Statistical modeling of extracellular vesicle cargo to predict clinical trial outcomes for hypoplastic left heart syndrome

• Type of Material: Article
• Authors: Jessica R. Hoffman, Emory University; Hyun-Ji Park, Emory University; Sruti Bheri, Emory University; Manu Platt, Emory University; Joshua M. Hare, University of Miami; Sunjay Kaushal, Northwestern University; Judith L. Bettencourt, University of Texas, Houston; Dejian Lai, University of Texas, Houston; Tim Slesnick, Emory University; William Mahle, Emory University; Michael E Davis, Emory University
• Language: English
• Date: 2023-09-21
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Author(s)
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.isci.2023.107980
• Title of Journal or Parent Work: iScience
• Volume: 26
• Issue: 10
• Start Page: 107980
• Grant/Funding Information: The authors acknowledge funding by the National Institutes of Health grants: R01HL145644 (M.E.D.), F31HL154725 (J.R.H.), T32GM008602 (J.R.H.), as well as the American Heart Association Postdoctoral Fellowship 837187 (H.J.P.), and Additional Ventures. This work was also funded by a grant from the Marcus Foundation (M.E.D. and J.M.H).
• Keywords: Drug delivery system; Statistical physics; Medicine; Cardiology
• Research Categories: Biology, Cell; Health Sciences, General; Biology, Molecular

Abstract

Cardiac-derived c-kit+ progenitor cells (CPCs) are under investigation in the CHILD phase I clinical trial (NCT03406884) for the treatment of hypoplastic left heart syndrome (HLHS). The therapeutic efficacy of CPCs can be attributed to the release of extracellular vesicles (EVs). To understand sources of cell therapy variability we took a machine learning approach: combining bulk CPC-derived EV (CPC-EV) RNA sequencing and cardiac-relevant in vitro experiments to build a predictive model. We isolated CPCs from cardiac biopsies of patients with congenital heart disease (n = 29) and the lead-in patients with HLHS in the CHILD trial (n = 5). We sequenced CPC-EVs, and measured EV inflammatory, fibrotic, angiogeneic, and migratory responses. Overall, CPC-EV RNAs involved in pro-reparative outcomes had a significant fit to cardiac development and signaling pathways. Using a model trained on previously collected CPC-EVs, we predicted in vitro outcomes for the CHILD clinical samples. Finally, CPC-EV angiogenic performance correlated to clinical improvements in right ventricle performance.