Cellular cardiomyoplasty--a novel approach to treat heart disease.
Cellular cardiomyoplasty--a novel approach to treat heart disease.
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DOI：
10.1111/j.1527-5299.2002.00292.x
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发表时间：
2002-07-01
期刊：
影响因子：
--
通讯作者：
Kloner, Robert A
中科院分区：
文献类型：
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作者：
Muller-Ehmsen, Jochen;Kedes, Laurence H;Kloner, Robert A
细胞移植是治疗心脏病的一种新的实验策略，如心肌梗死和心力衰竭。其有益作用可包括移植细胞对收缩功能的主动贡献、心脏力学的被动改善、新血管生成的诱导或对心脏生物学的其他间接影响。几种细胞类型已被用于心脏细胞移植，包括来自胎儿或新生动物的心脏细胞和心肌细胞系、骨骼肌成肌细胞和骨骼肌细胞系、平滑肌细胞和各种干细胞（成人或胚胎）。这些细胞中的许多细胞在实验性缺血性和非缺血性心脏病中获得了令人鼓舞的结果，包括移植后细胞成功存活，整合到宿主心肌中，以及改善患病心脏的功能。这些研究中的大多数发现心肌收缩力改善，一些发现血管生成增强。然而，这些作用的机制仍然不清楚，剂量（细胞数量）对功能反应的影响也完全不清楚。此外，没有进行足够的比较研究，以允许一种细胞类型优于另一种。目前的数据表明，无论使用何种细胞种类，如果使用未成熟和未分化的细胞，则可以实现最佳的存活和整合。任何一种干细胞在无限的可复制性和可塑性方面都有明显的优势，但能否完全分化成熟为心肌细胞仍需证明。目前，一些临床研究正在探索缺血性心脏病患者的细胞心肌成形术的治疗益处，但必须注意的是，在这种策略增加心脏病患者的治疗选择之前，还有许多问题需要解决。
Cell transplantation is a novel experimental strategy to treat heart disease, such as myocardial infarction and heart failure. Its beneficial effects may include active contribution of transplanted cells to contractile function, passive improvement of the mechanics of the heart, induction of neoangiogenesis or other indirect influences on the biology of the heart. Several cell types have been used for cardiac cell transplantation including cardiac cells from fetal or newborn animals and cardiac muscle cell lines, skeletal myoblasts and skeletal muscle cell lines, smooth muscle cells, and a variety of stem cells, either adult or embryonic. With many of these cells, encouraging results in experimental ischemic and nonischemic heart disease have been obtained including successful cell survival after transplantation, integration into the host myocardium, and improvement of the function of diseased hearts. Most of these studies found cardiac contractility improved and some found enhanced angiogenesis. However, the mechanisms of these effects remain obscure, and the impact of dosage (cell number) on functional response is completely unclear. In addition, not enough comparative studies were performed to allow preference of one cell type over the other. The current data suggest that whatever cell species is used, the best survival and integration may be accomplished if immature and undifferentiated cells are used. Any kind of stem cell has obvious advantages in terms of endless reproducibility and plasticity, but the complete differentiation and maturation into cardiac myocytes still needs to be proven. At present several clinical studies are exploring the therapeutic benefits of cellular cardiomyoplasty in patients with ischemic heart disease, but it has to be noted that there are many issues that need to be addressed before this strategy will add to the therapeutic options for patients with heart disease.