101
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Building a better bridge: Remodeling, recovery, and a better understanding of the biologic foundation of mechanical circulatory support. J Thorac Cardiovasc Surg 2015; 150:1342-3. [PMID: 26546204 DOI: 10.1016/j.jtcvs.2015.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 09/08/2015] [Accepted: 09/09/2015] [Indexed: 11/21/2022]
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102
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Padda J, Sequiera GL, Sareen N, Dhingra S. Stem cell therapy for cardiac regeneration: hits and misses. Can J Physiol Pharmacol 2015; 93:835-41. [DOI: 10.1139/cjpp-2014-0468] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cardiac injury and loss of cardiomyocytes is a causative as well as a resultant condition of cardiovascular disorders, which are the leading cause of death throughout the world. This loss of cardiomyocytes cannot be completely addressed through the currently available drugs being administered, which mainly function only in relieving the symptoms. There is a huge potential being investigated for regenerative and cell replacement therapies through recruiting stem cells of various origins namely embryonic, reprogramming/induction, and adult tissue. These sources are being actively studied for translation to clinical scenarios. In this review, we attempt to discuss some of these promising scenarios, including the clinical trials and the obstacles that need to be overcome, and hope to address the direction in which stem cell therapy is heading.
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Affiliation(s)
- Jagjit Padda
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
| | - Glen Lester Sequiera
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
| | - Niketa Sareen
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
| | - Sanjiv Dhingra
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Regenerative Medicine Program, College of Medicine, Faculty of Health Sciences, University of Manitoba, R 3028-2, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
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103
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Snow-Lisy DC, Diaz EC, Bury MI, Fuller NJ, Hannick JH, Ahmad N, Sharma AK. The Role of Genetically Modified Mesenchymal Stem Cells in Urinary Bladder Regeneration. PLoS One 2015; 10:e0138643. [PMID: 26398705 PMCID: PMC4580420 DOI: 10.1371/journal.pone.0138643] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/03/2015] [Indexed: 01/01/2023] Open
Abstract
Recent studies have demonstrated that mesenchymal stem cells (MSCs) combined with CD34+ hematopoietic/stem progenitor cells (HSPCs) can function as surrogate urinary bladder cells to synergistically promote multi-faceted bladder tissue regeneration. However, the molecular pathways governing these events are unknown. The pleiotropic effects of Wnt5a and Cyr61 are known to affect aspects of hematopoiesis, angiogenesis, and muscle and nerve regeneration. Within this study, the effects of Cyr61 and Wnt5a on bladder tissue regeneration were evaluated by grafting scaffolds containing modified human bone marrow derived MSCs. These cell lines were engineered to independently over-express Wnt5a or Cyr61, or to exhibit reduced expression of Cyr61 within the context of a nude rat bladder augmentation model. At 4 weeks post-surgery, data demonstrated increased vessel number (~250 vs ~109 vessels/mm2) and bladder smooth muscle content (~42% vs ~36%) in Cyr61OX (over-expressing) vs Cyr61KD (knock-down) groups. Muscle content decreased to ~25% at 10 weeks in Cyr61KD groups. Wnt5aOX resulted in high numbers of vessels and muscle content (~206 vessels/mm2 and ~51%, respectively) at 4 weeks. Over-expressing cell constructs resulted in peripheral nerve regeneration while Cyr61KD animals were devoid of peripheral nerve regeneration at 4 weeks. At 10 weeks post-grafting, peripheral nerve regeneration was at a minimal level for both Cyr61OX and Wnt5aOX cell lines. Blood vessel and bladder functionality were evident at both time-points in all animals. Results from this study indicate that MSC-based Cyr61OX and Wnt5aOX cell lines play pivotal roles with regards to increasing the levels of functional vasculature, influencing muscle regeneration, and the regeneration of peripheral nerves in a model of bladder augmentation. Wnt5aOX constructs closely approximated the outcomes previously observed with the co-transplantation of MSCs with CD34+ HSPCs and may be specifically targeted as an alternate means to achieve functional bladder regeneration.
