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2014 ; 21
(14
): 2002-17
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Cardiac stem cells: biology and clinical applications
#MMPMID24597850
Goichberg P
; Chang J
; Liao R
; Leri A
Antioxid Redox Signal
2014[Nov]; 21
(14
): 2002-17
PMID24597850
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SIGNIFICANCE: Heart disease is the primary cause of death in the industrialized
world. Cardiac failure is dictated by an uncompensated reduction in the number of
viable and fully functional cardiomyocytes. While current pharmacological
therapies alleviate the symptoms associated with cardiac deterioration, heart
transplantation remains the only therapy for advanced heart failure. Therefore,
there is a pressing need for novel therapeutic modalities. Cell-based therapies
involving cardiac stem cells (CSCs) constitute a promising emerging approach for
the replenishment of the lost tissue and the restoration of cardiac
contractility. RECENT ADVANCES: CSCs reside in the adult heart and govern
myocardial homeostasis and repair after injury by producing new cardiomyocytes
and vascular structures. In the last decade, different classes of immature cells
expressing distinct stem cell markers have been identified and characterized in
terms of their growth properties, differentiation potential, and regenerative
ability. Phase I clinical trials, employing autologous CSCs in patients with
ischemic cardiomyopathy, are being completed with encouraging results. CRITICAL
ISSUES: Accumulating evidence concerning the role of CSCs in heart regeneration
imposes a reconsideration of the mechanisms of cardiac aging and the etiology of
heart failure. Deciphering the molecular pathways that prevent activation of CSCs
in their environment and understanding the processes that affect CSC survival and
regenerative function with cardiac pathologies, commonly accompanied by
alterations in redox conditions, are of great clinical importance. FUTURE
DIRECTIONS: Further investigations of CSC biology may be translated into highly
effective and novel therapeutic strategies aiming at the enhancement of the
endogenous healing capacity of the diseased heart.
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