Moving forward on the pathway of cell-based therapies in ischemic heart disease and heart failure - time for new recommendations?

Abstract

Although substantial advances have been made in treating ischemic heart disease and subsequent heart failure, the overall morbidity and mortality from these conditions remain high. Stem cell-based therapy has emerged as a promising approach for prompting cardiac rejuvenation. Various cell types have been tested in the clinical arena, proving consistent safety results. As for efficiency outcomes, contradictory findings have been reported, partly due to inconsistency in study protocols but also due to poor survival, engraftment and differentiation of transplanted cells in the hostile milieu of the ischemic host tissue. Studies have varied in terms of route of delivery, type and dose of implanted stem cells, patient selection and randomization, and assessment of therapeutic effect. Founded on the main achievements and challenges within almost 20 years of research, a number of official documents have been published by leading experts in the field. Core recommendations have focused on developing and optimizing effective strategies to enrich cell retention and their regenerative potential. Issued consensus and position papers have stemmed from an unmet need to provide a harmonized framework for future research, resulting in improved therapeutic application of cell-based therapies for cardiac regeneration and repair.

Keywords: Cardiac regeneration; Heart failure; Ischemic heart disease; Recommendations; Stem cell therapy.

Figure 1

Timeline of expert opinions in cell-based therapies for cardiac regeneration and repair. ESC: European Society of Cardiology; TACTICS: Transnational AllianCe for regenerative Therapies In Cardiovascular Syndromes.