Transplantation of Isl1+ cardiac progenitor cells in small intestinal submucosa improves infarcted heart function

Background: Application of cardiac stem cells combined with biomaterial scaffold is a promising therapeutic strategy for heart repair after myocardial infarction. However, the optimal cell types and biomaterials remain elusive. Methods: In this study, we seeded Isl1(+) embryonic cardiac progenitor cells (CPCs) into decellularized porcine small intestinal submucosa extracellular matrix (SIS-ECM) to assess the therapeutic potential of Isl1(+) CPCs and the biocompatibility of SIS-ECM with these cells. Results: We observed that SIS-ECM supported the viability and attachment of Isl1(+) CPCs. Importantly, Isl1+ CPCs differentiated into cardiomyocytes and endothelial cells 7 days after seeding into SIS-ECM. In addition, SIS-ECM with CPC-derived cardiomyocytes showed spontaneous contraction and responded to beta-adrenergic stimulation. Next, patches of SIS-ECM seeded with CPCs for 7 days were transplanted onto the outer surface of infarcted myocardium in mice. Four weeks after transplantation, the patches were tightly attached to the surface of the host myocardium and remained viable. Transplantation of patches improved cardiac function, decreased the left ventricular myocardial scarring area, and reduced fibrosis and heart failure. Conclusions: Transplantation of Isl1(+) CPCs seeded in SIS-ECM represents an effective approach for cell-based heart therapy.