Name: in vitro assessment of myocardial protection following hypothermia-preconditioning in a human cardiac myocytes model
Uploaded: 2020-10-27T14:45:00
Description: Watch this Scientific Journal Video about In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model at JoVE.com

This work was funded in part by the National Natural Science Foundation of China (81970265, 81900281,81700288), the China Postdoctoral Science Foundation (2019M651904); and the National Key Research and Development Program of China (2016YFC1101001, 2017YFC1308105).

Information regarding commercial reagents and instruments are listed in the Table of Materials.
The AC16 human cardiomyocyte cell line was derived from the fusion of primary cells from adult ventricular heart tissue with SV40-transformed human fibroblasts17, which were purchased from BLUEFBIO (Shanghai, China). The cell line develops many biochemical and morphological features characteristic of cardiomyocytes. In addition, the cell line is widely used t...

<ol>
	<li>Kim, B. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Myocardial+Ischemia+Induces+SDF-1alpha+Release+in+Cardiac+Surgery+Patients.">Myocardial Ischemia Induces SDF-1alpha Release in Cardiac Surgery Patients.</a> Journal of Cardiovascular Translational Research. 9 (3), 230-238 (2016).</li><li>Klein, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Less+invasive+ventricular+reconstruction+for+ischaemic+heart+failure.">Less invasive ventricular reconstruction for ischaemic heart failure.</a> EUROPEAN JOURNAL OF HEART FAILURE. 21 (12), 1638-1650 (2019).</li><li>Otto, K. 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M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiac+arrest+and+therapeutic+hypothermia+decrease+isoform-specific+cytochrome+P450+drug+metabolism.">Cardiac arrest and therapeutic hypothermia decrease isoform-specific cytochrome P450 drug metabolism.</a> DRUG METABOLISM AND DISPOSITION. 39 (12), 2209-2218 (2011).</li><li>Sharp, W. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inhibition+of+the+mitochondrial+fission+protein+dynamin-related+protein+1+improves+survival+in+a+murine+cardiac+arrest+model.">Inhibition of the mitochondrial fission protein dynamin-related protein 1 improves survival in a murine cardiac arrest model.</a> CRITICAL CARE MEDICINE. 43 (2), 38-47 (2015).</li><li>Zhu, W. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hsp90aa1:+a+novel+target+gene+of+miR-1+in+cardiac+ischemia/reperfusion+injury.">Hsp90aa1: a novel target gene of miR-1 in cardiac ischemia/reperfusion injury.</a> Sci Rep. 6, 24498 (2016).</li><li>Castedo, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+hypothermia+on+right+atrial+cardiomyocyte+apoptosis+in+patients+undergoing+aortic+valve+replacement.">Influence of hypothermia on right atrial cardiomyocyte apoptosis in patients undergoing aortic valve replacement.</a> Journal of Cardiothoracic Surgery. 2, 7 (2007).</li><li>Krech, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Moderate+therapeutic+hypothermia+induces+multimodal+protective+effects+in+oxygen-glucose+deprivation/reperfusion+injured+cardiomyocytes.">Moderate therapeutic hypothermia induces multimodal protective effects in oxygen-glucose deprivation/reperfusion injured cardiomyocytes.</a> Mitochondrion. 35, 1-10 (2017).</li><li>Cooper, W. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hypothermic+circulatory+arrest+causes+multisystem+vascular+endothelial+dysfunction+and+apoptosis.">Hypothermic circulatory arrest causes multisystem vascular endothelial dysfunction and apoptosis.</a> ANNALS OF THORACIC SURGERY. 69 (3), 696-702 (2000).</li><li>Kajimoto, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Selective+cerebral+perfusion+prevents+abnormalities+in+glutamate+cycling+and+neuronal+apoptosis+in+a+model+of+infant+deep+hypothermic+circulatory+arrest+and+reperfusion.">Selective cerebral perfusion prevents abnormalities in glutamate cycling and neuronal apoptosis in a model of infant deep hypothermic circulatory arrest and reperfusion.</a> JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM. 36 (11), 1992-2004 (2016).</li><li>Liu, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deep+Hypothermic+Circulatory+Arrest+Does+Not+Show+Better+Protection+for+Vital+Organs+Compared+with+Moderate+Hypothermic+Circulatory+Arrest+in+Pig+Model.">Deep Hypothermic Circulatory Arrest Does Not Show Better Protection for Vital Organs Compared with Moderate Hypothermic Circulatory Arrest in Pig Model.</a> Biomed Research International. 2019, 1420216 (2019).</li><li>Davidson, M. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Novel+cell+lines+derived+from+adult+human+ventricular+cardiomyocytes.">Novel cell lines derived from adult human ventricular cardiomyocytes.</a> JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY. 39 (1), 133-147 (2005).</li><li>Khan, K., Makhoul, G., Yu, B., Schwertani, A., Cecere, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+cytoprotective+impact+of+yes-associated+protein+1+after+ischemia-reperfusion+injury+in+AC16+human+cardiomyocytes.">The cytoprotective impact of yes-associated protein 1 after ischemia-reperfusion injury in AC16 human cardiomyocytes.</a> EXPERIMENTAL BIOLOGY AND MEDICINE. 