Harnessing Epicardial Progenitor Cells and Their Derivatives for Rescue and Repair of Cardiac Tissue After Myocardial Infarction.
Harnessing Epicardial Progenitor Cells and Their Derivatives for Rescue and Repair of Cardiac Tissue After Myocardial Infarction.
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DOI：
10.1007/s40610-017-0066-6
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Spees JL
中科院分区：
文献类型：
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作者：
Rao KS;Spees JL
缺血性心脏病和中风是全球死亡人数最多的疾病。尽管干预时间缩短，护理标准改善，但心肌梗死（MI）存活的5例患者中有1例仍面临长期慢性心力衰竭，5年死亡率约为50%。基于其分化和旁分泌活性的多潜能性，心外膜细胞及其衍生物具有拯救受损组织和/或促进心脏再生的潜力。在这里，我们回顾了心肌梗死的诊断和治疗，基本的心外膜细胞生物学，以及旨在利用心外膜细胞的修复特性的潜在治疗策略。在心脏发育过程中，覆盖心脏表面的心外膜细胞产生迁移祖细胞，这些细胞有助于冠状动脉血管系统和间质成纤维细胞。心外膜细胞还产生心肌扩张和心脏生长所需的旁分泌信号。在成人心肌梗死患者中，心外膜细胞及其衍生物提供影响心肌重塑和修复的旁分泌因子。目前，调节成人心外膜细胞命运和旁分泌活动的内在机制和外在信号仍然知之甚少。由于负性重塑或存活心脏组织大量丧失而导致心力衰竭的人类疾病需要新的、有效的治疗方法。对心脏生长、稳态和损伤期间心外膜细胞功能和心外膜介导的生长因子、细胞因子和激素分泌的更好理解可能导致治疗心肌梗死患者的新方法。
Ischemic heart disease and stroke lead to the greatest number of deaths worldwide. Despite decreased time to intervention and improvements in the standard of care, 1 out of 5 patients that survive a myocardial infarction (MI) still face long-term chronic heart failure and a 5-year mortality rate of about 50%. Based on their multi-potency for differentiation and paracrine activity, epicardial cells and their derivatives have potential to rescue jeopardized tissue and/or promote cardiac regeneration. Here we review the diagnosis and treatment of MI, basic epicardial cell biology, and potential treatment strategies designed to harness the reparative properties of epicardial cells. During cardiac development, epicardial cells covering the surface of the heart generate migratory progenitor cells that contribute to the coronary vasculature and the interstitial fibroblasts. Epicardial cells also produce paracrine signals required for myocardial expansion and cardiac growth. In adults with myocardial infarction, epicardial cells and their derivatives provide paracrine factors that affect myocardial remodeling and repair. At present, the intrinsic mechanisms and extrinsic signals that regulate epicardial cell fate and paracrine activity in adults remain poorly understood. Human diseases that result in heart failure due to negative remodeling or extensive loss of viable cardiac tissue require new, effective treatments. Improved understanding of epicardial cell function(s) and epicardial-mediated secretion of growth factors, cytokines and hormones during cardiac growth, homeostasis and injury may lead to new ways to treat patients with myocardial infarction.