Cell Therapies in Cardiology

摘要: Over the last 12 years, idea of using stem and progenitor cells (SPC) to regenerate human heart vessels underwent rapid translation from basic studies animal preclinical experiments clinical application in trials. Two aspects SPC therapy are essential for future application: better understanding mechanisms as well assessment controlled randomized Several cardiac repair after cell have been postulated primarily mediated by paracrine effects (antiapoptotic, proangiogenic, activation resident (CSC), antifibrotic) differentiation into blood vessels. Paracrine seem very likely because were shown secrete a variety cytokines, chemokines, growth factors more recently microvesicles (MV) containing micro-ribonucleic acids (RNAs). By attenuation inflammatory process, induction angiogenesis or cell-derived MV might trigger innate reparatory mechanisms. Cell was evaluated trial patients with acute myocardial infarction (MI), chronic ischemia (no-option angina), failure due ischemic nonischemic cardiomyopathy. Both nonrandomized small trials (RCT) showed excellent safety profile no excess adverse events up 10 years therapy. Meta-analyses systematic reviews show consistently modest improvement left ventricle ejection fraction (LVEF) reduction (LV) remodeling MI An ultimate goal all innovative therapies is not only improve symptoms demonstrate efficacy respect surrogate end-points, but also survival. So far study had statistical power evaluate on mortality, cardiovascular (CV) mortality MI, which common limitation small-sized should be further according evidence-based medicine (EBM) any other therapeutic innovation.