Macrophage subpopulations are essential for infarct repair with and without stem cell therapy

Tamar Ben-Mordechai, Radka Holbova, Natalie Landa-Rouben, Tamar Harel-Adar, Micha S. Feinberg, Ihab Abd Elrahman, Galia Blum, Fred H. Epstein, Zmira Silman, Smadar Cohen, Jonathan Leor*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

211 Scopus citations


Objectives This study sought to investigate the hypothesis that the favorable effects of mesenchymal stromal cells (MSCs) on infarct repair are mediated by macrophages. Background The favorable effects of MSC therapy in myocardial infarction (MI) are complex and not fully understood. Methods We induced MI in mice and allocated them to bone marrow MSCs, mononuclear cells, or saline injection into the infarct, with and without early (4 h before MI) and late (3 days after MI) macrophage depletion. We then analyzed macrophage phenotype in the infarcted heart by flow cytometry and macrophage secretome in vitro. Left ventricular remodeling and global and regional function were assessed by echocardiography and speckle-tracking based strain imaging. Results The MSC therapy significantly increased the percentage of reparative M2 macrophages (F4/80+CD206+) in the infarcted myocardium, compared with mononuclear- and saline-treated hearts, 3 and 4 days after MI. Macrophage cytokine secretion, relevant to infarct healing and repair, was significantly increased after MSC therapy, or incubation with MSCs or MSC supernatant. Significantly, with and without MSC therapy, transient macrophage depletion increased mortality 30 days after MI. Furthermore, early macrophage depletion produced the greatest negative effect on infarct size and left ventricular remodeling and function, as well as a significant incidence of left ventricular thrombus formation. These deleterious effects were attenuated with macrophage restoration and MSC therapy. Conclusions Some of the protective effects of MSCs on infarct repair are mediated by macrophages, which are essential for early healing and repair. Thus, targeting macrophages could be a novel strategy to improve infarct healing and repair.

Original languageEnglish
Pages (from-to)1890-1901
Number of pages12
JournalJournal of the American College of Cardiology
Issue number20
StatePublished - 12 Nov 2013
Externally publishedYes


FundersFunder number
European Commission-Cardiovascular Disease
Israeli National Nanotechnology Initiative
US-Israel bi-national science foundation
Leona M. and Harry B. Helmsley Charitable Trust
Seventh Framework Programme
Ministry of Culture and Sport


    • inflammation
    • macrophage
    • mesenchymal stroma cell
    • myocardial infarction
    • remodeling


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