Differentiation and Long-Term Survival of C2C12 Myoblast Grafts in Heart
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Differentiation and long-term survival of C2C12 myoblast grafts in heart. G Y Koh, … , M H Soonpaa, L J Field J Clin Invest. 1993;92(3):1548-1554. https://doi.org/10.1172/JCI116734. Research Article Find the latest version: https://jci.me/116734/pdf Rapid Publication Differentiation and Long-Term Survival of C2C12 Myoblast Grafts in Heart Gou Young Koh, Michael G. Klug, Mark H. Soonpaa, and Loren J. Field Krannert Institute ofCardiology, Indiana University School ofMedicine, Indianapolis, Indiana 46202-4800 Abstract formation of chimeric myotubes expressing wild-type dystro- phin. We have assessed the ability of skeletal myoblasts to form In contrast to skeletal muscle, the myocardium lacks a re- long-term, differentiated grafts in ventricular myocardium. generative stem cell system. Furthermore, ventricular cardio- C2C12 myoblasts were grafted directly into the heart of synge- myocytes in the adult mammalian heart are permanently with- neic mice. Viable grafts were observed as long as 3 mo after drawn from the cell cycle (6, 7). Myofiber loss due to trauma implantation. Immunohistological analyses revealed the pres- or disease is consequently irreversible. These observations ence of differentiated myotubes that stably expressed the skele- prompted several groups to determine if targeted oncogene ex- tal myosin heavy chain isoform. Thymidine uptake studies indi- pression could induce cardiomyocyte proliferation. Expression cated that virtually all of the grafted skeletal myocytes were of the SV40 large T antigen oncogene in the hearts of trans- withdrawn from the cell cycle by 14 d after grafting. Graft genic mice (8-10) or in virally transfected rat cardiomyocytes myocytes exhibited ultrastructural characteristics typical of (11) resulted in a sustained proliferative response. Elevated differentiated myotubes. Graft formation and the associated expression of c-myc during embryogenesis increased develop- myocardial remodeling did not induce overt cardiac arrhyth- mental cardiomyocyte hyperplasia in transgenic mice (12). mia. This study indicates that the myocardium can serve as a Cardiomyocyte proliferation was also observed following retro- stable platform for skeletal myoblast grafts. The long-term sur- viral transduction of ras or myc in embryonic rat ( 13) or avian vival, differentiated phenotype, and absence of sustained prolif- (14) cardiomyocytes. Thus targeted oncogene expression, at erative activity observed in myoblast grafts raise the possibility least in some instances, can bypass the cues that usher cell cycle that similar grafting approaches may be used to replace dis- withdrawal during normal cardiomyocyte development. Pres- eased myocardium. Furthermore, the genetic tractability of ently it is not clear if targeted oncogene expression can induce myoblasts could provide a useful means for the local delivery of proliferation in adult cardiomyocytes. recombinant molecules to the heart. (J. Clin. Invest. 1993. Given the absence of significant regenerative potential in 92:1548-1554.) Key words: skeletal myoblasts * intracardiac mammalian myocardium, we have previously conducted a se- grafts * cell transplantation * gene therapy * myocardial repair ries of experiments to determine if cardiomyocytes manipu- lated in vitro could form intracardiac grafts ( 15). These experi- Introduction ments utilized AT- 1 cardiomyocytes, which were derived from It is now well established that the regenerative capacity of skele- transgenic mice expressing the SV40 large T antigen oncogene tal muscle resides in the satellite cells first described by Mauro in the atrium (8, 16). AT-l cardiomyocytes retain the capacity in 1961 (1). Trauma induces satellite cell proliferation and for proliferation in culture while displaying a differentiated phe- subsequent differentiation into new (or regenerated) muscle notype ( 17, 18). Our results showed that AT- I cardiomyocytes fibers. Satellite cell (myoblast) lines that retain the capacity to formed long-term, differentiated intracardiac grafts without differentiate into myotubes in culture have been isolated from having a deleterious effect on cardiac function. However, the a number of species, including mouse and human. Several unchecked proliferation of grafted AT- 1 cells limits the poten- groups have shown that myoblasts have the capacity to fuse to tial value of these grafts for both myocardial repair and long- preexisting fibers when introduced directly into the skeletal term delivery of recombinant molecules. muscle of a syngeneic host (2, 3). Thus, skeletal muscle regen- The successful use of skeletal myoblasts in the grafting ex- eration can be engendered via heterokaryon formation be- periments mentioned above