title: Cell therapy for heart disease after 15 years: Unmet expectations.
abstract: Over the past two decades cardiac cell therapy (CCT) has emerged as a promising new strategy to cure heart diseases at high unmet need. Thousands of patients have entered clinical trials for acute or chronic heart conditions testing different cell types, including autologous or allogeneic bone marrow (BM)-derived mononuclear or selected cells, BM- or adipose tissue-derived mesenchymal cells, or cardiac resident progenitors based on their potential ability to regenerate scarred or dysfunctional myocardium. Nowadays, the original enthusiasm surrounding the regenerative medicine field has been cushioned by a cumulative body of evidence indicating an inefficient or modest efficacy of CCT in improving cardiac function, along with the continued lack of indisputable proof for long-term prognostic benefit. In this review, we have firstly comprehensively outlined the positive and negative results of cell therapy studies in patients with acute myocardial infarction, refractory angina and chronic heart failure. Next, we have discussed cell therapy- and patient-related variables (e.g. cell intrinsic and extrinsic characteristics as well as criteria of patient selection and proposed methodologies) that might have dampened the efficacy of past cell therapy trials. Finally, we have addressed critical factors to be considered before embarking on further clinical trials.
authors.affiliation: Vascular Biology and Regenerative Medicine Unit, Centro Cardiologico Monzino-IRCCS, via Carlo Parea 4, 20138, Milan, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Nigro
authors.affiliation: Vascular Biology and Regenerative Medicine Unit, Centro Cardiologico Monzino-IRCCS, via Carlo Parea 4, 20138, Milan, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Bassetti
authors.affiliation: Department of Cardiovascular Surgery, Centro Cardiologico Monzino-IRCCS, via Carlo Parea 4, 20138, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cavallotti
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino-IRCCS, via Carlo Parea 4, 20138, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Catto
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino-IRCCS, via Carlo Parea 4, 20138, Milan, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Carbucicchio
authors.affiliation: Vascular Biology and Regenerative Medicine Unit, Centro Cardiologico Monzino-IRCCS, via Carlo Parea 4, 20138, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, via Festa del Perdono 7, 20122, Milan, Italy. Electronic address: giulio.pompilio@ccfm.it.
authors.forename: Giulio
authors.initials: G
authors.lastname: Pompilio
mesh_terms: D000787:Angina Pectoris / Q000628:therapy*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D018579:Patient Selection
keywords: Cardiac disease; Cell therapy; Stem cells