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Disease-modifying bioactivity of intravenous cardiosphere-derived cells and exosomes in mdx mice
Russell G. Rogers, … , Michael I. Lewis, Eduardo Marbán
Russell G. Rogers, … , Michael I. Lewis, Eduardo Marbán
Published April 4, 2019
Citation Information: JCI Insight. 2019;4(7):e125754. https://doi.org/10.1172/jci.insight.125754.
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Research Article Muscle biology Stem cells

Disease-modifying bioactivity of intravenous cardiosphere-derived cells and exosomes in mdx mice

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Abstract

Dystrophin deficiency leads to progressive muscle degeneration in Duchenne muscular dystrophy (DMD) patients. No known cure exists, and standard care relies on the use of antiinflammatory steroids, which are associated with side effects that complicate long-term use. Here, we report that a single intravenous dose of clinical-stage cardiac stromal cells, called cardiosphere-derived cells (CDCs), improves the dystrophic phenotype in mdx mice. CDCs augment cardiac and skeletal muscle function, partially reverse established heart damage, and boost the regenerative capacity of skeletal muscle. We further demonstrate that CDCs work by secreting exosomes, which normalize gene expression at the transcriptome level, and alter cell signaling and biological processes in mdx hearts and skeletal muscle. The work reported here motivated the ongoing HOPE-2 clinical trial of systemic CDC delivery to DMD patients, and identifies exosomes as next-generation cell-free therapeutic candidates for DMD.

Authors

Russell G. Rogers, Mario Fournier, Lizbeth Sanchez, Ahmed G. Ibrahim, Mark A. Aminzadeh, Michael I. Lewis, Eduardo Marbán

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Figure 2

Biological effects of CDC or EXO treatment in mdx mouse hearts.

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Biological effects of CDC or EXO treatment in mdx mouse hearts.
(A) Tran...
(A) Transcriptome analysis of vehicle, cardiosphere-derived cell–treated (CDC-treated), and CDC-derived exosome–treated (EXO-treated) mdx hearts using 2-dimensional hierarchical clustering of genes with at least 1.5-fold change between WT/vehicle, CDC/vehicle, and EXO/vehicle. Both CDC and EXO treatment reversed the transcriptomic profile and partially normalized gene expression. (B) Representative NF-κB immunoblot and quantification of NF-κB phosphorylation in mdx hearts (n = 5 per group). Both CDC and EXO treatment reduced NF-κB phosphorylation. (C) Pooled data of CD68+ pixels from D reveal that CDC and EXO treatment reduces macrophage abundance (n = 6 per group). (D) Immunohistochemical staining for CD68 and α-sarcomeric actinin (α-SA) in vehicle-, CDC-, and EXO-treated mdx hearts. Scale bars: 50 μm. (E) Colorimetric analysis of protein-carbonyl adducts reveal normalization by CDC and EXO treatment (n = 7–11 per group). (F) Pooled data of Ki-67+ cardiomyocytes from F reveal that CDC and EXO treatment induces cardiomyocyte proliferation (n = 6 per group). (G) Immunohistochemical staining for Ki-67 and α-SA in vehicle-, CDC-, and EXO-treated mdx hearts. Scale bars: 50 μm. (H) Representative immunoblot of mitochondrial electron transport chain complex subunits. (I) Pooled data from H reveal that CDC and EXO treatment restores the protein levels of complexes involved in oxidative phosphorylation (OXPHOS) (n = 5–6 per group). Bar graphs depict mean ± SEM. Statistical significance was determined by ANOVA with P ≤ 0.05. When appropriate, a Newman-Keuls correction for multiple comparisons was applied. *Significantly different from WT; #significantly different from vehicle. Dashed lines in B and H represent splice sites among lanes run on the same immunoblot.

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