Clinical applications of stem cell therapy for regenerating the heart (original) (raw)
Related papers
Stem cell-based therapies for heart regeneration: what did the bench teach us?
Cardiovascular & hematological disorders drug targets, 2010
Stem cell-based therapies represent a promising therapy for myocardial infarction. Pre-clinical and clinical tests performed in the last 10 years indicate that several types of stem cells and their progenies reduce infarct size and improve cardiac contractile function. The mechanism is dependent on the type of cell and involves a combination of several factors, such as: (i) the formation of new blood vessels, (ii) the release of pro-survival, pro-angiogenic and anti-inflammatory factors (paracrine effect), and (iii) the functional contribution of cardiomyocytes. With the exception of cardiac progenitor cells and pluripotent stem cells (human embryonic stem cells and inducible pluripotent stem cells) that have the unquestioned ability to give rise to cardiomyocytes, the other stem cells, including bone-marrow stem cells and fetal stem cells, have none or very limited capacity to differentiate into contractile cells. For both cases, it is of the utmost importance to develop strategies...
Stem cells for cardiac repair in acute myocardial infarction
Expert Review of Cardiovascular Therapy, 2011
Despite recent advances in medical therapy, reperfusion strategies, implantable cardio verterdefibrillators and cardiac assist devices, ischemic heart disease is a frequent cause of morbidity and mortality worldwide. Cell therapy has been introduced as a new treatment modality to regenerate lost cardiomyocytes. At present, several cell types seem to improve left ventricular function in animal models as well as in humans, but evidence for true generation of new myocardium is confined to the experimental models. In the clinical perspective, myocardial regeneration has been replaced by myocardial repair, as other mechanisms seem to be involved. Clinical studies on adult stem cells suggest, at best, moderate beneficial effects on surrogate end points, but some applications may qualify for evaluation in larger trials. Complete regeneration of the myocardium by cell therapy after a large myocardial infarction is still visionary, but pluripotent stem cells and tissue engineering are important tools to solve the puzzle.
USE OF STEM CELL THERAPIES FOR REGENERATION OF DAMAGED HEART TISSUE AFTER ACUTE MYOCARDIAL INFARCTION (Atena Editora), 2023
Objective: To analyze the current literature on the use of stem cell therapies for the regeneration of injured cardiac tissue after acute myocardial infarction. Methodology: Bibliographic review study through searches in PubMed databases, published from 2017 to 2022, totaling 11 studies used to compose the bibliographic review. Results: The studies demonstrate that different types of stem cells can be used, including embryonic stem cells, induced pluripotent stem cells and skeletal myoblasts. Several mechanisms of action of stem cells occur, including the release of exosomes, the modulation of the inflammatory response, the regulation of gene expression and the interaction with the extracellular matrix. Clinical evidence has shown that stem cell transplantation can result in significant improvements in cardiac function, including increased left ventricular ejection fraction and reduced ventricular volume of muscle and intraventricular cavity. These encouraging results underscore the therapeutic potential of stem cells in regenerating heart tissue and treating cardiovascular disease. Conclusion: It is important to highlight that further studies are needed to deepen the understanding of the mechanisms of action of stem cells and their clinical application, seeking to improve the efficacy and safety of stem cell therapies for heart disease and other medical conditions.
Stem cells for myocardial repair
Thrombosis & Haemostasis, 2010
There is a growing interest in the clinical application for stem cell as a novel therapy for treatment of acute myocardial infarction and chronic myocardial ischaemia. The initial premise is the transplanted exogenous stem cells can engraft and integrate with host myocardium for cardiac regeneration. However, recent experimental studies suggest that multiple mechanisms, including remodelling of extracellular matrix, enhancement of neovascularisation and recruitment of endogenous stem cells are more likely to contribute to the beneficial effects of stem cell therapy that direct trans-differentiation of stem cells into functional myocardium. Among different potential cell sources, bone marrow-derived cells and skeletal myoblasts have been tested in pilot clinical trials. Phase I/II randomised controlled clinical trials suggest that intracoronary or intramyocardial injection of bone marrow-derived cells may be safe and feasible strategies for treatment of acute myocardial infarction as well as chronic myocardial ischaemia. In addition, these studies show a modest, but significant improvement in left ventricular ejection fraction and clinical status of patients after cell transplantation. Nevertheless, most of these studies included a relatively small sample size (<200) and short duration of follow-up (<6 months), and the clinical efficacy of stem cell therapy need to be confirmed by future clinical trials. Furthermore, the optimal timing, cell types and mode of delivery need to be addressed, and strategies to improve cell survival and engraftment should also be developed to overcome the potential hurdles related to cell-based therapy.
