Mesenchymal stem cells and cardiac repair: principles and practice

Mesenchymal stem cells (MSCs) are cluster of differentiation 34 (CD34)-CD45-negative nonhematopoietic progenitors derived typically from the stromal fraction of the bone marrow. These stem cells display multipotent properties with a demonstrable differentiation capacity along multiple mesodermal lineages. In the setting of myocardial injury, preclinical studies indicate benefit of both autologous and allogeneic transplantation in line with a recognized immunotolerant profile. Initial clinical experience supports the value of mesenchymal stem-cell-based therapy in ischemic cardiomyopathy. Experience is however limited to naïve mesenchymal stem cells, with efforts underway to identify optimal means of enhancing the cardiogenic potential of transplanted cells through guided cardiopoiesis with the ultimate aim of achieving standardized therapy of the ischemic myocardium.