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J Thorac Cardiovasc Surg 2003;126:124-132
© 2003 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Cardiomyocyte-mediated contact programs human mesenchymal stem cells to express cardiogenic phenotype

^a Department of Cardiovascular Medicine and Surgery, Drexel University College of Medicine, Philadelphia, Pa, USA

Abstract was accepted for oral presentation at the American Heart Association’s Scientific Sessions, Chicago, Ill, November 17-20, 2002.

Received for publication September 30, 2002; accepted for publication December 3, 2002.

^* Address for reprints: J. Yasha Kresh, PhD, Department of Cardiovascular Medicine and Surgery, Mail Stop 111, 245 North 15th St, Drexel University College of Medicine, Philadelphia, PA 19102, USA.

BACKGROUND: Intercellular crosstalk and cellular plasticity are key factors in embryogenesis and organogenesis. The microenvironment plays a critical role in directing the progression of stem cells into differentiated cells. We hypothesized that intercellular interaction between adult human mesenchymal stem cells and adult human cardiomyocytes would induce stem cells to acquire the phenotypical characteristics of cardiomyocytes, and we tested the role that direct cell-to-cell contact plays in directing this differentiation process. Human mesenchymal stem cells were cultured in the presence of human cardiomyocytes ("coculture") or in the presence of media conditioned by separate cultures of human cardiomyocytes ("conditioned media").

METHODS: Human cardiomyocytes were labeled with chloromethyl derivatives of fluorescein diacetate. In the coculture experiments, human mesenchymal stem cells and human cardiomyocytes were mixed at a 1:1 ratio in smooth muscle 2 media and seeded at a cell density of 10,000 cells/cm². Cells were cocultured in an incubator at 37°C for 48 hours. Subsequently, fluorescence-activated cell sorting was used to extract the differentiating human mesenchymal stem cells. In the conditioned media experiments, human mesenchymal stem cells were incubated in media previously conditioned by cardiomyocytes, in the presence and absence of serum (±serum). The conditioned media was changed 3 times, at intervals of 48 hours. Total RNA was isolated and reverse transcriptase-polymerase chain reaction was performed for expression of contractile proteins and cardiac specific genes. Immunostaining against myosin heavy chain, ß-actin troponin-T, and troponin-I was performed.

RESULTS: Fluorescence-activated cell sorting analysis identified 66% of the human mesenchymal stem cells in the G1 phase. Differentiated hMSCs from the coculture experiments expressed myosin heavy chain, ß-actin, and troponin-T by reverse transcriptase–polymerase chain reaction. Immunostaining was also positive against myosin heavy chain and troponin-T. In contrast, only ß-actin expression was observed in the human mesenchymal stem cells incubated with conditioned media ± serum.

CONCLUSION: In addition to soluble signaling molecules, direct cell-to-cell contact is obligatory in relaying the external cues of the microenvironment controlling the differentiation of adult stem cells to cardiomyocytes. These data indicate that human mesenchymal stem cells are plastic and can be reprogrammed into a cardiomyogenic lineage that may be used in cell-based therapy for treating heart failure.