Device encapsulated MSCs for adaptive secretome therapy to effectively target ischaemic heart injury

Abstract Effective long-term strategies to protect the ischaemic heart remain a significant challenge. Mesenchymal stem cells (MSCs) offer therapeutic potential primarily through their secretome, a bioactive factor-rich milieu with broad beneficial effects. However, existing delivery methods have not been shown to provide sustained benefits. Herein, we introduce an innovative approach for sustained MSC-secretome delivery for long-term cardioprotection. In a rat model of chronic myocardial infarction, Cymerus MSCs, derived from human induced pluripotent stem cells (iPSCs), were encapsulated in a Procyon immunoisolation device and implanted subcutaneously. A human-iPSC-derived engineered cardiac microtissue model was used to simulate ischaemia-reperfusion injury and assess cardioprotective effects in a human context. The MSC-loaded Procyon device significantly improved cardiac function and reduced adverse left ventricular remodelling over a 12-week period. These positive effects were consistent across both young and middle-aged, male and female rats, indicating broad applicability. The encapsulated MSCs remained viable and continuously released therapeutic secretome for 12 weeks. In vitro , the MSC secretome protected human engineered cardiac microtissues from simulated ischaemia-reperfusion injury, restoring contractile function, improving cell viability, and reducing oxidative stress. Proteomic analysis of MSCs revealed 179 unique cellular proteins post-implantation, linked to adaptive immune and inflammatory responses as well as wound healing. MSC secretome profiling revealed increased protein diversity associated with tissue repair and immune regulation, suggesting MSCs undergo an adaptive response to ischaemic conditions, enhancing their therapeutic potential. This translational study highlights a clinically viable, minimally invasive method for sustained cardioprotection, harnessing the MSC secretome to address a pivotal gap in current treatments for ischaemic heart disease.