Stem Cells in Cardiovascular Medicine: Historical Overview and Future Prospects

Abstract

Cardiovascular diseases remain the leading cause of death in the developed world, accounting for more than 30% of all deaths. In a large proportion of these patients, acute myocardial infarction is usually the first manifestation, which might further progress to heart failure. In addition, the human heart displays a low regenerative capacity, leading to a loss of cardiomyocytes and persistent tissue scaring, which entails a morbid pathologic sequela. Novel therapeutic approaches are urgently needed. Stem cells, such as induced pluripotent stem cells or embryonic stem cells, exhibit great potential for cell-replacement therapy and an excellent tool for disease modeling, as well as pharmaceutical screening of novel drugs and their cardiac side effects. This review article covers not only the origin of stem cells but tries to summarize their translational potential, as well as potential risks and clinical translation.

The Potential Properties of Natural Compounds in Cardiac Stem Cell Activation: Their Role in Myocardial Regeneration

“…Embryonic stem cells (ESCs) are pluripotent cells derived from the inner cell mass of pre-implantation blastocysts of a murine or human host. ESCs showed the ability to discriminate in cells of all three germ layers, thus, including the generation of cardiac myocytes [ 40 , 72 , 73 ]. From early studies conducted on different animal models of acute MI and IHDs, such as pig or guinea pig, the injected ESCs have shown the ability to act as a biological pacemaker in electro-physiologically silenced or atrioventricular blocked hearts [ 74 , 75 ].…”

“…For this reason, many countries have imposed prohibitions on research funding and on the use of human ESCs (hESCs) derived from an embryo destruction [ 18 ]. In addition, some studies have identified the ability of ESCs to generate teratomas (tumors of mixed germ layers) and graft refusal when transplanted undifferentiated [ 73 ], together with genetic variability and the risk of immune rejection due to their nature of pluripotency and allogeneic cell type [ 83 ]. Many efforts to enhance purifications and differentiations protocols are ongoing [ 84 ].…”

Great Expectations: Induced pluripotent stem cell technologies in neurodevelopmental impairments

“…Obtained easily, these cells can differentiate into any desired cells theoretically, and are applied to the study of any target cells, which are not affected by species-specific differences. The iPSCs disease models have been applied to some organ systems [21][22][23][26][27][28][29][30][31][32]. Besides, the current reprogrammed iPSCs have been widely used to study disease models and cell replacement therapy in animal experiments, which is possible to study the pathogenesis of diseases [33].…”

Preconditioned and Genetically Modified Stem Cells for Myocardial Infarction Treatment

“…Particularly, human ESCs in a cocktail of factors targeting potential death pathways showed improved survival [ 129 ]. It was demonstrated that one-to-one electrophysiological coupling between the graft and host cardiac cells enhanced the engraftment of human ESC-derived CMs and suppressed ventricular arrhythmia [ 130 ]. Moreover, Shiba and colleagues reported reduced immunogenicity in the MHC-matched Cynomolgus monkeys upon the allogenic transplantation of iPSC-CMs [ 131 ].…”