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Published on: September 3, 2020
Stem cell therapy in ischemic heart disease
Julia N E Sunkomat1, Mohamed A Gaballa
1University of Arizona Sarver Heart Center, Section of Cardiology, Tucson, AZ 85624, USA.
Insights
Stem cell therapy shows promise for treating cardiovascular diseases, including coronary artery disease and heart failure. Further research is needed to optimize patient selection, cell type, delivery, and dosage for effective and safe cardiac repair.
Area of Science:
- Cardiology
- Regenerative Medicine
- Stem Cell Biology
Background:
- Coronary artery disease (CAD) is a leading cause of mortality globally.
- Sequelae of CAD, such as myocardial infarction and congestive heart failure (CHF), significantly impact patient quality of life and healthcare costs.
- Stem cell therapy is emerging as a highly active research area in cardiology due to its potential for neovascularization and improved cardiac function.
Purpose of the Study:
- To provide a systematic overview of the science behind stem cells and their effects on ischemic myocardium.
- To highlight the potential of stem cell therapy in treating various cardiovascular conditions.
- To identify key challenges and questions that need to be addressed for the clinical application of stem cell therapy.
Main Methods:
- Review of published studies on stem cell transplantation in myocardial infarction models.
- Analysis of variations in experimental designs, including ischemia models, donor/recipient species, cell delivery techniques, cell types, cell numbers, and timing.
- Systematic overview of the scientific literature concerning stem cell effects in ischemic myocardium.
Main Results:
- Published studies, despite design variations, consistently highlight the potential of stem cell therapy in cardiovascular disease treatment.
- Stem cells may contribute to neovascularization and improve cardiac function post-myocardial infarction.
- Stem cell therapy's applications extend beyond ischemic heart disease to non-ischemic cardiomyopathy, peripheral vascular disease, and aging.
Conclusions:
- Stem cell therapy holds significant promise for revolutionizing heart failure treatment and managing cardiovascular diseases.
- Key obstacles, including patient selection, optimal cell type, delivery route, dosage, and comparative efficacy/safety, require further investigation.
- Stem cells offer potential as gene therapy vectors and can be integrated with existing therapeutic modalities to improve patient outcomes.
Abstract:
Coronary artery disease (CAD) remains the leading cause of death in the Western world. The high impact of its main sequelae, acute myocardial infarction and congestive heart failure (CHF), on the quality of life of patients and the cost of health care drives the search for new therapies. The recent finding that stem cells contribute to neovascularization and possibly improve cardiac function after myocardial infarction makes stem cell therapy the most highly active research area in cardiology. Although the concept of stem cell therapy may revolutionize heart failure treatment, several obstacles need to be addressed. To name a few: 1) Which patient population should be considered for stem cell therapy? 2) What type of stem cell should be used? 3) What is the best route for cell delivery? 4) What is the optimum number of cells that should be used to achieve functional effects? 5) Is stem cell therapy safer and more effective than conventional therapies? The published studies vary significantly in design, making it difficult to draw conclusions on the efficacy of this treatment. For example, different models of ischemia, species of donors and recipients, techniques of cell delivery, cell types, cell numbers and timing of the experiments have been used. However, these studies highlight the landmark concept that stem cell therapy may play a major role in treating cardiovascular diseases in the near future. It should be noted that stem cell therapy is not limited to the treatment of ischemic cardiac disease. Non-ischemic cardiomyopathy, peripheral vascular disease, and aging may be treated by stem cells. Stem cells could be used as vehicle for gene therapy and eliminate the use of viral vectors. Finally, stem cell therapy may be combined with pharmacological, surgical, and interventional therapy to improve outcome. Here we attempt a systematic overview of the science of stem cells and their effects when transplanted into ischemic myocardium.
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