Institute of Cardiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli, 8, Rome, 00168, Italy.
Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia.
Pharmacol Res. 2018 Jan;127:67-76. doi: 10.1016/j.phrs.2017.06.001. Epub 2017 Jun 7.
Heart failure and acute myocardial infarction are conditions that are associated with high morbidity and mortality. Significant dysfunction of the heart muscle can occur as the consequence of end-stage chronic cardiovascular diseases or acute ischemic events that are marked by large infarction area and significant tissue necrosis. Despite the remarkable improvement of conventional treatments, a substantial proportion of patients still develops severe heart failure that can only be resolved by heart transplantation or mechanical device implantation. Therefore, novel approaches based on stem-cell therapy can directly modify the disease process and alter its prognosis. The ability of the stem-cells to modify and repair the injured myocardium is a challenging but intriguing concept that can potentially replace expensive and invasive methods of treatment that are associated with increased risks and significant financial costs. In that sense, granulocyte colony-stimulating factor (G-CSF) seems as an attractive treatment approach. Based on the series of pre-clinical experiments and a limited amount of clinical data, it was demonstrated that G-CSF agents possess the ability to mobilize stem-cells from bone marrow and induce their differentiation into cardiomyocytes or endothelial cells when brought into contact with injured regions of the myocardium. However, clinical benefits of G-CSF use in damaged myocardium remain unclear and are the topic of expert discussion. The main goal of this review is to present relevant and up-to-date evidence on G-CSF therapy use in pre-clinical models and in humans and to provide a rationale for its potential clinical applications in the future.
心力衰竭和急性心肌梗死是与高发病率和死亡率相关的疾病。终末期慢性心血管疾病或急性缺血事件可导致心肌显著功能障碍，其特征为大面积梗死和显著组织坏死。尽管常规治疗有显著改善，但仍有相当一部分患者发生严重心力衰竭，只能通过心脏移植或机械装置植入来解决。因此，基于干细胞治疗的新方法可以直接改变疾病进程并改变其预后。干细胞修饰和修复受损心肌的能力是一个具有挑战性但又引人入胜的概念，它可能替代昂贵和侵入性的治疗方法，这些方法与风险增加和巨大的财务成本相关。从这个意义上说，粒细胞集落刺激因子 (G-CSF) 似乎是一种有吸引力的治疗方法。基于一系列临床前实验和有限的临床数据，证明 G-CSF 药物具有从骨髓中动员干细胞的能力，并在与心肌损伤区域接触时诱导其分化为心肌细胞或内皮细胞。然而，G-CSF 在受损心肌中的临床应用益处仍不清楚，这是专家讨论的主题。本综述的主要目的是介绍 G-CSF 治疗在临床前模型和人类中的相关和最新证据，并为其未来的潜在临床应用提供理论依据。
