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- 저자 : 강현재 (검색결과 149 건)
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강현재,김효수,나상훈,장서영,강원준,연태진,구본권,김용진,이동수,손대원,한규섭,오병희,박영배 대한심장학회 2006 Korean Circulation Journal Vol.36 No.2
Background and Objectives:Granulocytes-colony stimulating factor (G-CSF) has a stem cell mobilizing capacityand favorable effects on ventricular remodeling following a myocardial infarction. G-CSF based stem cell therapyhas shown favorable results in animal studies. However, the long term outcome of G-CSF based stem cell therapyin clinical trial remains unknown. Herein, we report the six month follow up results of two different G-CSF basedstem cell therapy strategies. Subjects and Methods:We compared the intra-coronary infusion of mobilized peripheralblood stem cells (PBSCs) with G-CSF (n=10), mobilization with G-CSF alone (n=16) and controlpercutaneous coronary intervention (PCI) alone (n=15) in patients following a myocardial infarction. Results:At the six month follow up evaluations, the intra-coronary cell infusion was found to have improved the leftventricular (LV) systolic function and remodeling compared to the baseline, whereas G-CSF alone showed noimprovement. Therefore, an intra-coronary cell infusion showed better improvements in the LV systolic function(p<0.001) and remodeling (p<0.01) than G-CSF alone. Cell infusion also showed better results than the controlPCI alone group, but these did not reach statistical significance with the limited number of patients used in thisstudy. Patients who received G-CSF administration showed a modest increase of binary restenosis (p=0.185) and agreater late loss in the minimal luminal diameter at the 6 month follow up than the control group. Conclusion:An intra-coronary cell infusion of mobilized PBSCs using G-CSF was found to be better than G-CSF alone atthe six month follow up evaluation. G-CSF was also found to increase the potential risk of restenosis, especiallywhen administered prior to stent implantation. The efficacy of an intra-coronary infusion of mobilized PBSCsshould be evaluated in a large randomized controlled trial. (Korean Circulation J 2006;36:99-107) 배경 및 목적: G-CSF를 이용한 줄기세포치료법이 심기능 호전에 미치 는 효과가 임상연구에서 체계적으로 평가되지 못하고 있다. 이에 저자들은 G-CSF를 이용한 2가지 줄기세포 치료법인 줄기세포 동원유도법과 동원유도된 줄기세포를 채집하여 관 동맥 내로 주입하는 방법을 대조군 연구를 통하여 비교 평 가하고자 하였다. 방 법: 심근경색증 환자를 대상으로 G-CSF 단독 투여군(n=16), 동원유도된 줄기세포를 모집하여 관동맥 내로 투여하는 세 포주입군(n=10), 그리고 대조군(n=15)으로 무작위 배정하여 심기능의 호전여부를 6개월 추적관찰을 통해 평가하였다. 결 과: 6개월 추적 관찰결과 세포주입군에서만 치료 전에 비하여 유의한 좌심실 수축기기능의 호전(p<0.001)과 좌심실 용적 의 감소(p<0.01)를 관찰할 수 있었으며, G-CSF군에서는 호 전이 관찰되지 않았다. 세포주입군에서 대조군에 비해 심기 능의 호전의 정도가 큰 경향을 보였으나, 통계적인 유의성 은 확인하지 못하였다. 또한 G-CSF를 투여 받은 경우에 대 조군에 비해 재협착의 빈도가 증가하는 경향을 보였으나 통 계적 유의성은 없었다(p=0.185). 결 론: G-CSF는 효과적으로 줄기세포를 동원할 수 있었으며, 관 동맥 내 세포주입법이 G-CSF 단독 투여에 비해 심기능의 호전에 있어 우월한 효과를 보였다. G-CSF 투여는 관동맥 재협착을 경도로 증가시키는 경향성을 보였다. 줄기세포치료 HyuHyun-Jae Kang, et al:G-CSF in Myocardial Infarction·107 법의 효과는 대규모의 장기간 대조군 연구를 통하여 평가되 어야 할 것으로 판단된다.
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강현재,박영배,김효수 대한의사협회 2011 대한의사협회지 Vol.54 No.5
Cardiovascular disease has been one of leading causes of death and has an increasing importance in Korea. However the current treatment modalities for cardiovascular disease have limited efficacy. To overcome the limitations of current therapies, stem cell therapy has been evaluated as a new therapeutic option. Most experience and achievements of stem cell therapy for clinical applications have come from bone marrow-derived stem cells. Recent metaanalyses showed that stem cell therapy is safe and effective for improving cardiac systolic functions in patients with acute myocardial infarction. However, the long term efficacy and effects on clinical outcomes need to be determined. Stem cell therapy for acute cardiovascular disease,especially for acute myocardial infarction, has a proven efficacy and safety in short term follow up. Newer stem cell sources and therapeutic approaches such as adjunctive therapy or pretransplantation cultivation will be applied in this field to improve the efficacy of stem cell therapy. Stem cell therapy is a promising new therapeutic option for cardiovascular disease.
