Abstract
In clinical cellular cardiomyoplasty, bone marrow cells and myoblasts are introduced mainly to ischemic cardiomyopathy tissue via several cell delivery systems, such as needle injection or catheter. These clinical studies have demonstrated the safety and feasibility of this technique, but its effectiveness for treating heart failure, especially in the long term, is still under discussion. Neither of these cell types can differentiate into cardiomyocytes; rather, they improve the failing heart mainly by the paracrine effects of some cytokines, such as Hepatocyte growth factor (HGF) and Vascular endothelial growth factor (VEGF). Thus, many researchers have a great interest in stem cells, which exist in bone marrow, circulating blood, atrium, and adipose tissue, and can differentiate into cardiomyocytes. Although several stem cells with the potential to differentiate into various cell types have been reported, few can differentiate into cardiomyocytes. Moreover, beating cells that can demonstrate synchronized contraction with native cardiomyocytes are critical for the complete repair of severe heart failure. Therefore, stem cells with a high differentiation capacity should be explored for the goal of completely repairing severely damaged myocardium. In this review, we summarize the clinical protocols and basic experiments for cellular cardiomyoplasty using bone marrow cells, myoblasts, and other stem cells.
Highlights
INTRODUCTIONTo overcome heart failure many basical studies have been done and some technologies have been introduced to the treatment of heart failure clinically based on the experimental data
To overcome heart failure many basical studies have been done and some technologies have been introduced to the treatment of heart failure clinically based on the experimental data. cell therapy was recently introduced to clinical situation in heart failure, tremendous experimental studies (Bench work) have been done before clinical trials (Bed side work)
CD133+ cells, which include hematopoietic stem cells, are reported to have angiogenic potential [53]. Because of this potential angiogenic capacity, CD133+ cell transplantation was tested clinically to treat ischemic myocardium. These cells were introduced into six patients who had old myocardial infarction (OMI) concomitant with coronary artery bypass grafting (CABG), and caused improved global systolic function and infarct tissue perfusion compared with the pre-treatment values [54]
Summary
To overcome heart failure many basical studies have been done and some technologies have been introduced to the treatment of heart failure clinically based on the experimental data. Cell therapy was recently introduced to clinical situation in heart failure, tremendous experimental studies (Bench work) have been done before clinical trials (Bed side work). In this review we present and analyze recent achievements in the laboratory and clinic in cellular cardiomyoplasty
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