Engineering Cardiac Stem Cells for the Treatment of the Damaged Heart

Abstract

Heart disease remains one of the leading causes of mortality in humans Current pharmacological treatment is only palliative not curative and the massive loss of cardiac tissue after acute myocardial infarction AMI is mainly substituted by a non functional scar Since there are not enough donors available for heart transplantation new approaches have been explored and the investigation efforts of many groups in the last decade have been directed towards the use of stem cells Unfortunately the stem cells used in most of the clinical trials mainly bone marrow derived stem cells BMSC have not shown a consistent and meaningful long term benefit Therefore some recent clinical studies have included different type of cells derived from cardiac tissue that still retain certain stem cell properties and in contrast to BMSC cardiomyogenic potential On the other hand cell reprogramming technologies have allowed the creation of novel cardiac cells including multipotent cardiac stem cells CSC with similar features and potential to embryonic CSC Here we will review the main CSC populations that are being investigated in clinical trials and in preclinical models with a special focus on the CSC obtained through different cell reprogramming strategies and the recent tissue engineering approaches used to improve the retention survival and function of CSC