Center for Vascular Biology, University of Connecticut Health Center, Farmington, CT 06030, United States.
Department of Echocardiography, Division of Cardiology, Hartford Hospital, Hartford, CT 06102, United States; Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, United States.
Pharmacol Ther. 2015 Jul;151:8-15. doi: 10.1016/j.pharmthera.2015.02.003. Epub 2015 Feb 20.
Cardiovascular disease (CVD) can be separated into two broad etiological categories, based on the presence or absence of ischemia as a causative factor. In both ischemic and non-ischemic heart disease, myocardial dysfunction or damage frequently results in the development of heart failure, characterized by dyspnea, fatigue and reduced survival. As one of the least regenerative organs in the human body, current standards of care are limited to mitigating loss and preventing recurrence of damage, rather than stimulating actual regeneration of functional heart tissue. Cell based therapies using progenitor cells from bone marrow and the heart itself have been evaluated in preclinical models, and have demonstrated some promise. Accordingly, several clinical trials using autologous stem and progenitor cells have been performed, showing that these cells can be used safely in humans, and suggesting that they may improve relevant clinical parameters in patients with heart disease. Two specific cell populations that are particularly promising are the bone marrow derived mesenchymal stem cell (MSC) and the heart muscle derived cardiac stem cell (CSC). This review will summarize preclinical studies evaluating these stem cell populations and will discuss the clinical application of these cells in contemporary clinical trials, and potential future investigations.
心血管疾病 (CVD) 可以根据是否存在缺血作为致病因素分为两个广泛的病因类别。在缺血性和非缺血性心脏病中，心肌功能障碍或损伤常导致心力衰竭的发展，其特征是呼吸困难、疲劳和生存能力降低。作为人体中再生能力最差的器官之一，目前的治疗标准仅限于减轻损失和预防损伤复发，而不是刺激功能性心脏组织的实际再生。使用骨髓和心脏自身的祖细胞的基于细胞的疗法已在临床前模型中进行了评估，并显示出一定的前景。因此，已经进行了几项使用自体干细胞和祖细胞的临床试验，表明这些细胞可以在人体中安全使用，并表明它们可能改善心脏病患者的相关临床参数。两种特别有前途的特定细胞群体是骨髓来源的间充质干细胞 (MSC) 和心脏肌肉来源的心脏干细胞 (CSC)。这篇综述将总结评估这些干细胞群体的临床前研究，并讨论这些细胞在当代临床试验中的临床应用以及潜在的未来研究。
