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Cell therapy in heart failure:where do they stand?
1Département de chirurgie cardiovasculaire, université Paris-Descartes, Sorbonne-Paris Cité ; Inserm U-970, Hôpital européen Georges-Pompidou, Paris, France.
La Revue Du Praticien
|December 5, 2018
Summary
Cell therapy shows promise for heart failure treatment by harnessing the body's repair mechanisms. Future strategies focus on optimizing cell selection, biomaterials, and delivery for enhanced therapeutic outcomes.
Area of Science:
- Cardiovascular Medicine
- Regenerative Medicine
- Cell Biology
Background:
- Cell transplantation is a proven therapeutic approach, explored for heart failure treatment.
- Initial strategies aimed to replace damaged cardiomyocytes, but a paradigm shift suggests paracrine effects are key.
- Early clinical trials yielded inconclusive results, highlighting the need for optimization.
Purpose of the Study:
- To review the current landscape of cell therapy for heart failure.
- To discuss the shift in understanding the mechanism of action towards paracrine signaling.
- To identify strategies for improving the efficacy of cell-based therapies.
Main Methods:
- Review of existing clinical trial data and scientific literature.
- Analysis of the evolving understanding of cell therapy mechanisms in heart failure.
- Discussion of optimization strategies including cell selection, biomaterials, and delivery.
Main Results:
- Early cell therapy trials for heart failure did not consistently demonstrate improved outcomes.
- Evidence suggests the primary therapeutic mechanism involves paracrine signaling, not direct cell replacement.
- Optimization through cell selection, biomaterial integration, and improved delivery is crucial.
Conclusions:
- Cell therapy for heart failure is evolving, with a focus on paracrine mechanisms.
- Future directions include refining cell selection, using biomaterials, and enhancing delivery for better graft retention.
- Acellular cell therapy, using only secreted factors, is a potential future approach.
Keywords:
Insuffisance cardiaque
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