Stougiannou Theodora M, Christodoulou Konstantinos C, Dimarakis Ioannis, Mikroulis Dimitrios, Karangelis Dimos
Department of Cardiothoracic Surgery, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece.
Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, WA 98195, USA.
Curr Issues Mol Biol. 2024 Mar 8;46(3):2181-2208. doi: 10.3390/cimb46030141.
Despite improvements in contemporary medical and surgical therapies, cardiovascular disease (CVD) remains a significant cause of worldwide morbidity and mortality; more specifically, ischemic heart disease (IHD) may affect individuals as young as 20 years old. Typically managed with guideline-directed medical therapy, interventional or surgical methods, the incurred cardiomyocyte loss is not always completely reversible; however, recent research into various stem cell (SC) populations has highlighted their potential for the treatment and perhaps regeneration of injured cardiac tissue, either directly through cellular replacement or indirectly through local paracrine effects. Different stem cell (SC) types have been employed in studies of infarcted myocardium, both in animal models of myocardial infarction (MI) as well as in clinical studies of MI patients, including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), Muse cells, multipotent stem cells such as bone marrow-derived cells, mesenchymal stem cells (MSCs) and cardiac stem and progenitor cells (CSC/CPCs). These have been delivered as is, in the form of cell therapies, or have been used to generate tissue-engineered (TE) constructs with variable results. In this text, we sought to perform a narrative review of experimental and clinical studies employing various stem cells (SC) for the treatment of infarcted myocardium within the last two decades, with an emphasis on therapies administered through thoracic incision or through percutaneous coronary interventions (PCI), to elucidate possible mechanisms of action and therapeutic effects of such cell therapies when employed in a surgical or interventional manner.
尽管当代医学和外科治疗有所进步，但心血管疾病（CVD）仍是全球发病和死亡的重要原因；更具体地说，缺血性心脏病（IHD）可能影响年仅20岁的个体。通常采用指南指导的药物治疗、介入或手术方法进行管理，但所导致的心肌细胞损失并不总是完全可逆的；然而，最近对各种干细胞群体的研究突出了它们在治疗甚至再生受损心脏组织方面的潜力，要么直接通过细胞替代，要么间接通过局部旁分泌作用。不同类型的干细胞已被用于心肌梗死的研究，包括在心肌梗死（MI）动物模型以及MI患者的临床研究中，这些干细胞包括胚胎干细胞（ESC）、诱导多能干细胞（iPSC）、多潜能干细胞（Muse细胞）、多能干细胞如骨髓来源细胞、间充质干细胞（MSC）以及心脏干细胞和祖细胞（CSC/CPC）。这些干细胞已直接作为细胞疗法应用，或以组织工程（TE）构建体的形式使用，结果各不相同。在本文中，我们试图对过去二十年中使用各种干细胞治疗梗死心肌的实验和临床研究进行叙述性综述，重点关注通过开胸手术或经皮冠状动脉介入治疗（PCI）给予的治疗方法，以阐明这种细胞疗法以手术或介入方式应用时可能的作用机制和治疗效果。
