Li Peng
Department of Geriatics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China.
World J Cardiol. 2024 Dec 26;16(12):776-780. doi: 10.4330/wjc.v16.i12.776.
In this article, we evaluate the comparative efficacy and safety of mesenchymal stem cells (MSCs) derived from bone marrow (BM-MSCs) and umbilical cord (UC-MSCs) in the treatment of heart failure and myocardial infarction. MSCs have gained importance as living bio drug due to their regenerative potential, with BM-MSCs being the most extensively studied. However, UC-MSCs offer unique advantages, such as noninvasive collection and fewer ethical concerns. This systematic review and meta-analysis summarizes data from 13 randomized controlled trials, which included a total of 693 patients. Their study shows that UC-MSCs significantly improved left ventricular ejection fraction by 5.08% at 6 months and 2.78% at 12 months compared with controls, while BM-MSCs showed no significant effect. Neither cell type showed significant changes in 6-minute walk distance. In addition, UC-MSCs and BM-MSCs had comparable safety profiles, with no significant differences in major adverse cardiac events, except for a lower rehospitalization rate observed with BM-MSCs. These results position UC-MSCs as a promising alternative in MSC-based therapies for cardiac disease, offering potential improvements in cardiac function while maintaining a favorable safety profile. Future research should focus on optimizing administration protocols and further exploring the long-term benefits and mechanisms of UC-MSCs in cardiac repair.
在本文中,我们评估了源自骨髓的间充质干细胞(BM-MSCs)和脐带间充质干细胞(UC-MSCs)在治疗心力衰竭和心肌梗死方面的相对疗效和安全性。由于其再生潜力,间充质干细胞作为一种活性生物药物已变得越来越重要,其中BM-MSCs是研究最为广泛的。然而,UC-MSCs具有独特的优势,如采集无创且伦理问题较少。这项系统评价和荟萃分析总结了13项随机对照试验的数据,这些试验共纳入了693例患者。他们的研究表明,与对照组相比,UC-MSCs在6个月时显著提高左心室射血分数5.08%,在12个月时提高2.78%,而BM-MSCs则无显著效果。两种细胞类型在6分钟步行距离方面均未显示出显著变化。此外,UC-MSCs和BM-MSCs具有相当的安全性,在主要不良心脏事件方面无显著差异,只是BM-MSCs的再住院率较低。这些结果表明,UC-MSCs在基于间充质干细胞的心脏病治疗中是一种有前景的替代方案,在维持良好安全性的同时,有望改善心脏功能。未来的研究应集中在优化给药方案,并进一步探索UC-MSCs在心脏修复中的长期益处和机制。