Gersh Bernard J, Simari Robert D, Behfar Atta, Terzic Carmen M, Terzic Andre
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clin Proc. 2009 Oct;84(10):876-92. doi: 10.4065/84.10.876.
From bone marrow transplants 5 decades ago to the most recent stem cell-derived organ transplants, regenerative medicine is increasingly recognized as an emerging core component of modern practice. In cardiovascular medicine, innovation in stem cell biology has created curative solutions for the treatment of both ischemic and nonischemic cardiomyopathy. Multiple cell-based platforms have been developed, harnessing the regenerative potential of various natural and bioengineered sources. Clinical experience from the first 1000 patients (approximately) who have received stem cell therapy worldwide indicates a favorable safety profile with modest improvement in cardiac function and structural remodeling in the setting of acute myocardial infarction or chronic heart failure. Further investigation is required before early adoption and is ongoing. Broader application in practice will require continuous scientific advances to match each patient with the most effective reparative phenotype, while ensuring optimal cell delivery, dosing, and timing of intervention. An interdisciplinary effort across the scientific and clinical community within academia, biotechnology, and government will drive the successful realization of this next generation of therapeutic agents for the "broken" heart.
从50年前的骨髓移植到最近的干细胞衍生器官移植，再生医学日益被视为现代医疗实践中一个新兴的核心组成部分。在心血管医学领域，干细胞生物学的创新为缺血性和非缺血性心肌病的治疗创造了治愈方案。已经开发了多种基于细胞的平台，利用各种天然和生物工程来源的再生潜力。全球首批约1000名接受干细胞治疗患者的临床经验表明，在急性心肌梗死或慢性心力衰竭的情况下，安全性良好，心脏功能和结构重塑有适度改善。在早期采用之前还需要进一步研究，并且相关研究正在进行中。在实践中的更广泛应用将需要持续的科学进展，以便为每位患者匹配最有效的修复表型，同时确保最佳的细胞递送、剂量和干预时机。学术界、生物技术界和政府的科学界与临床界之间的跨学科努力将推动为“受损”心脏成功实现下一代治疗药物。
