An innovative treatment for cardiac failure: Autologous stem cell transplantation

Gloria Invernici, Silvia Cristini, Stefania Navone, Laura Canzi, Eugenio A. Parati

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Heart failure results from the inability of the heart to pump enough blood to maintain physiological functions. It is one of the most common cardiovascular disorders in the world. In the final stage of heart failure, heart transplantation is the elective treatment. However, the availability of donor organs and immunological rejection limit this choise. Although immunosuppression agents can prevent rejection, they are associated with several complications including wound healing, opportunistic infections, drug-related toxicities, skin malignancies and low-grade lymphomas. Thus, current treatment is far from adequate. The most promising future treatment option is stem cell transplantation therapy for the repair of the damaged myocardium. This is based on the principle of enhancing the insufficient intrinsic repair mechanisms of the damaged heart and the employment of either fetal or post-natal stem cells. The discovery of pluripotent stem cells with their ability to repair adult tissue has prompted novel research into repair of the heart and blood vessels. This finding offers immense therapeutic possibilities but also problems that have never been encountered before. The use of stem cells for treatment of the heart, because of its simplicity in function and accessibility, is more advanced than in other organs. The initial report of an improvement in cardiac function in a mouse model of myocardial infarction treated with bone-marrow-derived progenitor cells led to a series of clinical studies in human beings. However, the significance of the results still remains unclear. In this context, human adult skeletal muscle stem cells represent an important and alternative source for cell therapy since they can be obtained easily from a small muscle biopsy and allow autologous transplantation. The pre-differentiating treatment is aimed to avoid side-effects which have been observed with undifferentiated myoblasts or embryonic stem cells transplantation. This source of stem cells could represent a new source for heart failure cell therapy. Skeletal muscle stem cells (SkmSCs), differentiated under GMP (Good Manufactory Practice) conditions, in the future could be injected into patients with acute myocardial infarction. The route of delivery of these stem cells could vary and include intracoronary, percutaneous intramyocardial or direct intramyocardial at the time of coronary artery bypass grafting. First protocols to amplify in vitro the SkmSCs population, and to drive their differentiation toward cardiomyogenic lineage must be optimized. Then Skm stem cells transplantation can be considered.

Original languageEnglish
Title of host publicationHeart Transplantation: Indications and Contraindications, Procedures and Complications
PublisherNova Science Publishers, Inc.
Pages143-205
Number of pages63
ISBN (Print)9781607412281
Publication statusPublished - Jan 2011

ASJC Scopus subject areas

  • Medicine(all)

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