Prósper Felipe, Herreros Jesús, Barba Joaquín
Servicio de Hematología y Area de Terapia Celular, Departamento de Cardiología y Cirugía Cardiovascular, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
Rev Esp Cardiol. 2004 Oct;57(10):981-8.
The last few years have witnessed growing interest in regenerative therapy for the failing heart by cell transplantation. Although initial studies with skeletal myoblasts are more than 10 years old, the potential of bone marrow-derived cells has led to a flurry of experimental studies generating generally positive but occasionally contradictory results. This has given rise on not a few occasions to conflicting viewpoints regarding the ethics of initiating clinical trials. We feel it is appropriate to offer a critical view of the use of stem cells for heart failure. Perhaps the thorniest question to answer at this time is whether clinical trials are justified or not in the light of current knowledge, or whether we should acquire deeper knowledge of the possible efficacy and safety of this type of treatment, and of the mechanisms that account for its efficacy, before we so much as initiate studies in humans. We feel there is now sufficient evidence to justify the performance of clinical trials despite the undoubtedly numerous questions that remain to be answered with experimental studies in animals.
在过去几年中，通过细胞移植对衰竭心脏进行再生治疗的兴趣日益浓厚。尽管最初关于骨骼肌成肌细胞的研究已有十多年历史，但骨髓来源细胞的潜力引发了一系列实验研究，这些研究总体上产生了积极但偶尔相互矛盾的结果。这在不少情况下引发了关于启动临床试验伦理的相互冲突的观点。我们认为，对干细胞用于心力衰竭治疗进行批判性审视是恰当的。目前最棘手的问题或许是，鉴于现有知识，临床试验是否合理，或者在我们甚至在人体开展研究之前，是否应该更深入了解这类治疗可能的疗效和安全性，以及其疗效的机制。我们认为，尽管在动物实验研究中无疑仍有众多问题有待解答，但现在已有足够证据证明开展临床试验是合理的。
