Limits...
Challenges for heart disease stem cell therapy.

Hoover-Plow J, Gong Y - Vasc Health Risk Manag (2012)

Bottom Line: Cardiovascular diseases (CVDs) are the leading cause of death worldwide.The use of stem cells to improve recovery of the injured heart after myocardial infarction (MI) is an important emerging therapeutic strategy.This review is an overview of stem cell therapy for CVD and discusses the challenges these three areas present for maximum optimization of the efficacy of stem cell therapy for heart disease, and new strategies in progress.

View Article: PubMed Central - PubMed

Affiliation: Departmentof Cardiovascular Medicine, Joseph J Jacobs Center for Thrombosis and Vascular Biology, Cleveland Clinic Lerner Research Institute, Cleveland, OH 44195, USA. hooverj@ccf.org

ABSTRACT
Cardiovascular diseases (CVDs) are the leading cause of death worldwide. The use of stem cells to improve recovery of the injured heart after myocardial infarction (MI) is an important emerging therapeutic strategy. However, recent reviews of clinical trials of stem cell therapy for MI and ischemic heart disease recovery report that less than half of the trials found only small improvements in cardiac function. In clinical trials, bone marrow, peripheral blood, or umbilical cord blood cells were used as the source of stem cells delivered by intracoronary infusion. Some trials administered only a stem cell mobilizing agent that recruits endogenous sources of stem cells. Important challenges to improve the effectiveness of stem cell therapy for CVD include: (1) improved identification, recruitment, and expansion of autologous stem cells; (2) identification of mobilizing and homing agents that increase recruitment; and (3) development of strategies to improve stem cell survival and engraftment of both endogenous and exogenous sources of stem cells. This review is an overview of stem cell therapy for CVD and discusses the challenges these three areas present for maximum optimization of the efficacy of stem cell therapy for heart disease, and new strategies in progress.

Show MeSH

Related in: MedlinePlus

Types of stem cells in use for heart disease therapy.1–7Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 2011–2012. All Rights Reserved.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3295632&req=5

f1-vhrm-8-099: Types of stem cells in use for heart disease therapy.1–7Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 2011–2012. All Rights Reserved.

Mentions: In the 1960s, Till et al,8 while studying the components responsible for regenerating blood cells, defined two required properties of SCs: (1) self-renewal – the ability to go through numerous cycles of cell division while maintaining the undifferentiated state; and (2) potency – the capacity to differentiate into specialized cell types. SCs are identified by their capacity to form colonies in culture and by cell surface markers that are cell specific. The majority of clinical trials of SC therapy for heart disease have used BM cells, particularly the mononuclear cells (MNCs) (Figure 1). In the ongoing trials listed in Table 1, other types of SCs are being tested, including specific BM, CD34+ or CD133+, and mesenchymal cells. One study tests adipose tissue-derived SCs, and three trials are testing cardiac progenitor/stem cells.


Challenges for heart disease stem cell therapy.

Hoover-Plow J, Gong Y - Vasc Health Risk Manag (2012)

Types of stem cells in use for heart disease therapy.1–7Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 2011–2012. All Rights Reserved.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3295632&req=5

f1-vhrm-8-099: Types of stem cells in use for heart disease therapy.1–7Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 2011–2012. All Rights Reserved.
Mentions: In the 1960s, Till et al,8 while studying the components responsible for regenerating blood cells, defined two required properties of SCs: (1) self-renewal – the ability to go through numerous cycles of cell division while maintaining the undifferentiated state; and (2) potency – the capacity to differentiate into specialized cell types. SCs are identified by their capacity to form colonies in culture and by cell surface markers that are cell specific. The majority of clinical trials of SC therapy for heart disease have used BM cells, particularly the mononuclear cells (MNCs) (Figure 1). In the ongoing trials listed in Table 1, other types of SCs are being tested, including specific BM, CD34+ or CD133+, and mesenchymal cells. One study tests adipose tissue-derived SCs, and three trials are testing cardiac progenitor/stem cells.

Bottom Line: Cardiovascular diseases (CVDs) are the leading cause of death worldwide.The use of stem cells to improve recovery of the injured heart after myocardial infarction (MI) is an important emerging therapeutic strategy.This review is an overview of stem cell therapy for CVD and discusses the challenges these three areas present for maximum optimization of the efficacy of stem cell therapy for heart disease, and new strategies in progress.

View Article: PubMed Central - PubMed

Affiliation: Departmentof Cardiovascular Medicine, Joseph J Jacobs Center for Thrombosis and Vascular Biology, Cleveland Clinic Lerner Research Institute, Cleveland, OH 44195, USA. hooverj@ccf.org

ABSTRACT
Cardiovascular diseases (CVDs) are the leading cause of death worldwide. The use of stem cells to improve recovery of the injured heart after myocardial infarction (MI) is an important emerging therapeutic strategy. However, recent reviews of clinical trials of stem cell therapy for MI and ischemic heart disease recovery report that less than half of the trials found only small improvements in cardiac function. In clinical trials, bone marrow, peripheral blood, or umbilical cord blood cells were used as the source of stem cells delivered by intracoronary infusion. Some trials administered only a stem cell mobilizing agent that recruits endogenous sources of stem cells. Important challenges to improve the effectiveness of stem cell therapy for CVD include: (1) improved identification, recruitment, and expansion of autologous stem cells; (2) identification of mobilizing and homing agents that increase recruitment; and (3) development of strategies to improve stem cell survival and engraftment of both endogenous and exogenous sources of stem cells. This review is an overview of stem cell therapy for CVD and discusses the challenges these three areas present for maximum optimization of the efficacy of stem cell therapy for heart disease, and new strategies in progress.

Show MeSH
Related in: MedlinePlus