Department of Health Sciences, Magna Græcia University of Catanzaro, Loc. Germaneto, 88100 Catanzaro, Italy.
Department of Experimental and Clinical Medicine, Magna Græcia University of Catanzaro, Loc. Germaneto, 88100 Catanzaro, Italy.
Int J Mol Sci. 2020 Oct 18;21(20):7701. doi: 10.3390/ijms21207701.
Cardiovascular disease (CVD) remains the leading cause of death in Western countries. Post-myocardial infarction heart failure can be considered a degenerative disease where myocyte loss outweighs any regenerative potential. In this scenario, regenerative biology and tissue engineering can provide effective solutions to repair the infarcted failing heart. The main strategies involve the use of stem and progenitor cells to regenerate/repair lost and dysfunctional tissue, administrated as a suspension or encapsulated in specific delivery systems. Several studies demonstrated that effectiveness of direct injection of cardiac stem cells (CSCs) is limited in humans by the hostile cardiac microenvironment and poor cell engraftment; therefore, the use of injectable hydrogel or pre-formed patches have been strongly advocated to obtain a better integration between delivered stem cells and host myocardial tissue. Several approaches were used to refine these types of constructs, trying to obtain an optimized functional scaffold. Despite the promising features of these stem cells' delivery systems, few have reached the clinical practice. In this review, we summarize the advantages, and the novelty but also the current limitations of engineered patches and injectable hydrogels for tissue regenerative purposes, offering a perspective of how we believe tissue engineering should evolve to obtain the optimal delivery system applicable to the everyday clinical scenario.
心血管疾病（CVD）仍然是西方国家的主要死亡原因。心肌梗死后心力衰竭可以被认为是一种退行性疾病，其中肌细胞的损失超过任何再生潜力。在这种情况下，再生生物学和组织工程可以为修复梗死性心力衰竭提供有效的解决方案。主要策略包括使用干细胞和祖细胞来再生/修复丢失和功能失调的组织，以悬浮液或封装在特定的递送系统中进行给药。几项研究表明，由于心脏微环境恶劣和细胞植入不良，直接注射心脏干细胞（CSC）在人类中的效果有限；因此，强烈提倡使用可注射水凝胶或预制贴片来获得更好的递送至干细胞与宿主心肌组织之间的整合。已经采用了几种方法来改进这些类型的构建体，试图获得优化的功能支架。尽管这些干细胞递送系统具有很有前景的特征，但很少有能应用于临床实践。在这篇综述中，我们总结了用于组织再生目的的工程化贴片和可注射水凝胶的优点、新颖性，但也指出了当前的局限性，提供了我们认为组织工程应该如何发展以获得适用于日常临床情况的最佳递送系统的观点。
