Department of Biomedical Engineering, Columbia University, New York, N.Y., USA.
Cells Tissues Organs. 2012;195(1-2):171-82. doi: 10.1159/000331392. Epub 2011 Oct 12.
Damaged heart muscle has only a minimal ability for regeneration following myocardial infarction in which cardiomyocytes are lost to ischemia. The most clinically promising approach to regeneration of cardiac muscle currently under investigation is that of injecting cardiogenic repair cells or implanting a preformed tissue-engineered patch. While major advances are being made in the derivation of functional human cardiomyocytes and the development of tissue-engineering modalities for cardiac repair, the host environment into which the repair cells are placed is largely overlooked. Within seconds of myocardial ischemia, hypoxia sets in in the myocardium and the inflammatory response starts, characterized by rapid deployment of circulating cells and the release of paracrine and autocrine signals. Therefore, the inflammatory conditions under which these interactions take place, the design of the scaffold material used, and the maturity of the implanted cells will determine the outcomes of any stem cell-based therapy. We discuss here the interactions between implanted and inflammatory cells of the host, which are critical for the design of effective heart repair therapies.
心肌梗死后，心肌细胞因缺血而死亡，受损的心肌仅有极微弱的再生能力。目前，在心肌再生领域最有临床应用前景的方法是注射成心肌修复细胞或植入预先构建的组织工程贴片。虽然在获得功能型人类心肌细胞和开发心脏修复的组织工程方式方面取得了重大进展，但人们在很大程度上忽视了修复细胞所处的宿主环境。心肌缺血发生后的几秒钟内，心肌就会出现缺氧，炎症反应开始，其特征是循环细胞的快速募集以及旁分泌和自分泌信号的释放。因此，这些相互作用发生的炎症条件、所用支架材料的设计以及植入细胞的成熟度将决定任何基于干细胞的治疗的结果。我们在这里讨论了宿主植入细胞和炎症细胞之间的相互作用，这对于设计有效的心脏修复疗法至关重要。
