Improved cell therapy by transplantation of cellularized biomaterials in ischemic heart ; Amélioration de la thérapie cellulaire par greffes de biomatériaux cellularisés dans un modèle d’ischémie myocardique chez le rat

Cell transplantation has emerged as a promising therapy for some kind of severe heart failure refractory to conventional treatment. We have attempted in this work to improve cell therapy by acting on two parameters: the loss and cell survival. In a first step, we compared the effects of two methods of epicardial deposition of cells via natural biomaterials (Cell sheet and gelatin matrix) compared to conventional cells injections into the myocardium. We chose to transplant muscle stem cells for a proof of concept study. Improved contractile function after 1 month associated with improved cell retention, an increased number of blood vessels and a decrease in the percentage of fibrosis were recorded in the groups of cellularized biomaterials compared with injections group. We attempted to confirm the benefits of the epicardial cover with another cell type. We chose to use stromal stem cells from adipose origin as ADSC for Adipose Derived Stromal / Stem Cells. However, despite the functional benefits provided after transplantation, ADSC sheets were hardly manipulated during surgery. In addition, ADSC were unable to generate new cardiomyocytes electrically and mechanically integrated into the host tissue. The objective of "regeneration" requires the input of contractile cells with potential of cardiac differentiation that should be achieved with embryonic stem cells (ESC). We chose to work with this cell type because of the possibility of deriving of cardiac progenitor from these cells. To reduce the hypoxic conditions of the ischemic environment, we co-transplanted cardiac progenitor derived from human embryonic stem cells with ADSC in order to develop the trophic properties, and thus optimize the graft survival. Both cell populations were transferred to the infarcted myocardium using a gelatin matrix (GELFILM ™) which represents better mechanical properties than the cell sheet. In this study, we observed a significant functional preservation against negative ventricular remodeling in the short (1 month) and long (6 ...