Advanced cell and gene therapies in cardiology

Area of Science:

• Cardiovascular Biology
• Regenerative Medicine
• Cell Therapy

Background:

• The heart possesses resident stem/progenitor cells, but their therapeutic efficacy is debated.
• Cardiac diseases remain a leading cause of mortality worldwide, necessitating novel treatment strategies.

Purpose of the Study:

• To review current evidence on cardiac stem/progenitor cells and cell-based therapies for heart disease.
• To evaluate alternative therapeutic approaches, including pluripotent stem cells, direct reprogramming, extracellular vesicles, and gene-based strategies.

Main Methods:

• Comprehensive literature review of preclinical and clinical studies.
• Analysis of diverse cell types and advanced therapeutic modalities for cardiac repair.
• Discussion of gene therapy and genome editing applications in cardiovascular medicine.

Main Results:

• Adult stem/progenitor cells demonstrated limited efficacy in most cardiac conditions, except possibly refractory angina.
• Pluripotent stem cell-derived cardiomyocytes present a viable, yet under-researched, therapeutic avenue.
• Direct reprogramming, extracellular vesicles, gene therapy, and genome editing show potential for treating various cardiac diseases.

Conclusions:

• Current cell therapies for cardiac diseases face significant challenges, with adult stem cells showing minimal benefit.
• Emerging strategies like pluripotent stem cells, direct reprogramming, extracellular vesicles, and gene/genome editing offer future therapeutic potential.
• Further preclinical and clinical research is essential to validate these advanced therapies for widespread clinical application.