Cell-Based Therapies for Myocardial Regeneration in Heart Failure: 20 Years of Debate

Bone-Marrow Stem Cells and Acellular Human Amniotic Membrane in a Rat Model of Heart Failure

“…Our results also demonstrated significant benefits in angiogenesis and cellular regeneration in the BMSC group, confirmed with immunohistochemistry by high levels of factor VIII, Connexin, and Desmine, in comparison to the control group (Figure 3). This fact reinforces the hypothesis that the mechanism of action of stem cells involves mainly autocrine and paracrine actions in the cellular microenvironment, and not the direct differentiation into cardiomyocytes as previously considered [11].…”

“…Thus, the evolution to heart failure is inevitable in most cases, mainly due to the extent of the infarct area and the pathological cardiac remodeling [ 29 ]. In this scenario, the use of compatible biomaterials with cell-regeneration potential emerges as a therapeutic alternative after AMI [ 11 ].…”

“…In our study, we chose to use the acellular form of human amniotic membrane, because the absence of the epithelium can contribute to the improvement of biocompatibility of the material, reducing the immunogenic response of the host [ 11 ], without losing collagen proteins and growth factors, which are preserved during the decellularization process [ 21 ]. Furthermore, the presence of connexin-43 observed in the hAM group demonstrated its ability to incorporate into the myocardium, making use of the amniotic membrane as an attractive biomaterial after AMI, as well as serving as a suitable three-dimensional support matrix for diverse cell populations, stimulating cell immigration and the possible differentiation of neighboring cells [ 19 , 20 , 54 ].…”

“…In this scenario, new therapeutic options, such as cell-based therapies, emerge as an alternative for the treatment of HF, due to the potential of restoring cardiac function, reducing infarct size and preventing cardiac remodeling [3,11]. Previous animal studies have demonstrated improvements in ventricular function with the use of bone marrow stem cells (BMSC) after AMI, showing the potential of angiogenesis, and the formation of undifferentiated cells and new cardiomyocytes [12,13].…”

Bone-marrow mononuclear cells and acellular human amniotic membrane improve global cardiac function without inhibition of the NLRP3 Inflammasome in a rat model of heart failure

“…Current therapeutic approaches for AMI include: reperfusion therapies, medications, cardiac rehabilitation, lifestyle changes and surgery in selected cases. Stem cells and human amniotic membrane have emerged as a alternative therapeutic options for AMI due to their ability to differentiate into various cell types and regenerate damaged tissue (Machado-Júnior et al 2020). Cell-based approaches with stem cells and human amniotic membrane was capable of reducing the inflammatory response and promoting significant improvements in global cardiac function after an ischemic injury in the heart (Guo et al 2007, Khorramirouz et al 2019.…”