeneration. Patients moved from mean NYHA class 2.5 to class 1. 2. CONCLUSIONS: A total autologous cell culture procedure was used in cellular cardiomyoplasty reducing the risk of arrhythmia. Human-autologous-serum cell expansion avoids the risk of prion, viral or zoonoses contamination. Since patients treated with noncultivated bone marrow cells are free of arrhythmia, the bovine-culture medium seems to be responsible for this complication. Cellular cardiomyoplasty may be efficient to avoid progression of ventricular remodeling and subsequent heart failure in ischemic heart disease.[1]

References

Autologous human serum for cell culture avoids the implantation of cardioverter-defibrillators in cellular cardiomyoplasty. Chachques, J.C., Herreros, J., Trainini, J., Juffe, A., Rendal, E., Prosper, F., Genovese, J. International journal of cardiology. (2004) [Pubmed]

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