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干细胞治疗心肌梗死和心力衰竭:一项全面的系统评价与批判性分析

Stem Cell Therapy for Myocardial Infarction and Heart Failure: A Comprehensive Systematic Review and Critical Analysis.

作者信息

Abouzid Mohamed R, Umer Ahmed Muaaz, Jha Suman Kumar, Akbar Usman A, Khraisat Own, Saleh Amr, Mohamed Kareem, Esteghamati Sadaf, Kamel Ibrahim

机构信息

Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, USA.

Internal Medicine Residency, Camden Clark Medical Center, Parkersburg, USA.

出版信息

Cureus. 2024 May 1;16(5):e59474. doi: 10.7759/cureus.59474. eCollection 2024 May.

Abstract

In exploring therapeutic options for ischemic heart disease (IHD) and heart failure, cell-based cardiac repair has gained prominence. This systematic review delves into the current state of knowledge surrounding cell-based therapies for cardiac repair. Employing a comprehensive search across relevant databases, the study identifies 35 included studies with diverse cell types and methodologies. Encouragingly, these findings reveal the promise of cell-based therapies in cardiac repair, demonstrating significant enhancements in left ventricular ejection fraction (LVEF) across the studies. Mechanisms of action involve growth factors that stimulate angiogenesis, differentiation, and the survival of transplanted cells. Despite these positive outcomes, challenges persist, including low engraftment rates, limitations in cell differentiation, and variations in clinical reproducibility. The optimal dosage and frequency of cell administration remain subjects of debate, with potential benefits from repeated dosing. Additionally, the choice between autologous and allogeneic stem cell transplantation poses a critical decision. This systematic review underscores the potential of cell-based therapies for cardiac repair, bearing implications for innovative treatments in heart diseases. However, further research is imperative to optimize cell type selection, delivery techniques, and long-term efficacy, fostering a more comprehensive understanding of cell-based cardiac repair.

摘要

在探索缺血性心脏病(IHD)和心力衰竭的治疗选择时,基于细胞的心脏修复已备受关注。本系统评价深入探讨了围绕基于细胞的心脏修复疗法的当前知识状态。通过对相关数据库进行全面检索,该研究确定了35项纳入研究,这些研究涉及多种细胞类型和方法。令人鼓舞的是,这些发现揭示了基于细胞的疗法在心脏修复中的前景,表明在各项研究中左心室射血分数(LVEF)有显著提高。作用机制涉及刺激血管生成、分化和移植细胞存活的生长因子。尽管有这些积极成果,但挑战依然存在,包括低植入率、细胞分化的局限性以及临床可重复性的差异。细胞给药的最佳剂量和频率仍是争论的话题,重复给药可能带来益处。此外,自体和异体干细胞移植之间的选择构成了一个关键决策。本系统评价强调了基于细胞的疗法在心脏修复中的潜力,对心脏病的创新治疗具有启示意义。然而,必须进一步开展研究以优化细胞类型选择、递送技术和长期疗效,促进对基于细胞的心脏修复有更全面的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c80f/11145929/26e33b0547d1/cureus-0016-00000059474-i01.jpg

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