prompted us to test their capacity tween host myotubes and histocompatible donor myoblasts. to generate intracardiac grafts. In this study we addressed three This observation has been exploited in studies with mdx mice issues. First, we determined if C2C12 myoblasts could form (4) and Duchenne's patients (5), where the introduction of stable grafts in a syngeneic myocardium. Second, we ascer- myoblasts carrying a normal dystrophin gene resulted in the tained the proliferative and differentiated status ofgrafted cells. Third, we determined if the presence of C2C12 grafts had a deleterious effect on host cardiac function. Our results indicate Address reprint requests to Loren J. Field, Krannert Institute of Cardi- that C2C 12 differentiate into myotubes when ology, 1111 West 10th Street, Indianapolis, IN 46202-4800. myoblasts Receivedfor publication 5 March 1993 and in revisedform 26 April grafted into the heart. The absence of tritiated thymidine up- 1993. take indicates that the grafted cells are withdrawn from the cell cycle by 14 days after implantation. There was no overt effect J. Clin. Invest. on cardiac function in animals bearing differentiated myotube ©D The American Society for Clinical Investigation, Inc. grafts. The implication of these results with respect to the po- 0021-9738/93/09/1548/07 $2.00 tential replacement of myocardial tissue and to the long-term Volume 92, September 1993, 1548-1554 delivery of recombinant proteins to the heart is discussed. 1548 G. Y. Koh, M. G. Klug, M. H. Soonpaa, and L. J. Field Methods Results C2C12 cell culture and myocardial grafting protocol. C2Cl2 myoblasts Several myoblast cell lines have been described that, as exem- were obtained from American Type Culture Collection (Rockville, plified by C2C 12 cells, have the capacity to differentiate into MD). Cells were maintained in the undifferentiated state by culturing myotubes in culture (21 ). C2C1 2 myoblasts were derived from at low density in high glucose DME supplemented with 20% FBS, 1% cultured explants of injured thigh muscle of C3H mice. When chicken embryo extract, 100 U/ml penicillin, and 100 ,g/ml strepto- maintained in serum-rich the mycin. For some studies, myogenic differentiation was induced by cul- media, myoblasts proliferate rap- an turing in DME supplemented with 2% horse serum and antibiotics. idly and retain undifferentiated phenotype. However, when Immediately before injection, myoblasts were harvested with trypsin, cultured in serum-poor media, myogenic differentiation is in- washed three times with serum-free DME, and directly injected into duced. The C2C1 2 cells withdraw from the cell cycle and fuse, the ventricular myocardium of adult syngeneic C3Heb/FeJ mice thereby forming multinucleated myotubes. Myogenic differen- (Jackson Laboratories, Bar Harbor, ME) under open heart surgery as tiation is also induced, as evidenced by the appearance of nu- described ( 15, 19). 4-10 X 104 cells were injected in a volume of 2-3 ,1 merous muscle-specific gene products. Thus, in this model, using a plastic syringe fitted with a 30-gauge needle. proliferation and myogenic differentiation are mutually exclu- Histology. Hearts were removed following cervical dislocation and sive (22). Myoblast differentiation in vitro is thought to mimic cryoprotected in 30% sucrose, embedded and sectioned at 10 Am with a satellite cell mediated myofiber regeneration in vivo. cryomicrotome as described (20). For hematoxylin and eosin (H and We have used C2C1 2 myoblasts to generate E)' staining, sections were postfixed in acetone/methanol ( 1:1) and long-term stained according to manufacturer's specifications (Sigma Diagnostics, grafts in the adult heart. Myoblasts were injected directly into St. Louis, MO). For immunohistology, methanol-fixed sections the myocardium of syngeneic C3Heb/FeJ mice and the viabil- (-20'C, 10 min) were reacted with the monoclonal anti-skeletal myo- ity of the grafted material was assessed. 100% ( 13/ 13) of the sin heavy chain antibody (MY-32; Sigma Chemical Corp., St. Louis, mice receiving intracardiac implants ofC2C 12 myoblastsdevel- MO) followed by rhodamine-conjugated sheep anti-mouse IgG oped grafts in the heart. Viable grafts were observed as long as 3 F(ab')2 fragment (Boehringer Mannheim, Indianapolis, IN), and visu- mo after implantation, the latest time point assayed to date. In alized by epifluorescence. For [3H]thymidine incorporation, mice all instances, the grafted material was not encapsulated (Fig. 1, were given a single bolus injection of isotope (400 MCi at 28 Ci/mM, A, D, F, and H). The differentiated status of the grafted C2C 12 Amersham, Arlington Heights, IL) and 18 h later killed by cervical cells was determined dislocation. by immunohistological assay with an The heart was removed, cryoprotected in 30% sucrose, chain This embedded,