Cellular therapy with autologous skeletal myoblasts for ischemic heart disease and heart failure

Cardiomyocytes are final differentiated cells that lose the ability to regenerate. Autologous cellular transplantation for cardiac repair has recently emerged as a promising new approach for end-stage heart failure that avoids the risk of immune rejection and ethical problems. Skeletal myoblasts (or satellite cells) are committed progenitor cells located under the basal lamina of adult skeletal muscle; they are committed to multiply after injury. They are highly resistant to ischemia and possess a considerable potential for division in culture. The cardiac milieu might alter the developmental program of grafted myoblast and facilitate their conversion to the slow-twitch phenotype, which is capable of performing cardiac work. We have used autologous cultured myoblast grafts for mouse and rat myocardial infarction in more than 200 cases. From these grafting experiments, it has been shown that cultured autologous myoblast grafting is a useful technique in the treatment of ischemic heart failure. This chapter offers a step-by-step guide to a successful research project on cultured myoblasts for the treatment of myocardial infarction, as well as a set of special techniques for yielding large numbers of skeletal myoblasts and studying postimplantation myocardial repair.