Imperial College London, National Heart and Lung Institute, Harefield Heart Science Centre, Harefield, Middlesex, UB9 6JH, UK.
Br Med Bull. 2010;94:65-80. doi: 10.1093/bmb/ldq005. Epub 2010 Mar 2.
Heart failure is a leading cause of morbidity and mortality worldwide. The current strategies for treatment are limited and new therapeutic approaches are needed. This review describes research performed in animal models of cardiac disease and clinical trials and discusses the mechanisms involved in possible beneficial effects of cell therapy. Cell therapy is a promising strategy to treat heart failure, as it aims to replenish the failing myocardium with contractile elements. However, cell therapy with adult progenitor cells induces a small improvement in heart function without significant cardiomyogenesis. Paracrine mechanisms are likely to be important. The most effective cell type for therapy remains unclear. Induced pluripotent stem cells have the greatest potential but more information on the properties of this cell type is needed. The integration of cells in the host myocardium and the routes of delivery remain controversial. The differentiation of cardiac cells from pluri- and multipotent cells and the understanding of their properties are growing points in cell therapy. More research is needed to correctly assess the physiological properties of differentiating cells, to dissect the role of the host environment in the integration and differentiation and to define the stage of differentiation required for cell transplantation.
心力衰竭是全球发病率和死亡率的主要原因。目前的治疗策略有限，需要新的治疗方法。本综述描述了在心脏病动物模型和临床试验中进行的研究，并讨论了细胞治疗可能有益作用涉及的机制。细胞治疗是治疗心力衰竭的一种有前途的策略，因为它旨在用收缩元素来补充衰竭的心肌。然而，用成体祖细胞进行细胞治疗仅能使心脏功能略有改善，而不会显著促进心肌生成。旁分泌机制可能很重要。最有效的治疗细胞类型仍不清楚。诱导多能干细胞具有最大的潜力，但需要更多关于这种细胞类型特性的信息。细胞在宿主心肌中的整合和输送途径仍存在争议。多能和多潜能细胞向心脏细胞的分化以及对其特性的理解是细胞治疗的增长点。需要进一步的研究来正确评估分化细胞的生理特性，剖析宿主环境在整合和分化中的作用，并确定细胞移植所需的分化阶段。
