The use of stem cells in ischemic heart disease treatment
- PMID: 30310400
- PMCID: PMC6180025
- DOI: 10.5114/kitp.2018.78446
The use of stem cells in ischemic heart disease treatment
Abstract
Ischemic heart disease is a major cause of death and disabilities worldwide. Unfortunately, not all patients are suitable for direct revascularization. Cell-based therapies may be alternative options because of their potential to promote neovascularisation and endothelial repair, improving myocardial perfusion. The success of cell-based therapies depends on the type of implanted stem cells, delivery method and underlying disease. Several different cell populations including bone marrow-derived mononuclear cells (MNCs), mesenchymal stromal cells (MSCs), CD34+, CD133+, endothelial progenitor cells, adipose-derived mesenchymal stromal cells (ASCs) and stem cells from placenta and umbilical cord have been investigated. Presently, no consensus exists about the best cell type for clinical regenerative therapy. Because the system of coronary arteries in the ischemic area is poor and most of the coronary artery is significantly narrowed or closed, direct implantation of stem cells in the ischemic area of the heart muscle appears an attractive method.
Choroba niedokrwienna serca jest główną przyczyną zgonu i niepełnosprawności na świecie. Nie wszyscy pacjenci mogą jednak być zakwalifikowani do bezpośrednich metod rewaskularyzacji. Alternatywą są terapie oparte na wykorzystaniu komórek macierzystych ze względu na ich potencjał do odbudowy łożyska naczyniowego oraz poprawy perfuzji mięśnia sercowego. Sukces terapii z użyciem komórek macierzystych zależy od rodzaju wszczepionych komórek macierzystych, metody podawania oraz choroby podstawowej. Przebadano kilka różnych populacji komórek, np. jednojądrzaste komórki szpiku kostnego (MNC), mezenchymalne komórki zrębowe (MSC), CD34+, CD133+, śródbłonkowe komórki progenitorowe, mezenchymalne komórki zrębowe pochodzące z tkanki tłuszczowej (ASC) i komórki macierzyste z łożyska, pępowiny oraz serce. Obecnie nie ma konsensusu dotyczącego wyboru optymalnego typu komórek w klinicznej terapii regeneracyjnej mięśnia sercowego. Ponieważ układ tętnic wieńcowych w obszarze niedokrwienia jest słaby, a większość tętnic wieńcowych jest znacznie zwężona lub zamknięta, bezpośrednia implantacja komórek macierzystych w obszarze niedokrwienia mięśnia sercowego wydaje się atrakcyjną metodą.
Keywords: ischemic heart disease; regenerative medicine; stem cells.
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