doi: 10.1161/CIRCRESAHA.108.175943
© 2008 American Heart Association, Inc.
Reviews |
Aging and Disease as Modifiers of Efficacy of Cell Therapy
From Molecular Cardiology, Department of Internal Medicine III (S.D.), University of Frankfurt, Germany; and the Departments of Anesthesia and Medicine (A.L.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.
Correspondence to Stefanie Dimmeler, PhD, Molecular Cardiology, Department of Internal Medicine III, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. E-mail Dimmeler{at}em.uni-frankfurt.de
This Review is part of a thematic series on Cellular Therapy, which includes the following articles:
The Stem Cell Movement [2008;102:1155–1168]
Aging and Disease as Modifiers of Efficacy of Cell Therapy
Genetic Enhancement of Stem Cell Engraftment, Survival, and Efficacy
Paracrine Signaling in Cell Transplantation
Assessment and Optimization of Cell Engraftment After Transplantation
Immune Biology of Stem Cells
Cardiogenic Differentiation and Transdifferentiation of Stem Cells
Stem Cell Homing to Sites of Injury
Regulatory Considerations in Cell Transplantation
Eduardo Marbán Editor
Cell therapy is a promising option for treating ischemic diseases and heart failure. Adult stem and progenitor cells from various sources have experimentally been shown to augment the functional recovery after ischemia, and clinical trials have confirmed that autologous cell therapy using bone marrow—derived or circulating blood–derived progenitor cells is safe and provides beneficial effects. However, aging and risk factors for coronary artery disease affect the functional activity of the endogenous stem/progenitor cell pools, thereby at least partially limiting the therapeutic potential of the applied cells. In addition, age and disease affect the tissue environment, in which the cells are infused or injected. The present review article will summarize current evidence for cell impairment during aging and disease but also discuss novel approaches how to reverse the dysfunction of cells or to refresh the target tissue. Pretreatment of cells or the target tissue by small molecules, polymers, growth factors, or a combination thereof may provide useful approaches for enhancement of cell therapy for cardiovascular diseases.
Key Words: angiogenesis • diabetes • stem cells
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