Abstract
Various researches on regenerative medicine were carried out experimentally, and selected modalities have been introduced to the clinical arena. Meanwhile, the presence of resident stem cells in the heart and their role in physiological cell turnover were demonstrated. So far skeletal myoblasts, bone marrow-derived cells, mesenchymal stromal cells, and resident cardiac cells have been applied for therapeutic myocardial regeneration. Among them, autologous transplantation of c-kit-positive cardiac stem cells in congestive heart failure patients resulted in an outstanding outcome, with long-lasting beneficial effects without major adverse events. By reviewing these clinical trials, an endeavor was made to seek for an ideal cellular therapy for cardiovascular diseases.
Highlights
Somatic stem cells had been identified in multiple organs except for the heart, and attempts were made to utilize them for therapeutic regeneration of cardiovascular diseases; in particular, skeletal myoblasts and bone marrow-derived cells were employed in many clinical trials as discussed below
This cell type does not differentiate into myocardium, it is equipped with advantageous features with low tumorigenicity and relative tolerance for ischemia in contrast to cardiomyocytes
Mesenchymal stromal cells (MSCs) are able to differentiate into osteoblasts, chondrocytes, and adipocytes in addition to myocytes and can be separated from other cells, by virtue of their tendency to adhere to plastic surface
Summary
Somatic stem cells had been identified in multiple organs except for the heart, and attempts were made to utilize them for therapeutic regeneration of cardiovascular diseases; in particular, skeletal myoblasts and bone marrow-derived cells were employed in many clinical trials as discussed below. The continuous turnover of myocardium in physiological and pathophysiological conditions has been demonstrated [2,3,4], improving dramatically our understanding of the self-renewing characteristic of the heart. This monumental discovery challenged the biological dogma and opened a new path leading to an unprecedented therapeutic option for devastating cardiovascular diseases
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