Stem Cell Mobilization by Granulocyte Colony-Stimulating Factor for Myocardial Recovery After Acute Myocardial Infarction

Using adult stem cells to treat heart failure--fact or fiction?

Heart failure is a major health problem on a global scale. Current therapies include drug treatments, lifestyle modification, device therapy and heart transplantation. However, the "holy grail" of heart failure treatment would be to achieve widespread regeneration of diseased cardiac tissue. Examples of regeneration of living tissue are present in nature and involve stem cells. The two key defining properties of stem cells are their ability to renew themselves through cell division and to differentiate into various cell types. Generally, stem cells can be classified into embryonic or adult forms. Human adult stem cells are ethically appealing and have already been used in clinical trials in a variety of disease states. Bone marrow derived stem cells, skeletal myoblasts and resident adult cardiac stem cells are being explored as potential cell types for heart failure treatment. These cells can be delivered to the heart via a number of routes. Several clinical trials using adult stem cell have shown improvements in cardiac function, however, the mechanism of their action is unclear and widespread tissue regeneration is not evident. A more comprehensive understanding of regenerative physiology at the "benchside" combined with ongoing investigations at the bedside, will be paramount in achieving the ultimate goal of stem cell treatment-complete regeneration and repair of tissue.

Myocardial repair: from salvage to tissue reconstruction

Cardiac tissue reconstruction following myocardial infarction represents a major challenge in cardiovascular therapy, as current clinical approaches are limited in their ability to regenerate or replace damaged myocardium. Thus, different novel treatments have been introduced aimed at myocardial salvage and repair. Here, we present a review of recent advancements in cardiac cell, gene-based and tissue engineering therapies. Selected strategies in cell therapy and new tools for myocardial gene transfer are summarized. Finally, we consider novel approaches to myocardial tissue engineering as a platform for the integration of various modalities in an attempt to rejuvenate infarcted tissue in vivo.