244 (10), 802-812 (2019).</li><li>Pan, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=miR-146a+attenuates+apoptosis+and+modulates+autophagy+by+targeting+TAF9b/P53+pathway+in+doxorubicin-induced+cardiotoxicity.">miR-146a attenuates apoptosis and modulates autophagy by targeting TAF9b/P53 pathway in doxorubicin-induced cardiotoxicity.</a> Cell Death Discovery. 10 (9), 668 (2019).</li><li>Schmitt, K. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=S100B+modulates+IL-6+release+and+cytotoxicity+from+hypothermic+brain+cells+and+inhibits+hypothermia-induced+axonal+outgrowth.">S100B modulates IL-6 release and cytotoxicity from hypothermic brain cells and inhibits hypothermia-induced axonal outgrowth.</a> NEUROSCIENCE RESEARCH. 59 (1), 68-73 (2007).</li><li>Tong, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deep+hypothermia+therapy+attenuates+LPS-induced+microglia+neuroinflammation+via+the+STAT3+pathway.">Deep hypothermia therapy attenuates LPS-induced microglia neuroinflammation via the STAT3 pathway.</a> Neuroscience. 358, 201-210 (2017).</li><li>Yu, Z. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Troxerutin+attenuates+oxygenglucose+deprivation+and+reoxygenationinduced+oxidative+stress+and+inflammation+by+enhancing+the+PI3K/AKT/HIF1alpha+signaling+pathway+in+H9C2+cardiomyocytes.">Troxerutin attenuates oxygenglucose deprivation and reoxygenationinduced oxidative stress and inflammation by enhancing the PI3K/AKT/HIF1alpha signaling pathway in H9C2 cardiomyocytes.</a> Molecular Medicine Reports. 22 (2), 1351-1361 (2020).</li><li>Drescher, C., Diestel, A., Wollersheim, S., Berger, F., Schmitt, K. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+does+hypothermia+protect+cardiomyocytes+during+cardioplegic+ischemia.">How does hypothermia protect cardiomyocytes during cardioplegic ischemia.</a> European journal of cardiothoracic surgery. 40 (2), 352-359 (2011).</li><li>Diestel, A., Drescher, C., Miera, O., Berger, F., Schmitt, K. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hypothermia+protects+H9c2+cardiomyocytes+from+H2O2+induced+apoptosis.">Hypothermia protects H9c2 cardiomyocytes from H2O2 induced apoptosis.</a> Cryobiology. 62 (1), 53-61 (2011).</li><li>Zhang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=HIF-1alpha/BNIP3+signaling+pathway-induced-autophagy+plays+protective+role+during+myocardial+ischemia-reperfusion+injury.">HIF-1alpha/BNIP3 signaling pathway-induced-autophagy plays protective role during myocardial ischemia-reperfusion injury.</a> BIOMEDICINE &amp; PHARMACOTHERAPY. 120, 109464 (2019).</li><li>An, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Exogenous+IL-19+attenuates+acute+ischaemic+injury+and+improves+survival+in+male+mice+with+myocardial+infarction.">Exogenous IL-19 attenuates acute ischaemic injury and improves survival in male mice with myocardial infarction.</a> BRITISH JOURNAL OF PHARMACOLOGY. 176 (5), 699-710 (2019).</li><li>Han, Y. S., Schaible, N., Tveita, T., Sieck, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Discontinued+stimulation+of+cardiomyocytes+provides+protection+against+hypothermia-rewarming-induced+disruption+of+excitation-contraction+coupling.">Discontinued stimulation of cardiomyocytes provides protection against hypothermia-rewarming-induced disruption of excitation-contraction coupling.</a> EXPERIMENTAL PHYSIOLOGY. 103 (6), 819-826 (2018).</li><li>Yarbrough, W. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Caspase+inhibition+attenuates+contractile+dysfunction+following+cardioplegic+arrest+and+rewarming+in+the+setting+of+left+ventricular+failure.">Caspase inhibition attenuates contractile dysfunction following cardioplegic arrest and rewarming in the setting of left ventricular failure.</a> Journal of cardiovascular pharmacology. 44 (6), 645-650 (2004).</li><li>Egorov, Y. V., Glukhov, A. V., Efimov, I. R., Rosenshtraukh, L. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hypothermia-induced+spatially+discordant+action+potential+duration+alternans+and+arrhythmogenesis+in+nonhibernating+versus+hibernating+mammals.">Hypothermia-induced spatially discordant action potential duration alternans and arrhythmogenesis in nonhibernating versus hibernating mammals.</a> AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY. 303 (8), 1035-1046 (2012).</li><li>Bobi, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Moderate+Hypothermia+Modifies+Coronary+Hemodynamics+and+Endothelium-Dependent+Vasodilation+in+a+Porcine+Model+of+Temperature+Management.">Moderate Hypothermia Modifies Coronary Hemodynamics and Endothelium-Dependent Vasodilation in a Porcine Model of Temperature Management.</a> Journal of the American Heart Association. 9 (3), 014035 (2020).</li><li>Dietrichs, E. 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The complexities of intact animals, including the interactions between different types of cells, often prevent detailed studies of specific components of I/R injury. Therefore, it is necessary to establish an in vitro cell model that can accurately reflect the molecular changes after ischemia in vivo. Research on OGD models has been previously reported13,22, and many sophisticated methods have been established23,<sup class="xref...

