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Embryonic Stem Cells for Severe Heart Failure: Why and How?

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Abstract

The experience accumulated in cardiac cell therapy suggests that regeneration of extensively necrotic myocardial areas is unlikely to be achieved by the sole paracrine effects of the grafted cells but rather requires the conversion of these cells into cardiomyocytes featuring the capacity to substitute for those which have been irreversibly lost. In this setting, the use of human pluripotent embryonic stem cells has a strong rationale. The experimental results obtained in animal models of myocardial infarction are encouraging. However, the switch to clinical applications still requires to address some critical issues, among which the optimization of the cardiac specification of the embryonic stem cells, the purification of the resulting progenitor cells so as to graft a purified population devoid from any contamination by residual pluripotent cells which carry the risk of tumorigenesis, and the control of the expected allogeneic rejection by clinically acceptable methods. If the solution to these problems is a prerequisite, the therapeutic success of this approach will also depend on the capacity to efficiently transfer the cells to the target tissue, to keep them alive once engrafted, and to allow them to spatially organize in such a way that they can contribute to the contractile function of the heart.

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Acknowledgments

This work was partly funded by the LeDucq Foundation (SHAPEHEART network).

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  1. Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Unité de chirurgie de l’insuffisance cardiaque, 20, rue Leblanc, 75015, Paris, France

    Philippe Menasché

  2. Université Paris Descartes, Sorbonne Paris Cité, France

    Philippe Menasché

  3. INSERM U 633, Paris, France

    Philippe Menasché

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  1. Philippe Menasché
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Correspondence to Philippe Menasché.

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Menasché, P. Embryonic Stem Cells for Severe Heart Failure: Why and How?. J. of Cardiovasc. Trans. Res. 5, 555–565 (2012). https://doi.org/10.1007/s12265-012-9356-9

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  • DOI: https://doi.org/10.1007/s12265-012-9356-9

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