Yong Jiahui, Tao Jing, Wang Kaiyang, Li Xia, Yang Yining
Department of Cardiology, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang, China.
Xinjiang Key Laboratory of Cardiovascular Homeostasis and Regeneration Research, Ürümqi, Xinjiang, China.
Stem Cell Rev Rep. 2025 May 5. doi: 10.1007/s12015-025-10888-7.
This review examines the application of stem cell therapy in myocardial remodeling following myocardial infarction, delving into the complex changes in the cardiac microenvironment after myocardial infarction, the potential mechanisms of stem cell treatment, and the progress of clinical research. It also provides an outlook on future research directions and clinical applications. After myocardial infarction, the heart undergoes a series of complex biological processes, including cardiomyocyte death and hypertrophy, activation and transdifferentiation of fibroblasts, remodeling of the extracellular matrix, functional changes in endothelial cells, and activation of inflammatory responses. These processes ultimately lead to pathological alterations in cardiac structure and function, known as cardiac remodeling. Stem cell therapy and its cell derivatives improve cardiac structure and function through multiple pathways, such as inducing myocardial regeneration, promoting angiogenesis, modulating the inflammatory microenvironment, and reducing fibrosis. However, stem cell therapy still faces many challenges in the treatment of myocardial infarction, such as low cell survival rates, excessive fibrosis, and low clinical translation efficiency. Despite these challenges, stem cell therapy, as an emerging treatment modality, shows great potential in cardiac remodeling after myocardial infarction. Therefore, this article, through its outlook on future research directions, emphasizes the importance of optimizing treatment strategies, developing new technologies, and conducting multicenter clinical trials, providing theoretical basis and practical guidance for the clinical application of stem cell therapy in myocardial repair after myocardial infarction.
本综述探讨了干细胞疗法在心肌梗死后心肌重塑中的应用，深入研究了心肌梗死后心脏微环境的复杂变化、干细胞治疗的潜在机制以及临床研究进展。同时，对未来的研究方向和临床应用进行了展望。心肌梗死后，心脏会经历一系列复杂的生物学过程，包括心肌细胞死亡和肥大、成纤维细胞的激活和转分化、细胞外基质重塑、内皮细胞功能变化以及炎症反应激活。这些过程最终导致心脏结构和功能的病理改变，即心脏重塑。干细胞疗法及其细胞衍生物通过多种途径改善心脏结构和功能，如诱导心肌再生、促进血管生成、调节炎症微环境以及减少纤维化。然而，干细胞疗法在治疗心肌梗死方面仍面临诸多挑战，如细胞存活率低、纤维化过度以及临床转化效率低等。尽管存在这些挑战，干细胞疗法作为一种新兴的治疗方式，在心肌梗死后的心脏重塑中显示出巨大潜力。因此，本文通过对未来研究方向的展望，强调了优化治疗策略、开发新技术以及开展多中心临床试验的重要性，为干细胞疗法在心肌梗死后心肌修复中的临床应用提供理论依据和实践指导。
