Cell-based therapy for chronic ischemic heart disease--a clinical perspective.
In patients with ischemic heart disease, the goal of cell therapy is to improve perfusion and function of the damaged heart muscle. For this review, we selected articles that reported the findings from the major clinical studies of cardiovascular stem cell therapy in patients with chronic ischemic heart disease. Because of the current status of development of clinical investigation in this field, all relevant studies were included. Initial clinical trials have shown that adult cell-based therapy is safe and may improve the quality of life and the functional status of patients with chronic myocardial ischemia. Adult bone marrow mononuclear cells have been most frequently used in cardiac cell therapy trials to date, but new cell types are now being assessed in both preclinical and clinical studies. Although not well defined, mechanisms underlying the benefits associated with cell therapy are most likely multiple and include a paracrine effect. Cell therapy in patients with chronic ischemic heart disease has been shown to be safe and feasible. Initial data have shown that cell therapy with autologous bone marrow cells is associated with modest functional improvements. This finding needs to be confirmed in subsequent phase 2 and 3 trials.
Perin
Emerson C
EC
Stem Cell Center, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, TX, USA. eperin@bluegate.com
Silva
Guilherme V
GV
D002908:Chronic Disease; D002986:Clinical Trials as Topic; D006801:Humans; D017202:Myocardial Ischemia / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*