Cardiac cell therapy: a realistic concept for elderly patients?
Established therapeutic concepts for heart failure in elderly patients aim at long-term medical and/or surgical palliation. Heart transplantation is limited to younger individuals, and permanent mechanical assist devices are not yet widely used. In this situation, myocardial cell therapy offers fascinating new perspectives, the ultimate goal being the complete regeneration of heart muscle and blood vessel cells. In small animal models, myocardial cell therapy often leads to a striking improvement of heart function, but the success in man has so far been modest. A possible explanation for the problems with bench-to-bedside translation of cardiac cell therapy is that mainly autologous cell products from aged patients with chronic diseases have been used so far. The aim of this paper is to summarize the current state of development of clinical cardiac cell therapy, to outline how autologous regenerative cells are subject to ageing processes, and to discuss whether the cardiac cell therapy in its present form is a realistic concept for elderly patients.
Stamm
Christof
C
Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
Nasseri
Boris
B
Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Cardiothoracic and Vascular Surgery, 13353 Berlin, Germany.
Drews
Thorsten
T
Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Cardiothoracic and Vascular Surgery, 13353 Berlin, Germany.
Hetzer
Roland
R
Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
D000367:Age Factors; D016922:Cellular Senescence; D006321:Heart / Q000502:physiology; D006333:Heart Failure / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods; D017202:Myocardial Ischemia / Q000628:therapy; D012038:Regeneration; D033581:Stem Cell Transplantation / Q000379:methods*