G-CSF therapy with mobilization of bone marrow stem cells for myocardial recovery after acute myocardial infarction--a relevant treatment?
This review of adjunctive therapy with subcutaneous granulocyte-colony stimulating factor (G-CSF) to patients with acute myocardial infarction (AMI) focus on the cardioprotective effects and potential mechanisms of G-CSF and discuss the therapeutic potential of G-CSF. All clinical trials published in peer-reviewed journals identified through PubMed are discussed. G-CSF treatment seems to be safe, and initial unblinded trials in patients with AMI were encouraging. However, larger double-blind placebo-controlled trials have not been able to demonstrate improved myocardial recovery after G-CSF treatment. Current controversies in interpretation of the results include 1) importance of direct cardiac effect of G-CSF vs indirect through bone marrow stem and progenitor cell mobilization, 2) importance of timing of G-CSF therapy, 3) importance of G-CSF dose, and 4) importance of cell types mobilized from the bone-marrow. Cell-based therapies to improve cardiac function remain promising and further experimental and clinical studies are warranted to determine the future role of G-CSF.
Ripa
Rasmus Sejersten
RS
Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Kastrup
Jens
J
D000818:Animals; D016026:Bone Marrow Transplantation / Q000379:methods*; D002316:Cardiotonic Agents; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D009203:Myocardial Infarction / Q000601:surgery*; D016896:Treatment Outcome
D002316:Cardiotonic Agents; D016179:Granulocyte Colony-Stimulating Factor