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강현재,배병석,김재훈,이봉렬,정병천,장희상 대한심장학회 2009 Korean Circulation Journal Vol.39 No.9
Background and Objectives: The purpose of this study was to investigate the relationship between chronic atrial fibrillation (AF) and reduced pulmonary function. Subjects and Methods: Eighty-six chronic AF patients who were enrolled from annual health examination programs were studied using echocardiography and pulmonary function tests (PFT). Echocardiography and PFT matched for age, gender, and year performed were selected by the control group who had normal sinus rhythms. Patients with ejection fractions <50%, valvular heart disease, or ischemic heart disease were excluded. Results: In the chronic AF patients, the forced expiratory volume at one second (FEV1), FEV1%, and FEV1/forced vital capacity (FVC) were significantly reduced, and the right ventricular systolic pressure was significantly increased. Episodes of heart failure were more frequently associated with the chronic AF patients than the controls. In particular, the FEV1% had the most meaningful relationship to chronic AF after an adjustment for cardiovascular risk factors {p=0.003, Exp (B)=0.978, 95% confidence interval (CI): 0.963-0.993}. Conclusion: Reduced FEV1%, which represents the severity of airway obstruction, was associated with chronic AF, and the greater the pulmonary function impairment, the greater the co-existence with AF and congestive heart failure in those with preserved left ventricular systolic function. Background and Objectives: The purpose of this study was to investigate the relationship between chronic atrial fibrillation (AF) and reduced pulmonary function. Subjects and Methods: Eighty-six chronic AF patients who were enrolled from annual health examination programs were studied using echocardiography and pulmonary function tests (PFT). Echocardiography and PFT matched for age, gender, and year performed were selected by the control group who had normal sinus rhythms. Patients with ejection fractions <50%, valvular heart disease, or ischemic heart disease were excluded. Results: In the chronic AF patients, the forced expiratory volume at one second (FEV1), FEV1%, and FEV1/forced vital capacity (FVC) were significantly reduced, and the right ventricular systolic pressure was significantly increased. Episodes of heart failure were more frequently associated with the chronic AF patients than the controls. In particular, the FEV1% had the most meaningful relationship to chronic AF after an adjustment for cardiovascular risk factors {p=0.003, Exp (B)=0.978, 95% confidence interval (CI): 0.963-0.993}. Conclusion: Reduced FEV1%, which represents the severity of airway obstruction, was associated with chronic AF, and the greater the pulmonary function impairment, the greater the co-existence with AF and congestive heart failure in those with preserved left ventricular systolic function.
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Magnetic Bionanoparticle Enhances Homing of Endothelial Progenitor Cells in Mouse Hindlimb Ischemia
강현재,김주영,Ho-Jae Lee,Keum-Hyun Kim,Tae-Youn Kim,Choon-Soo Lee,이현채,박태현,김효수,박영배 대한심장학회 2012 Korean Circulation Journal Vol.42 No.6
Background and Objectives: Poor homing efficiency is one of the major limitations of current stem cell therapy. Magnetic bionanopar-ticles (MPs) obtained from Magnetospirillum sp. AMB-1 have a lipid bilayer membrane and ferromagnetic properties. We evaluated a novel priming strategy using MPs to enhance the homing of transplanted progenitor cells to target tissue. Materials and Methods: Effects of MP on proliferation, viability, and migration of late human endothelial progenitor cells (EPCs) were ex-amined in vitro. Additionally, effects of MP on gene and protein expression related to survival and adhesion were evaluated. Homing and angiogenic efficiency of MP transferred late EPCs was evaluated in nude mouse hindlimb ischemia model. Results: Below threshold concentration, MP transfer did not influence proliferation or survival of late EPCs, but enhanced migration and trans-endothelial migration of late EPCs toward magnet. Below threshold concentration, MP transfer did not influence gene and protein expression related to survival. In the mouse hindlimb ischemia model, late EPCs treated with high dose MP (5 ug/mL) showed enhanced homing of injected late EPCs in the ischemic limb by magnet, compared to low dose MP (1 ug/mL) treated late EPCs. In addition, high dose MP transferred EPC showed significantly better improvement of perfusion in ischemic limb compared to untreated EPC. Conclusion: MP transfer with magnet application can be a promising novel strategy to enhance homing efficacy and outcomes of current stem cell therapy.
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