Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada.
Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Stem Cells Transl Med. 2018 Jul;7(7):543-550. doi: 10.1002/sctm.17-0210. Epub 2018 Apr 17.
The capacity of stem and progenitor cells to stimulate cardiac regeneration has been studied for almost 20 years, with very promising preclinical data and mixed clinical results. Several cell types have been studied, identified by their cell surface markers, differentiation capacity and their secreted growth factors. Bone marrow derived mesenchymal stem cells (MSCs) have been found to have potent regenerative capacity, through multiple mechanisms, including mesoderm lineage differentiation, immunomodulation, and paracrine stimulation. MSCs also secrete exosomes and microvesicles, which themselves contain potent angiogenic cytokines or mRNA molecules with effects on their local milieu. This concise review summarizes the mechanisms of MSC-based cardiac regeneration and highlighting results from molecular and preclinical studies. We also discuss clinical trial results to date, and ongoing studies. Furthermore, we discuss novel approaches for the enhancement of MSC based cardiac regeneration, such as genetic modification. Stem Cells Translational Medicine 2018;7:543-550.
近 20 年来，人们一直在研究干细胞和祖细胞刺激心脏再生的能力，临床前数据非常有前景，但临床结果喜忧参半。已经研究了多种细胞类型，它们是通过细胞表面标志物、分化能力和分泌的生长因子来识别的。骨髓间充质干细胞（MSCs）已被发现具有强大的再生能力，其机制包括中胚层谱系分化、免疫调节和旁分泌刺激。MSCs 还分泌外泌体和微泡，它们本身含有有效的血管生成细胞因子或具有影响局部微环境的 mRNA 分子。这篇简明的综述总结了基于 MSC 的心脏再生的机制，并强调了分子和临床前研究的结果。我们还讨论了迄今为止的临床试验结果和正在进行的研究。此外，我们还讨论了增强基于 MSC 的心脏再生的新方法，如基因修饰。《干细胞转化医学》2018 年；7:543-550。
