Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Exp Mol Med. 2010 Mar 31;42(3):155-65. doi: 10.3858/emm.2010.42.3.022.
In developed countries, in which people have nutrient-rich diets, convenient environments, and access to numerous medications, the disease paradigm has changed. Nowadays, heart failure is one of the major causes of death. In spite of this, the therapeutic efficacies of medications are generally unsatisfactory. Although whole heart transplantation is ideal for younger patients with heart failure, many patients are deemed to be unsuitable for this type of surgery due to complications and/or age. The need for therapeutic alternatives to heart transplantation is great. Regenerative therapy is a strong option. For this purpose, several cell sources have been investigated, including intrinsic adult stem or progenitor cells and extrinsic pluripotent stem cells. Most intrinsic stem cells seem to contribute to a regenerative environment via paracrine factors and/or angiogenesis, whereas extrinsic pluripotent stem cells are unlimited sources of cardiomyocytes. In this review, we summarize the various strategies for using regenerative cardiomyocytes including our recent progressions: non-genetic approaches for the purification of cardiomyocytes and efficient transplantation. We expect that use of intrinsic and extrinsic stem cells in combination will enhance therapeutic effectiveness.
在发达国家，人们的饮食营养丰富，环境便利，可获得众多药物，疾病模式已经发生了变化。如今，心力衰竭是主要死亡原因之一。尽管如此，药物的治疗效果通常并不令人满意。虽然心脏移植对于年轻的心力衰竭患者来说是理想的，但由于并发症和/或年龄的原因，许多患者被认为不适合这种手术。因此，迫切需要替代心脏移植的治疗方法。再生疗法是一个强有力的选择。为此，已经研究了几种细胞来源，包括内在的成体干细胞或祖细胞和外在的多能干细胞。大多数内在干细胞似乎通过旁分泌因子和/或血管生成来促进再生环境，而外在多能干细胞是心肌细胞的无限来源。在这篇综述中，我们总结了使用再生心肌细胞的各种策略，包括我们最近的进展：用于纯化心肌细胞和有效移植的非遗传方法。我们期望内在和外在干细胞的联合使用将提高治疗效果。
