Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Pharmacol Ther. 2018 Jan;181:156-168. doi: 10.1016/j.pharmthera.2017.08.004. Epub 2017 Aug 19.
Stem cells have the potential to differentiate into cardiovascular cell lineages and to stimulate tissue regeneration in a paracrine/autocrine manner; thus, they have been extensively studied as candidate cell sources for cardiovascular regeneration. Several preclinical and clinical studies addressing the therapeutic potential of endothelial progenitor cells (EPCs) and cardiac progenitor cells (CPCs) in cardiovascular diseases have been performed. For instance, autologous EPC transplantation and EPC mobilization through pharmacological agents contributed to vascular repair and neovascularization in different animal models of limb ischemia and myocardial infarction. Also, CPC administration and in situ stimulation of resident CPCs have been shown to improve myocardial survival and function in experimental models of ischemic heart disease. However, clinical studies using EPC- and CPC-based therapeutic approaches have produced mixed results. In this regard, intracoronary, intra-myocardial or intramuscular injection of either bone marrow-derived or peripheral blood progenitor cells has improved pathological features of tissue ischemia in humans, despite modest or no clinical benefit has been observed in most cases. Also, the intriguing scientific background surrounding the potential clinical applications of EPC capture stenting is still waiting for a confirmatory proof. Moreover, clinical findings on the efficacy of CPC-based cell therapy in heart diseases are still very preliminary and based on small-size studies. Despite promising evidence, widespread clinical application of both EPCs and CPCs remains delayed due to several unresolved issues. The present review provides a summary of the different applications of EPCs and CPCs for cardiovascular cell therapy and underlies their advantages and limitations.
干细胞具有分化为心血管细胞谱系并通过旁分泌/自分泌方式刺激组织再生的潜力；因此，它们被广泛研究作为心血管再生的候选细胞来源。已经进行了几项关于内皮祖细胞 (EPC) 和心脏祖细胞 (CPC) 在心血管疾病中的治疗潜力的临床前和临床研究。例如，自体 EPC 移植和通过药物诱导 EPC 动员促进了不同肢体缺血和心肌梗死动物模型中的血管修复和新生血管形成。此外，CPC 给药和原位刺激驻留 CPC 已被证明可改善缺血性心脏病实验模型中的心肌存活和功能。然而，使用基于 EPC 和 CPC 的治疗方法的临床研究产生了混合结果。在这方面，冠状动脉内、心肌内或肌肉内注射骨髓来源或外周血祖细胞改善了人类组织缺血的病理特征，尽管在大多数情况下观察到适度或没有临床益处。此外，EPC 捕获支架的潜在临床应用所围绕的令人着迷的科学背景仍在等待证实。此外，基于 CPC 的细胞治疗在心脏病中的疗效的临床发现仍然非常初步，并且基于小规模研究。尽管有很有前景的证据，但由于存在几个未解决的问题，EPC 和 CPC 的广泛临床应用仍然滞后。本综述提供了 EPC 和 CPC 用于心血管细胞治疗的不同应用的总结，并阐述了它们的优缺点。
