Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Expert Opin Biol Ther. 2023 Jul-Dec;23(10):951-967. doi: 10.1080/14712598.2023.2245329. Epub 2023 Aug 30.
Acute myocardial infarction (AMI) remains a leading cause of death in the United States. The limited capacity of cardiomyocytes to regenerate and the restricted contractility of scar tissue after AMI are not addressed by current pharmacologic interventions. Mesenchymal stem/stromal cells (MSCs) have emerged as a promising therapeutic approach due to their low antigenicity, ease of harvesting, and efficacy and safety in preclinical and clinical studies, despite their low survival and engraftment rates. Other stem cell types, such as induced pluripotent stem cells (iPSCs) also show promise, and optimizing cardiac repair requires integrating emerging technologies and strategies.
This review offers insights into advancing cell-based therapies for AMI, emphasizing meticulously planned trials with a standardized definition of AMI, for a bench-to-bedside approach. We critically evaluate fundamental studies and clinical trials to provide a comprehensive overview of the advances, limitations and prospects for cell-based therapy in AMI.
MSCs continue to show potential promise for treating AMI and its sequelae, but addressing their low survival and engraftment rates is crucial for clinical success. Integrating emerging technologies such as pluripotent stem cells and conducting well-designed trials will harness the full potential of cell-based therapy in AMI management. Collaborative efforts are vital to developing effective stem cell therapies for AMI patients.
急性心肌梗死(AMI)仍然是美国的主要死亡原因。目前的药物干预措施无法解决心肌细胞再生能力有限和 AMI 后疤痕组织收缩性受限的问题。间充质干细胞(MSCs)因其抗原性低、易于采集以及在临床前和临床研究中的疗效和安全性而成为一种有前途的治疗方法,尽管其存活率和植入率较低。其他干细胞类型,如诱导多能干细胞(iPSCs)也显示出希望,优化心脏修复需要整合新兴技术和策略。
本综述深入探讨了推进 AMI 的基于细胞的治疗方法,强调了针对 AMI 的精心计划的试验,采用标准化的 AMI 定义,实现从实验室到临床的方法。我们批判性地评估了基础研究和临床试验,为基于细胞的治疗在 AMI 中的进展、局限性和前景提供了全面的概述。
MSCs 继续显示出治疗 AMI 及其后遗症的潜力,但解决其低存活率和植入率是临床成功的关键。整合新兴技术,如多能干细胞,并进行精心设计的试验,将充分发挥基于细胞的治疗在 AMI 管理中的潜力。开展有效的 AMI 患者的干细胞治疗需要各方的合作努力。