The clinical application of mesenchymal stem cells and cardiac stem cells as a therapy for cardiovascular disease.

Abstract

Cardiovascular disease (CVD) can be separated into two broad etiological categories, based on the presence or absence of ischemia as a causative factor. In both ischemic and non-ischemic heart disease, myocardial dysfunction or damage frequently results in the development of heart failure, characterized by dyspnea, fatigue and reduced survival. As one of the least regenerative organs in the human body, current standards of care are limited to mitigating loss and preventing recurrence of damage, rather than stimulating actual regeneration of functional heart tissue. Cell based therapies using progenitor cells from bone marrow and the heart itself have been evaluated in preclinical models, and have demonstrated some promise. Accordingly, several clinical trials using autologous stem and progenitor cells have been performed, showing that these cells can be used safely in humans, and suggesting that they may improve relevant clinical parameters in patients with heart disease. Two specific cell populations that are particularly promising are the bone marrow derived mesenchymal stem cell (MSC) and the heart muscle derived cardiac stem cell (CSC). This review will summarize preclinical studies evaluating these stem cell populations and will discuss the clinical application of these cells in contemporary clinical trials, and potential future investigations.