Lee Namho, Thorne Tina, Losordo Douglas W, Yoon Young-sup
Division of Cardiovascular Research, Caritas St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02135, USA.
Cell Cycle. 2005 Jul;4(7):861-4. doi: 10.4161/cc.4.7.1799. Epub 2005 Jul 4.
Congestive heart failure is a growing, worldwide epidemic. The major causes of heart failure are related to irreversible damage resulting from myocardial infarction (heart attack). The long-standing axiom has been that the myocardium has a limited capacity for self-repair or regeneration; and the irreversible loss of cardiac muscle and accompanying contraction and fibrosis of myocardial scar tissue, sets into play a series of events, namely, progressive ventricular remodeling of nonischemic myocardium that ultimately leads to progressive heart failure. The loss of cardiomyocyte survival cues is associated with diverse pathways for heart failure, underscoring the importance of maintaining the number of viable cardiomyocytes during heart failure progression. Currently, no medication or procedure used clinically has shown efficacy in replacing the myocardial scar with functioning contractile tissue. Therefore, given the major morbidity and mortality associated with myocardial infarction and heart failure, new approaches have been sought to address the principal pathophysiologic deficits responsible for these conditions, resulting from the loss of cardiomyocytes and viable blood vessels. Recently, the identification of stem cells from bone marrow capable of contributing to tissue regeneration has ignited significant interest in the possibility that cell therapy could be employed therapeutically for the repair of damaged myocardium. In this review, we will discuss the currently available bone marrow-derived stem progenitor cells for myocardial repair and focus on the advantages of using recently identified novel bone marrow-derived multipotent stem cells (BMSC).
充血性心力衰竭是一种在全球范围内日益严重的流行病。心力衰竭的主要原因与心肌梗死(心脏病发作)导致的不可逆损伤有关。长期以来的公理是,心肌的自我修复或再生能力有限;心肌的不可逆丧失以及心肌瘢痕组织随之而来的收缩和纤维化,引发了一系列事件,即非缺血心肌的进行性心室重塑,最终导致进行性心力衰竭。心肌细胞存活信号的丧失与多种心力衰竭途径相关,这突出了在心力衰竭进展过程中维持存活心肌细胞数量的重要性。目前,临床上使用的任何药物或手术都未显示出能用有功能的收缩组织替代心肌瘢痕的疗效。因此,鉴于与心肌梗死和心力衰竭相关的主要发病率和死亡率,人们一直在寻求新的方法来解决由心肌细胞和存活血管丧失导致的这些病症的主要病理生理缺陷。最近,能够促进组织再生的骨髓干细胞的鉴定引发了人们对细胞疗法可用于治疗受损心肌修复可能性的极大兴趣。在这篇综述中,我们将讨论目前可用于心肌修复的骨髓来源的干祖细胞,并重点关注使用最近鉴定出的新型骨髓来源的多能干细胞(BMSC)的优势。