Reviews |
From the Center for Cardiovascular Biology (H.R., E.M., W.-Z.Z., M.A.L.), Institute for Stem Cell and Regenerative Medicine; and Departments of Pathology (H.R., W.-Z.Z., M.A.L.) and Medicine/Cardiology (E.M.), University of Washington, Seattle.
Correspondence to Michael A. Laflamme, MD, PhD, Department of Pathology, Center for Cardiovascular Biology, Institute for Stem Cell & Regenerative Medicine, University of Washington, 815 Mercer St, Seattle, WA 98109. E-mail laflamme{at}u.washington.edu
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 [2008;102:1319–1330]
Genetic Enhancement of Stem Cell Engraftment, Survival, and Efficacy [2008;102:1471–1482]
Cardiogenic Differentiation and Transdifferentiation of Progenitor Cells
Paracrine Signaling in Cell Transplantation
Assessment and Optimization of Cell Engraftment After Transplantation
Stem Cell Homing to Sites of Injury
Regulatory Considerations in Cell Transplantation
Eduardo Marbán Editor
In recent years, cell transplantation has drawn tremendous interest as a novel approach to preserving or even restoring contractile function to infarcted hearts. A typical human infarct involves the loss of approximately 1 billion cardiomyocytes, and, therefore, many investigators have sought to identify endogenous or exogenous stem cells with the capacity to differentiate into committed cardiomyocytes and repopulate lost myocardium. As a result of these efforts, dozens of stem cell types have been reported to have cardiac potential. These include pluripotent embryonic stem cells, as well various adult stem cells resident in compartments including bone marrow, peripheral tissues, and the heart itself. Some of these cardiogenic progenitors have been reported to contribute replacement muscle through endogenous reparative processes or via cell transplantation in preclinical cardiac injury models. However, considerable disagreement exists regarding the efficiency and even the reality of cardiac differentiation by many of these stem cell types, making these issues a continuing source of controversy in the field. In this review, we consider approaches to cell fate mapping and establishing the cardiac phenotype, as well as the present state of the evidence for the cardiogenic and regenerative potential of the major candidate stem cell types.
Key Words: stem cell progenitor myogenesis cardiomyocyte myocardial infarct
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