Regenerative Medicine for the Treatment of Ischemic Heart Disease; Status and Future Perspectives

Abstract

Cardiovascular disease is now the leading cause of adult death in the world. According to new estimates from the World Health Organization, myocardial infarction (MI) is responsible for four out of every five deaths due to cardiovascular disease. Conventional treatments of MI are taking aspirin and nitroglycerin as intermediate treatments and injecting antithrombotic agents within the first 3 h after MI. Coronary artery bypass grafting and percutaneous coronary intervention are the most common long term treatments. Since none of these interventions will fully regenerate the infarcted myocardium, there is value in pursuing more innovative therapeutic approaches. Regenerative medicine is an innovative interdisciplinary method for rebuilding, replacing, or repairing the missed part of different organs in the body, as similar as possible to the primary structure. In recent years, regenerative medicine has been widely utilized as a treatment for ischemic heart disease (one of the most fatal factors around the world) to repair the lost part of the heart by using stem cells. Here, the development of mesenchymal stem cells causes a breakthrough in the treatment of different cardiovascular diseases. They are easily obtainable from different sources, and expanded and enriched easily, with no need for immunosuppressing agents before transplantation, and fewer possibilities of genetic abnormality accompany them through multiple passages. The production of new cardiomyocytes can result from the transplantation of different types of stem cells. Accordingly, due to its remarkable benefits, stem cell therapy has received attention in recent years as it provides a drug-free and surgical treatment for patients and encourages a more safe and feasible cardiac repair. Although different clinical trials have reported on the promising benefits of stem cell therapy, there is still uncertainty about its mechanism of action. It is important to conduct different preclinical and clinical studies to explore the exact mechanism of action of the cells. After reviewing the pathophysiology of MI, this study addresses the role of tissue regeneration using various materials, including different types of stem cells. It proves some appropriate data about the importance of ethical problems, which leads to future perspectives on this scientific method.

Stem cell-based therapy for human diseases

“…In the last two decades, great advancements have been achieved in the development of novel regenerative medicine and cardiovascular research, especially stem cell technology. 297 The discovery of human embryonic stem cells and human induced pluripotent stem cells (hiPSCs) opened a new door for basic research and therapeutic investigation of the use of these cells to treat different diseases. 298 However, the clinical path of hiPSCs and hiPSC-derived cardiomyocytes in the treatment of cardiovascular diseases is limited due to the potential for teratoma formation with hiPSCs and the immaturity of hiPSC-derived cardiomyocytes, which might pose a risk of cancer formation, 299 arrhythmia, and cardiac arrest to patients.…”

Targeting Brain Tumors with Mesenchymal Stem Cells in the Experimental Model of the Orthotopic Glioblastoma in Rats

“…Currently, stem cell-based therapies are one of the most important emerging medical fields indifferent pathophysiological conditions and diseases, such as cardio-vascular diseases [ 26 , 27 , 28 ], autoimmune diseases [ 29 , 30 ], hereditary genetic conditions [ 31 ], and cancer [ 32 , 33 ]. Mesenchymal stem cells have attracted an increased attention as cellular vehicles for cancer therapy due to their low immunogenicity, fast ex vivo expansion, and inherent tumor-tropism and migratory properties.…”

Enhancing Mesenchymal Stem Cells (MSCs) for Therapeutic Purposes

“…As is known for most new therapies, the progression of MSC therapy has been hard, slow and punctuated by difficulties. The available evidence proves the safety of MSC transplantation, which represents a new, hopeful strategy for the management of cardiovascular disease, particularly ischemic and non-ischemic heart failure [139][140][141]. Up to date, numerous Phase I and Phase II trials have demonstrated promising results with regenerative medicine in the setting of heart failure and myocardial infarction [2].…”