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Stem Cells for Cardiac Repair: Status, Mechanisms, and New Strategies

DOI: 10.4061/2011/310928

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Abstract:

Faced with the end stage of heart disease, the current treatments only slow worsening of heart failure. Stem cells have the potential of self-renewal and differentiation. It is expected to replace and repair damaged myocardium. But many clinical trials have shown that the stem cell therapy of heart failure is modest or not effective. The possible causes for the limited effects of stem cell in curing heart failure are the stem cells which have been transplanted into the ischemic heart muscle may suffer low survival rate, affected by inflammatory molecules, proapoptotic factor, and lack of nutrients and oxygen, and then the stem cells which home and have been completely transplanted to the site of myocardial infarction become very small. Therefore, through preconditioning of stem cells and appropriate choice of genes for mesenchymal stem cell modification to improve the survival rate of stem cells, ability in homing and promoting angiogenesis may become the newly effective strategies for the application of stem cells therapy in heart failure. 1. Introduction With the changes in lifestyle and aging of population, the morbidity of hypertension, coronary heart disease, and other common cardiovascular disease has shown a continuous rising tendency. As the end stage of cardiovascular disease, heart failure suffers high morbidity and poor prognosis. Heart failure was mentioned on 277?193 death certificates and was the underlying cause in 56 565 of those deaths in the United States in 2007 [1, 2]. According to a random sampling survey to 15,518 residents aging from 35 to 74 in China in 2003, the prevalence of heart failure was 0.9%. It was lower than developed countries. However, the total prevalence was still up to 4,000,000, and the incidence was increasing ceaselessly [3]. Current drug treatment can only improve symptoms without preventing the ventricular remodeling and the deterioration of progressive heart function. Heart transplantation is an effective means of treating patients with heart failure. But the vast majority of patients are restricted by the age, the donor, surgical complications, medical costs, and so forth. Stem cells are the origin cells of various mature cells. They have the potential of self-renewal and differentiation. Either immediately after isolation or after expansion in vitro, stem cells are transplanted into a specific region of the heart, and ultimately replace, repair the myocardial necrosis or pathological cells; then the aim of curing heart failure can be achieved and it has brought a bright prospect for the treatment of heart

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