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Combination Cell Therapy for Ischemic Cardiomyopathy
Journal of the American College of Cardiology ( IF 24.0 ) Pub Date : 2017-11-01 , DOI: 10.1016/j.jacc.2017.09.1065
Fabio A. Recchia , Thomas E. Sharp

SEE PAGE 2504 W hat is the best stem cell type for the treatment of ischemic cardiomyopathy? How and when should stem cells be delivered after myocardial infarction? Are live stem cells even necessary, or can the same therapeutic effects be achieved by administering only their secreted factors? These and other questions have challenged the scientific community for almost 2 decades; the debate is animated, and leaders in the field are trying to come to a consensus (1). Proof-of-concept studies in rodent models yielded very encouraging results (2–4), which were confirmed only in part by preclinical large animal studies (5–10), whereas early phase I and II clinical trials have shown more modest improvements in cardiac structure and function (11–14). Although clinical data indicate that cell therapy is safe in patients with ischemic cardiomyopathy, none of the proposed strategies, to date, is approved as a routine clinical protocol for the treatment of heart diseases. An ideal stem cell candidate is not yet within arm’s reach. As the field has evolved, it has become clearer that the beneficial impact of stem cell therapy is likely the result of poorly defined “paracrine effects,” rather than transdifferentiation (1,15). Therefore, the search for a cell that releases factors promoting wound healing or regeneration after injury has become a

中文翻译:

缺血性心肌病的联合细胞疗法

参见第 2504 页 治疗缺血性心肌病的最佳干细胞类型是什么?心肌梗塞后应如何以及何时输送干细胞?是否需要活干细胞,或者仅给予其分泌因子即可达到相同的治疗效果?这些问题和其他问题已经挑战了科学界近 20 年。辩论很激烈,该领域的领导者正试图达成共识 (1)。啮齿类动物模型的概念验证研究产生了非常令人鼓舞的结果 (2-4),仅部分被临床前大型动物研究证实 (5-10),而早期 I 和 II 期临床试验显示心脏结构和功能(11-14)。尽管临床数据表明细胞疗法对缺血性心肌病患者是安全的,迄今为止,没有一项提议的策略被批准为治疗心脏病的常规临床方案。理想的干细胞候选者尚未达到。随着该领域的发展,干细胞治疗的有益影响可能是定义不明确的“旁分泌效应”的结果,而不是转分化的结果,这一点变得越来越清晰 (1,15)。因此,寻找一种能在损伤后释放促进伤口愈合或再生的因子的细胞已成为一种研究。” 而不是转分化 (1,15)。因此,寻找一种能在损伤后释放促进伤口愈合或再生的因子的细胞已成为一种研究。” 而不是转分化 (1,15)。因此,寻找一种能在损伤后释放促进伤口愈合或再生的因子的细胞已成为一种研究。
更新日期:2017-11-01
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