Stem cell therapy in cardiology.

Cell therapy provides one of the most important solutions to the unmet need for new treatments in cardiovascular disease. This area of research has undergone a rapid translation into humans, with the bone marrow mononuclear cell predominating as the cell type with most clinical data. Confidence in the use of this cell type has grown over the last year with the publication of the results of Phase II/III trials in the setting of acute and chronic ischemia confirming safety and biological activity. A large pan-European outcome study is now being planned, which will definitely address the therapeutic potential of this cell type with respect to mortality. Data for the use of selected populations of cells, bioengineered cells/scaffolds and the resident stem cell population continue to grow, with some of these approaches reported in Phase I clinical trials with promising results. There is still some way to go and these more complicated cell therapy products will need to undergo the same scrutiny that has been applied to the results of the bone marrow mononuclear cell trials to date. Ultimately, these engineered biologics will have to justify the costs involved in producing them by significantly improving on results obtained by using bone marrow mononuclear cells for cardiovascular repair. The continued success of this area of translational medicine relies on the ongoing partnership between clinicians and scientists, who have thus far demonstrated a determined and pragmatic approach to solving some of the complexities of moving from bench to bedside. The next 5-years will see this partnership reach fruition as the long-awaited results of outcome studies of cell therapy in the treatment of cardiovascular disease are published.