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Affiliation(s)
- Devon C. Snow-Lisy
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, United States of America
| | - Edward C. Diaz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, United States of America
| | - Matthew I. Bury
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, United States of America
| | - Natalie J. Fuller
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, United States of America
| | - Jessica H. Hannick
- Department of Urology, Loyola University Health System, Maywood, IL, United States of America
| | - Nida Ahmad
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, United States of America
| | - Arun K. Sharma
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, United States of America
- Northwestern University Feinberg School of Medicine, Department of Urology, Chicago, IL, United States of America
- Northwestern University, Simpson Querrey Institute for BioNanotechnology, Chicago, IL, United States of America
- Northwestern University, Department of Biomedical Engineering, Evanston, IL, United States of America
- * E-mail:
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104
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Affiliation(s)
- Stephen Farris
- From the Department of Medicine, Division of Cardiology (S.F., A.S.-O.), and Institute for Stem Cell and Regenerative Medicine (A.S.-O.), University of Washington School of Medicine, Seattle.
| | - April Stempien-Otero
- From the Department of Medicine, Division of Cardiology (S.F., A.S.-O.), and Institute for Stem Cell and Regenerative Medicine (A.S.-O.), University of Washington School of Medicine, Seattle
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105
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Left Ventricular Assist Devices: The Adolescence of a Disruptive Technology. J Card Fail 2015; 21:824-34. [PMID: 26318347 DOI: 10.1016/j.cardfail.2015.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 11/21/2022]
Abstract
Clinical outcomes for patients with advanced heart failure receiving left ventricular assist devices are driven by appropriate patient selection, refined surgical technique, and coordinated medical care. Perhaps even more important is innovative pump design. The introduction and widespread adoption of continuous-flow ventricular assist devices has led to a paradigm shift within the field of mechanical circulatory support, making the promise of lifetime device therapy closer to reality. The disruption caused by this new technology, on the one hand, produced meaningful improvements in patient survival and quality of life, but also introduced new clinical challenges, such as bleeding, pump thrombosis, and acquired valvular heart disease. Further evolution within this field will require financial investment to sustain innovation leading to a fully implantable, durable, and cost-effective pump for a larger segment of patients with advanced heart failure.
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106
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Left Ventricular Assist Devices: A Rapidly Evolving Alternative to Transplant. J Am Coll Cardiol 2015; 65:2542-55. [PMID: 26065994 DOI: 10.1016/j.jacc.2015.04.039] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 04/23/2015] [Accepted: 04/24/2015] [Indexed: 01/17/2023]
Abstract
Left ventricular assist devices are becoming an increasingly prevalent therapy for patients with Stage D heart failure with reduced ejection fraction. Technological advances have improved the durability of these devices and have significantly lengthened survival in these patients. Quality of life is also improved, although adverse events related to device therapy remain common. Nevertheless, with the continuing organ donor shortage for cardiac transplantation, left ventricular assist devices are frequently serving as a substitute for transplant, particularly in the elderly patient.
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107
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Comparison of adipose tissue- and bone marrow- derived mesenchymal stem cells for alleviating doxorubicin-induced cardiac dysfunction in diabetic rats. Stem Cell Res Ther 2015; 6:148. [PMID: 26296856 PMCID: PMC4546321 DOI: 10.1186/s13287-015-0142-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 04/23/2015] [Accepted: 08/03/2015] [Indexed: 01/22/2023] Open
Abstract
Introduction Doxorubicin (DOX) is a well-known anticancer drug. However its clinical use has been limited due to cardiotoxic effects. One of the major concerns with DOX therapy is its toxicity in patients who are frail, particularly diabetics. Several studies suggest that mesenchymal stem cells (MSCs) have the potential to restore cardiac function after DOX-induced injury. However, limited data are available on the effects of MSC therapy on DOX-induced cardiac dysfunction in diabetics. Our objective was to test the efficacy of bone marrow-derived (BM-MSCs) and adipose-derived MSCs (AT-MSCs) from age-matched humans in a non-immune compromised rat model. Methods Diabetes mellitus was induced in rats by streptozotocin injection (STZ, 65 mg/kg b.w, i.p.). Diabetic rats were treated with DOX (doxorubicin hydrochloride, 2.5 mg/kg b.w, i.p) 3 times/wk for 2 weeks (DOX group); or with DOX+ GFP labelled BM-MSCs (2x106cells, i.v.) or with DOX + GFP labelled AT-MSCs (2x106cells, i.v.). Echocardiography and Langendorff perfusion analyses were carried out to determine the heart function. Immunostaining and western blot analysis of the heart tissue was carried out for CD31 and to assess inflammation and fibrosis. Statistical analysis was carried out using SPSS and data are expressed as mean ± SD. Results Glucose levels in the STZ treated groups were significantly greater than control group. After 4 weeks of intravenous injection, the presence of injected MSCs in the heart was confirmed through fluorescent microscopy and real time PCR for ALU transcripts. Both BM-MSCs and AT-MSCs injection prevented DOX-induced deterioration of %FS, LVDP, dp/dt max and rate pressure product. Staining for CD31 showed a significant increase in the number of capillaries in BM-MSCs and AT-MSCs treated animals in comparison to DOX treated group. Assessment of the inflammation and fibrosis revealed a marked reduction in the DOX-induced increase in immune cell infiltration, collagen deposition and αSMA in the BM-MSCs and AT-MSCs groups. Conclusions In conclusion BM-MSCs and AT-MSCs were equally effective in mitigating DOX-induced cardiac damage by promoting angiogenesis, decreasing the infiltration of immune cells and collagen deposition. Electronic supplementary material The online version of this article (doi:10.1186/s13287-015-0142-x) contains supplementary material, which is available to authorized users.
