Cell delivery and tracking in post-myocardial infarction cardiac stem cell therapy: an introduction for clinical researchers

Abstract

Stem cell-based therapy for patients with postinfarct heart failure is a relatively new and revolutionary concept in cardiology. Despite the encouraging results from pre-clinical studies, outcomes from most clinical trials remain moderately positive while the clinical benefits are largely attributed to transplanted cell-associated paracrine effects in stimulating angiogenesis and protecting endogenous cardiomyocytes. This scenario indicates that there may be a considerably protracted iterative process of conceptual and procedural refinement before true clinical benefits can be fully materialized. At present, many pressing questions regarding cell therapy remain unanswered. In addition to the primary interest in determining the ideal type of stem cells with best cardiogenic potential in vitro and in vivo, there are growing concerns on the impact of the host cardiac milieu on the transplanted cells, including their survival, migration, engraftment, and transdifferentiation as well as contribution to left ventricular function. Effective cell delivery and tracking methods are central to the unraveling of these questions. To date, celldelivery modalities are yet to be optimized and strategies for safe and effective assessment of cells transplanted in the recipients are to be established. In this review, we discuss cell delivery and tracking modalities that are adopted in the current pre-clinical and clinical studies. We further discussed emerging technologies that are poised to impact the success of cell therapy.

Improving Viability of Stem Cells During Syringe Needle Flow Through the Design of Hydrogel Cell Carriers

“…For example, hydrogels may act as scaffolds for local cell adhesion, 7,21 allowing for additional control over implant localization at the target site and for support of new tissue growth. 10,22,26 Additionally, hydrogels may be designed to protect encapsulated cells from local inflammation and surrounding macrophages. 27 Certain hydrogels may also strategically deliver anti-apoptotic or pro-stimulatory factors.…”

Factors Secreted by Mesenchymal Stem Cells and Endothelial Progenitor Cells Have Complementary Effects on Angiogenesis In Vitro

“…T he stem cell therapy for postinfarct myocardial regeneration has been introduced more than 2 decades ago, but thus far, the functional improvements obtained are still limited due to the low survival rate of transplanted cells into the damaged myocardium [1,2]. Consequently, the clinical benefits are only transient and attributed mostly to transplanted cell-associated paracrine effects that stimulate angiogenesis and confer cardioprotection [3].…”

Multimodality Molecular Imaging of Cardiac Cell Transplantation: Part I. Reporter Gene Design, Characterization, and Optical in Vivo Imaging of Bone Marrow Stromal Cells after Myocardial Infarction

“…All other authors, who are not complex processes in vivo like multilineage growth and differentiation, angiogenesis, and ventricular remodeling, while pharmacologic therapy predictably targets a single cellular receptor for efficacy. Further confounding CCT is the choice of therapeutic cells (4,9) and cell delivery techniques (10), as well as the impact of host factors (11), suggesting that new approaches are needed to link data between model systems (12).…”