Bone Marrow-Derived Stem Cell Therapy for Myocardial Infarction

Abstract

Myocardial infarction is an acute condition resulting in severe morbidity and mortality. A promising approach to improve prognosis of heart attack patients includes the use of stem cells to repair or regenerate viable heart tissue. Among the first types of stem cells used to treat myocardial infarction were those derived from the human bone marrow. Despite enormous scientific effort, current stem cell therapies have only yielded moderate successes. Several studies and two meta-analyses showed that stem cell therapy significantly improved heart structure and function after myocardial infarction. However, other recent reports have failed to find any improvements. Better understanding of fundamental stem cell biology, including homing to the injured tissue, stem cell survival and mechanisms of repair (paracrine effects or cardiogenic transdifferentiation), might lead to improved outcome of (modified) stem cell therapies. Moreover, large-scale clinical trials, designed according to best current knowledge of stem cell preparation, route of administration, dosing and timing, should be focused on patient-centered end points. More consistency in positive results might ultimately lead to the widespread clinical application of stem cell therapy after myocardial infarction.