Drugs, gene transfer, signaling factors: a bench to bedside approach to myocardial stem cell therapy.
In the past few years, the dogma that the heart is a terminally differentiated organ has been challenged. Evidence from preclinical investigations emerged that there are cells, even in the heart itself, that may be able to restore impaired cardiac function after myocardial infarction. Although the exact mechanisms by which the infarcted heart can be repaired by stem cells are not yet fully defined, there is a new optimism among cardiologists that this treatment will prove successful in addressing the cause of heart failure after myocardial infarction-myocyte loss. Despite the promising preliminary data of human myocardial stem cell trials, scientists have also focused on the possibility of enhancing the underlying mechanisms of stem cell repair to gain healthier myocardial tissue. Attempts to induce neo-angiogenesis by transfecting stem cells with signaling factors (such as VEGF), to raise the number of endothelial progenitor cells with medical treatments (such as statins), to transfect stem cells with heat shock protein 70 (as a cardioprotective agent against ischemia) and to enhance the healing process after myocardial infarction with the use of various forms of stimulating factors (G-CSF, SCF, GM-CSF) have been made with notable results. In this article, we summarize the evidence from preclinical and clinical myocardial stem cell studies that have addressed the possibility of enhancing the regenerative capacity of cells used after myocardial infarction.
Department of Adult Cardiology, Gottsegen Hungarian Institute of Cardiology, Haller u. 29, Budapest 1096, Hungary.
Marton
M
Vertesaljai
Zsolt
Z
Piroth
Geza
G
Fontos
Gyorgy
G
Andreka
Gusztav
G
Font
Gergely
G
Szantho
Sandor
S
Lueff
Marienn
M
Reti
Tamas
T
Masszi
Laszlo
L
Ablonczy
Eszter D
ED
Juhasz
Tamas
T
Simor
Mark S
MS
Turner
Peter
P
Andreka
D000818:Animals; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D018014:Gene Transfer Techniques; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D019095:Point-of-Care Systems; D033581:Stem Cell Transplantation / Q000379:methods*; D016896:Treatment Outcome
D002317:Cardiovascular Agents