Ischemia/reperfusion-derived myocardial dysfunction is a common clinical scenario in patients after cardiac surgery1,2. During nonpulsatile low flow perfusion and periods of total circulatory arrest, damage involving all types of heart cells still occurs. In particular, the sensitivity of cardiomyocytes to ischemic injury is higher than that of other cell populations. At present, therapeutic hypothermia (TH) affords substantial protection against an expected ischemic insult in patients undergoing cardiac surgery3,4. TH is defined as a core body temperature of 14-34 &#176;C, although no consensus exists regarding a definition of cooling during cardiac surgery5,6,7. In 2013, an international panel of experts proposed a standardized reporting system to classify various temperature ranges of systemic hypothermic circulatory arrest8. Based on electroencephalography and metabolism studies of the brain, they divided hypothermia into four levels: profound hypothermia (&#8804; 14 &#176;C), deep hypothermia (14.1-20 &#176;C), moderate hypothermia (20.1-28 &#176;C), and mild hypothermia (28.1-34 &#176;C). The expert consensus provided a clear and uniform classification, allowing studies to be more comparable and provide more clinically relevant outcomes. This protection afforded by TH is based on its capacity to reduce the metabolic activity of cells, further limiting their rate of high-energy phosphates consumption9,10. However, the role of TH in myocardial protection is controversial and may have multiple effects depending on the degree of hypothermia.
Myocardial I/R is well known to be accompanied by increased cell apoptisis11. Recent reports have observed that programmed cardiomyocyte death increases during open-heart surgery, and may coincide with necrosis, thereby increasing the number of dead myocardial cells12. Therefore, reducing cardiomyocyte apoptosis is a useful therapeutic approach in clinical practice. In the mouse atrial HL-1 cardiomyocyte model, therapeutic hypothermia was shown to reduce the mitochondrial release of cytochrome c and apoptosis-inducing factor (AIF) during reperfusion13. However, the effect of temperature in regulating apoptosis is controversial and appears to depend on the degree of hypothermia. Cooper and colleagues observed that compared to a normothermic cardiopulmonary bypass control group, the apoptosis rate of myocardial tissue from pigs with the deep hypothermic circulatory arrest was increased14. In addition, the results of some studies have suggested that deep hypothermia may activate the apoptosis pathway, while less aggressive hypothermia appears to inhibit the pathway12,15,16. The reason for this result may be due to confounding effects associated with ischemic injury and a lack of understanding of the mechanisms by which temperature affects myocardial tissue. Therefore, the temperature limits at which apoptosis is enhanced or attenuated should be accurately defined.
To gain a better understanding of the mechanisms associated with the efficacy of hypothermia and provide a rational basis for its implementation in humans, it is essential to identify a culture condition similar to in vivo conditions that can produce damage similar to that observed for the clinical condition in a reproducible manner. An essential step towards achieving this goal is to establish the optimal conditions for inducing cardiomyocyte apoptosis. Accordingly, in the present study, we explored the methodological details regarding oxygen-glucose deprivation experiments with cultured cells, a facile in vitro model of ischemia-reperfusion. Furthermore, we evaluated the effect of different hypoxic-ischemic times on cardiomyocyte apoptosis, and verified our hypothesis regarding the effect of different temperature conditions on cell apoptosis in vitro.

