Staff member

Background Small cardiac tissue engineering constructs show promise for limiting post-infarct sequelae in animal models. This study sought to scale-up a 2-cm2 preclinical construct into a human-size advanced therapy medicinal product (ATMP; PeriCord), and to test it in a first-in-human implantation. Methods The PeriCord is a clinical-size (12–16 cm2) decellularised pericardial matrix colonised with human viable Wharton's jelly-derived mesenchymal stromal cells (WJ-MSCs). WJ-MSCs expanded following good manufacturing practices (GMP) met safety and quality standards regarding the number of cumulative population doublings, genomic stability, and sterility. Human decellularised pericardial scaffolds were tested for DNA content, matrix stiffness, pore size, and absence of microbiological growth. Findings PeriCord implantation was surgically performed on a large non-revascularisable scar in the inferior wall of a 63-year-old male patient. Coronary artery bypass grafting was concomitantly performed in the non-infarcted area. At implantation, the 16-cm2 pericardial scaffold contained 12·5 × 106 viable WJ-MSCs (85·4% cell viability; <0·51 endotoxin units (EU)/mL). Intraoperative PeriCord delivery was expeditious, and secured with surgical glue. The post-operative course showed non-adverse reaction to the PeriCord, without requiring host immunosuppression. The three-month clinical follow-up was uneventful, and three-month cardiac magnetic resonance imaging showed ~9% reduction in scar mass in the treated area. Interpretation This preliminary report describes the development of a scalable clinical-size allogeneic PeriCord cardiac bioimplant, and its first-in-human implantation. Funding La Marató de TV3 Foundation, Government of Catalonia, Catalan Society of Cardiology, “La Caixa” Banking Foundation, Spanish Ministry of Science, Innovation and Universities, Institute of Health Carlos III, and the European Regional Development Fund.

JTD Keywords: Advanced therapy medicinal product (ATMP), Biofabrication, Cardiac tissue engineering, Myocardial infarction, Scaffold, Wharton's jelly-derived mesenchymal stromal cells (WJ-MSCs)

Studies based on the cardiac and respiratory system have allowed a better knowledge of their behavior to contribute with the diagnosis and treatment of diseases associated with them. The main goal of this project was to analyze the behavior of the cardiorespiratory system in healthy subjects, depending on the body position. The electrocardiography and respiratory flow signals were recorded in two positions, supine and sitting. Each signal was analyzed considering sliding windows of 30 s, with and overlapping of 50%. Temporal and spectral features were extracted from each signal. A total of 187 features were extracted for each window. According to statistical analysis, 148 features showed significant differences when comparing the position of the subject. Afterwards, the classifications methods based on decision trees, k-nearest neighbor and support vector machines were applied to identify the best classification model. The most advantageous performance model was obtained with a linear support vector machine method, with an accuracy of 99.5%, a sensitivity of 99.2% and a specificity of 99.6%. In conclusion, we have observed that the position of the body (supine or sitting) could modulate the cardiac and respiratory system response. New statistical models might provide new tools to analyze the behavior of these systems and the cardiorespiratory interaction complexity.

JTD Keywords: Cardiac dynamics, Respiratory dynamics, Statistical models, Supine and sitting posture