Fat for fostering: Regenerating injured heart using local adipose tissue.
Fat for fostering: Regenerating injured heart using local adipose tissue.
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DOI：
10.1016/j.ebiom.2016.03.024
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发表时间：
2016-05
期刊：
影响因子：
11.1
通讯作者：
Qian L
中科院分区：
文献类型：
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作者：
Ma H;Liu J;Qian L
在EBioMedicine的这一期中，贝叶斯-Genis及其同事（贝叶斯-Genis等人，2016）报告了第一项临床研究，研究了接受冠状动脉旁路移植术（CABG）的慢性心肌梗死患者中脂肪移植物转位术（AGTP）的安全性和有效性。这种创新的方法利用当地现有的组织来修复受损的心肌，简化了手术程序，并可能避免使用非自体细胞或在培养皿中操作的干细胞的风险。心肌梗死（MI）是一种毁灭性的疾病，并且是西方国家发病率和死亡率的主要原因之一。在过去的十年中，在开发新的治疗方法来再生梗死心肌方面取得了重大进展，包括干细胞治疗和最新的重编程方法。干细胞治疗目前面临的挑战是细胞存活率低，有限的细胞间相互作用和移植细胞的功能整合，以及在动物模型中观察到的一些有益作用的机制尚不清楚。使用干细胞或干细胞衍生的心肌细胞的临床研究具有混合的结果（Mummery等人，2010年）。新出现的将内源性成纤维细胞转化为心肌细胞的重编程方法可能会克服其中一些挑战（Qian和Srivastava，2013）;然而，这种方法目前处于起步阶段，主要在小型啮齿动物上进行了有效性和安全性测试。在临床上，血运重建策略，包括纤溶、经皮冠状动脉介入治疗（PCI）和CABG，大大改善了急性心肌梗死患者的心肌挽救和预后。然而，错过再灌注治疗的狭窄最佳时间窗的患者或在血运重建期间经历有害的缺血再灌注损伤的患者将随着时间的推移而形成心肌瘢痕，这最终导致心脏功能障碍、恶性心律失常、心源性猝死和其他主要心血管事件（Klem等人，
In this issue of EBioMedicine, Bayes-Genis and colleagues (Bayes-Genis et al., 2016) reported the first clinical study investigating safety and efficacy of the adipose graft transposition procedure (AGTP) in patients with chronic myocardial infarction undergoing coronary artery bypass graft (CABG) surgery. This innovative approach takes advantage of the local existing tissue to repair damaged myocardium, simplifying the surgical procedure and potentially avoiding the risks of using nonautologous cells or stem cells that have been manipulated in petri dish. Myocardial infarction (MI) is a devastating disease condition, and is one of the leading causes of morbidity and mortality in western countries. In the past decade, significant advance has been made to develop novel therapeutic approaches to regenerate infarcted myocardium, including the stem cell therapy and the most recent reprogramming approaches. Stem cell therapy currently faces the challenges of poor cell survival, limited cell–cell interaction and functional integration of engrafted cells, as well as unclear mechanisms of some beneficial effects observed in animal model. Clinical studies of using stem cell or stem cell-derived cardiomyocytes have a mixed result (Mummery et al., 2010). The newly emerged reprogramming approach converting endogenous fibroblasts into cardiomyocytes could potentially overcome some of these challenges (Qian and Srivastava, 2013); however, this approach is currently at its fledgling stage and has been primarily tested on small rodents for effectiveness and safety. In clinic, revascularization strategies, including fibrinolysis, percutaneous coronary intervention (PCI), and CABG, have greatly improved myocardial salvage and prognosis in patients suffering from acute myocardial infarction. However, patients who miss the narrow optimal time window for reperfusion therapy or those who experience detrimental ischemia reperfusion injury during revascularization, will develop myocardial scar over time, which ultimately contributes to cardiac dysfunction, malignant arrhythmia, sudden cardiac death and other major cardiovascular events (Klem et al.,