Letters to Editor
+
Effects of CD133 Stem Cell on Myocardial Regeneration Through
Increased Vascular Endhotelial Growth Factor Correlated with Cardiac
Magnetic Resonance Imaging Results in Coronary Artery Bypass Graft
Surgery Patients with Low Ejection Fraction
To the Editor :
The original article by Soetisna, et
al conclude that CD 133+ stem cell
implantation improves myocardial
function which proven by Cardiac MRI
examination and VEGF levels in the
blood. CD133 + is a subtype of multipotent
Bone Marrow Mono Nuclear Cell
(BMMNC) which has a high ability of
angiogenesis, high success rate of
transplantation, high homing ability and
secrete VEGF.1,2 As we know, when
myocardial infarction occurs, the existing
resident stem cells are insufficient to repair
myocardial and vascular cells because the
endogenous regenerative capacity of the
heart muscle and the resident stem cells
cannot compensate for myocardial
damage. Implanted stem cell therapy with
its paracrine and autocrine effects
contributes to the heart muscle repair and
regeneration.3
This experimental study was
conducted using a parallel, open label,
single blinded design at National Cardiac
Center Harapan Kita. This research took
approximately 2 years, started from March
2016 to June 2018. The research subjects
were divided into two groups, in the
control group CABG procedure only and
CABG group procedure performed
accompanied by transepicardial and
transseptal implantation of CD133+ bone
marrow stem cells. Bone marrow
aspirations are obtained 24 hours before
CABG is performed.All patients were
assessed at the same imaging facility in
our hospital before surgery and six months
after the procedure. Measurement of
VEGF levels in the blood is done in our
laboratory using the ELISA method.
The result are significant
improvement in ejection fraction , WMSI
and Scar Size Regression followed by a
significant increase in VEGF levels in
treatment group. The result in perfusion
segment is increase but the statistical result
was not significant. The author conclude
that The increase in VEGF levels is
expected to continue the process of
myocardial function restoration when the
myocardial perfusion improvement is still
not optimal.4
Tri Wisesa Sortisna, MD, PHD, MHA
(tricts2000@yahoo.com)
Disclosure
The author report no cloflict of interest
References
Nasseri BA, Ebell W, Dandel M, Kukucka M, Gebker R, Doltra
A, et al. Autologous CD133+ bone marrow cells and bypass
grafting for regeneration of ischaemic myocardium: The
Cardio133 trial. Eur Heart J. 2014;35(19):1263–74.
Stamm C, Kleine HD, Choi YH, Dunkelmann S, Lauffs JA,
Lorenzen B, et al. Intramyocardial delivery of CD133+ bone
marrow cells and coronary artery bypass grafting for chronic
ischemic heart disease: Safety and efficacy studies. J Thorac
Cardiovasc Surg. 2007;133(3).
Gnecchi M, Zhang Z, Ni A, Dzau VJ. Paracrine mechanisms in
adult stem cell signaling and therapy. Circ Res.
2008;103(11):1204–19.
Li G hua, Luo B, Lv Y xia, Zheng F, Wang L, Wei M xi, et al.
Dual effects of VEGF-B on activating cardiomyocytes and
cardiac stem cells to protect the heart against short- and long-
term ischemia-reperfusion injury. J Transl Med. 2016;14(1):1–
14.