Departments of Anesthesia and Medicine, and Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, MA, USA
Circ J. 2010 Jan;74(1):13-7. doi: 10.1253/circj.cj-09-0665. Epub 2009 Nov 17.
The plasticity of bone marrow-derived progenitor cells (BMPCs) and their ability to acquire the myocyte lineage and regenerate dead myocardium after infarction has been challenged. Similarly, although several laboratories have identified cardiac progenitor cells (CPCs), the controversy concerning myocyte regeneration in the adult heart has not been resolved. The therapeutic efficacy of these 2 classes of progenitor cells depends on their ability to (1)survive in the hostile milieu of the damaged heart, (2)engraft within the myocardium and (3)grow and differentiate. BMPCs may have a growth potential that is superior to that of CPCs, but transdifferentiation could affect this characteristic and CPCs may constitute a more powerful form of therapy for cardiac repair. The process of transdifferentiation may alter the growth behavior of BMPCs, which may result in losing part of their capability of dividing through alterations of the telomere-telomerase system, premature cellular senescence and apoptosis. Moreover, myocytes derived from BMPCs may possess inherent limitations in the acquisition of the adult phenotype. The opposite may also be true and BMPCs may retain a stronger regenerative capacity than CPCs, representing the most appropriate cells for the damaged heart even after transdifferentiation. Ultimately, the question to be addressed is whether BMPCs are superior, equal or inferior to CPCs for the regeneration of cardiomyocytes and coronary vessels in acute and chronic ischemic heart failure. (Circ J 2010; 74: 13 - 17).
骨髓来源的祖细胞（BMPCs）的可塑性及其获得肌细胞谱系并在梗塞后再生死亡心肌的能力一直受到质疑。同样，尽管有几个实验室已经鉴定出心脏祖细胞（CPCs），但成人心脏中肌细胞再生的争议尚未解决。这 2 类祖细胞的治疗功效取决于它们的能力：（1）在受损心脏的恶劣环境中存活；（2）在心肌内植入；（3）生长和分化。BMPCs 可能具有优于 CPCs 的生长潜力，但转分化可能会影响这种特性，而 CPCs 可能构成心脏修复的更有效形式的治疗方法。转分化的过程可能会改变 BMPCs 的生长行为，这可能导致通过端粒-端粒酶系统的改变、过早的细胞衰老和细胞凋亡而失去部分分裂能力。此外，源自 BMPCs 的肌细胞在获得成人表型方面可能存在固有局限性。反之亦然，BMPCs 可能比 CPCs 保留更强的再生能力，即使在转分化后，它们也是受损心脏的最合适细胞。最终，要解决的问题是，在急性和慢性缺血性心力衰竭中，BMPCs 是否优于、等于或劣于 CPCs 来再生心肌细胞和冠状动脉。（Circ J 2010; 74: 13 - 17）。
