ЭФФЕКТ НИТРОГЛИЦЕРИНА НА ПРОЛИФЕРАТИВНЫЙ И МИГРАЦИОННЫЙ ПОТЕНЦИАЛ МОНОНУКЛЕАРНЫХ КЛЕТОК ПЕРИФЕРИЧЕСКОЙ КРОВИ

Aim. To study the effects of nitroglycerin on proliferative and migratory activity of mononuclear cells and endothelial progenitor cells in patients with chronic heart failure.Materials and methods. Proliferative potential of peripheral blood mononuclear cells in donors and patients were studied in MTT-test in the presence of 50 and 100 mg/ml nitroglycerin. Proliferation and migration of endothelial progenitor cells in patients were evaluated by changes in the cell impedance in real-time in the presence of various doses of nitroglycerin.Results. It is shown that nitroglycerin reduces in vitro both spontaneous and Concanavalin A stimulated proliferative activity of mononuclear cells in patients with chronic heart failure. Peripheral blood mononuclear cells in patients with chronic heart failure, obtained after procedure of mobilization by granulocyte colony-stimulating factor respond to nitroglycerin dose of 50 mg/ml with the increased proliferative activity, and with the suppressed proliferative activity to nitroglycerin dose of 100 mg/ml. Mononuclear cells of healthy donors respond to 50 mg/ml of nitroglycerin with the activation of proliferative capacity, but at a dose of 100 mg/ml spontaneous proliferative activity of mononuclear cells inhibit. It is also shown that the presence of nitroglycerin in medium dose in stimulating test leads to the inhibition of mononuclear cells proliferation from healthy donors. It is shown the stimulating effect of nitroglycerin on proliferative and migration potential of endothelial progenitor cells.Conclusion. Multidirectional and dose-dependent effects of nitroglycerin to the various types of human cells in vitro were observed.Цель. Изучить эффекты влияния нитроглицерина на пролиферативную и миграционную активность мононуклеарных клеток и эндотелиальных прогениторных клеток у пациентов с хронической сердечнойнедостаточностью.Материалы и методы. Пролиферативный потенциал мононуклеарных клеток периферической крови у доноров и пациентов изучали в МТТ-тесте в присутствии 50 и 100 мкг/мл нитроглицерина, пролиферацию и миграцию эндотелиальных прогениторных клеток пациентов оценивали по изменению клеточного импеданса в режиме реального времени в присутствии различных доз нитроглицерина.Результаты. Показано, что нитроглицерин снижает пролиферативную активность in vitro мононуклеарных клеток пациентов с хронической сердечной недостаточностью, как спонтанную, так и стимулированную Конканавалин А. Мононуклеарные клетки периферической крови пациентов с хронической сердечной недостаточностью, полученные после процедуры мобилизации гранулоцитарным колониестимулирующим фактором, отвечают увеличением пролиферативной активности на нитроглицерин в дозе 50 мкг/мл, а при дозе 100 мкг/мл – подавлением пролиферативной активности. Мононуклеары условно здоровых доноров в ответ на стимуляцию нитроглицерином отвечают активацией пролиферативного потенциала. Показан стимулирующий эффект нитроглицерина на пролиферативный и миграционный потенциал эндотелиальных прогениторных клеток.Заключение. Установлен разнонаправленный и дозозависимый эффект нитроглицерина на различные типы клеток человека in vitro

Клинико-функциональная оценка интрамиокардиальной имплантации аутологичных клеток костного мозга, обработанных эритропоэтином, в хирургии ИБС (6-месячные результаты)

