Viability and differentiation of autologous skeletal myoblast grafts in ischaemic cardiomyopathy

• Published in: The Lancet (British edition) Vol. 361; no. 9356; pp. 491 - 492
• Main Authors: Hagège, Albert A, Carrion, Claire, Menasché, Philippe, Vilquin, Jean-Thomas, Duboc, Denis, Marolleau, Jean-Pierre, Desnos, Michel, Bruneval, Patrick
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 08-02-2003; Lancet; Elsevier Limited; Elsevier
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Case studies; Cell Differentiation - physiology; Cell Survival - physiology; Coronary Artery Bypass; Heart attacks; Humans; Life Sciences; Male; Medical sciences; Microscopy, Confocal; Myoblasts, Skeletal - pathology; Myoblasts, Skeletal - transplantation; Myocardial infarction; Myocardial Infarction - pathology; Myocardial Infarction - surgery; Myocardium - pathology; Skeletal system; Skin & tissue grafts; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Ventricular Dysfunction, Left - pathology; Ventricular Dysfunction, Left - surgery; Human; Infarct; Cardiomyopathy; Stem cell; Cell biology; Cardiovascular disease; Histology; Cell differentiation; Striated muscle; Coronary heart disease; Myocardial disease; Case study; Autograft; Association; Treatment; Ischemia; Heart disease; Myoblast; Myocardium; Graft; Elderly; Viability
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(03)12458-0

Autologous skeletal myoblast transplantation might improve postinfarction ventricular function, but graft viability and differentiation (ie, proof of concept) has not been shown. A 72-year-old man had autologous cultured myoblasts from his vastus lateralis injected to an area of transmural inferior myocardial infarction in non-reperfused scar tissue. He showed improvement in symptoms and left-ventricular ejection fraction. When he died 17·5 months after the procedure, the grafted post-infarction scar showed well developed skeletal myotubes with a preserved contractile apparatus. 65% of myotubes expressed the slow myosin isoform and 33% coexpressed the slow and fast isoforms (
vs 44% and 0·6%, respectively, in skeletal muscle). Myoblast grafts can survive and show a switch to slow-twitch fibres, which might allow sustained improvement in cardiac function.