Hashmi Shiraz, Mustafa Mian Kamal, Khan Irfan, Shahabuddin Syed, Sami Shahid
Department of Surgery, Aga Khan University Hospital.
Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2023 Feb;73(Suppl 1)(2):S116-S123. doi: 10.47391/JPMA.AKUS-19.
Ischaemic heart diseases (IHDs) are the leading contributor to mortality worldwide and more than 60% occur in low-to-middle-income countries (LMICs) and 40% of these are specified as premature. Despite notable improvements in treatment options, premature deaths due to IHDs including ischaemic heart failure (IHF) continue to rise in the South Asian population due to prevalent conventional and inherent cardiovascular risk profiles. Stem cell (SCs) therapy has emerged as a potential frontier in regenerative therapy for acute and chronic illnesses. Among various available sources of SCs, the safety and efficacy of mesenchymal stem cells (MSCs) for non-functional cardiomyocytes have been established, but robust evidence necessitates to endorse these preliminary investigations. Little work has been conducted in resource constraints countries and needs immediate attention of all the stakeholders to explore non-conventional cost-effective and sustainable interventions for long term management of IHDs including IHF. This review article provides an overview of basic technical aspects of SCs therapy and a way forward to inspire the scientific community and health authorities to setup priorities via collaborative public and private partnership toward the formulation and execution of sustainable strategies for IHDs to explore the new contextual destination in the field of SCs therapy.
缺血性心脏病(IHD)是全球死亡的主要原因,超过 60%发生在中低收入国家(LMICs),其中 40%被指定为过早发生。尽管治疗选择有了显著的改善,但由于南亚人口中普遍存在传统和固有心血管风险因素,包括缺血性心力衰竭(IHF)在内的 IHD 导致的过早死亡仍在继续上升。干细胞(SCs)治疗已成为急性和慢性疾病再生治疗的一个潜在前沿领域。在各种可用的 SCs 来源中,间充质干细胞(MSCs)对非功能性心肌细胞的安全性和有效性已经得到证实,但需要强有力的证据来支持这些初步研究。在资源有限的国家,这项工作开展得很少,所有利益相关者都需要立即关注,探索非传统的、具有成本效益的和可持续的干预措施,以长期管理 IHD,包括 IHF。这篇综述文章提供了 SCs 治疗的基本技术方面的概述,并为激发科学界和卫生当局提供了一个思路,通过公共和私人合作建立优先事项,制定和执行可持续的 IHD 战略,探索 SCs 治疗领域的新的背景目标。