Aim. Clinical and functional evaluation of the implantation of autologous bone marrow cells treated with erythropoietin in laser channels during coronary bypass grafting in patients with end-stage coronary lesion.Materials and methods. 60 patients with coronary artery disease with diffuse and (or) distal right coronary artery disease were randomized into two groups: patients of group 1 (n = 30) underwent coronary bypass grafting, implantation of autologous bone marrow cells treated with erythropoietin in laser channels, patients of the 2nd group (n = 30) were operated with coronary bypass grafting of the left coronary artery system. Assessment of the clinical status, myocardial perfusion and contractility was performed initially, 6 months after the operation.Results. Six months after the operation, there was a more pronounced decrease in angina pectoris (CCS) in the main group compared to the control group, also we revealed a 6-minute walk test scores improvement. Based on two-stage scintigraphy (Tc99) in the main group before the surgical treatment, a rest perfusion defect was 8.5% [3.5, 18.5], a stress-induced perfusion defect – 7.0% [6.0, 12, 3]. In the control group, the rest defect was 9.1% [5.6, 12.4], the stress-induced perfusion defect was 7.3% [6.1, 8.7]. 6 months after surgery rest perfusion defect at the indirect revascularization group was 6.0% [2.5, 16.5] (p = 0.008), a stress-induced defect was 4.0% [1.5, 6.3] (p = 0.05). In the control group, the rest defect was 8.7% [5.3, 10.3], the stress-induced perfusion defect was 6.8% [5.3, 9.1] (p = 0.21). The results of scintigraphy with MIBG showed a left ventricle innervation defect (PID) significant decrease in the main group: initially 15.4% [14.2, 16.3], after 6 months 11.7% [9.3, 13, 2] (p = 0.045). In the control group, there was an unreliable decrease in PID: initially 14.3% [10.2, 17.3], after 6 months 13.8% [9.1, 14.2] (p = 0.14).Conclusion. Our preliminary results revealed more pronounced effect of the new indirect revascularization method expressed as in myocardial perfusion improve, myocardial sympathetic innervation restoration and clinical status improvement in comparison with control group.Цель. Клинико-функциональная оценка эффекта применения трансмиокардиальной лазерной реваскуляризации в сочетании с имплантацией прекондиционированных эритропоэтином клеток аутологичного костного мозга в хирургии ишемической болезни сердца.Материалы и методы. Больные ИБС с диффузным и(или) дистальным поражением правой коронарной артерии (n = 60) рандомизированы на две группы: пациентам 1-й группы (n = 30) выполнено коронарное шунтирование, c имплантацией прекондиционированных эритропоэтином клеток аутологичного костного мозга в область нижней стенки левого желудочка, пациентам 2-й группы (группа контроля, n = 30) выполнено коронарное шунтирование системы левой коронарной артерии. Оценка клинического статуса, перфузии и сократительной способности миокарда выполнена исходно, через 6 месяцев после операции.Результаты. Через 6 месяцев после операции выявлено более выраженное снижение функционального класса (ФК) стенокардии (ССS) в основной группе по сравнению с группой контроля, улучшение показателей теста 6-минутной ходьбы. По результатам двухэтапной сцинтиграфии миокарда с технетрилом (Тс99) М в основной группе до хирургического лечения отмечен стойкий дефект перфузии 8,5% [3,5; 18,5], стресс-индуцированный дефект перфузии 7,0% [6,0; 12,3]. В контрольной группе – стабильный дефект 9,1% [5,6; 12,4], стресс-индуцированный дефект перфузии 7,3% [6,1; 8,7]. Через 6 месяцев в основной группе стойкий дефект перфузии составил 6,0% [2,5; 16,5] (p = 0,008), стресс-индуцированный дефект – до 4,0% [1,5; 6,3] (p = 0,05). В контрольной группе – стабильный дефект 8,7% [5,3; 10,3], стресс-индуцированный дефект перфузии 6,8% [5,3; 9,1] (р = 0,21). Результаты сцинтиграфии с МIBG демонстрируют значимое уменьшение площади дефекта иннервации (ПДИ) в сегментах нижней стенки левого желудочка в основной группе: исходно 15,4% [14,2; 16,3], через 6 месяцев 11,7% [9,3; 13,2] (р = 0,045). В контрольной группе выявлено недостоверное уменьшение ПДИ: исходно 14,3% [10,2; 17,3], через 6 месяцев 13,8% [9,1; 14,2] (р = 0,14).Заключение. Исследование продемонстрировало улучшение перфузии в зоне непрямой реваскуляризации, восстановление симпатической иннервации миокарда, лучшие показатели ФК (CCS), теста 6-минутной ходьбы у пациентов в основной группе