<table>
	<tbody>
		<tr>
			<td>Annexin V-FITC cell apoptosis detection kit</td>
			<td>Bio-Technology,China</td>
			<td>C1062M</td>
			<td></td>
		</tr>
		<tr>
			<td>Cardiac myocyte growth supplement</td>
			<td>Sciencell,USA</td>
			<td>6252</td>
			<td></td>
		</tr>
		<tr>
			<td>Caspase 3 activity assay kit</td>
			<td>Bio-Technology,China</td>
			<td>C1115</td>
			<td></td>
		</tr>
		<tr>
			<td>Caspase 8 activity assay kit</td>
			<td>Bio-Technology,China</td>
			<td>C1151</td>
			<td></td>
		</tr>
		<tr>
			<td>DMEM, no glucose</td>
			<td>Gibco,USA</td>
			<td>11966025</td>
			<td></td>
		</tr>
		<tr>
			<td>Dulbecco&#39;s modified eagle medium</td>
			<td>Gibco,USA</td>
			<td>11960044</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal bovine serum</td>
			<td>Gibco,USA</td>
			<td>16140071</td>
			<td></td>
		</tr>
		<tr>
			<td>Flow cytometry</td>
			<td>CytoFLEX,USA</td>
			<td>B49007AF</td>
			<td></td>
		</tr>
		<tr>
			<td>Human myocardial cells</td>
			<td>BLUEFBIO,China</td>
			<td>BFN60808678</td>
			<td></td>
		</tr>
		<tr>
			<td>Mitochondrial membrane potential assay kit with JC-1</td>
			<td>Bio-Technology,China</td>
			<td>C2006</td>
			<td></td>
		</tr>
		<tr>
			<td>Penicillin/Streptomycin solution</td>
			<td>Gibco,USA</td>
			<td>10378016</td>
			<td></td>
		</tr>
		<tr>
			<td>Reactive oxygen species assay kit</td>
			<td>Bio-Technology,China</td>
			<td>S0033S</td>
			<td></td>
		</tr>
		<tr>
			<td>Three-gas incubator</td>
			<td>Memmert,Germany</td>
			<td>ICO50</td>
			<td></td>
		</tr>
		<tr>
			<td>Trypsin-EDTA (0.25%)</td>
			<td>Gibco,USA</td>
			<td>25200056</td>
			<td></td>
		</tr>
	</tbody>
</table>

in vitro assessment of myocardial protection following hypothermia-preconditioning in a human cardiac myocytes model

Ischemia/reperfusion-derived myocardial dysfunction is a common clinical scenario in patients after cardiac surgery. In particular, the sensitivity of cardiomyocytes to ischemic injury is higher than that of other cell populations. At present, hypothermia affords considerable protection against an expected ischemic insult. However, investigations into complex hypothermia-induced molecular changes remain limited. Therefore, it is essential to identify a culture condition similar to in vivo conditions that can induce damage similar to that observed in the clinical condition in a reproducible manner. To mimic ischemia-like conditions in vitro, the cells in these models were treated by oxygen/glucose deprivation (OGD). In addition, we applied a standard time-temperature protocol used during cardiac surgery. Furthermore, we propose an approach to use a simple but comprehensive method for the quantitative analysis of myocardial injury. Apoptosis and expression levels of apoptosis-associated proteins were assessed by flow cytometry and using an ELISA kit. In this model, we tested a hypothesis regarding the effects of different temperature conditions on cardiomyocyte apoptosis in vitro. The reliability of this model depends on strict temperature control, controllable experimental procedures, and stable experimental results. Additionally, this model can be used to study the molecular mechanism of hypothermic cardioprotection, which may have important implications for the development of complementary therapies for use with hypothermia.

The effect of OGD exposure on the viability of HCMs was determined by CCK-8 assay. Compared with that observed in the control group, cell viability was significantly decreased in a time-dependent manner (Figure 2A). The apoptosis rates of HCMs at different times after reperfusion showed a specific trend, where from 0 to 16 h, the apoptosis rates gradually increased and reached the maximum rate at the 16 h time point (Figure 2B). As OGD for 12 h reduced cell acti...

Watch this Scientific Journal Video about In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model at JoVE.com

In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model

The distinct effects of different degrees of hypothermia on myocardial protection have not been thoroughly evaluated. The goal of the present study was to quantify the levels of cell death following different hypothermia treatments in a human cardiomyocyte-based model, laying the foundation for future in-depth molecular research.

Ischemia/reperfusion-derived myocardial dysfunction is a common clinical scenario in patients after cardiac surgery. In particular, the sensitivity of ...

