Stem Cell Research in Cardiovascular System / 대한해부학회지

ABSTRACT

Myocardial infarction leads to loss of tissue and impairment of cardiac performance. Because cardiomyocytes have a limited ability to self-renewal, and thus the transplantation of adult stem cells into infarcted region is a promising therapy to regenerate damaged cardiac tissue. Stem cells for myocardial regeneration are mesenchymal- and hematopoietic stem cells derived from bone marrow, or skeletal myoblasts in animals, and these stem cells generated cardiomyocytes and endothelial cells in the infarcted regions, and improved cardiac function. Clinical data showed that autologous mesenchymal stem cells and skeletal myoblasts increased ejection fraction and blood flow, and decreased infarct size in patients. Some researchers have used a different strategy that cytokine-mobilized bone marrow cells or angioblasts homed to the infarcted region, replicated, differentiated, and improved cardiac function. The current trend is the combined use of cytokine treatment and cell transplantation to increase the efficiency of myocardial regeneration. In addition, genetic manipulation of adult stem cells has been done to express cardioprotective recombinant proteins, or enhance angiogenesis in animal study. Thus cellular transplantation, cytokine induction and gene therapy should not be viewed as competitive but rather as complementary with the common and final goal of improving the outcome of heart failure patients. In this review, we will discuss about studies for myocardial repair in animal and in patients.