Research ArticleBioengineering

An off-the-shelf artificial cardiac patch improves cardiac repair after myocardial infarction in rats and pigs

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Science Translational Medicine  08 Apr 2020:
Vol. 12, Issue 538, eaat9683
DOI: 10.1126/scitranslmed.aat9683

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Acellular advantage

Cell therapy for cardiac remodeling after myocardial infarction is therapeutic, in part, because of paracrine effects. Capitalizing on this, Huang et al. created acellular cardiac patches from decellularized myocardium and encapsulated factors secreted from human cardiac stromal cells. Patches retained potency after cryopreservation and improved cardiac function, reduced infarct size, and increased angiogenesis when applied to rat and pig hearts after myocardial infarction. This cell-free approach can help augment cardiac remodeling.

Abstract

Cell therapy has been a promising strategy for cardiac repair after injury or infarction; however, low retention and engraftment of transplanted cells limit potential therapeutic efficacy. Seeding scaffold material with cells to create cardiac patches that are transplanted onto the surface of the heart can overcome these limitations. However, because patches need to be freshly prepared to maintain cell viability, long-term storage is not feasible and limits clinical applicability. Here, we developed an off-the-shelf therapeutic cardiac patch composed of a decellularized porcine myocardial extracellular matrix scaffold and synthetic cardiac stromal cells (synCSCs) generated by encapsulating secreted factors from isolated human cardiac stromal cells. This fully acellular artificial cardiac patch (artCP) maintained its potency after long-term cryopreservation. In a rat model of acute myocardial infarction, transplantation of the artCP supported cardiac recovery by reducing scarring, promoting angiomyogenesis, and boosting cardiac function. The safety and efficacy of the artCP were further confirmed in a porcine model of myocardial infarction. The artCP is a clinically feasible, easy-to-store, and cell-free alternative to myocardial repair using cell-based cardiac patches.

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