Guhathakurta Soma, Subramanyan Usha R, Balasundari Ramesh, Das Chandan K, Madhusankar Nainar, Cherian Kotturathu Mammen
Frontier Lifeline Pvt. Ltd, Mogappair, Chennai 600 101, India.
Asian Cardiovasc Thorac Ann. 2009 Dec;17(6):581-6. doi: 10.1177/0218492309349363.
Growing myocardial cells from human stem cells and stem cell transplantation to repair injured myocardium are new frontiers in cardiovascular research. The 1st stage of this study was conducted to determine whether transplantation of autologous bone marrow stem cells into infarcted myocardium of sheep could differentiate into beating cardiomyocytes. The 2nd stage was to demonstrate transdifferentiation of human bone marrow mesenchymal stem cells to precursor cardiomyocytes in vitro, using a novel conditioning medium. In the 3rd stage, a clinical trial of stem cell implantation in patients with severe myocardial dysfunction involved injection of peripheral blood-derived endothelial precursor cells in 11 patients and autologous bone marrow mononuclear cells in 29. A marginal improvement in myocardial function was noted at 3 months (mean increase in ejection fraction, 6% +/- 1%), although it plateaued at 6 months. The trial proved to be safe because there was no procedure-related mortality. There is growing optimism that stem cell therapy may delay heart transplantation.
从人类干细胞培育心肌细胞以及进行干细胞移植以修复受损心肌，是心血管研究的新前沿领域。本研究的第一阶段旨在确定将自体骨髓干细胞移植到绵羊梗死心肌中是否能分化为跳动的心肌细胞。第二阶段是使用一种新型条件培养基，在体外证明人类骨髓间充质干细胞向心肌前体细胞的转分化。在第三阶段，一项针对严重心肌功能障碍患者的干细胞植入临床试验，对11名患者注射外周血来源的内皮祖细胞，对29名患者注射自体骨髓单个核细胞。3个月时观察到心肌功能有轻微改善（射血分数平均增加6%±1%），不过在6个月时趋于平稳。该试验被证明是安全的，因为没有与手术相关的死亡病例。人们越来越乐观地认为干细胞疗法可能会推迟心脏移植。
