Abstract
Cardiovascular disease remains the number one cause of morbidity and mortality in the world. With great advances in medical and interventional therapies, patients who suffer from acute myocardial infarction have a longer life expectancy than before, but gradually develop chronic heart failure in their later life due to irreversible loss of cardiomyocytes. So far, heart transplantation is the only therapeutic option for advanced heart failure. However, the shortage of donor organs largely limits its role as the gold standard therapy. In the past decades, stem cell-based regenerative medicine has been proposed as a promising approach for the treatment of heart failure based on numerous animal studies. A variety of potential stem cell types, including skeletal myoblasts and bone marrowderived stem cells, have been investigated in clinical trials for cardiac repair and regeneration, but have shown mixed results in heart functional improvement or life-threatening disadvantages such as ventricular arrhythmia. On the other hand, due to the advantages of autologous origin and cardiac-committed lineage, cardiac stem cell therapy has emerged as a promising cell-based strategy for treatment of HF. Thus, this review discusses the current therapies for heart failure and further focuses on stem cell therapy using different endogenous cardiac stem cells, purified by stem cell surface markers (e.g., c-kit or Sca-1) or derived from explants via the formation of cardiospheres. In addition, the potential effect of patient age on cell-based therapy for heart disease is discussed.
Highlights
Cardiovascular disease is a leading cause of death worldwide and becomes increasingly prevalent in the elderly population [1]
Based on numerous experimental studies and recent clinical trials, there has been growing evidence showing that cardiac stem cells can be grown as autologous cells for cardiac therapy, especially c-kit+ CSCs and cardiospherederived cells (CDCs), as demonstrated by feasibility, safety and functional improvement
Regardless of age or disease, cardiac stem cells have been isolated and expanded from the diseased heart from most patients [128,88,130]. This means that cell transplantation with autologous CSCs is a viable treatment in routine clinical practice
Summary
Cardiovascular disease is a leading cause of death worldwide and becomes increasingly prevalent in the elderly population [1]. Two phase I clinical studies, SCIPIO and CADUCEUS, using c-kit+ CSCs and cardiospherederived cells (CDCs), respectively, confirmed early short-term safety and therapeutic efficacy (improvement in EF, reduced infarct size or increased viable myocardium) in patients with ischemic heart failure [9,10].
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