Injury to the myocardium is a major cause of death, as the human heart has limited capacity of regeneration. Possible approaches to treat heart failure include transplantation of bone marrow or other progenitor cells into the heart. Several types of stem cells have been used so far to repopulate functional myocytes or vascular cells in the damaged myocardium, including endothelial progenitor cells and bone marrow-derived stromal stem cells. Long-term studies with bone marrow-derived cells have however shown that new myocytes do not acquire the adult phenotype. Indeed experimental evidence showed that these cells resemble neonatal cells, which die with time by apoptosis. Furthermore, the bone marrow is not easily accessible, and harvesting of bone marrow determines discomfort to the patient. Recent studies have shown that a population of cells derived from collagenase-digested adipose tissue can be induced to differentiate into multiple cell lineages (including endothelial progenitor cells and cardiomyocytes). These observations have raised the possibility that the adipose tissue stromal stem cells may serve as an alternative, and perhaps preferable, cell source for clinical applications. Recently, the recognition that the adult heart possesses a pool of resident cardiac progenitor cells (CSCs) which are self-renewing, clonogenic and multipotent dictates a different approach, that is boosting regeneration through inducing endogenous cells to differentiate /proliferate in situ to replace lost cardiomyocytes. In this context, a major challenge is represented by the identification of growth factors that selectively promote resident CSCs proliferation, migration and differentiaion, opening great prospects for future stem cell-based tissue engineering.
Stem cells sources for cardiac regeneration: basic principles and route of delivery
Rosalinda Madonna
2015-01-01
Abstract
Injury to the myocardium is a major cause of death, as the human heart has limited capacity of regeneration. Possible approaches to treat heart failure include transplantation of bone marrow or other progenitor cells into the heart. Several types of stem cells have been used so far to repopulate functional myocytes or vascular cells in the damaged myocardium, including endothelial progenitor cells and bone marrow-derived stromal stem cells. Long-term studies with bone marrow-derived cells have however shown that new myocytes do not acquire the adult phenotype. Indeed experimental evidence showed that these cells resemble neonatal cells, which die with time by apoptosis. Furthermore, the bone marrow is not easily accessible, and harvesting of bone marrow determines discomfort to the patient. Recent studies have shown that a population of cells derived from collagenase-digested adipose tissue can be induced to differentiate into multiple cell lineages (including endothelial progenitor cells and cardiomyocytes). These observations have raised the possibility that the adipose tissue stromal stem cells may serve as an alternative, and perhaps preferable, cell source for clinical applications. Recently, the recognition that the adult heart possesses a pool of resident cardiac progenitor cells (CSCs) which are self-renewing, clonogenic and multipotent dictates a different approach, that is boosting regeneration through inducing endogenous cells to differentiate /proliferate in situ to replace lost cardiomyocytes. In this context, a major challenge is represented by the identification of growth factors that selectively promote resident CSCs proliferation, migration and differentiaion, opening great prospects for future stem cell-based tissue engineering.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
