Autologous mesenchymal stem cell transplantation after acute myocardial infarction

Abstract

The report by Chen et al 1 Chen S. Fang W. Ye F. Liu Y. Qian J. Shan S. Zhang J. Zhao Chunhua R. Liao L. Lin S. Sun J. Effect on left ventricular function of intracoronary transplantation of autologous bone marrow mesenchymal cell in patients with acute myocardial infarction. Am J Cardiol. 2004; 94: 92-95 Abstract Full Text Full Text PDF PubMed Scopus (1039) Google Scholar on transcatheter intracoronary transplantation of autologous mesenchymal bone marrow–derived stem cells (BMSCs) is an important contribution on myocardial repair after myocardial infarction. Its importance resides in several aspects. We would like to mention only 2: first, ejection fraction increase in the treatment arm is larger than that observed with mononuclear bone marrow cells in other attempts to regenerate myocardial tissue after acute myocardial infarction in humans, larger than that observed for instance in the recently published BOOST trial. 2 Wollert K.C. Meyer G.P. Lotz J. Ringes-Lichtenberg S. Lippolt P. Breidenbach C. Fichtner S. Korte T. Hornig B. Messinger D. Arseniev L. Hertenstein B. Ganser A. Drexler H. Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial. Lancet. 2004; 364: 141-148 Abstract Full Text Full Text PDF PubMed Scopus (1975) Google Scholar In the BOOST trial, the only other similarly sized trial published to date, the treatment arm underwent auto-transplantation of a bone-marrow-cell preparation containing mostly hematopoietic stem cells. Second, recent experimental data using molecular markers cast doubt that bone marrow–derived hematopoietic stem cells transplanted into ischemic myocardium can transdifferentiate into myocardial tissue. 3 Murry C.E. Soonpaa M.H. Reinecke H. Nakajima H. Nakajima H.O. Rubart M. Pasumarthi K.B.S. Ismail Virag J. Bartelmez S.H. Poppa V. et al. Haematopoietic stem cells do not transdifferentiate into cardiac myocytes in myocardial infarcts. Nature. 2004; 428: 664-668 Crossref PubMed Scopus (1887) Google Scholar , 4 Balsam LB, Wagers AJ, Christensen JL, Kofidis T, Weissman IL, Robbins RC. Haematopoietic stem cells adopt mature haematopoietic fates in ischaemic myocardium. Nature 428:668–673. Google Scholar In 1 of these studies, myocardial function was assessed, and cell transplantation produced a modest increase in systolic function, probably mediated through angiogenic stimulation. These data emphasize the need for continued research on which subset of BMSCs will effectively regenerate myocardium, an example of which is the work by Chen et al. 1 Chen S. Fang W. Ye F. Liu Y. Qian J. Shan S. Zhang J. Zhao Chunhua R. Liao L. Lin S. Sun J. Effect on left ventricular function of intracoronary transplantation of autologous bone marrow mesenchymal cell in patients with acute myocardial infarction. Am J Cardiol. 2004; 94: 92-95 Abstract Full Text Full Text PDF PubMed Scopus (1039) Google Scholar