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April 24, 2026Journal of the American College of Cardiology301 citationsOpen Access

Mitochondria-Rich Extracellular Vesicles From Autologous Stem Cell–Derived Cardiomyocytes Restore Energetics of Ischemic Myocardium

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GIGentaro IkedaMSMichelle SantosoYTYuko Tada

Key Result

Intramyocardial injection of mitochondria-rich extracellular vesicles significantly improved post-MI cardiac function through restoration of bioenergetics and mitochondrial biogenesis in a murine model.

Key Points

  • This research aims to demonstrate the potential of extracellular vesicles for restoring cardiac energy levels after a heart attack.
  • Utilized human-induced pluripotent stem cell-derived cardiomyocytes (iCMs) to produce mitochondria-rich extracellular vesicles (M-EVs).
  • Investigated therapeutic effects of M-EVs in a murine model of myocardial infarction via intramyocardial injection.
  • Analyzed the transfer and impact of M-EVs on intracellular energetics and mitochondrial biogenesis.
  • Treatment with 1.0 × 10^8/ml M-EVs improved ATP production and contractile function 3 hours post-treatment.
  • M-EVs activated mitochondrial biogenesis in recipient iCMs, supporting energy restoration within 24 hours.
  • Injection of M-EVs significantly improved post-MI cardiac function through enhanced bioenergetics.

Structured PICO

Do mitochondria-rich extracellular vesicles from autologous stem cell-derived cardiomyocytes restore energetics and improve cardiac function in ischemic myocardium models?

P
Population
In vitro human-induced pluripotent stem cell-derived cardiomyocytes (iCMs) and in vivo murine myocardial infarction (MI) model
I
Intervention
Mitochondria-rich extracellular vesicles (M-EVs) derived from iCMs (1.0 × 10^8/ml in vitro, 1.0 × 10^8 intramyocardial injection in vivo)
C
Comparator
Isolated mitochondria (in vitro) or untreated controls
O
Outcome
Intracellular ATP production, contractile profiles, and post-MI cardiac functionsurrogate

Mitochondria-rich extracellular vesicles from stem cell-derived cardiomyocytes restore bioenergetics and improve cardiac function in preclinical models of myocardial ischemia.

Abstract

BACKGROUND: Mitochondrial dysfunction results in an imbalance between energy supply and demand in a failing heart. An innovative therapy that targets the intracellular bioenergetics directly through mitochondria transfer may be necessary. OBJECTIVES: The purpose of this study was to establish a preclinical proof-of-concept that extracellular vesicle (EV)-mediated transfer of autologous mitochondria and their related energy source enhance cardiac function through restoration of myocardial bioenergetics. METHODS: Human-induced pluripotent stem cell-derived cardiomyocytes (iCMs) were employed. iCM-conditioned medium was ultracentrifuged to collect mitochondria-rich EVs (M-EVs). Therapeutic effects of M-EVs were investigated using in vivo murine myocardial infarction (MI) model. RESULTS: Electron microscopy revealed healthy-shaped mitochondria inside M-EVs. Confocal microscopy showed that M-EV-derived mitochondria were transferred into the recipient iCMs and fused with their endogenous mitochondrial networks. Treatment with 1.0 × 108/ml M-EVs significantly restored the intracellular adenosine triphosphate production and improved contractile profiles of hypoxia-injured iCMs as early as 3 h after treatment. In contrast, isolated mitochondria that contained 300× more mitochondrial proteins than 1.0 × 108/ml M-EVs showed no effect after 24 h. M-EVs contained mitochondrial biogenesis-related messenger ribonucleic acids, including proliferator-activated receptor γ coactivator-1α, which on transfer activated mitochondrial biogenesis in the recipient iCMs at 24 h after treatment. Finally, intramyocardial injection of 1.0 × 108 M-EVs demonstrated significantly improved post-MI cardiac function through restoration of bioenergetics and mitochondrial biogenesis. CONCLUSIONS: M-EVs facilitated immediate transfer of their mitochondrial and nonmitochondrial cargos, contributing to improved intracellular energetics in vitro. Intramyocardial injection of M-EVs enhanced post-MI cardiac function in vivo. This therapy can be developed as a novel, precision therapeutic for mitochondria-related diseases including heart failure.

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Cite This Study

Ikeda et al. (2021) studied Myocardial infarction. Mitochondria-rich extracellular vesicles (M-EVs) vs. Isolated mitochondria was evaluated on Restoration of intracellular ATP production, contractile profiles, and post-MI cardiac function. Intramyocardial injection of mitochondria-rich extracellular vesicles significantly improved post-MI cardiac function through restoration of bioenergetics and mitochondrial biogenesis in a murine model.

synapsesocial.com/papers/69ebde446651671f0a73fab6https://doi.org/10.1016/j.jacc.2020.12.060
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