Local Implantation of Autologous Bone Marrow Cells for Therapeutic Angiogenesis in Patients With Ischemic Heart Disease. Clinical Trial and Preliminary Results.

Myocardial Repair Achieved by the Intramyocardial Implantation of Adult Cardiomyocytes in Combination with Bone Marrow Cells

“…To observe the survival of donor adult cardiomyocytes after implantation, donor cardiomyocytes were iso-DISCUSSION lated from GFP-transgenic rats, but bone marrow cells were collected from wild-type rats. We observed that Many experimental studies and clinical trials have shown that the delivery of various cells into the injured some of the GFP-positive cardiomyocytes survived in heart can potentially improve myocardial perfusion and Using an in vitro coculture model, we confirmed that bone marrow cells could increase survival and inhibit cardiac function (1, 3,5,11,13,14,17,18,20,27). However, because of the specific electrophysiological, structural, apoptosis of isolated adult cardiomyocytes.…”

“…sources, including neonatal cardiomyocytes (18), adult cardiomyocytes (20), cardiac stem cells (1), myoblasts Adult cardiomyocytes have also been considered as cell sources for myocardial repair. However, the implan-(3), smooth muscle cells (13), bone marrow-derived stem cells (5,14,17,27), and embryonic stem cell-derived tation of adult cardiomyocytes has not been trialed clinically because the collection of cardiomyocytes by biopsy cardiomyocytes (11), have all shown considerable myogenic and angiogenic potency in different experimental is so invasive, the ex vivo expansion of adult cardiomyocytes is extremely difficult, and the survival of adult models of heart injury. Considering the immunological and ethical problems, autologous cells are still the most cardiomyocytes is very poor after implantation.…”

Transplantation of Autologous Fresh Bone Marrow Into Infarcted Myocardium: A Word of Caution

“…19 Indeed, it is likely that there is an optimal time window that needs to be fine tuned. The coincident assumption that the efficacy of BM transplantation requires target tissues to be reversibly damaged, as opposed to irreversibly necrotic, is also supported by the improvement in coronary perfusion following intramyocardial surgical 20 or endocardial 21 injections of unfractionated BM in patients with ischemic symptoms. These data are paralleled by the increase in neovascularization induced by intramuscular injections of fresh mononuclear cells in rats 22 and patients 12 with severe lower limb ischemia.…”

Melhora sintomática e da capacidade de exercício após o transplante autólogo, transendocárdico, de células mononucleares da medula óssea em pacientes com cardiopatia isquêmica grave, sustentada até o sexto mês de evolução

“…In experimental models of acute and chronic myocardial ischemia 22,[33][34][35][36][37][38][39][40][41][42][43] , the implantation of bone marrow mononuclear cells (BMMC) has been able to improve myocardial contraction and perfusion 22,41,42,44,45 . Such results have been reproduced in a recent clinical phase-1 study in human beings 30,31,[46][47][48][49] , including our previous publication when the safety of that procedure was assessed 50 .…”