Despite significant therapeutic advances over several decades, myocardial infarction remains the most common cause of death worldwide. In this context, cell-based therapy was considered a promising novel strategy for regeneration of healthy, functionally integrated, myocardial tissue. Unfortunately, the clinical trials using cell-based therapy did not always confirm the preclinical experimental results.1,2 Therefore, in the last decade, the efforts were focused on studying the complex molecular and cellular mechanisms contributing to improved myocardial remodeling and function after stem cell transplantation.3 Article, see p 312 Because cell-based therapy has been proposed, various cell types were tested in transplantation experiments.4–10 Among all, autologous bone marrow-derived CD34+ stem cells demonstrate a major benefit, showing favorable impact on angiogenic growth, without the toxicity and inflammatory response observed in nonautologous cell-based therapy.11,12 However, insufficient number of donor stem cells, low cell viability, and inefficient expansion techniques limit the effects of this therapy. In this regard, overexpressing angiogenic growth factors in transplanted cells has been reported to be beneficial by attenuating myocardial ischemia and preserving the heart function.13–17 In this issue of Circulation Research , Mackie et al investigate the mechanisms of preserving the heart function after transplantation of CD34+ cells overexpressing sonic hedgehog (Shh) protein, a well-established angiogenic factor.18 After …
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