Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN 55905, USA.
The Christ Hospital Heart and Vascular Center, The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, OH 45219, USA.
Cardiovasc Res. 2020 Jul 1;116(8):1424-1433. doi: 10.1093/cvr/cvaa027.
CD34+ cells are haematopoietic stem cells used therapeutically in patients undergoing radiation or chemotherapy due to their regenerative potential and ability to restore the haematopoietic system. In animal models, CD34+ cells have been associated with therapeutic angiogenesis in response to ischaemia. Several trials have shown the potential safety and efficacy of CD34+ cell delivery in various cardiovascular diseases. Moreover, Phase III trials have now begun to explore the potential role of CD34+ cells in treatment of both myocardial and peripheral ischaemia. CD34+ cells have been shown to be safe and well-tolerated in the acute myocardial infarction (AMI), heart failure, and angina models. Several studies have suggested potential benefit of CD34+ cell therapy in patients with coronary microvascular disease as well. In this review, we will discuss the therapeutic potential of CD34+ cells, and describe the pertinent trials that have used autologous CD34+ cells in no-options refractory angina, AMI, and heart failure. Lastly, we will review the potential utility of autologous CD34+ cells in coronary endothelial and microvascular dysfunction.
CD34+ 细胞是造血干细胞,由于其再生潜能和恢复造血系统的能力,在接受放疗或化疗的患者中被用于治疗。在动物模型中,CD34+ 细胞与缺血后的治疗性血管生成有关。多项试验表明,CD34+ 细胞在各种心血管疾病中的应用具有潜在的安全性和疗效。此外,目前已经开始进行 III 期试验,以探索 CD34+ 细胞在治疗心肌和外周缺血方面的潜在作用。CD34+ 细胞在急性心肌梗死 (AMI)、心力衰竭和心绞痛模型中已被证明是安全且耐受良好的。多项研究还表明,CD34+ 细胞治疗对冠状动脉微血管疾病患者可能有益。在这篇综述中,我们将讨论 CD34+ 细胞的治疗潜力,并描述已在无选择难治性心绞痛、AMI 和心力衰竭中使用自体 CD34+ 细胞的相关试验。最后,我们将回顾自体 CD34+ 细胞在冠状动脉内皮和微血管功能障碍中的潜在应用。