Kaminski Alexander, Steinhoff Gustav
Department of Cardiac Surgery, University of Rostock, Rostock, Germany.
Semin Thorac Cardiovasc Surg. 2008 Summer;20(2):119-25. doi: 10.1053/j.semtcvs.2008.03.003.
Since the first reports of the capacity of bone marrow stem cells for use in cardiac repair and regeneration after acute myocardial infarction, today, the therapeutic strategy of direct cell administration during cardiac surgery is entering clinical practice. Here we report on the current knowledge of the "new cellular tool" in the cardiac surgeon's hands that is enabling them to exceed the limits of modern methods for myocardial revascularization and repair in cardiac surgery. Therefore, we discuss preclinical data focusing on bone marrow stem cell types and point to the current mechanistic explanation of their effects. With 7 years' experience after completing Phase I and Phase II clinical trials with cardiac transplantation of autologous intramyocardial bone marrow stem cells, we draw conclusions about surgical applicability, safety, and efficacy. At present, the functional effects of this treatment are highly promising to become a standard treatment. Further clarification by prospective randomized clinical Phase III trials is necessary in this field.
自从首次报道骨髓干细胞用于急性心肌梗死后心脏修复和再生的能力以来，如今，心脏手术期间直接细胞给药的治疗策略正在进入临床实践。在此，我们报告心脏外科医生手中“新细胞工具”的当前知识，这使他们能够超越心脏手术中现代心肌血运重建和修复方法的局限。因此，我们讨论聚焦于骨髓干细胞类型的临床前数据，并指出其作用的当前机制解释。在完成自体心肌内骨髓干细胞心脏移植的I期和II期临床试验7年后，我们得出关于手术适用性、安全性和有效性的结论。目前，这种治疗的功能效果极有希望成为一种标准治疗方法。该领域有必要通过前瞻性随机临床III期试验作进一步阐明。