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108
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Mesenchymal stromal cell therapy: different sources exhibit different immunobiological properties. Transplantation 2015; 99:1113-8. [PMID: 26035274 DOI: 10.1097/tp.0000000000000734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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109
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Sunagawa G, Byram N, Karimov JH, Horvath DJ, Moazami N, Starling RC, Fukamachi K. In vitro hemodynamic characterization of HeartMate II at 6000 rpm: Implications for weaning and recovery. J Thorac Cardiovasc Surg 2015. [DOI: 10.1016/j.jtcvs.2015.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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110
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Percutaneous Fluoroscopic-Guided Endomyocardial Delivery in an Experimental Model of Left Ventricular Assist Device Support. J Cardiovasc Transl Res 2015; 8:381-4. [PMID: 26149227 DOI: 10.1007/s12265-015-9642-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/15/2015] [Indexed: 10/23/2022]
Abstract
Endomyocardial delivery in the setting of active left ventricular assist device (LVAD) support has rarely been studied. The objective was to establish a protocol for endomyocardial injections during LVAD support without compromising mechanical circulation. LVAD implantation was performed in four pigs. A curved needle catheter was percutaneously inserted into the right carotid artery and positioned into the left ventricle under fluoroscopic guidance. In the setting of increasing LVAD flows (2.3-3.1 l/min), percutaneous methylene blue dye administration into the myocardium proceeded without complications in all pigs. Transection of excised hearts revealed an anterior, lateral, inferior, and septal wall distribution of methylene blue documenting injections in all four regions of the left ventricle. Ex vivo, the catheter could be maneuvered close to the LVAD inflow cannula despite augmentation of LVAD flow up to 5 l/min. Endomyocardial injections during LVAD support was found to be feasible and safe with the curved needle catheter.
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111
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Abstract
Despite substantial clinical advances over the past 65 years, cardiovascular disease remains the leading cause of death in America. The past 15 years has witnessed major basic and translational interest in the use of stem and precursor cells as a therapeutic agent for chronically injured organs. Among the cell types under investigation, adult mesenchymal stem cells are widely studied, and in early stage, clinical studies show promise for repair and regeneration of cardiac tissues. The ability of mesenchymal stem cells to differentiate into mesoderm- and nonmesoderm-derived tissues, their immunomodulatory effects, their availability, and their key role in maintaining and replenishing endogenous stem cell niches have rendered them one of the most heavily investigated and clinically tested type of stem cell. Accumulating data from preclinical and early phase clinical trials document their safety when delivered as either autologous or allogeneic forms in a range of cardiovascular diseases, but also importantly define parameters of clinical efficacy that justify further investigation in larger clinical trials. Here, we review the biology of mesenchymal stem cells, their interaction with endogenous molecular and cellular pathways, and their modulation of immune responses. Additionally, we discuss factors that enhance their proliferative and regenerative ability and factors that may hinder their effectiveness in the clinical setting.
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Affiliation(s)
- Vasileios Karantalis
- From the University of Miami Miller School of Medicine, Interdisciplinary Stem Cell Institute, FL
| | - Joshua M Hare
- From the University of Miami Miller School of Medicine, Interdisciplinary Stem Cell Institute, FL.
