Doss Michael Xavier, Sachinidis Agapios, Hescheler Jürgen
Center of Physiology and Pathophysiology, Institute of Neurophysiology, University of Cologne, Robert Koch Str. 39, 50931 Cologne, Germany.
Chin J Physiol. 2008 Aug 31;51(4):226-9.
Cardiovascular diseases are the leading cause of death globally. The pluripotency and indefinite proliferative capacity of embryonic stem (ES) cells make them a promising candidate for the cell replacement therapy where the damaged cells are replaced by the functional cells derived from stem cells in vitro. Emerging results with human ES cells for the myocardial repair are encouraging, but this approach is still in its infancy and is under extensive investigation. The daily upcoming experimental observations are reinforcing the solid hope that ES cells will be the potential source for use in cell replacement therapy. Although this demands serious considerations ethically and on practical applicability, the newly upcoming discoveries show that the adult human fibroblasts can be reprogrammed to embryonic stem cell like cells (called induced pluripotent stem cells) which can be used for cell replacement therapies. Remarkably, this obviates the need for the embryo destruction and overcomes related immunological problems which are the long time hurdles for the ES cell based cell replacement therapy. This review weighs the actual stand off in the human ES cells based cell replacement therapy for the treatment of cardiovascular degenerative diseases with a special emphasis on the hurdles and challenges to be resolved before the onset of clinical trials and the potential of the recently reported "induced pluripotent stem cells" for their use in cell replacement therapy.
心血管疾病是全球主要的死亡原因。胚胎干细胞（ES细胞）的多能性和无限增殖能力使其成为细胞替代疗法的一个有前景的候选者，在这种疗法中，受损细胞由体外源自干细胞的功能细胞替代。人类ES细胞用于心肌修复的新成果令人鼓舞，但这种方法仍处于起步阶段，正在进行广泛研究。每天不断涌现的实验观察结果都在强化一种坚定的希望，即ES细胞将成为细胞替代疗法的潜在来源。尽管这在伦理和实际适用性方面需要认真考虑，但新出现的发现表明，成人成纤维细胞可以被重编程为类似胚胎干细胞的细胞（称为诱导多能干细胞），可用于细胞替代疗法。值得注意的是，这消除了对胚胎破坏的需求，并克服了相关的免疫问题，而这些问题长期以来一直是基于ES细胞的细胞替代疗法的障碍。本综述权衡了基于人类ES细胞的细胞替代疗法在治疗心血管退行性疾病方面的实际现状，特别强调了在临床试验开始之前需要解决的障碍和挑战，以及最近报道的“诱导多能干细胞”在细胞替代疗法中的应用潜力。
