The bone marrow-cardiac axis: role of endothelial progenitor cells in heart failure
Simon Maltais1, Louis P Perrault, Hung Q Ly
1Department of Surgery, Université de Montréal, Quebec, Canada.
Insights
Bone marrow-derived cells, including endothelial progenitor cells (EPCs), show potential for treating congestive heart failure (CHF). Further research is needed to understand the bone marrow-cardiac axis for myocardial regeneration and heart function recovery in advanced CHF.
Area of Science:
- Cardiovascular Medicine
- Regenerative Medicine
- Cell Biology
Background:
- Congestive heart failure (CHF) is a major cause of mortality with limited therapeutic options.
- Current treatments for heart failure (HF) have shown limited impact due to complex pathophysiology.
- Novel molecular and biological pathways are crucial for effective CHF treatment.
Purpose of the Study:
- To review the role of the bone marrow-cardiac axis and bone marrow-derived endothelial progenitor cells (EPCs) in congestive heart failure (CHF).
- To explore the potential of modulating bone marrow (BM) and EPCs for myocardial regeneration and cardiac function recovery.
- To address uncertainties and unresolved mechanisms in the BM-cardiac axis for treating advanced CHF.
Main Methods:
- Review of recent experimental and pre-clinical studies on bone marrow-derived cells in heart failure.
- Analysis of the literature concerning endothelial progenitor cells (EPCs) and their role in cardiac repair.
- Focus on the bone marrow-cardiac axis in the context of congestive heart failure (CHF) pathophysiology and progression.
Main Results:
- Bone marrow (BM)-derived endothelial progenitor cells (EPCs) are implicated in cardiac regeneration and function recovery in heart failure (HF).
- Modulating the interaction between BM and circulating EPCs presents a potential therapeutic strategy for CHF.
- Significant uncertainties remain regarding the precise mechanisms underlying the functional benefits observed in studies.
Conclusions:
- The bone marrow-cardiac axis and BM-derived EPCs are critical in the pathophysiology and progression of CHF.
- Further basic science and clinical research are essential to fully elucidate the association between BM and heart function recovery in advanced CHF.
- Targeting the BM-cardiac axis offers a promising avenue for developing new therapeutic strategies for congestive heart failure (CHF).
Abstract:
Congestive heart failure (CHF) remains a leading cause of mortality in the developed world. The complex mechanisms involved in the pathophysiology of heart failure (HF) explain some of the limited impact of current recognised therapeutic strategies. There is, therefore, a definite need for new alternative molecular and biological pathways to address the treatment of this condition. Over the past decade, much research has focussed upon identifying the ideal cell type to promote myocardial regeneration. Recently, striking reports suggested the concept that bone-marrow (BM)-derived endothelial progenitor cells (EPCs) participate in cardiac regeneration and function recovery in the setting of progressive HF. The modulation of this complex interaction between the BM and the circulating EPCs could be at the crossroad of multiple therapeutic strategies aimed to protect or restore the myocardium in the setting of the CHF. However, there are uncertainties and unresolved issues regarding the mechanisms possibly responsible for the functional benefits observed in chronic experimental and pre-clinical studies. Hence, the BM-cardiac axis concept has created overwhelming enthusiasm and subsequent scepticism in the field of cardiac repair and regeneration. Further intensive research in basic science and clinical arenas are needed to elucidate the potential association between BM and heart function recovery, particularly in the progression towards advance stages of CHF. In this review, we focus on the importance of the BM-cardiac axis and BM-derived EPCs in the pathophysiology, clinical progression and potential treatment of CHF.
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