Lemarchand P
Inserm, UMR915, Faculté de Médecine,Institut du Thorax, 44000 Nantes, France.
Transfus Clin Biol. 2009 May;16(2):146-7. doi: 10.1016/j.tracli.2009.03.015. Epub 2009 May 13.
Despite important progress in cardiology, acute myocardial infarction (AMI) is the major cause of congestive heart failure and subsequent mortality. The rationale for cell therapy to be administered after AMI is derived from the assumption that given the insufficient regeneration in the injured heart tissue, stem cells from the bone marrow may be able to replace or repair damaged vascular and cardiac tissue. Results of the first phase I clinical trials using bone marrow stem/progenitor cell therapy for AMI were published in 2002 to 2004. Although not designed to test the efficacy of the intervention, the initial trials indicated a promising improvement in a number of clinical outcomes and cardiac function and suggested the intervention was safe. Recently, randomized controlled trials of cardiac cell therapy for AMI were published, with mixed results. A meta-analysis including 13 trials with a total of 811 participants showed an improved left ventricular ejection fraction by 2.99%. A large multicentre international trial is warranted to further document the efficacy of cardiac cell therapy on clinical outcomes.
尽管心脏病学取得了重大进展,但急性心肌梗死(AMI)仍是充血性心力衰竭及后续死亡的主要原因。AMI后进行细胞治疗的理论依据源于这样一种假设,即鉴于受损心脏组织再生不足,骨髓干细胞或许能够替代或修复受损的血管和心脏组织。2002年至2004年发表了首批使用骨髓干/祖细胞治疗AMI的I期临床试验结果。尽管这些试验并非旨在测试干预措施的疗效,但初步试验表明,多项临床结局和心脏功能有了令人鼓舞的改善,并表明该干预措施是安全的。最近,发表了针对AMI的心脏细胞治疗的随机对照试验,结果不一。一项纳入13项试验、共811名参与者的荟萃分析显示,左心室射血分数提高了2.99%。有必要开展一项大型多中心国际试验,以进一步证明心脏细胞治疗对临床结局的疗效。