Abstract

The adult myocardium harbours a population of resident (endogenous) multipotent cardiac stem and progenitor cells (eCSCs). Manipulation of these cells in situ and ex vivo has opened new therapeutic avenues for anatomical and functional myocardial regeneration. However, recently the ability of the c-kitpos stem and progenitor cells to transdifferentiate into new cardiomyocytes has been disputed. Within an already highly controversial research field, these publications have caused significant confusion in their interpretation. Importantly, identifying, tracing and characterising stem and progenitor cells according to expression of a single surface receptor such as c-kit do not identify eCSCs. As discussed in this chapter, eCSCs isolated from the adult heart have a specific phenotype, being negative for blood lineage markers such as CD34, CD45 and CD31, and exhibit properties of stem and progenitor cells, being clonogenic, self-renewing and multipotent. Under the appropriate conditions, eCSCs differentiate into fully functional beating cardiomyocytes and regenerate cardiomyocytes lost from damage in vivo. Finally, eCSCs are susceptible to the effects of ageing, making regulation of this parameter highly impactful in the efficacy of myocardial regenerative therapies.

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