The goal of the present study was to quantify the levels of cell death, following different hypothermia treatments in a human cardiomyocyte-based model. This model can be used to study the molecular mechanism of hypothermic cardioprotection, which may have important implications for the development of complimentary therapies for use with hypothermia. To culture the HCM cells, thaw the cryopreserved cells from liquid nitrogen in a 37-degree Celsius water bath and maintain them in a humidifier incubator under an atmosphere with 95%air and 5%carbon dioxide.Once the cells reach 60 to 70%confluence, aspirate the medium from the six-well plate and gently wash the cells three times with PBS. Add two milliliters of fresh sugar-free medium into each well and culture the cells at a constant temperature in a three-gas incubator under a mixture of 95%nitrogen, 5%carbon dioxide, and 0.1%oxygen at 37 degrees Celsius. For the time-temperature protocol, aspirate the medium from the six-well plate and add two milliliters of fresh sugar-free medium.Culture the cells in a tri-gas incubator for 12 hours to establish hypoxia. Set the temperature program starting with 10 hours of low temperature treatment, followed by a rewarming phase for two hours and 24 hours of normothermia. Remove three Petri dishes at every time point for analysis.After the low temperature treatment, aspirate the medium from the six-well plate and wash three times with PBS. Add two milliliters of fresh medium to each well, then maintain the cells at 37 degrees Celsius in a humidified incubator under an atmosphere with 95%air and 5%carbon dioxide. Add eight microliters of CCK-8 solution to each well of the plate and leave the plate for one hour in the incubator.After the incubation, measure the absorbance at 450 nanometers using a microplate reader. For apoptosis analysis, add five microliters of Annexin V-FITC to dye the cells. Then add 10 microliters of propidium iodide to the cell suspension.Gently mix the cells and incubate them for 20 minutes at room temperature in the dark. In the flow cytometry software, open two dot plot windows and select forward scattered light on the x-axis and side scattered light on the y-axis. Select the PE detection channel and FITC.Click Record to collect particles from the suspension in the blank sample tube, then gate the cell population for further analysis in the first dot plot. Next, place the single-stained samples on the tube support arm. Click Record to collect particles from the suspension and gate the cell population for further analysis.For mitochondrial assessment, add 0.5 milliliters of JC-1 working solution to each tube containing the trypsinized cells and incubate them in a 37 degrees Celsius incubator for 20 minutes. After incubation, centrifuge the cells at 600 times g for three minutes at four degrees Celsius and resuspend the HCMs in one milliliter of ice-cold staining buffer in a 1.5-milliliter centrifuge tube. Measure the fluorescence intensity of JC-1 by selecting the PE and FITC detection channels.For the reactive oxygen species assay, stain the cells and culture medium with 10 micromolar DCFDA and adjust the cell density to around one to 10 million cells. Incubate these cells for 30 minutes at 37 degrees Celsius, then analyze them on a flow cytometer. Add 40 microliters of buffer solution to the enzyme-labeled plate, then add 80 microliters of the sample.Then add 10 microliters of two millimolar acetyl DEVDp-nitroanilide and incubate the plate at 37 degrees Celsius for 120 minutes. Measure the A405 value on a microplate reader machine using the manufacturer's instructions. The temperature conditions in the time-temperature protocol were created and maintained using a tri-gas incubator, which allows for precise temperature regulation at three time points.The effect of oxygen and glucose deprivation, or OGD, on the viability of HCMs was determined using the CCK-8 assay. Compared with the control group, cell viability was significantly decreased in a time-dependent manner. The apoptosis rates of HCMs gradually increased between zero and 16 hours after reperfusion, then reached the maximum rate at the 16-hour time point.Compared with the OGD group, the percentage of viable cells was higher in the three groups treated with hypothermia. In addition, cells in the deep hypothermia group had the highest viability, 2.1-fold higher than that observed in the OGD group. Flow cytometry results confirmed that hypothermia prevented the apoptosis of HCMs under OGD conditions.Hypothermia treatment also decreased the intracellular ROS levels in HCMs. Mitochondrial membrane potential was detected with JC-1 staining. After OGD treatment, the red-to-green fluorescence ratio was decreased.Hypothermia significantly inhibited this OGD-induced effect. Moreover, a decrease of caspase-8 and caspase-3 was observed in the cells that were treated with hypothermia. The reliability of this model depends on strict temperature control, controllable experimental procedures, and stable experimental results.This method can be used to further explore the specific mechanism of hypothermic treatment on cell apoptosis and to study the molecular mechanism of hypothermic cardioprotection. It is of great significance for the development of hypothermic adjuvant therapy.

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Research

JoVE Journal

Medicine

Stem Cell Transplantation in an in vitro Simulated Ischemia/Reperfusion Model

Stem cell transplantation protocols are finding their way into clinical practice1,2,3. Getting better results, making the protocols more robust, and finding new sources for implantable cells are the focus of recent research4,5. Investigating the effectiveness of cell therapies is not an easy task and new tools are needed to investigate the mechanisms involved in the treatment process6. We designed an experimental protocol of ischemia/reperfusion in order to allow the observation of cellular connections and even subcellular mechanisms during ischemia/reperfusion injury and after stem cell transplantation and to evaluate the efficacy of cell therapy. H9c2 cardiomyoblast cells were placed onto cell culture plates7,8. Ischemia was simulated with 150 minutes in a glucose free medium with oxygen level below 0.5%. Then, normal media and oxygen levels were reintroduced to simulate reperfusion. After oxygen glucose deprivation, the damaged cells were treated with transplantation of labeled human bone marrow derived mesenchymal stem cells by adding them to the culture. Mesenchymal stem cells are preferred in clinical trials because they are easily accessible with minimal invasive surgery, easily expandable and autologous. After 24 hours of co-cultivation, cells were stained with calcein and ethidium-homodimer to differentiate between live and dead cells. This setup allowed us to investigate the intercellular connections using confocal fluorescent microscopy and to quantify the survival rate of postischemic cells by flow cytometry. Confocal microscopy showed the interactions of the two cell populations such as cell fusion and formation of intercellular nanotubes. Flow cytometry analysis revealed 3 clusters of damaged cells which can be plotted on a graph and analyzed statistically. These populations can be investigated separately and conclusions can be drawn on these data on the effectiveness of the simulated therapeutical approach.

