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Published on: September 3, 2020
G-CSF for stem cell therapy in acute myocardial infarction: friend or foe?
Winston Shim1, Ashish Mehta, Sze Yun Lim
1Research and Development Unit, National Heart Centre Singapore , 17, Third Hospital Avenue, Mistri Wing, Singapore 168752. winston.shim.s.n@nhcs.com.sg
Insights
Granulocyte colony-stimulating factor (G-CSF) shows variable efficacy in repairing hearts after myocardial infarction. Future strategies may improve stem cell therapy outcomes for cardiac repair.
Area of Science:
- Cardiovascular Research
- Regenerative Medicine
- Stem Cell Biology
Background:
- Stem cell therapy is a promising treatment for acute myocardial infarction.
- Granulocyte colony-stimulating factor (G-CSF) mobilizes stem cells and offers cardioprotection.
- Clinical trials investigating G-CSF for cardiac repair have yielded inconsistent results.
Purpose of the Study:
- To review the clinical efficacy of G-CSF in cardiac repair following myocardial infarction.
- To analyze factors influencing the variable outcomes of G-CSF-based cardiac therapy.
- To explore mechanisms of stem cell homing and engraftment in infarcted hearts.
Main Methods:
- Review of clinical trial data on G-CSF for acute myocardial infarction.
- Analysis of paracrine effects and stem cell mobilization by G-CSF.
- Examination of signaling pathways involved in bone marrow stem cell homing.
Main Results:
- Clinical trials show variable improvements in cardiac function and left ventricular remodeling.
- Doubts exist regarding the overall effectiveness of G-CSF in promoting functional recovery.
- Clinical experiences provide insights into stem cell behavior in the infarcted heart.
Conclusions:
- G-CSF therapy for myocardial infarction has shown mixed clinical outcomes.
- Understanding stem cell homing and signaling pathways is crucial for improving therapy.
- Optimizing G-CSF strategies is essential for enhancing future clinical benefits in cardiac repair.
Abstract:
Stem cell-based therapy has emerged as a potential therapeutic option for patients with acute myocardial infarction. The ability of granulocyte colony-stimulating factor (G-CSF) to mobilize endogenous stem cells as well as to protect cardiomyocytes at risk via paracrine effects has attracted considerable attention. In the past decade, a number of clinical trials were carried out to study the efficacy of G-CSF in cardiac repair. These trials showed variable outcomes in terms of improved cardiac contractile function and suppressed left ventricular negative remodelling. Critical examinations of these results have raised doubts concerning the effectiveness of G-CSF in modulating functional recovery. However, these cumulative clinical experiences are helpful in the understanding of mechanisms and roles of signalling pathways in regulating homing and engraftment of bone marrow stem cells to the infarcted heart. In this review, we discuss some of the observations that may have influenced the clinical outcomes. Improving strategies that target the critical aspects of G-CSF-driven cardiac therapy may provide a better platform to augment clinical benefits in future trials.
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