Stamm Christof
Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Deutschland.
Charité Universitätsmedizin, Berlin, Deutschland.
Z Herz Thorax Gefasschir. 2022;36(2):107-114. doi: 10.1007/s00398-021-00476-5. Epub 2022 Jan 5.
Cardiac cell therapy covers more than two decades of tumultuous history. In this period of time, the perception of the heart as an organ consisting of a fixed number of terminally differentiated cardiomyocytes fundamentally changed. Suddenly, the myocardium was (or is) considered to be regenerative by intrinsic progenitor cells, inducible proliferation, and in particular by exogenic transplanted cells. While the clinical translation of real cardiomyocytes obtained by cellular reprogramming has progressed only slowly, a multitude of clinical studies were carried out with cell products of somatic origin. This was mostly based on assumptions and experimentally acquired data with respect to the plasticity of adult precursor cells that, in retrospect, lacked validity. Accordingly, on closer inspection the results of the clinical studies were not convincing but they were nevertheless often presented and viewed in a very optimistic light. Today, cardiac cell therapy with cells of a somatic origin is considered to have failed. Recapitulating the stages of this era can help recognize and avoid such undesirable developments in the future.
心脏细胞治疗已有二十多年的动荡历史。在这段时间里,人们对心脏作为一个由固定数量的终末分化心肌细胞组成的器官的认知发生了根本性的改变。突然间,心肌被(或现在被)认为可通过内源性祖细胞、诱导增殖,特别是外源性移植细胞实现再生。虽然通过细胞重编程获得的真正心肌细胞的临床转化进展缓慢,但针对体细胞来源的细胞产品进行了大量临床研究。这主要基于关于成体前体细胞可塑性的假设和实验获得的数据,回过头来看,这些数据缺乏有效性。因此,仔细审视临床研究结果并不令人信服,但它们仍然常常以非常乐观的态度呈现和看待。如今,体细胞来源的细胞进行心脏细胞治疗被认为已经失败。回顾这个时代的各个阶段有助于认识并避免未来出现此类不良发展。