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(Circulation Research. 2007;100:1101.)
© 2007 American Heart Association, Inc.

Editorials

Patient and Cellular Characteristics Determine Efficacy of Cell Therapy

Marc S. Penn

From the Department of Cell Biologyl Department of Cardiovascular Medicine; Department of Biomedical Engineering; Cleveland Clinic Foundation, Cleveland, Ohio.

Correspondence to Marc S. Penn, MD, PhD, Director, Bakken Heart-Brain Institute, Departments of Cardiovascular Medicine and Cell Biology, NE3, 9500 Euclid Avenue, Cleveland, OH 44195. E-mail pennm@ccf.org

See related article, pages 1234–1241

Key Words: chronic heart failure • stem cells • biomarkers

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Recent clinical trials have demonstrated the safety and potential benefits of the stem cell based therapies for the preservation and treatment of cardiac dysfunction following acute myocardial infarction.^1,2 More recently Assmus and colleagues published the TOPCARE-CHD trial in which they compared the effects of infusing circulating progenitor cells to bone marrow mononuclear cells in patients at a time remote from acute myocardial infarction (average time from AMI to infusion, 6 to7 years).³ Using a crossover clinical trial design that study demonstrated that circulating progenitor cells offered no benefit, where as infusion of whole bone marrow mononuclear cells resulted in an increase of 2.9% in the ejection fraction compared with a loss of 1.2% in control patients.³ The observation that circulating progenitor cells and bone marrow mononuclear cells lead to improved function in acute myocardial infarction,⁴ but only bone marrow derived progenitor cells led to improvement at times significantly remote from AMI suggest that different cell populations or delivery strategies may be efficacious in one setting but not another. For example, CD34⁺ cells are present in both circulating progenitor cells and whole bone marrow mononuclear preparations, mesenchymal stem cells are only present in the bone derived progenitor cell preparations.

Similarly, the literature to date has demonstrated critical differences between myocardial tissue immediately after and that at times remote from an acute ischemic event with respect to the expression of stem cell homing factors, inflammatory infiltrates and putative differentiation factors.^5,6,7 Thus, although CD34⁺ cells may be able to home to myocardial tissue . . . [Full Text of this Article]

Related Article:

Transcoronary Transplantation of Functionally Competent BMCs Is Associated With a Decrease in Natriuretic Peptide Serum Levels and Improved Survival of Patients With Chronic Postinfarction Heart Failure: Results of the TOPCARE-CHD Registry

Birgit Assmus, Ulrich Fischer-Rasokat, Jörg Honold, Florian H. Seeger, Stephan Fichtlscherer, Torsten Tonn, Erhard Seifried, Volker Schächinger, Stefanie Dimmeler, and Andreas M. Zeiher
Circ. Res. 2007 100: 1234-1241. [Abstract] [Full Text] [PDF]

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