Stem cells as therapy for cardiac disease — a review

Abstract

Acute myocardial infarction (AMI) is one of the most significant causes of morbidity and mortality worldwide. Stem cells represent an enormous chance to rebuild damaged heart tissue. Correct definition of the cardiac progenitors is necessary to understand heart development, and would pave the way for the use of cardiac progenitors in the treatment of heart disease. Identifying, purifying and differentiating native cardiac progenitor cells are indispensable if we are to overcome congenital and adult cardiac diseases. To understand their functions, physiology and action, cells are tested in animal models, and then in clinical trials. But because clinical trials yield variable results, questions about proper cardiac stem cells remain unanswered. Transplanted stem cells release soluble factors, acting in a paracrine fashion, which contributes to cardiac regeneration. Cytokines and growth factors have cytoprotective and neovascularizing functions, and may activate resident cardiac stem cells. Understanding all these mechanisms is crucial to overcoming heart diseases. (Folia Histochemica et

Stem Cell Therapy for Heart Disease

“…20 They increase in numbers and migration after ischemia, 2,21 and may be activated by transplanted cells. 22 However, CSC are limited by their small population and reduced effects with aging.…”

“…22 However, CSC are limited by their small population and reduced effects with aging. 2,8 Moreover, their differentiation potential is low and inadequate to replace lost cardiomyocytes. 23 Clinical translation is challenged by small numbers obtained from biopsy, necessitating prolonged expansion in culture before delivery.…”

“…19 They differentiate into several cell lines, including cardiomyocytes. 2 BMC are the most promising and dominate clinical studies, as they are easily obtained and cultured with differentiation capacity. 19 BMC contain a mixture of HSC, EPC, MSC, and multipotent adult progenitor cells (MAPC).…”

“…If flow is not quickly reestablished, loss of cardiomyocytes can be massive. 2 Significant declines in CAD mortality rates are attributable to decreased AMI incidence coupled with improved survival from aggressive revascularization. 1 AMI patients who previously might not have survived without percutaneous coronary intervention (PCI) are now living longer, 1 but with considerable left ventricular dysfunction.…”

“…3,4 Heart failure (HF) subsequently ensues, affecting 5.7 million Americans. 1,2,4,5 Despite advanced therapies, this is expected to increase to 9.6 million by 2030. 1 Left ventricular dysfunction ultimately affects contractility, worsening HF and increasing mortality.…”