Evidence map›Paper›PMID 42094594›Full record

ArticleTheranostics2026

Human atrial extracellular vesicles suppress NLRP3 inflammasome activation and profibrotic signaling in a patient-specific iPSC model of postoperative atrial fibrillation.

Noreen Ahmed, Bin Ye, Wenbin Liang, Buu-Khanh Lam, Fraser Rubens, Saad Khan, David Courtman, Duncan John Stewart, Darryl Raymond Davis

Abstract read
In one paragraph

Article in Theranostics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Noreen AhmedUniversity of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, University of Ottawa, Ottawa, Canada K1Y4W7.
Bin YeUniversity of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, University of Ottawa, Ottawa, Canada K1Y4W7.
Wenbin LiangUniversity of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, University of Ottawa, Ottawa, Canada K1Y4W7.
Buu-Khanh LamUniversity of Ottawa Heart Institute, Division of Cardiac Surgery, Department of Surgery, University of Ottawa, Ottawa, Canada K1Y4W7.
Fraser RubensUniversity of Ottawa Heart Institute, Division of Cardiac Surgery, Department of Surgery, University of Ottawa, Ottawa, Canada K1Y4W7.
Saad KhanOttawa Hospital Research Institute, Division of Regenerative Medicine, Department of Medicine, University of Ottawa; Ottawa, Canada.
David CourtmanOttawa Hospital Research Institute, Division of Regenerative Medicine, Department of Medicine, University of Ottawa; Ottawa, Canada.
Duncan John StewartUniversity of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, University of Ottawa, Ottawa, Canada K1Y4W7.
Darryl Raymond DavisUniversity of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, University of Ottawa, Ottawa, Canada K1Y4W7.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Postoperative atrial fibrillation (AF) remains a common and morbid complication of cardiac surgery, driven by inflammation and fibrosis for which targeted therapies are limited. Conventional antiarrhythmic and anticoagulant strategies have little impact on its incidence or recurrence. We previously demonstrated that a single intracardiac injection of extracellular vesicles (EVs) derived from human heart explant-derived cells prevents postoperative AF in preclinical models. The present study aimed to elucidate the mechanisms underlying this protective effect in human cells. Methods: Induced pluripotent stem cells (iPSCs) were generated from circulating mononuclear cells obtained from cardiac surgery patients at high and low risk for postoperative AF, then differentiated into atrial fibroblasts. These cells were compared with primary human atrial fibroblasts isolated from surgical tissue. Clinical-grade cardiac EVs were manufactured from heart explant-derived cells and characterized for size, surface markers, and microRNA cargo. Both iPSC-derived and primary fibroblasts were exposed to inflammatory (IL-6, TGF-β1, lipopolysaccharide) and fibrotic stimuli, with or without EV treatment. Inflammasome activation and cytokine secretion were assessed by transcript and protein analyses. Results: iPSC-derived and primary atrial fibroblasts exhibited comparable antigenic and functional profiles and efficiently internalized cardiac EVs. EV treatment markedly suppressed activation of the NLRP3 inflammasome following lipopolysaccharide and nigericin stimulation, resulting in reduced secretion of Caspase-1, IL-1β, and IL-18 and corresponding transcript downregulation. EVs also attenuated IL-6 and TGF-β1 induced fibroblast proliferation, confirming their anti-inflammatory and antifibrotic effects across cell sources and patient risk groups. Conclusions: This study establishes a patient-specific human cellular model of cardiac fibrosis, a key determinant of postoperative AF, and identifies heart-derived EVs as potent suppressors of inflammasome activation and profibrotic signaling. These findings provide mechanistic insight into the anti-inflammatory and antifibrotic actions of cardiac EVs and support their further development as a cell-free biologic for the prevention of postoperative AF.

Indexed as

Atrial FibrillationExtracellular VesiclesHeart AtriaInduced Pluripotent Stem CellsInflammasomesNLR Family, Pyrin Domain-Containing 3 ProteinPostoperative ComplicationsCells, CulturedCytokinesFibroblastsFibrosisHumansMaleSignal TransductionCytokinesInflammasomesNLR Family, Pyrin Domain-Containing 3 ProteinNLRP3 protein, humancardiac fibrosisextracellular vesiclesinduced pluripotent stem cellsNLRP3 inflammasomepostoperative atrial fibrillation

Identifiers

PMID42094594
PMCPMC13141743

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.