Cell-Based and Selected Cell-Free Therapies for Myocardial Infarction: How Do They Compare to the Current Treatment
Mária Csöbönyeiová1,2, Nikoleta Beerová3, Martin Klein1,2
1National Institute of Rheumatic Diseases, Nábrežie I. Krasku 4, 921 12 Piešťany, Slovakia.
Insights
Novel cell-based and cell-free therapies show promise for myocardial repair after heart attack. Stem cells, telocytes, and exosomes offer new avenues for regenerating heart tissue and treating heart failure.
Area of Science:
- Cardiovascular Research
- Regenerative Medicine
- Cell Biology
Background:
- Myocardial infarction (MI) causes cardiomyocyte death, leading to heart failure, a major cause of mortality.
- Current therapies for MI and heart failure are limited and non-curative.
- Regenerative approaches using cell-based therapies are a key research focus for myocardial repair.
Purpose of the Study:
- To review novel strategies for myocardial repair.
- To explore the potential of various cell types and cell-free approaches for cardiac regeneration.
- To highlight recent insights into therapeutic applications for heart disease.
Main Methods:
- Review of preclinical and clinical studies on stem cell transplantation (mesenchymal stem cells (MSCs), induced pluripotent stem cells (iPSCs)).
- Investigation of telocytes as a potential source for cardiac regeneration.
- Analysis of cell-free therapeutic tools, including exosomes derived from MSCs/iPSCs and other approaches like gene therapy and acellular cardiac patches.
Main Results:
- Stem cell transplantation (MSCs, iPSCs) has shown modest improvements in myocardial regeneration and reduced infarct size.
- Telocytes demonstrate therapeutic effects in various heart pathologies, including MI.
- Exosomes derived from MSCs/iPSCs represent a promising cell-free therapy for cardiovascular diseases due to their cargo.
Conclusions:
- Cell-based therapies, including stem cells and telocytes, offer significant potential for myocardial regeneration.
- Cell-free approaches, particularly exosome-based therapies, are emerging as powerful tools for cardiovascular disease treatment.
- Further research into these novel strategies is crucial for advancing myocardial repair and treating heart failure.
Abstract:
Because of cardiomyocyte death or dysfunction frequently caused by myocardial infarction (MI), heart failure is a leading cause of morbidity and mortality in modern society. Paradoxically, only limited and non-curative therapies for heart failure or MI are currently available. As a result, over the past two decades research has focused on developing cell-based approaches promoting the regeneration of infarcted tissue. Cell-based therapies for myocardial regeneration include powerful candidates, such as multipotent stem cells (mesenchymal stem cells (MSCs), bone-marrow-derived stem cells, endothelial progenitor cells, and hematopoietic stem cells) and induced pluripotent stem cells (iPSCs). These possess unique properties, such as potency to differentiate into desired cell types, proliferation capacity, and patient specificity. Preclinical and clinical studies have demonstrated modest improvement in the myocardial regeneration and reduced infarcted areas upon transplantation of pluripotent or multipotent stem cells. Another cell population that need to be considered as a potential source for cardiac regeneration are telocytes found in different organs, including the heart. Their therapeutic effect has been studied in various heart pathologies, such as MI, arrhythmias, or atrial amyloidosis. The most recent cell-free therapeutic tool relies on the cardioprotective effect of complex cargo carried by small membrane-bound vesicles-exosomes-released from stem cells via exocytosis. The MSC/iPSC-derived exosomes could be considered a novel exosome-based therapy for cardiovascular diseases thanks to their unique content. There are also other cell-free approaches, e.g., gene therapy, or acellular cardiac patches. Therefore, our review provides the most recent insights into the novel strategies for myocardial repair based on the regenerative potential of different cell types and cell-free approaches.