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112
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Of mice and men: the best laid scheme? J Am Coll Cardiol 2015; 65:1435-7. [PMID: 25857909 DOI: 10.1016/j.jacc.2015.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 02/22/2015] [Indexed: 11/21/2022]
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113
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Tseng CCS, Ramjankhan FZ, de Jonge N, Chamuleau SAJ. Advanced Strategies for End-Stage Heart Failure: Combining Regenerative Approaches with LVAD, a New Horizon? Front Surg 2015; 2:10. [PMID: 25905105 PMCID: PMC4387859 DOI: 10.3389/fsurg.2015.00010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 03/07/2015] [Indexed: 12/15/2022] Open
Abstract
Despite the improved treatment of cardiovascular diseases, the population with end-stage heart failure (HF) is progressively growing. The scarcity of the gold standard therapy, heart transplantation, demands novel therapeutic approaches. For patients awaiting transplantation, ventricular-assist devices have been of great benefit on survival. To allow explantation of the assist device and obviate heart transplantation, sufficient and durable myocardial recovery is necessary. However, explant rates so far are low. Combining mechanical circulatory support with regenerative therapies such as cell (-based) therapy and biomaterials might give rise to improved long-term results. Although synergistic effects are suggested with mechanical support and stem cell therapy, evidence in both preclinical and clinical setting is lacking. This review focuses on advanced and innovative strategies for the treatment of end-stage HF and furthermore appraises clinical experience with combined strategies.
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Affiliation(s)
- Cheyenne C S Tseng
- Department of Cardiology, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands ; Interuniversity Cardiology Institute of the Netherlands , Utrecht , Netherlands
| | - Faiz Z Ramjankhan
- Department of Cardio-thoracic Surgery, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands
| | - Nicolaas de Jonge
- Department of Cardiology, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands
| | - Steven A J Chamuleau
- Department of Cardiology, Division Heart and Lungs, University Medical Center , Utrecht , Netherlands
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114
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Affiliation(s)
- Vasileios Karantalis
- From the Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, FL
| | | | - Wayne Balkan
- From the Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, FL
| | - Joshua M Hare
- From the Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, FL.
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115
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Abstract
Heart failure is a global problem with an estimated prevalence of 38 million patients worldwide, a number that is increasing with the ageing of the population. It is the most common diagnosis in patients aged 65 years or older admitted to hospital and in high-income nations. Despite some progress, the prognosis of heart failure is worse than that of most cancers. Because of the seriousness of the condition, a declaration of war on five fronts has been proposed for heart failure. Efforts are underway to treat heart failure by enhancing myofilament sensitivity to Ca(2+); transfer of the gene for SERCA2a, the protein that pumps calcium into the sarcoplasmic reticulum of the cardiomyocyte, seems promising in a phase 2 trial. Several other abnormal calcium-handling proteins in the failing heart are candidates for gene therapy; many short, non-coding RNAs--ie, microRNAs (miRNAs)--block gene expression and protein translation. These molecules are crucial to calcium cycling and ventricular hypertrophy. The actions of miRNAs can be blocked by a new class of drugs, antagomirs, some of which have been shown to improve cardiac function in animal models of heart failure; cell therapy, with autologous bone marrow derived mononuclear cells, or autogenous mesenchymal cells, which can be administered as cryopreserved off the shelf products, seem to be promising in both preclinical and early clinical heart failure trials; and long-term ventricular assistance devices are now used increasingly as a destination therapy in patients with advanced heart failure. In selected patients, left ventricular assistance can lead to myocardial recovery and explantation of the device. The approaches to the treatment of heart failure described, when used alone or in combination, could become important weapons in the war against heart failure.
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Affiliation(s)
- Eugene Braunwald
- TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
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116
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Wang S, Mundada L, Johnson S, Wong J, Witt R, Ohye RG, Si MS. Characterization and angiogenic potential of human neonatal and infant thymus mesenchymal stromal cells. Stem Cells Transl Med 2015; 4:339-50. [PMID: 25713463 DOI: 10.5966/sctm.2014-0240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Resident mesenchymal stromal cells (MSCs) are involved in angiogenesis during thymus regeneration. We have previously shown that MSCs can be isolated from enzymatically digested human neonatal and infant thymus tissue that is normally discarded during pediatric cardiac surgical procedures. In this paper, we demonstrate that thymus MSCs can also be isolated by explant culture of discarded thymus tissue and that these cells share many of the characteristics of bone marrow MSCs. Human neonatal thymus MSCs are clonogenic, demonstrate exponential growth in nearly 30 population doublings, have a characteristic surface marker profile, and express pluripotency genes. Furthermore, thymus MSCs have potent proangiogenic behavior in vitro with sprout formation and angiogenic growth factor production. Thymus MSCs promote neoangiogenesis and cooperate with endothelial cells to form functional human blood vessels in vivo. These characteristics make thymus MSCs a potential candidate for use as an angiogenic cell therapeutic agent and for vascularizing engineered tissues in vitro.
