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Mesenchymal stem cell therapy in heart disease

Mesenchymal stem cell therapy in heart disease

Abstract

Cardiovascular disease is among the main causes of mortality and morbidity worldwide. Despite significant advances in medical and interventional therapy, the prognosis of conditions such as ischemic heart disease is still dismal. There is thus a need to investigate new therapeutic tools, one of which is stem cell therapy. Hematopoietic stem cells are the most studied type, and the fact that their biology is relatively well understood has led to their being used in preclinical research and clinical trials. However, the results of some of these studies have been controversial, which has opened the way for studies on other cell types, such as mesenchymal stem cells. These cells have immunomodulatory properties which suggest that they have therapeutic potential in cardiology. In the present article, the authors review the state of the art regarding mesenchymal stem cells, from basic and translational research to their use in clinical trials on ischemic heart disease, heart failure and arrhythmias, and discuss possible future uses.

Keywords: Mesenchymal stem cells. Cardiovascular system. Myocardial ischemia. Heart failure. Arrhythmias. Translational research.

Full Text


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Introduction

Cardiovascular disease is among the main causes of mortality and morbidity worldwide and in many areas is the leading cause of death. Despite significant advances in recent years in medical and interventional therapy, the prognosis of conditions such as ischemic heart disease following myocardial infarction (MI) is still dismal for many patients,1 which has stimulated an intense search for new therapeutic tools.

One such tool, stem cells, has recognized potential in this area, since their ability to differentiate into mature cells means that it may become possible to regenerate structurally and functionally damaged tissue.

Hematopoietic stem cells were the first lineage to be studied in preclinical research and clinical trials. Their biology is relatively well understood following a long period of animal research and then application in practice, mainly in the field of hematology, in which their clinical value is well established. They have also been used in numerous clinical trials for cardiovascular therapy,2 but the results of some of these studies have been controversial, and even those with positive results have not had as significant a clinical impact as initially hoped, which has led investigators to consider other cell types as possible therapeutic tools.

Among the most promising are mesenchymal stem cells (MSCs), due to their strong paracrine function, which gives them potential immunomodulatory effects via anti-inflammatory and antiapoptotic actions. This may enable them to counteract the pathological mechanisms involved in various diseases of the cardiovascular system; MSCs may also be able to transdifferentiate into cardiomyocytes.3

In the present article, the authors review the state of the art regarding the translational application of these cells, from preclinical research to their use in clinical trials in various areas of cardiology.

State of the art Preclinical research

There has naturally been more preclinical than clinical research into different aspects of the use of MSCs, including their collection, treatment and...


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João Pedro Lopes a, , António Fiarresga a, Pedro Silva Cunha a, Joana Feliciano a, Rui Cruz Ferreira a,

a Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal
Journal: Mesenchymal stem cell therapy in heart disease

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