Cardiac stem cell trials and the new world of cellular reprogramming: Time to move on

Rosengart, Todd K.; Patel, Vivek; Sellke, Frank W.

doi:10.1016/j.jtcvs.2017.11.104

Cited by 6 publications

(4 citation statements)

References 25 publications

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“…7 Many investigators have turned toward alternative cardiac regenerative strategies as a more promising approach to address the growing HF epidemic. [22][23][24] Angina Refractory to Conventional Therapy Another potential application of biological therapy is "no-option" angina, strictly defined as severe, life-limiting angina due to CAD, refractory to maximal medical therapy, and without surgical or percutaneous revascularization options. 25,26 Coronary insufficiency in these patients is attributed to coronary artery stenosis on angiography and/or microvascular dysfunction.…”

Section: Target Patient Populations and Current Therapeutic Gaps Advanced Hfmentioning

confidence: 99%

Clinical potential of angiogenic therapy and cellular reprogramming

2021

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Feature Editor Note-You're driving along the freeway during rush hour. You're running late and find yourself in bumper-to-bumper traffic. You have 3 options: (1) do nothing, suffer with anguish inside; (2) find productive ways to pass the time, like listen to a podcast or talk on the phone; or (3) get off on the next exit and find an alternative, roundabout path to your destination. Similarly, patients suffering from coronary artery disease can opt to do nothing; stop progression and treat their symptoms with medical therapy; or undergo revascularization either percutaneously or surgically.There are few options, however, for those who develop chronic coronary artery disease without suitable revascularization strategies. They have missed their exit and are stuck in this metaphorical traffic jam, with no radio and no cell phone. These patients may experience refractory angina or develop ischemic cardiomyopathy and heart failure. Exploring solutions to this increasingly widespread problem is imperative. Chronic heart failure is rising, while the number of organs available for transplantation remains limited. Similarly, bridge therapies such as ventricular assist devices are resource intensive and are typically only performed at select, high-volume institutions.

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Section: Target Patient Populations and Current Therapeutic Gaps Advanced Hfmentioning

confidence: 99%

Clinical potential of angiogenic therapy and cellular reprogramming

2021

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“…Indeed, prior studies have demonstrated that fibroblasts can be driven directly into cardiomyocytes by distinct combinations of lineage-significant transcription factors or microRNAs[26-30]. Of note, induced in situ fibroblast reprogramming improved cardiac function in animal myocardial infarction models, with 30%-40% increase in left ventricle ejection fraction and reduction of fibrotic scar by up to 50%[31].…”

Section: The Presentmentioning

confidence: 99%

Moving forward on the pathway of cell-based therapies in ischemic heart disease and heart failure – time for new recommendations?

Micheu

2019

WJSC

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Although substantial advances have been made in treating ischemic heart disease and subsequent heart failure, the overall morbidity and mortality from these conditions remain high. Stem cell-based therapy has emerged as a promising approach for prompting cardiac rejuvenation. Various cell types have been tested in the clinical arena, proving consistent safety results. As for efficiency outcomes, contradictory findings have been reported, partly due to inconsistency in study protocols but also due to poor survival, engraftment and differentiation of transplanted cells in the hostile milieu of the ischemic host tissue. Studies have varied in terms of route of delivery, type and dose of implanted stem cells, patient selection and randomization, and assessment of therapeutic effect. Founded on the main achievements and challenges within almost 20 years of research, a number of official documents have been published by leading experts in the field. Core recommendations have focused on developing and optimizing effective strategies to enrich cell retention and their regenerative potential. Issued consensus and position papers have stemmed from an unmet need to provide a harmonized framework for future research, resulting in improved therapeutic application of cell-based therapies for cardiac regeneration and repair.

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“…Over the past several years, preclinical and clinical studies about the potential cardiac application of stem cell therapy have been conducted extensively, primarily in adult ischemic heart disease. 1,2 More recently, this potential therapeutic option has gained attention in the world of congenital heart disease. This has been due, in part, to the discovery that neonatal myocardium retains greater regenerative potential than adult heart tissue.…”

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confidence: 99%