title: From Bone Marrow to Cardiac Atrial Appendage Stem Cells for Cardiac Repair: A Review.
abstract: Traditionally the heart is considered a terminally differentiated organ. However, at the beginning of this century increased mitotic activity was reported in ischemic and idiopathic dilated cardiomyopathy hearts, compared to healthy controls, underscoring the potential of regeneration after injury. Due to the presence of adult stem cells in bone marrow and their purported ability to differentiate into other cell lineages, this cell population was soon estimated to be the most suited candidate for cardiac regeneration. Clinical trials with autologous bone marrow-derived mononuclear cells, using either an intracoronary or direct intramyocardial injection approach consistently showed only minor improvement in global left ventricular ejection fraction. This was explained by their limited cardiomyogenic differentiation potential. To obtain more convincing improvement in cardiac function, based on true myocardial regeneration, the focus of research has shifted towards resident cardiac progenitor cells. Several isolation procedures have been described: the c-kit surface marker was the first to be used, however experimental research has clearly shown that c-kit+ cells only marginally contribute to regeneration post myocardial infarction. Sphere formation was used to isolate the so-called cardiosphere derived cells (CDC), and also in this cell population cardiomyogenic differentiation is a rare event. Recently a new type of stem cells derived from atrial tissue (cardiac atrial stem cells - CASCs) was identified, based on the presence of the enzyme aldehyde dehydrogenase (ALDH). Those cells significantly improve both regional and global LV ejection fraction, based on substantial engraftment and consistent differentiation into mature cardiomyocytes (98%).
authors.affiliation: Jessa Ziekenhuis vwz Department of Cardiothoracic and Vascular Surgery, Hasselt, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Hendrikx
authors.forename: Yanick
authors.initials: Y
authors.lastname: Fanton
authors.forename: Leen
authors.initials: L
authors.lastname: Willems
authors.forename: Annick
authors.initials: A
authors.lastname: Daniels
authors.forename: Jeroen
authors.initials: J
authors.lastname: Declercq
authors.forename: Severina
authors.initials: S
authors.lastname: Windmolders
authors.forename: Karen
authors.initials: K
authors.lastname: Hensen
authors.forename: Remco
authors.initials: R
authors.lastname: Koninckx
authors.forename: Luc
authors.initials: L
authors.lastname: Jamaer
authors.forename: Jasperina
authors.initials: J
authors.lastname: Dubois
authors.forename: Dagmara
authors.initials: D
authors.lastname: Dilling-Boer
authors.forename: Jos
authors.initials: J
authors.lastname: Vandekerkhof
authors.forename: Filip
authors.initials: F
authors.lastname: Hendrikx
authors.forename: Eric
authors.initials: E
authors.lastname: Bijnens
authors.forename: Nick
authors.initials: N
authors.lastname: Heuts
authors.forename: Boris
authors.initials: B
authors.lastname: Robic
authors.forename: Virginie
authors.initials: V
authors.lastname: Bito
authors.forename: Marcel
authors.initials: M
authors.lastname: Ameloot
authors.forename: Paul
authors.initials: P
authors.lastname: Steels
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Rummens
mesh_terms: D000444:Aldehyde Dehydrogenase / Q000378:metabolism; D020517:Atrial Appendage / Q000166:cytology*; D001854:Bone Marrow Cells / Q000166:cytology*; D002454:Cell Differentiation; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells / Q000166:cytology* / Q000201:enzymology / Q000378:metabolism; D009203:Myocardial Infarction / Q000628:therapy; D032383:Myocytes, Cardiac / Q000166:cytology / Q000201:enzymology / Q000378:metabolism; D012038:Regeneration; D016276:Ventricular Function / Q000502:physiology
chemical_list: D000444:Aldehyde Dehydrogenase