Adult Stem Cell-Based Therapy for the Heart
This chapter dicusses the regenerative properties of stem cell as a medicine for heart therapy. The ability to mobilize and activate endogenous stem/progenitor cells in diseased organs or to introduce exogenous stem cells for tissue regeneration/repair may impact many diseases, including those affecting the brain, skeletal muscle, pancreas, and heart. Acute myocardial infarction (AMI) is caused by the abrupt closure of a coronary artery due primarily to thrombus formation. The most effective therapy for AMI is represented by timely revascularization of the infarcted-related artery, obtained with thrombolytic agents, percutaneous coronary intervention, or by-pass surgery. With the advent of reperfusion therapies, the institution of intensive care units, the introduction of effective drugs such as beta-blockers and ACE-inhibitors, the occurrence of complications in patients with AMI has been reduced, and life-expectancy improved. Despite all these advances, AMI still produces significant morbidity and mortality, especially in those patients who missed the window of opportunity for timely reperfusion. In patients with large infarcts, ventricular remodeling ensues and often leads to congestive heart failure. Recently, stem cell administration has been under investigation as a possible regenerative or reparative therapy for AMI. This strategy is based on the hypothesis that certain multipotent stem cell types, once injected into the heart, would be able to repopulate the necrotic tissue and differentiate into new cardiomyocytes, thus rescuing contractile function. Stem cell therapy has also been tested in models of chronic myocardial infarction (CMI) and chronic ischemic heart disease. © 2010 Elsevier Inc. All rights reserved.
