Myocardial cell therapy at the crossroads
Myocardial cell therapy at the crossroads
复制标题
心肌细胞治疗处于十字路口
DOI：
10.1038/ncpcardio0743
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
V. Fuster
中科院分区：
文献类型：
--
作者：
B. Nadal;V. Fuster
2001 年，第一份记录啮齿类动物使用骨髓源推定干细胞 (BMDSC) 实现梗塞后心肌再生的报告引起了科学和临床的极大兴趣。然而，尽管引起了人们的兴趣，这些早期报告既没有鉴定出假定的治疗细胞，也没有提供剂量效应关系或最佳给药参数的数据。此外，他们没有深入了解 BMDSC 分化为心肌细胞的机制。在第一次临床试验之前，设想了一项艰巨的动物实验计划。令人惊讶的是，在啮齿动物研究发表后 6 个月内，一项 BMDSC 心肌移植的 I 期非随机临床试验发表，报告显示射血分数 (EF) 略有改善。不幸的是，许多研究人员将这篇文章解读为将 BMDSC 移植或动员到人类心肌中的临床试验蜂拥而至的开始——事先没有在动物模型中进行验证。
In 2001, the first reports documenting postinfarct myocardial regeneration in rodents using bone-marrow-derived putative stem cells (BMDSCs) elicited great scientific and clinical interest. Despite the interest generated, however, these early reports neither identified the putative therapeutic cells nor provided data on dose–effect relationships or optimal administration parameters. Furthermore, they provided no insight into the mechanism or mechanisms responsible for the differentiation of BMDSCs into myocardial cells. An arduous program of animal experimentation was envisaged before the first clinical trials.Surprisingly, within 6 months of the rodent study's publication, a phase I, nonrandomized clinical trial of BMDSC myocardial transplantation was published that reported a modest improvement in ejection fraction (EF). Unfortunately many investigators interpreted this publication as the starting shot for a stampede of clinical trials transplanting or mobilizing BMDSCs into human myocardium—without prior validation in animal models.