Cellular therapy and myocardial tissue engineering: the role of adult stem and progenitor cells

Abstract

Acquired cardiovascular diseases and complex congenital heart diseases are leading causes of morbidity and mortality. Cellular therapy and tissue engineering are emerging as promising alternative approaches to treat cardiovascular diseases. Cellular therapy involves isolating cells and delivering the cells to the site of cardiac injury to restore blood flow and contractility to previously infarcted, scarred or dysfunctional heart. Myocardial tissue engineering, engineered heart tissue by seeding cells in three-dimensional matrices of biodegradable polymers or cell sheet engineering without artificial scaffolds to form new myocardial constructs. Questions are common to both these approaches, such as the best cell source and optimal conditions for therapeutic application. The capabilities of stem cells for pluripotency and long-term self-renewal make it an ideal source for myocardial tissue engineering and cell therapy. We review the current understanding of postnatal adult stem and progenitor cells in cellular therapy and myocardial tissue engineering from a surgical view point, and highlight the latest advances in these exciting fields.

Injectable hydrogel as stem cell scaffolds from the thermosensitive terpolymer of NIPAAm/AAc/HEMAPCL

“…2 Accordingly, as one of the most successful methods of restoring the injured myocardium, stem cell therapy has been widely studied in the past few years. 3,4 Experiments discussed in previous papers demonstrate a beneficial effect on tissue regeneration and function recovery of the infarcted myocardium after transplanting stem cells to the injured area. [5][6][7][8] However, transplantation by direct cell injection cannot attain these results due to low cell retention rate and cell redistribution into other organs, 9,10 so improvement of cell retention and survival in target tissue presents a big challenge for tissue engineering.…”

Minimally invasive cell-seeded biomaterial systems for injectable/epicardial implantation in ischemic heart disease

“…59 Cell transplantation may be accomplished in one of the following ways: (1) transplanting cells through transepicardial, intracoronary or transendocardial delivery; (2) mobilizing resident stem cells to the injured site using cytokines, such as granulocyte colony-stimulating factor and stem cell factor; or (3) treatment with growth factors, such as insulin-like and hepatocyte growth factors, to induce differentiation of cardiac progenitor cells into cardiomyocytes. 60 …”

The Future of Cell Therapy and Tissue Engineering in Cardiovascular Disease: The New Era of Biological Therapeutics

“…It is well known that the heart is one of the least regenerative organs in the human body (Wu KH 2006). Nevertheless, in recent years many scientists have envisioned the possibility of regeneration of the myocardium and reproduction of autologous heart tissue in vitro or in vivo (Zund G 1996;Shimizu T 2002;Leor J 2004;Shin M 2004;Zammaretti P 2004;Leor J 2005;Shaoping Zhong 2005;Ishii O 2006;Sekine H 2006;.…”

“…Scar formation secondary to cardiac remodeling and fibrosis results in increased risk of fatal dysrrythmias as this tissue becomes a nidus for dyrrthmia origination and propagation. (Strauer BE 2002;Stamm C 2003;Galiñanes M 2004;Pittenger MF 2004;Wollert KC 2004;Dib N 2005;Dimmeler S 2005;Patel AN 2005;Deindl E 2006;Engelmann MG 2006;Schächinger V 2006;Tse HF 2006;Wu KH 2006;Kissel CK 2007;Stamm C 2007;Theiss HD 2007;Yerebakan C 2008).…”

“…Although there appears to be postnatal cardiomyocyte turnover and generation, this is insufficient to replenish lost heart cells (myocytes) post MIs and in the setting of nonischemic cardiomyopathies. Therefore the need for regenerative therapies for heart failure is becoming even more so important with an aging population as more patients are surviving their heart attacks and progressing on to develop heart failure (Akins 2002;Wu KH 2006;Li SC 2009). …”