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用于治疗缺血性心脏病的再生医学:现状与未来展望

Regenerative Medicine for the Treatment of Ischemic Heart Disease; Status and Future Perspectives.

作者信息

Arjmand Babak, Abedi Mina, Arabi Maryam, Alavi-Moghadam Sepideh, Rezaei-Tavirani Mostafa, Hadavandkhani Mahdieh, Tayanloo-Beik Akram, Kordi Ramin, Roudsari Peyvand Parhizkar, Larijani Bagher

机构信息

Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Front Cell Dev Biol. 2021 Sep 10;9:704903. doi: 10.3389/fcell.2021.704903. eCollection 2021.

Abstract

Cardiovascular disease is now the leading cause of adult death in the world. According to new estimates from the World Health Organization, myocardial infarction (MI) is responsible for four out of every five deaths due to cardiovascular disease. Conventional treatments of MI are taking aspirin and nitroglycerin as intermediate treatments and injecting antithrombotic agents within the first 3 h after MI. Coronary artery bypass grafting and percutaneous coronary intervention are the most common long term treatments. Since none of these interventions will fully regenerate the infarcted myocardium, there is value in pursuing more innovative therapeutic approaches. Regenerative medicine is an innovative interdisciplinary method for rebuilding, replacing, or repairing the missed part of different organs in the body, as similar as possible to the primary structure. In recent years, regenerative medicine has been widely utilized as a treatment for ischemic heart disease (one of the most fatal factors around the world) to repair the lost part of the heart by using stem cells. Here, the development of mesenchymal stem cells causes a breakthrough in the treatment of different cardiovascular diseases. They are easily obtainable from different sources, and expanded and enriched easily, with no need for immunosuppressing agents before transplantation, and fewer possibilities of genetic abnormality accompany them through multiple passages. The production of new cardiomyocytes can result from the transplantation of different types of stem cells. Accordingly, due to its remarkable benefits, stem cell therapy has received attention in recent years as it provides a drug-free and surgical treatment for patients and encourages a more safe and feasible cardiac repair. Although different clinical trials have reported on the promising benefits of stem cell therapy, there is still uncertainty about its mechanism of action. It is important to conduct different preclinical and clinical studies to explore the exact mechanism of action of the cells. After reviewing the pathophysiology of MI, this study addresses the role of tissue regeneration using various materials, including different types of stem cells. It proves some appropriate data about the importance of ethical problems, which leads to future perspectives on this scientific method.

摘要

心血管疾病目前是全球成年人死亡的主要原因。根据世界卫生组织的最新估计,心肌梗死(MI)导致的死亡占心血管疾病所致死亡的五分之四。MI的传统治疗方法是将阿司匹林和硝酸甘油作为中间治疗手段,并在MI发生后的前3小时内注射抗血栓药物。冠状动脉搭桥术和经皮冠状动脉介入治疗是最常见的长期治疗方法。由于这些干预措施都无法使梗死心肌完全再生,因此探索更具创新性的治疗方法具有重要意义。再生医学是一种创新性的跨学科方法,用于重建、替换或修复身体不同器官缺失的部分,尽可能使其与原始结构相似。近年来,再生医学已被广泛应用于治疗缺血性心脏病(全球最致命的因素之一),通过使用干细胞修复心脏受损部分。在此,间充质干细胞的发展为不同心血管疾病的治疗带来了突破。它们易于从不同来源获取,易于扩增和富集,移植前无需免疫抑制剂,多次传代后发生基因异常的可能性较小。不同类型干细胞的移植可产生新的心肌细胞。因此,由于其显著的益处,干细胞疗法近年来受到关注,因为它为患者提供了一种无药物和手术的治疗方法,并促进了更安全可行的心脏修复。尽管不同的临床试验报道了干细胞疗法的有益前景,但其作用机制仍存在不确定性。开展不同的临床前和临床研究以探索细胞的确切作用机制非常重要。在回顾了MI的病理生理学后,本研究探讨了使用包括不同类型干细胞在内的各种材料进行组织再生的作用。它证明了一些关于伦理问题重要性的适当数据,这为这种科学方法带来了未来展望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed94/8461329/e93b57b77e0d/fcell-09-704903-g001.jpg

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