Centre for Research in Vascular Biology, Biosciences Institute, University College Cork, Cork, Ireland.
Arterioscler Thromb Vasc Biol. 2010 Jun;30(6):1080-7. doi: 10.1161/ATVBAHA.109.198895. Epub 2010 May 7.
Cell therapy to treat vascular and cardiovascular diseases has evolved over the past decade with improved understanding of progenitor cell mobilization, recruitment, and differentiation. The beneficial effects seen in several preclinical studies have prompted translation of adult vascular progenitor therapy to clinical trials. To date, progenitor cells isolated from bone marrow and peripheral blood have been tested in the context of acute myocardial infarction and chronic ischemic cardiomyopathy, with moderate benefit. This therapeutic effect occurs despite a relatively small number of injected progenitor cells and short-term residence in the target zone. Thus, indirect benefits, such as paracrine factors released from these cells, have been suggested as significant contributors to therapeutic efficacy. Several additional vascular progenitors of endothelial, smooth muscle, mesenchymal, and cardiac origin have been identified that may contribute to vasculogenesis. Indeed, a unifying paradigm for the most effective cell therapy strategies to date appears to be robust support of angiogenesis. Here we discuss a number of progenitor cells that currently show potential as cardiovascular therapeutics, either singly or in combination. We look at emerging cell types and disease targets that may be exploited for therapeutic benefit and future strategies that may maximize clinical efficacy.
细胞疗法治疗血管和心血管疾病在过去十年中得到了发展，对祖细胞动员、募集和分化的理解也有所提高。几项临床前研究的有益效果促使成人血管祖细胞治疗转化为临床试验。迄今为止，已经从骨髓和外周血中分离出祖细胞，在急性心肌梗死和慢性缺血性心肌病的背景下进行了测试，效果中等。尽管注射的祖细胞数量相对较少，并且在靶区的停留时间较短，但仍出现了这种治疗效果。因此，有人认为这些细胞释放的旁分泌因子等间接益处是治疗效果的重要贡献者。已经确定了几种其他来源的内皮、平滑肌、间充质和心肌的血管祖细胞，它们可能有助于血管生成。事实上，迄今为止最有效的细胞治疗策略的一个统一范例似乎是对血管生成的有力支持。在这里，我们讨论了一些目前作为心血管治疗剂具有潜力的祖细胞，无论是单独使用还是联合使用。我们着眼于新兴的细胞类型和疾病靶点，这些靶点可能被利用来获得治疗益处，并探讨可能最大限度提高临床疗效的未来策略。
