Role of mast cells and their mediators in failing myocardium under mechanical ventricular support

Ahmet Akgul, Christian A. Skrabal, Larry O. Thompson, Matthias Loebe, Javier A. Lafuente, George P. Noon, Keith A. Youker

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background Mast cells have been implicated in tissue remodeling and fibroblast stimulation. We explored the effect of mechanical support by left ventricular assist device (LVAD) in failing myocardium and looked into grade and distribution of interstitial fibrosis, mast cell density, mast cell phenotypes and basic fibroblast growth factor (bFGF) expression pre- and post-LVAD. Methods Myocardial tissue was obtained from 20 patients with end-stage cardiomyopathy at the time of LVAD implantation and LVAD removal and from 7 donor hearts not used for transplantation. Tissue sections were stained for mast cells using tryptase as a marker and the myocardial fibrosis was measured. Double staining for tryptase and chymase was performed for detection of chymase-positive mast cells. Fluorescent microscopy showed the relationship of mast cells to bFGF, and bFGF expression was quantified by Western blot. Results There was a significant increase in mast cells in heart failure vs normal myocardium. A secondary increase in mast cells occurred after long-term (>40 days) support compared with matched pre-LVAD samples (mean ± SEM; 57.4 ± 8.6 cells/10 fields vs 45.1 ± 7.6 SEM cells/10 fields, p < 0.01). The secondary increase in mast cells was associated specifically with an increase in chymase-negative mast cells (p < 0.01). These findings are statistically significant with concurrent decreased expression of bFGF and decreased fibrosis in the same patient tissues (p < 0.01). Conclusions We suggest that, under long-term support, there is a change in phenotypic expression in mast cells, which can alter fibroblast functions. The decreased myocardial bFGF levels might be the result of these phenotypically altered mast cells.

Original languageEnglish (US)
Pages (from-to)709-715
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume23
Issue number6
DOIs
StatePublished - Jun 2004
Externally publishedYes

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Mast Cells
Myocardium
Heart-Assist Devices
Fibroblast Growth Factor 2
Chymases
Tryptases
Fibrosis
Fibroblasts
Device Removal
Cardiomyopathies
Microscopy
Heart Failure
Cell Count
Transplantation
Western Blotting
Tissue Donors
Staining and Labeling
Phenotype

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Role of mast cells and their mediators in failing myocardium under mechanical ventricular support. / Akgul, Ahmet; Skrabal, Christian A.; Thompson, Larry O.; Loebe, Matthias; Lafuente, Javier A.; Noon, George P.; Youker, Keith A.

In: Journal of Heart and Lung Transplantation, Vol. 23, No. 6, 06.2004, p. 709-715.

Research output: Contribution to journalArticle

Akgul, Ahmet ; Skrabal, Christian A. ; Thompson, Larry O. ; Loebe, Matthias ; Lafuente, Javier A. ; Noon, George P. ; Youker, Keith A. / Role of mast cells and their mediators in failing myocardium under mechanical ventricular support. In: Journal of Heart and Lung Transplantation. 2004 ; Vol. 23, No. 6. pp. 709-715.
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AU - Thompson, Larry O.

AU - Loebe, Matthias

AU - Lafuente, Javier A.

AU - Noon, George P.

AU - Youker, Keith A.

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N2 - Background Mast cells have been implicated in tissue remodeling and fibroblast stimulation. We explored the effect of mechanical support by left ventricular assist device (LVAD) in failing myocardium and looked into grade and distribution of interstitial fibrosis, mast cell density, mast cell phenotypes and basic fibroblast growth factor (bFGF) expression pre- and post-LVAD. Methods Myocardial tissue was obtained from 20 patients with end-stage cardiomyopathy at the time of LVAD implantation and LVAD removal and from 7 donor hearts not used for transplantation. Tissue sections were stained for mast cells using tryptase as a marker and the myocardial fibrosis was measured. Double staining for tryptase and chymase was performed for detection of chymase-positive mast cells. Fluorescent microscopy showed the relationship of mast cells to bFGF, and bFGF expression was quantified by Western blot. Results There was a significant increase in mast cells in heart failure vs normal myocardium. A secondary increase in mast cells occurred after long-term (>40 days) support compared with matched pre-LVAD samples (mean ± SEM; 57.4 ± 8.6 cells/10 fields vs 45.1 ± 7.6 SEM cells/10 fields, p < 0.01). The secondary increase in mast cells was associated specifically with an increase in chymase-negative mast cells (p < 0.01). These findings are statistically significant with concurrent decreased expression of bFGF and decreased fibrosis in the same patient tissues (p < 0.01). Conclusions We suggest that, under long-term support, there is a change in phenotypic expression in mast cells, which can alter fibroblast functions. The decreased myocardial bFGF levels might be the result of these phenotypically altered mast cells.

AB - Background Mast cells have been implicated in tissue remodeling and fibroblast stimulation. We explored the effect of mechanical support by left ventricular assist device (LVAD) in failing myocardium and looked into grade and distribution of interstitial fibrosis, mast cell density, mast cell phenotypes and basic fibroblast growth factor (bFGF) expression pre- and post-LVAD. Methods Myocardial tissue was obtained from 20 patients with end-stage cardiomyopathy at the time of LVAD implantation and LVAD removal and from 7 donor hearts not used for transplantation. Tissue sections were stained for mast cells using tryptase as a marker and the myocardial fibrosis was measured. Double staining for tryptase and chymase was performed for detection of chymase-positive mast cells. Fluorescent microscopy showed the relationship of mast cells to bFGF, and bFGF expression was quantified by Western blot. Results There was a significant increase in mast cells in heart failure vs normal myocardium. A secondary increase in mast cells occurred after long-term (>40 days) support compared with matched pre-LVAD samples (mean ± SEM; 57.4 ± 8.6 cells/10 fields vs 45.1 ± 7.6 SEM cells/10 fields, p < 0.01). The secondary increase in mast cells was associated specifically with an increase in chymase-negative mast cells (p < 0.01). These findings are statistically significant with concurrent decreased expression of bFGF and decreased fibrosis in the same patient tissues (p < 0.01). Conclusions We suggest that, under long-term support, there is a change in phenotypic expression in mast cells, which can alter fibroblast functions. The decreased myocardial bFGF levels might be the result of these phenotypically altered mast cells.

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