Stem cell therapy for cardiac regeneration: past, present, and future

Mesenchymal Stem Cell Therapy for Acute Myocardial Infarction: Protocol for a Systematic Review and Meta-Analysis

BACKGROUND

Medical therapy and interventional approaches have improved outcomes in patients with acute myocardial infarction (MI). However, these strategies are inadequate for replacing cells lost during tissue ischemia, thereby leaving behind noncontractile scar tissue. The anti-inflammatory and immune modulating properties of mesenchymal stem cells (MSCs) may prove useful in inducing functional cardiac regeneration following acute MI.

OBJECTIVE

This is a protocol for systematic review and meta-analysis that will aggregate and synthesize high-level clinical data on the effects of MSC therapy for acute MI. The findings of this study may serve as evidence for clinicians and researchers in guiding the use of MSC therapy as an adjunct to reperfusion and optimal medical therapy in patients with acute MI.

METHODS

The proposed systematic review is registered with PROSPERO (International Prospective Register of Systematic Reviews). A systematic search of bibliographical databases, including Embase, PubMed, and Cochrane was conducted from inception to June 2023 to identify English-language human studies with adult patients receiving MSC therapy and optimal medical therapy for acute MI in comparison with respective controls. Article screening was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data on functional cardiac outcomes and major adverse cardiac events were extracted and analyzed as primary outcomes.

RESULTS

Literature search and article screening commenced in June 2023. Data extraction and analysis will be completed by October 2024. The findings will be synthesized and reported by the end of November 2024.

CONCLUSIONS

This systematic review and meta-analysis will summarize the best available updated evidence from published randomized controlled trials on the effects of MSC therapy for the treatment of acute MI. The findings of this systematic review and meta-analysis may shed light on the efficacy of MSC therapy in improving cardiac functional and structural parameters and reducing adverse cardiac events following acute MI.

TRIAL REGISTRATION

PROSPERO CRD42024522398; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=522398.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/60591.

Human platelet lysate combined with mesenchymal stem cells pretreated with platelet lysate improved cardiac function in rats with myocardial infarction

Myocardial infarction (MI) is a leading cause of heart failure, disability and mortality worldwide. In this study, the effects of intramyocardial injection of human platelet lysate (HPL), bone marrow mesenchymal stem cells pretreated with HPL (PMSCs), and PMSC lysate (lys), alone and in combination were investigated on MI-induced by LAD ligation in male Wistar rats. The experiment was carried out on sham, vehicle (Veh), HPL, PMSCs, PMSC lysate (PMSC lys), HPL + PMSCs, and HPL + PMSC lys groups. SBP, DBP, and ± dp/dt max were monitored by the PowerLab physiograph. The MSC characteristics and CD31, NKX2.5, and cardiac troponin I (cTnI) contents were determined by flow cytometry, immunohistochemistry, and immunofluorescence, respectively. SBP, DBP, and ± dp/dt max that decreased in the MI group were recovered by HPL, PMSC, PMSC lys, HPL + PMSC, and HPL + PMSC lys treatments. CD31 density was higher in all treated groups compared to the Veh group. CD31 density in the HPL + PMSCs and HPL + PMSC lys groups was higher than in the PMSCs group. The number of Dil+/NKX2.5 + and Dil+/cTnI + cells was higher in the HPL + PMSCs group compared to the PMSCs group. The HPL and PMSCs mitigates heart injuries and cardiac dysfunction after MI. HPL provides an appropriate environment for cardiomyocyte differentiation from PMSCs.