Myocardial Regeneration and Stem Cell Repair
Current Problems in Cardiology, 2008
Recent evidence would suggest that the heart is not a terminally differentiated organ and has the ability to regenerate itself under normal and pathophysiologic conditions. A major effort has been made to identify precursor cells that are capable of differentiating into cell lineages different from their organ of origin. Embryonic stem cells and bone marrow-derived cells (BMCs) have been studied and characterized, and BM precursor cells are currently being utilized as therapy in clinical trials of patients with heart failure of ischemic and nonischemic etiologies. Controversy remains, however, whether BMCs are the best cells to be used for replacement therapy. The existence of a cardiac stem cell (CSC) has also been described, which has the ability to generate new cardiac myocytes and blood vessels, raising the possibility of rebuilding a damaged heart with the organ's own precursor stem cell population. Animal studies have suggested such a possibility, and a clinical trial using CSCs is in progress. This monograph discusses our current understanding of myocardial regeneration and the roles that endogenous and exogenous stem cells may have in the future therapy of cardiovascular disease. (Curr Probl Cardiol 2008;33:91-153.) C ardiovascular diseases, including acute myocardial infarction and congestive heart failure, are the leading causes of death in the industrialized world. The epidemic problem of heart failure, Funded research work from the National Institutes of Health. The authors have no conflicts of interest to disclose. Curr Probl Cardiol 2008;33:91-153.
Regenerative Cardiovascular Therapies: Stem Cells and Beyond
International Journal of Molecular Sciences, 2019
Although reperfusion therapy has improved outcomes, acute myocardial infarction (AMI) is still associated with both significant mortality and morbidity. Once irreversible myocardial cell death due to ischemia and reperfusion sets in, scarring leads to reduction in left ventricular function and subsequent heart failure. Regenerative cardiovascular medicine experienced a boost in the early 2000s when regenerative effects of bone marrow stem cells in a murine model of AMI were described. Translation from an animal model to stem cell application in a clinical setting was rapid and the first large trials in humans suffering from AMI were conducted. However, high initial hopes were early shattered by inconsistent results of randomized clinical trials in patients suffering from AMI treated with stem cells. Hence, we provide an overview of both basic science and clinical trials carried out in regenerative cardiovascular therapies. Possible pitfalls in specific cell processing techniques and...
Current Cardiology Reviews, 2011
Degeneration of cardiac tissues is considered a major cause of mortality in the western world and is expected to be a greater problem in the forthcoming decades. Cardiac damage is associated with dysfunction and irreversible loss of cardiomyocytes. Stem cell therapy for ischemic heart failure is very promising approach in cardiovascular medicine. Initial trials have indicated the ability of cardiomyocytes to regenerate after myocardial injury. These preliminary trials aim to translate cardiac regeneration strategies into clinical practice. In spite of advances, current therapeutic strategies to ischemic heart failure remain very limited. Moreover, major obstacles still need to be solved before stem cell therapy can be fully applied. This review addresses the current state of research and experimental data regarding embryonic stem cells (ESCs), myoblast transplantation, histological and functional analysis of transplantation of co-cultured myoblasts and mesenchymal stem cells, as well as comparison between mononuclear and mesenchymal stem cells in a model of myocardium infarction. We also discuss how research with stem cell transplantation could translate to improvement of cardiac function.