Therapeutic myocardial angiogenesis

The Role of Synthetic Extracellular Matrices in Endothelial Progenitor Cell Homing for Treatment of Vascular Disease

“…Clinical trials for treatment of patients with CAD, including the TOPCARE-AMI, 65 REPAIR-AMI, 66 and TOPCARE-CHD 6 studies, administered heterogenous bone-marrow derived progenitor cells via bolus intracoronary infusion and provided proof of concept with moderate yet statistically significant improvements of left ventricular function. 62 Albeit simple delivery routes, these methods of cellular infusion often have limited efficacy due to high cell death and poor recruitment and/or retention within the ischemic target. 2,70 In particular, the majority of systemically infused cells often get trapped in the microvasculature of other off-target organs/tissues.…”

An Inconvenient Truth

“…Interestingly, even though results from animal studies and early clinical studies using angiogenic/arteriogenic proteins or genes have been very encouraging, larger randomized trials have not yet conclusively demonstrated clinical benefits. 7 As an alternative approach to augmenting blood vessel growth, cell therapies using either bone marrow-derived mononuclear cells or progenitor cells/stem cells have been developed, and, so far, early clinical studies and animal studies have also been positive. 7 However, larger randomized placebo-controlled trials are still lacking, and a recent metaanalysis of the smaller clinical trials with bone marrow-derived cells pointed out that the overall clinical improvements may be more modest than previously assumed.…”

“…7 As an alternative approach to augmenting blood vessel growth, cell therapies using either bone marrow-derived mononuclear cells or progenitor cells/stem cells have been developed, and, so far, early clinical studies and animal studies have also been positive. 7 However, larger randomized placebo-controlled trials are still lacking, and a recent metaanalysis of the smaller clinical trials with bone marrow-derived cells pointed out that the overall clinical improvements may be more modest than previously assumed. 8 Many reasons for the apparent discrepancy between the animal studies or early small clinical studies and the larger controlled clinical trials have been proposed.…”

“…8 Many reasons for the apparent discrepancy between the animal studies or early small clinical studies and the larger controlled clinical trials have been proposed. 7 One of the most compelling potential explanations is that patients differ significantly in their responses to angiogenic or arteriogenic factors and that animal studies or small clinical studies are likely to have a homogeneous group of therapy recipients. On the other hand, larger clinical trials have a broad heterogeneity of patients with different cardiovascular risk factors and lifestyle, medication compliance, pathophysiology, and endogenous expression of growth factors or cytokines.…”

Terapia celular associada à revascularização transmiocárdica laser como proposta no tratamento da angina refratária

“…Recently, cellular therapy emerged as a therapeutic strategy for tissue repair in cardiovascular medicine [4,5]. In experimental animal models, it was shown that bone marrow cells have the capacity to differentiate between contractile cells or blood vessels in ischemic tissues [6,7].…”