Cardiovascular surgery for realization of regenerative medicine

Abstract

Regenerative medicine is emerging as a new approach to the treatment of severe cardiovascular diseases that are resistant to conventional therapies. Although the type of cell transplanted (e.g., pluripotent stem cells, bone marrow-derived stem cells, skeletal myoblasts, or cardiac stem cells) influences the outcome of stem cell transplantation, the method of transplantation is also important, as the efficiency of engraftment after simple needle injection is poor. Scaffold-free cell sheet transplantation technology is one of the most promising methods in this regard. Although the results of clinical trials of stem cell therapy have been marginal to date, further elucidation of the actual mechanisms of cardiac repair following cell therapy would enhance the potential for full-scale implementation of stem cell therapy. In addition to stem cell therapy, the field of cardiovascular regenerative medicine includes interspecific chimera technology, drug delivery systems using biodegradable materials, and gene therapy. Integration of these new modalities with conventional therapies will be important to realize the goal of cardiovascular regenerative medicine tailored to the condition of each individual patient. Cardiovascular surgery would be an excellent means of carrying out this strategy and could potentially resolve the health problems of the increasing number of advanced cardiovascular patients. Herein, we review the recent basic and clinical research associated with the realization of regenerative medicine in the field of cardiovascular surgery.

Fetal mesenchymal stem cells ameliorate acute lung injury in a rat cardiopulmonary bypass model

“…26 MSCs are considered an attractive cell source for regenerative medicine because of their excellent capacity for proliferation and differentiation. [27][28][29] A considerable number of clinical trials using MSCs have been conducted targeting various disorders, including acute myocardial infarction, 30 ischemic heart failure, 31,32 graft versus host disease, 33 inflammatory bowel disease, 34 and respiratory disease. 35 Several studies that have used experimental animal models of lung injury induced by lipopolysaccharides, 7 bleomycin, 36 artificial ventilation, 9 and hemorrhage shock 8 generally have demonstrated that MSCs attenuate the production of inflammatory cytokines and reduce edema and neutrophil recruitment.…”

Prevention of retrosternal adhesion by novel biocompatible glue derived from food additives

“…15 We have previously reported the effectiveness of the biodegradable glue as a novel surgical sealant for lung air leakage 14 or an attachment medium for sustained release of antibiotics or antiarrhythmic drugs in experimental animal models. [16][17][18] The purpose of this study is to examine the effect of the biodegradable glue on retrosternal adhesion and, using a rabbit pericardiectomy model, to evaluate the inflammatory and fibrogenic capacity and biocompatibility of the glue for wide clinical application of this new material in cardiac surgery.…”

Human-Induced Pluripotent Stem Cell-Derived Engineered Cardiac Tissues

“…HiPSCs are now one of the most promising cell sources for cardiac regenerative cell therapy [54][55][56]. There are major methods of cell delivery, including intracoronary or intramuscular injection of dispersed cells and epicardial transplantation of engineered tissues [57].…”