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Review Article Open Access
Improvements in the care of patients with cardiovascular disease have led to improved survival but also a burgeoning population of patients with advanced heart disease. Cardiac stem cells (CSC) continue to promise opportunities to repair damaged cardiac tissue. However, precisely how stem cells accomplish cardiac repair, especially after ischemic damage, remains controversial. It has been postulated that the clinical benefit of adult stem cells for cardiovascular disease results from the release of cytokines and growth factors by the transplanted cells, stimulation of new blood vessel growth, enhancing tissue perfusion, and via preservation or even regeneration of myocardial tissue, leading to improvements in cardiac performance after myocardial infarction and in patients with advanced heart failure, reducing inflammation, and scar formation, as well as protecting cardiomyocytes from apoptosis. In addition, reducing fibrosis these factors might also stimulate endogenous repair by activating cardiac stem cells. Interestingly, stem cells discovered to be resident in the heart appear to be functionally superior to extra-cardiac adult stem cells when transplanted for cardiac repair and regeneration. Stem cells are the seeds of tissue repair and regeneration and a promising source for novel therapies. However, apart from hematopoietic stem cell (HSC) transplantation, all other stem cell treatments however remain experimental. Mounting hopes have encouraged numerous clinical trials, but it has been difficult to obtain unequivocal evidence for robust clinical benefit. This review provides a historic framework and an abridgment of how the theories of CSC origin and potential evolved from early times to the present day. The development of more effective cardiac therapies may thus require targeting this important cell population. Here, we summarize and offer some thoughts on the state of the field of cell therapy for ischemic heart diseases and the therapeutic potential of cardiac stem cells.
Cardiovascular disease, Hematopoietic stem cell, Clinical trials, Cardiac therapies, Cardiovascular disease, Hematopoietic stem cell, Clinical trials, Cardiac therapies