Stem Cells and Cardiac Disease: Where are We Going?

Abstract

During the last 10 years we have witnessed the development of a new field in research termed Stem Cell Therapy. Classically, it was considered that cells had a limited division and differentiation ability; however, this dogma was challenged when new exciting results about cell multi/pluripotency were presented to the scientific community. It was found that cells from one adult tissue source were able to originate cells of a very different type. The possibility of transplanting these cells into damaged organs with the aim of substituting sick or dead tissue, triggered many studies to understand the plasticity of the stem cells and their potential in pathological situations. Nowadays, much more is understood about stem cells, although of course, many questions, especially about their mechanism of action, still need to be answered. Their benefit after transplantation has been shown experimentally and even clinically in some cases; however, the degree of stem cell contribution through their own differentiation into the transplanted tissue, has turned out to be generally low, and increasing evidence indicates that a trophic effect must play an important role in such a benefit. A better understanding of the paracrine mechanisms involved could be of great relevance in order to develop new therapies focused on stimulating endogenous cells. On the other hand, more sophisticated methods for cell transplantation combined with bio-engineering techniques have been devised in cardiac disease models. In this review we will try to provide a critical overview of the stem cell studies performed until now and to discuss some of the questions raised about the mechanisms that are involved in their putative reparative effect in cardiovascular diseases, and their origin.

Stem cells supporting other stem cells

“…However, further examination of these improvements revealed that very few stem cell-derived cells were actually incorporated long-term into the tissues of interest. It is now well appreciated that stem cells secrete paracrine factors which have a trophic, cell protective effect on extant tissue cells, and much of the improved tissue functionality in disease models can be attributed to this effect, rather than new cells from the stem cells (Zandonella, 2005; Caplan and Dennis, 2006; Gnecchi et al, 2008; Pelacho and Prosper, 2008; Uccelli et al, 2011). …”

Mesenchymal Stem Cells and Cardiovascular Disease: A Bench to Bedside Roadmap

“…Their capacity for differentiation has made stem cells outstanding candidates for the treatment of degenerative diseases, substituting for cells lost during the course of the disorder. Consequently, cardiac diseases and MI have been the object of intense research [5]. Among the cell types studied, mesenchymal stem cells (MSCs) are strong candidates for success in the MI setting.…”

Adipose-derived Stem Cells for Myocardial Infarction

“…Among the diversity of sources (reviewed in [2,3]), adipose tissue has become one of the most attractive not only due to its regenerative potential but also for other more practical reasons. Free of ethical, oncological, and immunological concerns present in pluripotent cells (embryonic stem cells or induced pluripotent stem cells (iPS)), adipose tissue stem cell obtention lacks the painful and time-consuming process associated with cells from other sources as skeletal muscle, bone marrow, or heart.…”