title: Role of adult bone marrow stem cells in the repair of ischemic myocardium: current state of the art.
abstract: OBJECTIVE
  To review the milestones in stem cell therapy for ischemic heart disease from early basic science to large clinical studies and new therapeutic approaches.
  
  
  METHODS
  Basic research and clinical trials (systematic review) were used. The heart has the ability to regenerate through activation of resident cardiac stem cells or through recruitment of a stem cell population from other tissues, such as bone marrow. Although the underlying mechanism is yet to be made clear, numerous studies in animals have documented that transplantation of bone marrow-derived stem cells or circulating progenitor cells following acute myocardial infarction and ischemic cardiomyopathy is associated with a reduction in infarct scar size and improvements in left ventricular function and myocardial perfusion.
  
  
  RESULTS
  Cell-based cardiac therapy has expanded considerably in recent years and is on its way to becoming an established cardiovascular therapy for patients with ischemic heart disease. There have been recent insights into the understanding of mechanisms involved in the mobilization and homing of the imported cells, as well as into the paracrine effect, growth factors, and bioactive molecules. Additional information has been obtained regarding new stem cell sources, cell-based gene therapy, cell-enhancement strategies, and tissue engineering, all of which should enhance the efficacy of human cardiac stem cell therapy.
  
  
  CONCLUSIONS
  The recently published trials using bone marrow-origin stem cells in cardiac repair reported a modest but significant benefit from this therapy. Further clinical research should aim to optimize the cell types utilized and their delivery mode, and pinpoint optimal time of cell transplantation.
authors: Department of Cardiology, Medical University of Vienna, Vienna, Austria.
authors: Silvia
authors: S
authors: Charwat
authors: Mariann
authors: M
authors: Gyöngyösi
authors: Irene
authors: I
authors: Lang
authors: Senta
authors: S
authors: Graf
authors: Gilbert
authors: G
authors: Beran
authors: Rayyan
authors: R
authors: Hemetsberger
authors: Noemi
authors: N
authors: Nyolczas
authors: Heinz
authors: H
authors: Sochor
authors: Dietmar
authors: D
authors: Glogar
mesh_terms: D000818:Animals; D016026:Bone Marrow Transplantation / Q000379:methods*; D006333:Heart Failure / Q000601:surgery; D006801:Humans; D023421:Models, Animal; D009203:Myocardial Infarction / Q000601:surgery; D017202:Myocardial Ischemia / Q000601:surgery*; D033581:Stem Cell Transplantation / Q000379:methods*