Fujita Jun, Fukuda Keiichi
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2012 Sep;113(5):441-5.
Morbidity and mortality in heart failure (HF) remain high in developed countries. Cardiac regenerative therapy with stem cells has the potential to improve the treatment of HF. Several cell sources have been investigated for cardiac cell transplantation therapy. The most representative cell sources are bone marrow stem cells, skeletal myoblasts, and cardiac progenitor cells. Skeletal myoblasts raise the issue of arrhythmo-genicity. Regenerative cardiomyocytes derived from human embryonic stem cells (hESCs) or human induced pluripotent stem cells (hiPSCs) are the most promising, because ESCs and iPSCs can potentially generate both contraction recovery and electromechanical coupling with host cardiomyocytes. The functional mechanism of myocardial cell transplantation therapy may be cardiac differentiation, cytokine effects, neovascularization, and intrinsic cardiac progenitor differentiation. It is critical to establish the differentiation protocol from hESCs and hiPSCs to cardiomyocytes. The survival of transplanted cells is also very important. The clinical application of myocardial cell therapy is anxiously awaited for the treatment of HF.
在发达国家，心力衰竭（HF）的发病率和死亡率仍然很高。干细胞心脏再生疗法有可能改善HF的治疗。已经对几种细胞来源进行了心脏细胞移植治疗的研究。最具代表性的细胞来源是骨髓干细胞、骨骼肌成肌细胞和心脏祖细胞。骨骼肌成肌细胞引发了心律失常的问题。源自人类胚胎干细胞（hESCs）或人类诱导多能干细胞（hiPSCs）的再生心肌细胞是最有前景的，因为胚胎干细胞和诱导多能干细胞有可能同时实现收缩恢复以及与宿主心肌细胞的机电耦合。心肌细胞移植治疗的功能机制可能是心脏分化、细胞因子作用、新血管形成以及心脏固有祖细胞分化。建立从hESCs和hiPSCs到心肌细胞的分化方案至关重要。移植细胞的存活也非常重要。心肌细胞疗法的临床应用备受期待，有望用于HF的治疗。
