Safety and efficacy of autologous thymosin beta 4 pre-treated endothelial progenitor cell transplantation in patients with acute ST segment elevation myocardial infarction: A pilot study

摘要

Background. Experimental studies and clinical trials suggest that endothelial progenitor cell (EPC) transplantation can repair "broken" heart. However, transplantation of autologous EPCs has numerous limitations, including the limited supply of expanded EPCs, the impaired function and activity of the transplanted cells and so on. Therefore, we investigated the feasibility, safety and initial clinical outcome of autologous thymosin beta 4 (T beta 4) pre-treated EPC transplantation in patients with acute ST segment elevation myocardial infarction (STEMI). Methods. Ten patients with STEMI were included; they were randomized to 2 groups: EPC transplantation group (control group; n = 5) and T beta 4-pre-treated EPC transplantation group (experimental group; n = 5). EPCs were pre-treated with T beta 4 24 hours before transplantation in experimental group. Cardiac function was evaluated using echocardiography and emission computed tomography, as well as the 6-min walking test before and 6 months after the intervention. Results. After 6 months of follow-up, the average 6-min walking distance was increased by 38.2 m (from 263 +/- 42 m to 302 +/- 34 m) in the control group and 75.7 m (from 264 +/- 42 m to 340 +/- 44 m) in the experimental group; the average difference of the 6-min walking distance was 37.5 m (95% confidence interval [CI], 28.7-56.3 m; P < 0.01). In addition, the cardiac function in the experimental group was more significantly improved than that of the control group. There were no severe complications related to the procedure in either group during the follow-up. Discussion. Our pilot study suggested that T beta 4-optimized EPC transplantation appeared to be feasible and safe, and might have beneficial effects on exercise capacity and left ventricular function in patients with STEMI.