Rationale:
Autophagy can preserve cell viability under conditions of mild ischemic stress by degrading damaged organelles for ATP production, but under conditions of severe ischemia, it can promote cell death and worsen cardiac performance. Mesenchymal stem cells (MSCs) are cardioprotective when tested in animal models of myocardial infarction (MI), but whether these benefits occur through the regulation of autophagy is unknown.
Objective:
To determine whether transplanted MSCs reduce the rate of autophagic degradation (autophagic flux) in infarcted hearts and if so, to characterize the mechanisms involved.
Methods and Results:
Treatment with transplanted MSCs improved cardiac function and infarct size while reducing apoptosis and measures of autophagic flux (BafA1-induced LC3-II accumulation and autophagosome/autolysosome prevalence) in infarcted mouse hearts. In hypoxia and serum deprivation (H/SD)-cultured neonatal mouse cardiomyocytes (NMCMs), autophagic flux and cell death, as well as p53-Bnip3 signaling, declined when the cells were cultured with MSCs or MSCs-secreted exosomes, but the changes associated with MSCs-secreted exosomes (MSCs-exo) were largely abolished by pretreatment with the exosomal inhibitor GW4869. Furthermore, a mimic of the exosomal oligonucleotide miR-125b reduced, while an anti-miR-125b oligonucleotide increased, autophagic flux, cell death, via modulating p53-Bnip3 signaling in H/SD-cultured NMCMs. In the in vivo mouse MI model, MSCs-exo, but not the exosomes obtained from MSCs pretreated with the anti-miR-125b oligonucleotide (MSCs-exoanti-miR-125b), recapitulated the same results as the in vitro experiments. Moreover, measurements of infarct size and cardiac function were significantly better in group that were treated with MSCs-exo than the MSCs-exoanti-miR-125b group.
Conclusions:
The beneficial effects offered by MSCs transplantation after MI are at least partially due to improved autophagic flux through excreted exosome containing mainly miR-125b-5p.