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Bone Marrow Therapies for Chronic Heart Disease

Iman Saramipoor Behbahan1, Armand Keating2, Robert Peter Gale3

  • 1Clinical Observer, Division of Hematology, Stanford MDS Center, Stanford University, Palo Alto, California, USA.

Stem Cells (Dayton, Ohio)
|June 19, 2015
PubMed

Insights

Bone marrow cells show limited long-term benefit for chronic heart failure. While not becoming heart cells, they may offer short-term advantages through paracrine effects, with stronger studies showing smaller benefits.

Area of Science:

  • Cardiology
  • Regenerative Medicine
  • Cell Biology

Background:

  • Chronic heart failure (CHF) is a major cause of mortality, driving the search for novel therapeutic strategies.
  • Bone marrow-derived cells (BMDCs) have been investigated for their potential regenerative capacity in treating CHF.
  • Numerous clinical trials have explored the efficacy of BMDCs in patients with heart failure.

Purpose of the Study:

  • To critically evaluate the current understanding of BMDC biology in the context of heart failure.
  • To assess the clinical application and therapeutic benefits of infusing BMDCs for chronic heart failure.
  • To determine the likelihood of BMDC trans-differentiation into functional cardiomyocytes and their overall impact.

Main Methods:

  • Systematic review and critical analysis of existing scientific literature on BMDCs and heart failure.
  • Evaluation of data from clinical trials investigating BMDC infusion in CHF patients.
  • Assessment of the biological mechanisms, including paracrine effects and trans-differentiation, of BMDCs.

Main Results:

  • Evidence suggests BMDCs are unlikely to differentiate into functional cardiomyocytes post-infusion.
  • Most clinical trials report modest short-term benefits, with minimal to no long-term improvements in CHF patients.
  • A correlation exists between study design stringency and observed effect size, with more rigorous trials showing smaller benefits.

Conclusions:

  • The infusion of BMDCs into patients with chronic heart failure may provide short-term benefits, but substantial long-term advantages are unlikely.
  • Observed benefits are more probably attributed to paracrine mechanisms rather than the trans-differentiation of BMDCs into cardiomyocytes.
  • Further research is needed to clarify the precise role and optimal application of BMDCs in heart failure therapy.

Keywords:
Cell transplantationChronic heart diseaseHematopoietic cell transplantationHematopoietic cells

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