Noorabadi Parisa, Shahabi Rabori Venus, Jamali Sara, Jafari Negar, Saberiyan Mohammadreza
Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Mol Biol Rep. 2025 May 28;52(1):511. doi: 10.1007/s11033-025-10580-6.
Cardiovascular diseases (CVDs) remain the leading cause of global mortality, with myocardial infarction (MI) and subsequent heart failure (HF) posing significant clinical challenges. Despite advancements in pharmacological and surgical interventions, the limited regenerative capacity of the adult human heart necessitates innovative therapeutic strategies. Stem cell-based therapies have emerged as a promising approach to cardiac regeneration, aiming to restore damaged myocardial tissue through cell replacement and paracrine-mediated repair mechanisms. This review provides a comprehensive overview of the current landscape of stem cell therapies for cardiac regeneration, focusing on the molecular mechanisms, cell types, delivery techniques, and recent clinical advancements. We highlight the roles of key signaling pathways, including NOTCH, PI3K/Akt, Wnt/β-catenin, Hippo/YAP, and MAPK, in regulating cardiomyocyte proliferation, angiogenesis, fibrosis, and inflammation. Additionally, we discuss the therapeutic potential of various stem cell types, such as mesenchymal stem cells (MSCs), cardiac progenitor cells (CPCs), induced pluripotent stem cells (iPSCs), and embryonic stem cells (ESCs), in promoting cardiac repair. Despite promising preclinical results, challenges such as low cell retention, immune rejection, and inconsistent clinical outcomes persist. Recent advancements in genetic engineering, and innovative delivery methods, including transendocardial and intracoronary injections, offer new avenues for enhancing therapeutic efficacy. This review underscores the need for further research to optimize stem cell-based therapies, improve clinical trial design, and translate these innovative approaches into effective treatments for heart disease. By addressing these challenges, stem cell therapy holds the potential to revolutionize cardiac regeneration and improve outcomes for patients with ischemic heart disease and heart failure.
心血管疾病(CVDs)仍然是全球死亡的主要原因,心肌梗死(MI)及随后的心力衰竭(HF)带来了重大的临床挑战。尽管在药物和手术干预方面取得了进展,但成年人心脏有限的再生能力需要创新的治疗策略。基于干细胞的疗法已成为心脏再生的一种有前景的方法,旨在通过细胞替代和旁分泌介导的修复机制来恢复受损的心肌组织。本综述全面概述了当前用于心脏再生的干细胞疗法的现状,重点关注分子机制、细胞类型、递送技术和近期的临床进展。我们强调了关键信号通路的作用,包括NOTCH、PI3K/Akt、Wnt/β-连环蛋白、Hippo/YAP和MAPK,它们在调节心肌细胞增殖、血管生成、纤维化和炎症方面的作用。此外,我们讨论了各种干细胞类型,如间充质干细胞(MSCs)、心脏祖细胞(CPCs)、诱导多能干细胞(iPSCs)和胚胎干细胞(ESCs)在促进心脏修复方面的治疗潜力。尽管临床前结果很有前景,但诸如细胞保留率低、免疫排斥和临床结果不一致等挑战仍然存在。基因工程的最新进展以及创新的递送方法,包括经心内膜和冠状动脉内注射,为提高治疗效果提供了新途径。本综述强调需要进一步研究以优化基于干细胞的疗法,改进临床试验设计,并将这些创新方法转化为心脏病的有效治疗方法。通过应对这些挑战,干细胞疗法有可能彻底改变心脏再生,并改善缺血性心脏病和心力衰竭患者的治疗结果。