Simpson David, Dudley Samuel C
Georgia Institute of Technology, Atlanta, GA 30332, USA.
Curr Stem Cell Res Ther. 2009 Sep;4(3):210-23. doi: 10.2174/157488809789057437.
Heart failure accounts for more deaths in the United States than any other detrimental human pathology. Recently, repairing the heart after seemingly irreversible injury leading to heart failure appears to have come within reach. Cellular cardiomyoplasty, transplanting viable cell alternatives into the diseased myocardium, has emerged as a promising possible solution. Translating this approach from the laboratory to the clinic, however, has been met with several challenges, leaving many questions unanswered. This review assesses the state of investigation of several progenitor cell sources, including induced pluripotent stem cells, embryonic stem cells, bone marrow stem cells, adipose-derived adult stem cells, amniotic fluid stem cells, skeletal muscle progenitors, induced pluripotent stem cells and cardiac progenitors. Several current roadblocks to maximum success are discussed. These include understanding the need for cardiomyocyte differentiation, appreciating the role of paracrine factors, and addressing the low engraftment rates using current techniques. Tissue engineering strategies to address these obstacles and to help maximize cellular cardiomyoplasty success are reviewed.
在美国，心力衰竭导致的死亡人数比任何其他有害的人类疾病都要多。最近，在看似不可逆转的损伤导致心力衰竭后修复心脏似乎已触手可及。细胞心肌成形术，即将有活力的细胞替代物移植到患病心肌中，已成为一种有前景的可能解决方案。然而，将这种方法从实验室转化到临床遇到了几个挑战，留下了许多未解决的问题。这篇综述评估了几种祖细胞来源的研究现状，包括诱导多能干细胞、胚胎干细胞、骨髓干细胞、脂肪来源的成体干细胞、羊水干细胞、骨骼肌祖细胞、诱导多能干细胞和心脏祖细胞。讨论了当前几个阻碍取得最大成功的障碍。这些障碍包括理解心肌细胞分化的必要性、认识旁分泌因子的作用以及解决使用当前技术时的低植入率问题。还综述了应对这些障碍并帮助最大限度提高细胞心肌成形术成功率的组织工程策略。
