ReviewCell Therapy for Heart Disease: Great Expectations, As Yet Unmet
Section snippets
Transplanting Contractile Cells
The primary goal of cardiac cell therapy is to increase the number of contractile cells in the ventricular myocardium to improve systolic heart function. Additional possible actions of cell therapy in the heart include paracrine effects supporting angiogenesis, modulation of extracellular matrix components, supportive effects on cardiomyocytes suffering from ischaemic stress, and stimulating interactions with resident cardiac progenitor cells (Fig. 2). Originally, immortalised myocyte lines and
Clinical Cell Therapy
The spectrum of cell products for clinical cardiac cell therapy is currently limited to adult progenitor cells that are freshly isolated or undergo in vitro expansion with minimal manipulation of their biologic characteristics. Clinical stem cell products that require a more complex manufacturing process are under development, but have not yet been used in humans. Much of the clinical cell therapy data is being discussed with vehemence. Even though clinical cell therapy has been performed for
Clinical Translation Problems
Although the experimental basis of myocardial cell therapy is incomplete, numerous clinical applications have already been initiated. Attention mainly focuses on the cell product, but there are many other factors that need to be considered to maximise the likelihood of successful cell-based myocardial regeneration. The following sections will look at these factors.
Summary
While cardiac cell therapy has initially caused tremendous excitement, reluctance currently dominates. There have been – and will be more – substantial obstacles and setbacks along the road to success, but only about 15 years have so far been spent trying to develop therapies involving cell-based cardiac regeneration. The early clinical use of marrow-derived cells for heart disease has been much criticised, but it is understandable that physicians began by testing the clinical efficacy of bone
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Drug delivery for cardiac regeneration
2018, Applications of Nanocomposite Materials in Drug DeliveryStem cell and gene-based approaches for cardiac repair
2018, Design of Nanostructures for Versatile Therapeutic ApplicationsDesigning Acellular Injectable Biomaterial Therapeutics for Treating Myocardial Infarction and Peripheral Artery Disease
2017, JACC: Basic to Translational ScienceCitation Excerpt :Although injectable biomaterial-alone approaches and biomaterial patches (40,42,51) have gained attention for their therapeutic benefits, injectable versions have the advantage of a minimally invasive delivery route (52). Current delivery approaches include intracoronary infusion via a balloon infusion catheter, direct epicardial injection with a single- or double-barrel syringe, or transendocardial injection via a catheter (Figure 3) (53). Epicardial injections have the most control over delivery but often require an invasive surgical procedure, which is likely to complicate widespread use.
Stem cell therapies for congenital heart disease
2016, Biomedicine and PharmacotherapyCitation Excerpt :The use of bone marrow mononuclear cells (BMMNCs), purified progenitor cells (CD34+ or CD133 + ), endothelial progenitor cells (EPCs), and MSCs in experimental and clinical studies has provided informative data related to human CVDs. [38] However, as they are multipotent, it should be noted that bone marrow-derived cells could differentiate into a variety of cell types when transplanted, thereby carrying a potential risk of bone, cartilage, and adipose tissue formation in the heart [39]. HSCs, identified by the expression of cell surface antigens such as CD34, CD133, c-kit (CD117), and stem cell antigen-1 (Sca-1), are lineage negative (Lin–).
Insight on stem cell preconditioning and instructive biomaterials to enhance cell adhesion, retention, and engraftment for tissue repair
2016, BiomaterialsCitation Excerpt :Similarly, in models of cardiac defects, a number of studies have indicated that implanted MSCs engrafted and differentiated into CMCs [96]. However, it has not been conclusively established that locally implanted cells endow a sufficient number of integrated CMCs to account for the improvements in cardiac function seen in many studies [97]. Similarly, in the CNS, experiments indicated that MSCs injected into the ventricles of the brain of newborn pups migrated throughout the brain and differentiated as the organ developed [98].
Hydrogels for cardiac repair
2014, Cardiac Regeneration and Repair: Biomaterials and Tissue Engineering