Mazhari Ramesh, Hare Joshua M
Department of Medicine, Division of Cardiology and Interdisciplinary Stem Cell Institute, Leonard M Miller School of Medicine, Miami, FL 33136, USA.
Prog Cardiovasc Dis. 2007 May-Jun;49(6):387-95. doi: 10.1016/j.pcad.2007.03.004.
Congestive heart failure and coronary artery disease are the leading causes of morbidity and mortality in the United States despite substantial therapeutic advances in the last half century. Only very recently have studies arisen that support possibility of regenerating tissue of damaged human organs including the heart. In this regard, there is growing pre-clinical and clinical evidence demonstrating the safety and efficacy of cell-based myocardial regeneration using a variety of cell lines. Although the data on the exact mechanism of action and the fate of the administered cells is controversial, there is consistent evidence for improved cardiac function and myocardial regeneration using different cell types. This extraordinarily exciting scientific advance has forced cardiovascular scientists to re-evaluate the long-held paradigm of cardiac myocyte terminal differentiation and life-long longevity of the cardiac myocytes that comprise the heart. Whereas, these new ideas originated with attempts to perform cellular transplantation using exogenous stem or precursor cells, mechanistic insights have rapidly evolved to the realization that adult organs harbor stem cells with significant plasticity, capable of repopulating their respective organ. Indeed these cells may be harnessed as a therapeutic agent or may represent the target of regenerative therapeutic strategies.
尽管在过去半个世纪里治疗方法取得了重大进展，但充血性心力衰竭和冠状动脉疾病仍是美国发病和死亡的主要原因。直到最近才有研究表明受损人体器官（包括心脏）的组织再生具有可能性。在这方面，越来越多的临床前和临床证据证明了使用多种细胞系进行基于细胞的心肌再生的安全性和有效性。尽管关于给药细胞的确切作用机制和命运的数据存在争议，但使用不同细胞类型改善心脏功能和心肌再生有一致的证据。这一极其令人兴奋的科学进展迫使心血管科学家重新评估长期以来关于心肌细胞终末分化以及构成心脏的心肌细胞终身寿命的范式。然而，这些新观点源于使用外源性干细胞或前体细胞进行细胞移植的尝试，对机制的深入了解已迅速发展到认识到成体器官含有具有显著可塑性的干细胞，能够重新填充各自的器官。事实上，这些细胞可被用作治疗剂，或者可能代表再生治疗策略的靶点。
