Stem cells and cardiovascular disease

Abstract

Several recent discoveries have shifted the paradigm that there is no potential for myocardial regeneration and have fueled enthusiasm for a new frontier in the treatment of cardiovascular disease-stem cells. Fundamental to this emerging field is the cumulative evidence that adult bone marrow stem cells can differentiate into a wide variety of cell types, including cardiac myocytes and endothelial cells. This phenomenon has been termed stem cell plasticity and is the basis for the explosive recent interest in stem cell-based therapies. Directed to cardiovascular disease, stem cell therapy holds the promise of replacing lost heart muscle and enhancing cardiovascular revascularization. Early evidence of the feasibility of stem cell therapy for cardiovascular disease came from a series of animal experiments demonstrating that adult stem cells could become cardiac muscle cells (myogenesis) and participate in the formation of new blood vessels (angiogenesis and vasculogenesis) in the heart after myocardial infarction. These findings have been rapidly translated to ongoing human trials, but many questions remain. This review focuses on the use of adult bone marrow-derived stem cells for the treatment of ischemic cardiovascular disease and will contrast how far we have come in a short time with how far we still need to go before stem cell therapy becomes routine in cardiovascular medicine.

Effects of adrenomedullin on acute ischaemia-induced collateral development and mobilization of bone-marrow-derived cells

“…Transplantation of peripheral or bone-marrow-derived EPCs augments collateral blood flow and prevents hindlimb autoamputation [20]. In the same way, after acute myocardial infarction, transplantation of bone-marrow-derived EPCs or CD34-positive cells resulted in angiogenesis and improved cardiac function [26,27].…”

“…Bone-marrow-derived EPCs (endothelial progenitor cells) have been shown to participate in angiogenesis in tumours [13] and tissue ischaemia [14]. EPCs are mobilized into the systemic circulation by several angiogenic substances via NO-related mechanisms [15][16][17][18][19][20].…”

Successful implantation of intravenously administered stem cells correlates with severity of inflammation in murine myocarditis

“…Direct cellular transplantation of various types of stem cells in the heart has shown a remarkable ability to produce a sustained improvement in cardiac structure and function [1,10,17,18,30]. The majority of these reports are in the setting of the acute myocardial infarction (MI), raising the possibility that the factors up-regulated during MI are critical to the success of stem cell transplantation and subsequent proliferation and differentiation into functional myocytes.…”

Modelo experimental de doença pulmonar intersticial fibrosante associado à terapia celular utilizando células mononucleares de medula óssea

“…Com relação a alíquota de CMMO infundida nos animais tratados (1X10 8 células) a literatura não têm ainda preconizado protocolo que contemple o modelo utilizado nesta pesquisa para infusão "in vivo", portanto, foi utilizado protocolo desenvolvido por trabalhos realizados em cardiologia (ABBOTT; GIORDANO, 2003;BOCCHI;ISSA, 2003).…”

“…Esse processo de plasticidade das células-tronco tem sido demonstrado em vários estudos com células mioblásticas esqueléticas, células da medula óssea e células hematopoiéticas em infarto do miocárdio, na qual há habilidade destas células se diferenciarem em células endoteliais e em cardiomiócitos, participando da angiogênese, e isto tem sido demonstrado em modelos animais (ABBOTT; GIORDANO, 2003).…”