Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.
Int J Mol Sci. 2024 Jun 17;25(12):6634. doi: 10.3390/ijms25126634.
The purpose of this review is to summarize the current understanding of the therapeutic effect of stem cell-based therapies, including hematopoietic stem cells, for the treatment of ischemic heart damage. Following PRISMA guidelines, we conducted electronic searches in MEDLINE, and EMBASE. We screened 592 studies, and included RCTs, observational studies, and cohort studies that examined the effect of hematopoietic stem cell therapy in adult patients with heart failure. Studies that involved pediatric patients, mesenchymal stem cell therapy, and non-heart failure (HF) studies were excluded from our review. Out of the 592 studies, 7 studies met our inclusion criteria. Overall, administration of hematopoietic stem cells (via intracoronary or myocardial infarct) led to positive cardiac outcomes such as improvements in pathological left-ventricular remodeling, perfusion following acute myocardial infarction, and NYHA symptom class. Additionally, combined death, rehospitalization for heart failure, and infarction were significantly lower in patients treated with bone marrow-derived hematopoietic stem cells. Our review demonstrates that hematopoietic stem cell administration can lead to positive cardiac outcomes for HF patients. Future studies should aim to increase female representation and non-ischemic HF patients.
本次综述的目的在于总结目前对于基于干细胞疗法（包括造血干细胞）治疗缺血性心脏损伤的疗效的理解。我们根据 PRISMA 指南，在 MEDLINE 和 EMBASE 上进行了电子检索。我们筛选了 592 项研究，纳入了评估造血干细胞疗法对心力衰竭成年患者疗效的 RCT、观察性研究和队列研究。本综述排除了涉及儿科患者、间充质干细胞疗法和非心力衰竭（HF）的研究。在这 592 项研究中，有 7 项符合纳入标准。总体而言，造血干细胞的输注（通过冠状动脉内或心肌梗死部位）可带来积极的心脏转归，例如改善病理性左心室重构、急性心肌梗死后的灌注和 NYHA 症状分级。此外，骨髓来源的造血干细胞治疗可显著降低联合死亡、心力衰竭再入院和梗死的发生率。本综述表明，造血干细胞的输注可为心力衰竭患者带来积极的心脏转归。未来的研究应旨在增加女性和非缺血性 HF 患者的代表性。