THE EFFECTS OF NITROGLYCERIN ON THE PROLIFERATIVE AND MIGRATORY POTENTIAL OF PERIPHERAL BLOOD MONONUCLEAR CELLS

Aim. To study the effects of nitroglycerin on proliferative and migratory activity of mononuclear cells and endothelial progenitor cells in patients with chronic heart failure.Materials and methods. Proliferative potential of peripheral blood mononuclear cells in donors and patients were studied in MTT-test in the presence of 50 and 100 mg/ml nitroglycerin. Proliferation and migration of endothelial progenitor cells in patients were evaluated by changes in the cell impedance in real-time in the presence of various doses of nitroglycerin.Results. It is shown that nitroglycerin reduces in vitro both spontaneous and Concanavalin A stimulated proliferative activity of mononuclear cells in patients with chronic heart failure. Peripheral blood mononuclear cells in patients with chronic heart failure, obtained after procedure of mobilization by granulocyte colony-stimulating factor respond to nitroglycerin dose of 50 mg/ml with the increased proliferative activity, and with the suppressed proliferative activity to nitroglycerin dose of 100 mg/ml. Mononuclear cells of healthy donors respond to 50 mg/ml of nitroglycerin with the activation of proliferative capacity, but at a dose of 100 mg/ml spontaneous proliferative activity of mononuclear cells inhibit. It is also shown that the presence of nitroglycerin in medium dose in stimulating test leads to the inhibition of mononuclear cells proliferation from healthy donors. It is shown the stimulating effect of nitroglycerin on proliferative and migration potential of endothelial progenitor cells.Conclusion. Multidirectional and dose-dependent effects of nitroglycerin to the various types of human cells in vitro were observed

Clinical and functional evaluation of intramyocardial implantation of autologous bone marrow cells treated with erythropoietinduring the CAD surgery (6-month results)

Aim. Clinical and functional evaluation of the implantation of autologous bone marrow cells treated with erythropoietin in laser channels during coronary bypass grafting in patients with end-stage coronary lesion.Materials and methods. 60 patients with coronary artery disease with diffuse and (or) distal right coronary artery disease were randomized into two groups: patients of group 1 (n = 30) underwent coronary bypass grafting, implantation of autologous bone marrow cells treated with erythropoietin in laser channels, patients of the 2nd group (n = 30) were operated with coronary bypass grafting of the left coronary artery system. Assessment of the clinical status, myocardial perfusion and contractility was performed initially, 6 months after the operation.Results. Six months after the operation, there was a more pronounced decrease in angina pectoris (CCS) in the main group compared to the control group, also we revealed a 6-minute walk test scores improvement. Based on two-stage scintigraphy (Tc99) in the main group before the surgical treatment, a rest perfusion defect was 8.5% [3.5, 18.5], a stress-induced perfusion defect – 7.0% [6.0, 12, 3]. In the control group, the rest defect was 9.1% [5.6, 12.4], the stress-induced perfusion defect was 7.3% [6.1, 8.7]. 6 months after surgery rest perfusion defect at the indirect revascularization group was 6.0% [2.5, 16.5] (p = 0.008), a stress-induced defect was 4.0% [1.5, 6.3] (p = 0.05). In the control group, the rest defect was 8.7% [5.3, 10.3], the stress-induced perfusion defect was 6.8% [5.3, 9.1] (p = 0.21). The results of scintigraphy with MIBG showed a left ventricle innervation defect (PID) significant decrease in the main group: initially 15.4% [14.2, 16.3], after 6 months 11.7% [9.3, 13, 2] (p = 0.045). In the control group, there was an unreliable decrease in PID: initially 14.3% [10.2, 17.3], after 6 months 13.8% [9.1, 14.2] (p = 0.14).Conclusion. Our preliminary results revealed more pronounced effect of the new indirect revascularization method expressed as in myocardial perfusion improve, myocardial sympathetic innervation restoration and clinical status improvement in comparison with control group