Stem Cell Transplantation in an in vitro Simulated Ischemia/Reperfusion Model

We demonstrate how to set up an in vitro ischemia/reperfusion model and how to evaluate the effect of stem cell therapy on postischemic cardiac cells.

Stem cell transplantation protocols are finding their way into clinical practice1,2,3. Getting better results, making the protocols more robust, and ...

Assessment of Cardiac Function and Myocardial Morphology Using Small Animal Look-locker Inversion Recovery (SALLI) MRI in Rats

Small animal magnetic resonance imaging is an important tool to study cardiac function and changes in myocardial tissue. The high heart rates of small animals (200 to 600 beats/min) have previously limited the role of CMR imaging. Small animal Look-Locker inversion recovery (SALLI) is a T1 mapping sequence for small animals to overcome this problem 1. T1 maps provide quantitative information about tissue alterations and contrast agent kinetics. It is also possible to detect diffuse myocardial processes such as interstitial fibrosis or edema 1-6. Furthermore, from a single set of image data, it is possible to examine heart function and myocardial scarring by generating cine and inversion recovery-prepared late gadolinium enhancement-type MR images 1.
	The presented video shows step-by-step the procedures to perform small animal CMR imaging. Here it is presented with a healthy Sprague-Dawley rat, however naturally it can be extended to different cardiac small animal models.

Assessment of Cardiac Function and Myocardial Morphology Using Small Animal Look-locker Inversion Recovery SALLI MRI in Rats

Contrast enhanced cardiac magnetic resonance (CMR) imaging allows comprehensive in vivo assessment of the heart in small animal models of cardiovascular disease. Here we detail the procedures to perform CMR imaging, reconstruction and analysis using Small Animal Lock-Locker Inversion Recovery (SALLI) in rats.

Small animal magnetic resonance  imaging is an important tool to study cardiac function and changes in myocardial  tissue. The high heart rates of small ...

Myocardial Infarction and Functional Outcome Assessment in Pigs

Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One important prerequisite is a good understanding of all safety and efficacy aspects obtained in a large animal model that validly reflect the human scenario of myocardial infarction (MI). Pigs are widely used in this regard since their cardiac size, hemodynamics, and coronary anatomy are close to that of humans. Here, we present an effective protocol for using the porcine MI model using a closed-chest coronary balloon occlusion of the left anterior descending artery (LAD), followed by reperfusion. This approach is based on 90 min of myocardial ischemia, inducing large left ventricle infarction of the anterior, septal and inferoseptal walls. Furthermore, we present protocols for various measures of outcome that provide a wide range of information on the heart, such as cardiac systolic and diastolic function, hemodynamics, coronary flow velocity, microvascular resistance, and infarct size. This protocol can be easily tailored to meet study specific requirements for the validation of novel cardioregenerative biologics at different stages (i.e. directly after the acute ischemic insult, in the subacute setting or even in the chronic MI once scar formation has been completed). This model therefore provides a useful translational tool to study MI, subsequent adverse remodeling, and the potential of novel cardioregenerative agents.

This protocol describes the porcine myocardial infarction (MI) model using a 90 min closed-chest coronary balloon occlusion of the left anterior descending artery (LAD), followed by reperfusion. Furthermore, the protocol for several outcome parameters, such as cardiac function, hemodynamics, microvascular resistance, and infarct size, are also presented.

Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One ...

Excitotoxic Stimulation of Brain Microslices as an In vitro Model of Stroke

Examining molecular mechanisms involved in neuropathological conditions, such as ischemic stroke, can be difficult when using whole animal systems. As such, primary or &#39;neuronal-like&#39; cell culture systems are commonly utilized. While&#160;these systems are relatively easy to work with, and are useful model systems in which various functional outcomes (such as cell death) can be readily quantified, the examined outcomes and pathways in cultured immature neurons (such as excitotoxicity-mediated cell death pathways) are not necessarily the same as those observed in mature brain, or in intact tissue. Therefore, there is the need to develop models in which cellular mechanisms in mature neural tissue can be examined. We have developed an in vitro technique that can be used to investigate a variety of molecular pathways in intact nervous tissue. The technique described herein utilizes rat cortical tissue, but this technique can be adapted to use tissue from a variety of species (such as mouse, rabbit, guinea pig, and chicken) or brain regions (for example, hippocampus, striatum, etc.). Additionally, a variety of stimulations/treatments can be used (for example, excitotoxic, administration of inhibitors, etc.). In conclusion, the brain slice model described herein can be used to examine a variety of molecular mechanisms involved in excitotoxicity-mediated brain injury.

Excitotoxic Stimulation of Brain Microslices as an In vitro Model of Stroke

We have developed a brain slice model which can be used to examine molecular mechanisms involved in excitotoxicity-mediated brain injury.&#160;This technique generates viable mature brain tissue and reduces animal numbers required for experimentation, whilst keeping the neuronal circuitry, cellular interactions, and postsynaptic compartments partly intact.

