Stem‐cell therapy for dilated cardiomyopathy: a pilot study evaluating retrograde coronary venous delivery

Abstract

Retrograde venous delivery of tyrosine mutant adeno-associated virus 2-stromal-derived factor-1 adipose-derived mesenchymal stem cells appears safe. Stem-cell therapy in dogs with occult-dilated cardiomyopathy does not appear to offer advantage compared to recently published survival data in similarly affected Dobermanns.

Retrograde Coronary Venous Infusion as a Delivery Strategy in Regenerative Cardiac Therapy: an Overview of Preclinical and Clinical Data

“…Retrograde coronary venous infusion has been performed in a number of different studies. In total, 21 preclinical studies are included in this review; 8 rat studies [ 10 – 17 ], 3 dog studies [ 18 – 20 ] and 10 pig studies [ 9 , 21 – 29 ]. Patients were treated in 6 studies [ 30 – 35 ].…”

“…Treatment was given in acute (acute myocardial infarction (AMI)) [ 9 , 13 – 15 , 19 , 20 , 22 – 25 , 29 ] and chronic setting (chronic myocardial infarction (CMI)) [ 10 – 12 , 17 , 21 , 26 – 29 ] and in chronic heart failure (CHF) [ 18 ]. One study treated healthy subjects ( n = 1) [ 16 ].…”

“…One study treated healthy subjects ( n = 1) [ 16 ]. Cell products administered included skeletal myoblasts ( n = 6) [ 10 , 12 , 15 , 16 , 21 , 26 ], bone marrow mononuclear cells ( n = 2) [ 11 , 29 ], peripheral blood mononuclear cells ( n = 2) [ 22 , 24 ], adipose-derived stem cells ( n = 3) [ 18 , 23 , 24 ], mesenchymal stem cells ( n = 6) [ 13 , 14 , 19 , 20 , 25 , 27 ], embryonic endothelial progenitor cell ( n = 1) [ 9 ], autologous unfractionated bone marrow ( n = 1) [ 28 ], and cardiac explant-derived c-Kit+ cells ( n = 1) [ 17 ]. One study administered both adipose-derived stem cells and peripheral blood mononuclear cells [ 24 ].…”

“…Seven studies only reported absence of arrhythmias without providing in-depth data [ 10 , 14 – 16 , 22 , 26 , 28 ]. Five articles provided more in-depth data on safety aspects of RCVI [ 11 , 12 , 18 , 20 , 23 ]. These five studies will be discussed in more detail below.…”

Thinking outside the box

“…In this issue of the journal, Pogue et al . () report the results of a clinical study in which commercially obtained mesenchymal stem cells of adipose origin were used via coronary venous delivery for injection into the myocardium of a group of Dobermanns with dilated cardiomyopathy, the majority of which were at the occult stage of the disease. On one level the results are disappointing.…”