Cell Therapy for the Heart

Abstract

The focus of this chapter is cell therapy for the heart. We begin this chapter by describing cell therapy as a potential treatment strategy for heart failure and in order to illustrate the concepts of cell therapy we use satellite cells as our first example. Satellite cells are found in skeletal muscle and are involved in muscle regeneration and repair in response to injury. In order to explain the role of satellite cells in cardiac cell therapy, we provide an overview of satellite cell biology and their role in skeletal muscle repair and regeneration. We next describe an innovative investigational strategy to support cardiac function—the use of latissimus dorsi muscle wrapped around the whole heart. After this, we present a case study that describes the use of primary satellite cells for cardiac cell transplantation. Our final case study describes the use of engineered 3D skeletal muscle tissue to support myocardial function. Following our case studies we describe important concepts related to stem cell engineering including the central dogma of cell biology, embryogenesis, stem cell differentiation, differentiation efficiency, and stem cell potency. We will show the current state of the art in the field of embryonic stem cells including the isolation and culture of embryonic stem cells, and strategies to drive the differentiation of embryonic stem cells to form cardiac myocytes. We then explore the potential use of embryonic stem cell derived cardiac myocytes in cardiac cell therapy and heart muscle tissue engineering. We next describe the current state of the art in the field of induced pluripotent stem cells. We start with the formation of induced pluripotent stem cells by the reprogramming of somatic cells. We then describe strategies to drive the differentiation of these cells to form cardiac myocytes; and then move onto to describe the potential applications of these cardiac myocytes in cardiac cell therapy and heart muscle tissue engineering. We next describe the current state of the art in the field of bone marrow MSCs; we include isolation techniques, culture and expansion protocols, and strategies to drive the differentiation of these cells to form cardiac myocytes. We conclude the chapter with the applications of bone marrow MSCs in cardiac cell therapy and heart muscle tissue engineering.