Examining molecular mechanisms involved in neuropathological conditions, such as ischemic stroke, can be difficult when using whole animal systems. As ...

Quantification of Neurovascular Protection Following Repetitive Hypoxic Preconditioning and Transient Middle Cerebral Artery Occlusion in Mice

Experimental animal models of stroke are invaluable tools for understanding stroke pathology and developing more effective treatment strategies. A 2 week protocol for repetitive hypoxic preconditioning (RHP) induces long-term protection against central nervous system (CNS) injury in a mouse model of focal ischemic stroke. RHP consists of 9 stochastic exposures to hypoxia that vary in both duration (2 or 4 hr) and intensity (8% and 11% O2). RHP reduces infarct volumes, blood-brain barrier (BBB) disruption, and the post-stroke inflammatory response for weeks following the last exposure to hypoxia, suggesting a long-term induction of an endogenous CNS-protective phenotype. The methodology for the dual quantification of infarct volume and BBB disruption is effective in assessing neurovascular protection in mice with RHP or other putative neuroprotectants. Adult male Swiss Webster mice were preconditioned by RHP or duration-equivalent exposures to 21% O2 (i.e. room air). A 60 min transient middle cerebral artery occlusion (tMCAo) was induced 2 weeks following the last hypoxic exposure. Both the occlusion and reperfusion were confirmed by transcranial laser Doppler flowmetry. Twenty-two hr after reperfusion, Evans Blue (EB) was intravenously administered through a tail vein injection. 2 hr later, animals were sacrificed by isoflurane overdose and brain sections were stained with 2,3,5- triphenyltetrazolium chloride (TTC). Infarcts volumes were then quantified. Next, EB was extracted from the tissue over 48 hr to determine BBB disruption after tMCAo. In summary, RHP is a simple protocol that can be replicated, with minimal cost, to induce long-term endogenous neurovascular protection from stroke injury in mice, with the translational potential for other CNS-based and systemic pro-inflammatory disease states.

This protocol describes repetitive hypoxic preconditioning, or brief exposures to systemic hypoxia that reduce infarct volumes and blood-brain barrier disruption following transient middle cerebral artery occlusion in mice. It also details dual quantification of infarct volume and blood-brain barrier disruption after stroke to assess the efficacy of neurovascular protection.

Experimental animal models of stroke are invaluable tools for understanding stroke pathology and developing more effective treatment strategies. A 2 week ...

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Mortality after acute myocardial infarction remains substantial and is associated with significant morbidity, like heart failure. Novel therapeutics are therefore required to confine cardiac damage, promote survival and reduce the disease burden of heart failure. Large animal experiments are an essential part in the translational process from experimental to clinical therapies. To optimize clinical translation, robust and representative outcome measures are mandatory. The present manuscript aims to address this need by describing the assessment of three clinically relevant outcome modalities in a pig acute myocardial infarction (AMI) model: infarct size in relation to area at risk (IS/AAR) staining, 3-dimensional transesophageal echocardiography (TEE) and admittance-based pressure-volume (PV) loops. Infarct size is the main determinant driving the transition from AMI to heart failure and can be quantified by IS/AAR staining. Echocardiography is a reliable and robust tool in the assessment of global and regional cardiac function in clinical cardiology. Here, a method for three-dimensional transesophageal echocardiography (3D-TEE) in pigs is provided. Extensive insight into cardiac performance can be obtained by admittance-based pressure-volume (PV) loops, including intrinsic parameters of myocardial function that are pre- and afterload independent. Combined with a clinically feasible experimental study protocol, these outcome measures provide researchers with essential information to determine whether novel therapeutic strategies could yield promising targets for future testing in clinical studies.

Reliable and accurate outcome assessment is the key for translation of preclinical therapies into clinical treatment. The current paper describes how to assess three clinically relevant primary outcome parameters of cardiac performance and damage in a pig acute myocardial infarction model.

Mortality after acute myocardial infarction remains substantial and is associated with significant morbidity, like heart failure. Novel therapeutics are ...

Myocardial Infarction in Neonatal Mice, A Model of Cardiac Regeneration

Myocardial infarction induced by coronary artery ligation has been used in many animal models as a tool to study the mechanisms of cardiac repair and regeneration, and to define new targets for therapeutics. For decades, models of complete heart regeneration existed in amphibians and fish, but a mammalian counterpart was not available. The recent discovery of a postnatal window during which mice possess regenerative capabilities has led to the establishment of a mammalian model of cardiac regeneration. A surgical model of mammalian cardiac regeneration in the neonatal mouse is presented herein. Briefly, postnatal day 1 (P1) mice are anesthetized by isoflurane and placed on an ice pad to induce hypothermia. After the chest is opened, and the left anterior descending coronary artery (LAD) is visualized, a suture is placed around the LAD to inflict myocardial ischemia in the left ventricle. The surgical procedure takes 10-15 min. Visualizing the coronary artery is crucial for accurate suture placement and reproducibility. Myocardial infarction and cardiac dysfunction are confirmed by triphenyl-tetrazolium chloride (TTC) staining and echocardiography, respectively. Complete regeneration 21 days post myocardial infarction is verified by histology. This protocol can be used to as a tool to elucidate mechanisms of mammalian cardiac regeneration after myocardial infarction.

