Advances in cell-based therapy for structural heart disease.
Congestive heart failure and coronary artery disease are the leading causes of morbidity and mortality in the United States despite substantial therapeutic advances in the last half century. Only very recently have studies arisen that support possibility of regenerating tissue of damaged human organs including the heart. In this regard, there is growing pre-clinical and clinical evidence demonstrating the safety and efficacy of cell-based myocardial regeneration using a variety of cell lines. Although the data on the exact mechanism of action and the fate of the administered cells is controversial, there is consistent evidence for improved cardiac function and myocardial regeneration using different cell types. This extraordinarily exciting scientific advance has forced cardiovascular scientists to re-evaluate the long-held paradigm of cardiac myocyte terminal differentiation and life-long longevity of the cardiac myocytes that comprise the heart. Whereas, these new ideas originated with attempts to perform cellular transplantation using exogenous stem or precursor cells, mechanistic insights have rapidly evolved to the realization that adult organs harbor stem cells with significant plasticity, capable of repopulating their respective organ. Indeed these cells may be harnessed as a therapeutic agent or may represent the target of regenerative therapeutic strategies.
Mazhari
Ramesh
R
Department of Medicine, Division of Cardiology and Interdisciplinary Stem Cell Institute, Leonard M Miller School of Medicine, Miami, FL 33136, USA. jhare@med.miami.edu
Hare
Joshua M
JM
D000818:Animals; D001854:Bone Marrow Cells / Q000502:physiology; D016026:Bone Marrow Transplantation; D006348:Cardiac Surgical Procedures / Q000941:ethics; D002454:Cell Differentiation; D049109:Cell Proliferation; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery; D003327:Coronary Disease / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D053595:Embryonic Stem Cells / Q000502:physiology / Q000637:transplantation; D042783:Endothelial Cells / Q000502:physiology / Q000637:transplantation; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000502:physiology; D032386:Myoblasts, Cardiac / Q000502:physiology / Q000637:transplantation; D032448:Myoblasts, Skeletal / Q000502:physiology / Q000637:transplantation; D009206:Myocardium / Q000473:pathology*; D019899:Paracrine Communication; D012038:Regeneration; D044968:Regenerative Medicine / Q000941:ethics / Q000639:trends*; D033581:Stem Cell Transplantation / Q000941:ethics; D013234:Stem Cells / Q000502:physiology*; D016896:Treatment Outcome