Cardiac progenitor cell sheet regenerates myocardium and renews hope for translation

Abstract

This editorial refers to ‘Transplantation of cardiac progenitor cell sheet onto infarcted heart promotes cardiogenesis and improves function’ by L. Zakharova et al ., pp. 40–49, this issue. The goal of myocardial regeneration strategies is to transform dead scar tissue into viable functional muscle. If achieved, we could eradicate congestive heart failure. Early work using cell suspensions with delivery by injection showed promise, but substantial regeneration has remained elusive for our patients, mostly due to poor viability and donor cell retention after transplantation. The enthusiasm for this strategy is fading. The innovative work of Zakharova et al .1 could restore hope and help guide us in the right direction. The authors assembled cardiac progenitor cells into a tissue-like sheet of cells and then delivered the construct onto the epicardial surface of an acute rat infarction. This unique approach enhanced stem cell engraftment and survival, stimulated a substantial cardiogenesis, and preserved left ventricular function to an extent that could prevent the transition to overt heart failure. Importantly, the donor cells did more than survive in the host myocardium; after engraftment, they showed an encouraging combination of controlled proliferation, purposeful migration, and targeted differentiation. The authors then extended, confirmed, and reproduced these results using human progenitor cells obtained from surgical biopsy. The potential for translation to our patients using this strategy is exciting. Progress in using cell …