“Second-generation” stem cells for cardiac repair

Abstract

Over the last years, stem cell therapy has emerged as an inspiring alternative to restore cardiac function after myocardial infarction. A large body of evidence has been obtained in this field but there is no conclusive data on the efficacy of these treatments. Preclinical studies and early reports in humans have been encouraging and have fostered a rapid clinical translation, but positive results have not been uniformly observed and when present, they have been modest. Several types of stem cells, manufacturing methods and delivery routes have been tested in different clinical settings but direct comparison between them is challenging and hinders further research. Despite enormous achievements, major barriers have been found and many fundamental issues remain to be resolved. A better knowledge of the molecular mechanisms implicated in cardiac development and myocardial regeneration is critically needed to overcome some of these hurdles. Genetic and pharmacological priming together with the discovery of new sources of cells have led to a "second generation" of cell products that holds an encouraging promise in cardiovascular regenerative medicine. In this report, we review recent advances in this field focusing on the new types of stem cells that are currently being tested in human beings and on the novel strategies employed to boost cell performance in order to improve cardiac function and outcomes after myocardial infarction.

Adipokine Imbalance in the Pericardial Cavity of Cardiac and Vascular Disease Patients

“…The pericardial cavity is considered for local treatment of ischemic heart disease and myocardial infarcts by drugs, angiogenic growth factors and stem cells [ 44 , 45 ]. Control of pericardial fluid composition is however poorly understood.…”

Mechanisms of Regenerative Potential Activation in Cardiac Mesenchymal Cells

“…In order to confirm that, we obtained a fraction of activated cardiac mesenchymal cells from the post-infarction area of the myocardium with promoted properties. The discovery and experimental use of cardiac mesenchymal cells have become a new focus in cardiovascular regenerative medicine [ 39 ]. Recently, clinical trials have been conducted using one type of these cells and their products in therapy, and mainly to improve the function of the heart with a single ventricle in patients with hypoplastic left heart syndrome [ 40 , 41 , 42 ].…”

Stem cell therapy for heart failure: Ensuring regenerative proficiency

“…Introduction of regenerative regimens in management algorithms is conceived to complement, and potentially transform the available armamentarium. Early experience in clinical cardiac regeneration supports the compatibility of stem cell-based therapies as adjuvants to established practice [70]. However, lack of therapeutic consistency inherent to patient-derived stem cell populations remains a central hurdle limiting adoption.…”