Strategies to Enhance the Effectiveness of Adult Stem Cell Therapy for Ischemic Heart Diseases Affecting the Elderly Patients.
Strategies to Enhance the Effectiveness of Adult Stem Cell Therapy for Ischemic Heart Diseases Affecting the Elderly Patients.
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DOI：
10.1007/s12015-016-9642-z
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发表时间：
2016-04
影响因子：
4.8
通讯作者：
Cai C
中科院分区：
文献类型：
--
作者：
Khatiwala R;Cai C
心肌梗死和慢性缺血性心脏病对老年患者的影响比任何其他患者群体都要普遍和不成比例。尽管有可用的治疗方法，但心脏组织经常由于心脏损伤而永久性受损。本文综述了近年来提出使用修饰的自体成体干细胞促进梗死后心脏组织愈合的文献。这种新的细胞治疗方法包括从患者体内分离成体干细胞，对这些干细胞进行体外操作，然后移植回患者自己的心脏以加速愈合。影响这一过程的障碍之一是，心脏问题在老年患者中越来越常见，从他们的组织中回收的干细胞往往是早衰或已经衰老。因此，苛刻的体外操作可导致老化的干细胞在移植后经历大量的体内凋亡。文献中的共识是抑制或逆转成体干细胞中的衰老起始将是最大的益处。事实上，人们认为这种策略可以降低干细胞死亡率，并迫使老年干细胞采用与年轻干细胞相似的更具弹性的表型。这篇综述将讨论选择最有效的和最新的策略，用于实验，以提高目前的干细胞治疗缺血性心脏病的有效性。
Myocardial infarctions and chronic ischemic heart disease both commonly and disproportionately affect elderly patients more than any other patient population. Despite available treatments, heart tissue is often permanently damaged as a result of cardiac injury. This review aims to summarize recent literature proposing the use of modified autologous adult stem cells to promote healing of post-infarct cardiac tissue. This novel cellular treatment involves isolation of adult stem cells from the patient, in vitro manipulation of these stem cells, and subsequent transplantation back into the patient’s own heart to accelerate healing. One of the hindrances affecting this process is that cardiac issues are increasingly common in elderly patients, and stem cells recovered from their tissues tend to be pre-senescent or already in senescence. As a result, harsh in vitro manipulations can cause the aged stem cells to undergo massive in vivo apoptosis after transplantation. The consensus in literature is that inhibition or reversal of senescence onset in adult stem cells would be of utmost benefit. In fact, it is believed that this strategy may lower stem cell mortality and coerce aged stem cells into adopting more resilient phenotypes similar to that of their younger counterparts. This review will discuss a selection of the most efficient and most-recent strategies used experimentally to enhance the effectiveness of current stem cell therapies for ischemic heart diseases.