Abstract
Ischemic heart disease (IHD) is the leading cause of mortality worldwide. Stem cell transplantation has become a promising approach for the treatment of IHD in recent decades. It is generally recognized that preclinical cell-based therapy is effective and have yielded encouraging results, which involves preventing or reducing myocardial cell death, inhibiting scar formation, promoting angiogenesis, and improving cardiac function. However, clinical studies have not yet achieved a desired outcome, even multiple clinical studies showing paradoxical results. Besides, many fundamental puzzles remain to be resolved, for example, what is the optimal delivery timing and approach? Additionally, limited cell engraftment and survival, challenging cell fate monitoring, and not fully understood functional mechanisms are defined hurdles to clinical translation. Here we review some of the current dilemmas in stem cell-based therapy for IHD, along with our efforts and opinions on these key issues.
Highlights
Ischemic heart disease (IHD) is the leading cause of death worldwide (Moran et al, 2013), and it is estimated to have 11 million patients with IHD in China (The Writing Committee of the Report on Cardiovascular Health and Diseases in China, 2020)
The results argued that stem cell therapy had Current Dilemma for Cellular Therapy no significant effects on the improvement of myocardial contractility, ventricular remodeling and clinical prognosis
Several clinical trials found that stem cell transplantation had a moderate or subtle improvement in the heart function of patients with acute myocardial infarction (AMI) and chronic heart failure after 1 year’s follow-up (Cong et al, 2015; Henry et al, 2017)
Summary
Ischemic heart disease (IHD) is the leading cause of death worldwide (Moran et al, 2013), and it is estimated to have 11 million patients with IHD in China (The Writing Committee of the Report on Cardiovascular Health and Diseases in China, 2020). The results argued that stem cell therapy had. Several clinical trials found that stem cell transplantation had a moderate or subtle improvement in the heart function of patients with AMI and chronic heart failure after 1 year’s follow-up (Cong et al, 2015; Henry et al, 2017). The ejection fraction of patients in the treatment group increased by 4–6% compared with the control group, and stem cell transplantation inhibited the early ventricular remodeling (Gyöngyösi et al, 2015). What do these discrepancies come from? The following unsolved issues of stem cell therapy might be able to answer this question
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