This protocol describes a highly reproducible model of cardiac regeneration by surgical induction of myocardial infarction in the left ventricle of postnatal day 1 mice. The method involves induction of hypothermic anesthesia and ligation of the left anterior descending coronary artery.

Myocardial infarction induced by coronary artery ligation has been used in many animal models as a tool to study the mechanisms of cardiac repair and ...

A Flow Cytometry-based Assay for Measuring Mitochondrial Membrane Potential in Cardiac Myocytes After Hypoxia/Reoxygenation

Timely and efficient reperfusion of the occluded coronary artery is the best strategy for decreasing myocardial infarct size in patients with a ST-segment elevated myocardial infarction. However, reperfusion per se can result in further cardiomyocyte death, a phenomenon known as reperfusion injury. The opening of the mitochondrial permeability transition pore (mPTP), with the decrease of the mitochondrial membrane potential (MMP), or mitochondrial depolarization, is universally recognized as the final step of reperfusion injury and is responsible for mitochondrial and cardiomyocyte death. JC-1 is a lipophilic cationic dye that accumulates in mitochondria depending on the value of MMP. The higher the MMP is, the more JC-1 accumulates in the mitochondria. The increasing amounts of JC-1 in mitochondria can be reflected by a fluorescence emission shift from green (~530 nm) to red (~590 nm). Therefore, the reduction of the red/green fluorescence intensity ratio can indicate the depolarization of mitochondria. Here, we take advantage of JC-1 to measure MMP, or the opening of mPTP in human cardiac myocytes after hypoxia/reoxygenation, detected by flow cytometry.

Here, we present a protocol that uses JC-1 dye to assess the mitochondrial membrane potential of cells after being exposed to hypoxia/reoxygenation with or without a protective agent.

Timely and efficient reperfusion of the occluded coronary artery is the best strategy for decreasing myocardial infarct size in patients with a ST-segment ...

Implantation of hiPSC-derived Cardiac-muscle Patches after Myocardial Injury in a Guinea Pig Model

Due to the limited regeneration capacity of the heart in adult mammals, myocardial infarction results in an irreversible loss of cardiomyocytes. This loss of relevant amounts of heart muscle mass can lead to the heart failure. Besides heart transplantation, there is no curative treatment option for the end-stage heart failure. In times of organ donor shortage, organ independent treatment modalities are needed. Left-ventricular assist devices are a promising therapy option, however, especially as destination therapy, limited by its side-effects like stroke, infections and bleedings. In recent years, several cardiac repair strategies including stem cell injection, cardiac progenitors or myocardial tissue engineering have been investigated. Recent improvements in cell biology allow for the differentiation of large amounts of cardiomyocytes derived from human induced pluripotent stem cells (iPSC). One of the cardiac repair strategies currently under evaluation is to transplant artificial heart tissue. Engineered heart tissue (EHT) is a three-dimensional in vitro created cardiomyocyte network, with functional properties of native heart tissue. We have created EHT-patches from hiPSC derived cardiomyocytes. Here we present a protocol for the induction of left ventricular myocardial cryoinjury in a guinea pig, followed by implantation of hiPSC derived EHT on the left ventricular wall.

Here we present a protocol for the induction of left ventricular cryoinjury followed by the implantation of a cardiac muscle patch, derived from human iPS-cell cardiomyocytes in a guinea pig model.

Due to the limited regeneration capacity of the heart in adult mammals, myocardial infarction results in an irreversible loss of cardiomyocytes. This loss ...

Isolation of Atrial Myocytes from Adult Mice

The electrophysiological properties of atrial myocytes importantly affect overall cardiac function. Alterations in the underlying ionic currents responsible for the action potential can cause pro-arrhythmic substrates that underlie arrhythmias, such as atrial fibrillation, which are highly prevalent in many conditions and disease states. Isolating adult mouse atrial cardiomyocytes for use in patch-clamp experiments has greatly advanced our knowledge and understanding of the cellular electrophysiology in the healthy atrial myocardium and in the setting of atrial pathophysiology. In addition, studies using genetic mouse models have elucidated the role of a vast array of proteins in regulating atrial electrophysiology. Here we provide a detailed protocol for the isolation of cardiomyocytes from the atrial appendages of adult mice using a combination of enzymatic digestion and mechanical dissociation of these tissues. This approach consistently and reliably yields isolated atrial cardiomyocytes that can then be used to characterize cellular electrophysiology by measuring action potentials and ionic currents in patch-clamp experiments under a number of experimental conditions.

This protocol is used to isolate single atrial cardiomyocytes from the adult mouse heart using a chunk digestion approach. This approach is used to isolate right or left atrial myocytes that can be used to characterize atrial myocyte electrophysiology in patch-clamp studies.