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Affiliation(s)
- Shuyun Wang
- Department of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery and Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA; Department of General Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Lakshmi Mundada
- Department of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery and Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA; Department of General Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sean Johnson
- Department of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery and Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA; Department of General Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Joshua Wong
- Department of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery and Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA; Department of General Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Russell Witt
- Department of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery and Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA; Department of General Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Richard G Ohye
- Department of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery and Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA; Department of General Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ming-Sing Si
- Department of Cardiac Surgery, Section of Pediatric Cardiovascular Surgery and Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA; Department of General Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
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117
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Young PP, Schäfer R. Cell-based therapies for cardiac disease: a cellular therapist's perspective. Transfusion 2015; 55:441-51; quiz 440. [PMID: 25145464 PMCID: PMC5771653 DOI: 10.1111/trf.12826] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/14/2014] [Accepted: 07/14/2014] [Indexed: 12/14/2022]
Abstract
Cell-based therapy is an exciting, promising, and a developing new treatment for cardiac diseases. Stem cell-based therapies have the potential to fundamentally transform the treatment of ischemic cardiac injury and heart failure by achieving what would have been unthinkable only a few years ago-the Holy Grail of myocardial regeneration. Recent therapeutic approaches involve bone marrow (BM)-derived mononuclear cells and their subsets such as mesenchymal stem/stromal cells (MSCs), endothelial progenitor cells as well as adipose tissue-derived MSCs, cardiac tissue-derived stem cells, and cell combinations. Clinical trials employing these cells have demonstrated that cellular therapy is feasible and safe. Regarding delivery methods, the safety of catheter-based, transendocardial and -epicardial stem cell injection has been established. However, the results, while variable, suggest rather modest clinical efficacy overall in both heart failure and ischemic heart disease, such as in acute myocardial infarction. Future studies will focus on determining the most efficacious cell type(s) and/or cell combinations and the most reasonable indications and optimal timing of transplantation, as well as the mechanisms underlying their therapeutic effects. We will review and summarize the clinical trial results to date. In addition, we discuss challenges and operational issues in cell processing for cardiac applications.
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Affiliation(s)
- Pampee P. Young
- Department of Pathology, Microbiology and Immunology, Nashville, Tennessee
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Veterans Affairs, Nashville, Tennessee
| | - Richard Schäfer
- Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Donor Service Baden-Württemberg-Hessen gGmbH, Johann-Wolfgang-Goethe-University Hospital, Frankfurt am Main, Germany
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118
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Anastasiadis K, Antonitsis P, Koletsa T, Kostopoulos I, Westaby S. Evidence for neoangiogenesis in the ischemic human heart after mechanical support and autologous bone marrow stem cell implantation. J Heart Lung Transplant 2015; 34:1208-10. [PMID: 25612861 DOI: 10.1016/j.healun.2014.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 11/04/2014] [Accepted: 11/12/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
| | | | - Triantafyllia Koletsa
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Kostopoulos
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stephen Westaby
- Oxford Heart Centre, The John Radcliffe Hospital, Headington, Oxford, United Kingdom
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119
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Carrier M, Perrault LP. Surgical Treatments for Patients With Terminal Heart Failure: Mechanical Support Compared With Transplantation. Can J Cardiol 2014; 30:S455-8. [DOI: 10.1016/j.cjca.2014.06.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 06/27/2014] [Accepted: 06/28/2014] [Indexed: 12/11/2022] Open
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120
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Squiers JJ, Hutcheson KA, Thatcher JE, DiMaio JM. Cardiac stem cell therapy: checkered past, promising future? J Thorac Cardiovasc Surg 2014; 148:3188-93. [PMID: 25433891 DOI: 10.1016/j.jtcvs.2014.10.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 10/17/2014] [Indexed: 12/29/2022]
Affiliation(s)
- John J Squiers
- University of Texas Southwestern Medical Center, Dallas, Tex
| | | | | | - J Michael DiMaio
- Spectral MD, Dallas, Tex; Baylor University Medical Center, Dallas, Tex.
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121
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Ramakrishna H, Augoustides JGT, Gutsche JT, Stein E, Weiss SJ, Vernick WJ. Incidental tricuspid regurgitation in adult cardiac surgery: focus on current evidence and management options for the perioperative echocardiographer. J Cardiothorac Vasc Anesth 2014; 28:1414-20. [PMID: 25319991 DOI: 10.1053/j.jvca.2014.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Indexed: 11/11/2022]
Affiliation(s)
| | - John G T Augoustides
- Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Jacob T Gutsche
- Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Erica Stein
- Department of Anesthesiology, Ohio State University, Columbus, OH
| | - Stuart J Weiss
- Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - William J Vernick
- Cardiovascular and Thoracic Section, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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