Cho Gun-Sik, Fernandez Laviel, Kwon Chulan
Division of Cardiology, Department of Medicine, Institute for Cell Engineering, Johns Hopkins University , Baltimore, Maryland.
Antioxid Redox Signal. 2014 Nov 10;21(14):2018-31. doi: 10.1089/ars.2014.6063. Epub 2014 Sep 22.
Despite decades of progress in cardiovascular biology and medicine, heart disease remains the leading cause of death, and there is no cure for the failing heart. Since heart failure is mostly caused by loss or dysfunction of cardiomyocytes (CMs), replacing dead or damaged CMs with new CMs might be an ideal way to reverse the disease. However, the adult heart is composed mainly of terminally differentiated CMs that have no significant self-regeneration capacity.
Stem cells have tremendous regenerative potential and, thus, current cardiac regenerative research has focused on developing stem cell sources to repair damaged myocardium.
In this review, we examine the potential sources of cells that could be used for heart therapies, including embryonic stem cells and induced pluripotent stem cells, as well as alternative methods for activating the endogenous regenerative mechanisms of the heart via transdifferentiation and cell reprogramming. We also discuss the current state of knowledge of cell purification, delivery, and retention.
Efforts are underway to improve the current stem cell strategies and methodologies, which will accelerate the development of innovative stem-cell therapies for heart regeneration.
尽管心血管生物学和医学在过去几十年取得了进展,但心脏病仍然是主要死因,且心力衰竭无法治愈。由于心力衰竭主要是由心肌细胞(CMs)的丢失或功能障碍引起的,用新的心肌细胞替代死亡或受损的心肌细胞可能是逆转该病的理想方法。然而,成年心脏主要由终末分化的心肌细胞组成,这些细胞没有显著的自我再生能力。
干细胞具有巨大的再生潜力,因此目前的心脏再生研究集中在开发用于修复受损心肌的干细胞来源。
在本综述中,我们研究了可用于心脏治疗的细胞潜在来源,包括胚胎干细胞和诱导多能干细胞,以及通过转分化和细胞重编程激活心脏内源性再生机制的替代方法。我们还讨论了细胞纯化、递送和保留的当前知识状态。
目前正在努力改进当前的干细胞策略和方法,这将加速用于心脏再生的创新干细胞疗法的开发。