A mechanistic roadmap for the clinical application of cardiac cell therapies
A mechanistic roadmap for the clinical application of cardiac cell therapies
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DOI：
10.1038/s41551-018-0216-z
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发表时间：
2018-06-01
影响因子：
28.1
通讯作者：
Marban, Eduardo
中科院分区：
文献类型：
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作者：
Marban, Eduardo
用于再生治疗的细胞的发展在其临床移植的道路上遇到了许多陷阱。在心脏病学方面，心脏靶向细胞疗法的临床研究早在20年前就开始了，但在获得批准的产品方面进展缓慢。在这个视角下，我提供了最近的心脏细胞疗法的概述，重点是限制细胞产品从研究实验室转化到临床实践的障碍。通过将心力衰竭作为目标适应症，我认为克服临床翻译局限性的策略需要越来越多地强调机制支持的疗效，而不是现象学观察。随着研究的进展，从细胞到旁分泌机制再到确定的因子，识别那些涉及到获得更好的治疗效果的确定的因素将更好地为使用细胞作为候选治疗提供信息。下一代无细胞生物制品可能会提供细胞治疗的好处，而不受全细胞产品的内在限制。
The development of cells for regenerative therapy has encountered many pitfalls on its path to clinical translation. In cardiology, clinical studies of heart-targeted cell therapies began two decades ago, yet progress towards reaching an approved product has been slow. In this Perspective, I provide an overview of recent cardiac cell therapies, with a focus on the hurdles limiting the translation of cell products from research laboratories to clinical practice. By focusing on heart failure as a target indication, I argue that strategies for overcoming limitations in clinical translation require an increasing emphasis on mechanism-supported efficacy, rather than on phenomenological observations. As research progresses from cells to paracrine mechanisms to defined factors, identifying those defined factors that are involved in achieving superior therapeutic efficacy will better inform the use of cells as therapeutic candidates. The next generation of cell-free biologics may provide the benefits of cell therapy without the intrinsic limitations of whole-cell products.