Using Adult Stem Cells to Treat Heart Failure—Fact or Fiction?

Abstract

Heart failure is a major health problem on a global scale. Current therapies include drug treatments, lifestyle modification, device therapy and heart transplantation. However, the "holy grail" of heart failure treatment would be to achieve widespread regeneration of diseased cardiac tissue. Examples of regeneration of living tissue are present in nature and involve stem cells. The two key defining properties of stem cells are their ability to renew themselves through cell division and to differentiate into various cell types. Generally, stem cells can be classified into embryonic or adult forms. Human adult stem cells are ethically appealing and have already been used in clinical trials in a variety of disease states. Bone marrow derived stem cells, skeletal myoblasts and resident adult cardiac stem cells are being explored as potential cell types for heart failure treatment. These cells can be delivered to the heart via a number of routes. Several clinical trials using adult stem cell have shown improvements in cardiac function, however, the mechanism of their action is unclear and widespread tissue regeneration is not evident. A more comprehensive understanding of regenerative physiology at the "benchside" combined with ongoing investigations at the bedside, will be paramount in achieving the ultimate goal of stem cell treatment-complete regeneration and repair of tissue.