Unraveling the interplay between inflammation and stem cell mobilization or homing: Implications for tissue repair and therapeutics

Inflammation and stem cell mobilization or homing play pivotal roles in tissue repair and regeneration. This review explores their intricate interplay, elucidating their collaborative role in maintaining tissue homeostasis and responding to injury or disease. While examining the fundamentals of stem cells, we detail the mechanisms underlying inflammation, including immune cell recruitment and inflammatory mediator release, highlighting their self-renewal and differentiation capabilities. Central to our exploration is the modulation of hematopoietic stem cell behavior by inflammatory cues, driving their mobilization from the bone marrow niche into circulation. Key cytokines, chemokines, growth factors, and autophagy, an intracellular catabolic mechanism involved in this process, are discussed alongside their clinical relevance. Furthermore, mesenchymal stem cell homing in response to inflammation contributes to tissue repair processes. In addition, we discuss stem cell resilience in the face of inflammatory challenges. Moreover, we examine the reciprocal influence of stem cells on the inflammatory milieu, shaping immune responses and tissue repair. We underscore the potential of targeting inflammation-induced stem cell mobilization for regenerative therapies through extensive literature analysis and clinical insights. By unraveling the complex interplay between inflammation and stem cells, this review advances our understanding of tissue repair mechanisms and offers promising avenues for clinical translation in regenerative medicine.

Interleukin 10: Bridging the chasms in the immune landscape of multiple myeloma

Multiple myeloma (MM) is a complex hematologic malignancy characterized by the abnormal proliferation of plasma cells in the bone marrow, leading to significant clinical challenges and a high burden of morbidity and mortality. Interleukin 10 (IL-10), a cytokine with potent anti-inflammatory properties, has emerged as a critical player in the pathobiology of MM. This work delves into the multifaceted role of IL-10 in MM, exploring its contributions to tumor growth, immune evasion, and drug resistance. Here, we examine IL-10's interactions with various immune cells within the bone marrow microenvironment and its potential as a circulatory biomarker for MM. Furthermore, we particularly lay emphasis on the prognostic and diagnostic implications of IL-10 levels in MM patients and evaluate the therapeutic prospects of targeting IL-10 in MM treatment regimens. By synthesizing current research, this review aims to enhance the understanding of IL-10 as a circulatory biomarker in MM and to highlight novel avenues for therapeutic intervention, thereby translating to improved clinical outcomes for MM patient.

Toward the latest advancements in cardiac regeneration using induced pluripotent stem cells (iPSCs) technology: approaches and challenges

A novel approach to treating heart failures was developed with the introduction of iPSC technology. Knowledge in regenerative medicine, developmental biology, and the identification of illnesses at the cellular level has exploded since the discovery of iPSCs. One of the most frequent causes of mortality associated with cardiovascular disease is the loss of cardiomyocytes (CMs), followed by heart failure. A possible treatment for heart failure involves restoring cardiac function and replacing damaged tissue with healthy, regenerated CMs. Significant strides in stem cell biology during the last ten years have transformed the in vitro study of human illness and enhanced our knowledge of the molecular pathways underlying human disease, regenerative medicine, and drug development. We seek to examine iPSC advancements in disease modeling, drug discovery, iPSC-Based cell treatments, and purification methods in this article.

To Repair a Broken Heart: Stem Cells in Ischemic Heart Disease

Despite improvements in contemporary medical and surgical therapies, cardiovascular disease (CVD) remains a significant cause of worldwide morbidity and mortality; more specifically, ischemic heart disease (IHD) may affect individuals as young as 20 years old. Typically managed with guideline-directed medical therapy, interventional or surgical methods, the incurred cardiomyocyte loss is not always completely reversible; however, recent research into various stem cell (SC) populations has highlighted their potential for the treatment and perhaps regeneration of injured cardiac tissue, either directly through cellular replacement or indirectly through local paracrine effects. Different stem cell (SC) types have been employed in studies of infarcted myocardium, both in animal models of myocardial infarction (MI) as well as in clinical studies of MI patients, including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), Muse cells, multipotent stem cells such as bone marrow-derived cells, mesenchymal stem cells (MSCs) and cardiac stem and progenitor cells (CSC/CPCs). These have been delivered as is, in the form of cell therapies, or have been used to generate tissue-engineered (TE) constructs with variable results. In this text, we sought to perform a narrative review of experimental and clinical studies employing various stem cells (SC) for the treatment of infarcted myocardium within the last two decades, with an emphasis on therapies administered through thoracic incision or through percutaneous coronary interventions (PCI), to elucidate possible mechanisms of action and therapeutic effects of such cell therapies when employed in a surgical or interventional manner.