Cellular cardiomyoplasty with autologous skeletal myoblasts for ischemic heart disease and heart failure
Tóm tắt
Cell transplantation to repair or regenerate injured myocardium is a new frontier in the treatment of cardiovascular disease. Even though it is based on many years of pre-clinical studies, much remains to be understood about this methodology, even as it progresses to the clinic. For example, controversies exist over the specific cells to be used, the dosages needed for tissue repair, how cells will affect the electrical activity of the myocardium, and even whether the cells can improve myocardial function after transplantation — all of which are briefly reviewed here. Autologous skeletal myoblasts appear to be the most well studied and best first generation cells for cardiac repair. Yet cardiocytes and, more recently, stem cells have been proposed as cell sources for this technology. Their advantages and limitations are also discussed. Although cellular cardiomyoplasty (cell transplantation for cardiac repair) shows great pre-clinical promise, its future will heavily depend on conducting carefully controlled, randomized clinical trials with appropriate endpoints. Utilizing biologically active cells provides both an opportunity for tissue repair and the potential for not yet understood outcomes. As with any frontier, many pioneers will attempt to conquer it. But also as with any frontier, there are pitfalls and consequences to be considered that may surpass those of previous endeavors. The future thus requires careful consideration and well-designed trials rather than haste. The promise for cell transplantation is too great to be spoiled by ill-designed attempts that forget to account for the biology of both the cells and the myocardium.
Tài liệu tham khảo
Koh GY, Soonpaa MH, Klug MG, Field LJ: Long-term survival of AT-1 cardiomyocyte grafts in syngeneic myocardium. Am J Physiol. 1993, 264: H1727-H1733.
Taylor DA, Atkins BZ, Hungspreugs P, Jones TR, Reedy MC, Hutcheson KA, Glower DD, Kraus WE: Regenerating functional myocardium: improved performance after skeletal myoblast transplantation. Nat Med. 1998, 4: 929-933. 10.1038/2701.
Marelli D, Desrosiers C, El-Alfy M, Kao RL, Chiu RC-J: Cell transplantation for myocardial repair: an experimental approach. Cell Transpl. 1992, 1: 383-390.
Kessler PD, Byrne BJ: Myoblast cell grafting into heart muscle: cellular biology and potential applications. Annu Rev Physiol. 1999, 61: 219-242. 10.1146/annurev.physiol.61.1.219.
Li R, Jia ZQ, Rd W, Merante F, Mickle D: Smooth muscle cell transplantation into myocardial scar tissue improves heart function. J Mol Cell Cardiol. 1999, 31: 513-522. 10.1006/jmcc.1998.0882.
Robinson SW, Cho PW, Levitsky HI, Olson JL, Hruban RH, Acker MA, Kessler PD: Arterial delivery of genetically labelled skeletal myoblasts to the murine heart: long-term survival and phenotypic modification of implanted myoblasts. Cell Transpl. 1996, 5: 77-91. 10.1016/0963-6897(95)02016-0.
Murry CE, Wiseman RW, Schwartz SM, Hauschka SD: Skeletal myoblast transplantation for repair of myocardial necrosis. J Clin Invest. 1996, 98: 2512-2523.
Hutcheson KA, Atkins BZ, Hueman MT, Hopkins MB, Glower DD, Taylor DA: Comparing the benefits of cellular cardiomyoplasty with skeletal myoblasts or dermal fibroblasts on myocardial performance. Cell Transpl. 2000, 9: 359-368.
Li R, Weisel R, Mickle D, Choi A, Yau T: Survival and function of bioengineered cardiac grafts. Circulation. 1999, 100(19 suppl): I63-I69.
Klug MA, Soonpaa MH, Koh GY, Field LJ: Purification of cardiac myocytes differentiated from embryonic stem cells for use in intracardiac grafting. In Tissue Engineering. Edited by Hubbell JA, Reddi HA. Taos, NM: Keystone Symposia;. 1996
Wang J-S, Shum-Tim D, Chedrawy E, Eliopoulis N, Galipeau J, Chiu RC-J: Marrow stromal cells for cellular cardiomyoplasty: the importance of microenvironment for milieu dependent differentiation [abstract]. Circulation. 2000, 102(18 suppl II): II-683.
Orlic D, Kajstura J, Chimenti S, Jakoniuk I, Anderson SM, Li B, Pickel J, McKay R, Nadal-Ginard B, Bodine DM, Leri A, Anversa P: Bone marrow cells regenerate infarcted myocardium. Nature. 2001, 410: 701-705. 10.1086/172787.
Menasche P, Hagege A, Scorsin M, Pouzet B, Desnos M, Duboc D, Schwartz K, Vilquin J, Marroleau J: Myoblast transplantation for heart failure. Lancet. 2001, 357: 279-280. 10.1016/S0140-6736(00)03617-5.
Tremblay JP, Roy B, Goulet M: Human myoblast transplantation: a simple model for tumorigenicity. Neuromusc Disord. 1991, 1: 341-343. 10.1016/0960-8966(91)90120-H.
Field L: Future therapy for cardiovascular disease. In Proceedings of the NHLBI Workshop Cell Transplantation: Future Therapy for Cardiovascular Disease? Columbia, MD;. 1998
Atkins BZ, Hueman MT, Meuchel JM, Cottman MJ, Hutcheson KA, Taylor DA: Myogenic cell transplantation improves in vivo regional performance in infarcted rabbit myocardium. J Heart Lung Transpl. 1999, 18: 1173-1180. 10.1016/S1053-2498(99)00096-0.
Chachques J, Rajnoch C, Berrebi A, Borenstein N, Shen M, Attellis N, Fabiani J, Carpentier A: Cellular therapy reverses myocardial dysfunction. In Proceedings of the American Association for Thoracic Surgery 80th Annual Meeting. 2000
Chiu RC-J, Zibaitis A, Kao RL: Cellular cardiomyoplasty: myocardial regeneration with satellite cell implantation. Ann Thorac Surg. 1995, 60: 12-18. 10.1016/0003-4975(95)00374-T.
Toma C, Pittenger MF, Kessler PD: Adult human mesenchymal stem cells differentiate to a striated muscle phenotype following arterial delivery to the murine heart [abstract]. Circulation. 2000, 102(18 suppl II): II-683.
Bittner RE, Schofer C, Weipoltshammer K, Ivanova S, Streubel B, Hauser E, Freilinger M, Hoger H, Elbe-Burger A, Wachtler F: Recruitment of bone-marrow-derived cells by skeletal and cardiac muscle in adult dystrophic mdx mice. Anat Embryol. 1999, 199: 391-396. 10.1007/s004290050237.
Atkins BZ, Meuchel JM, Glower DD, Taylor DA: Cellular cardiomyoplasty improves diastolic properties of injured heart. J Surg Res. 1999, 85: 234-242. 10.1006/jsre.1999.5681.
Ellis M, Russell S, Taylor D: Translating cell transfer for cardiovascular disease to the bedside: a pre-clinical review and discussion of potential early trials. Cardiac Vasc Regeneration. 2000, 3: 197-203.