Rebuilding the damaged heart: Mesenchymal stem cells, cell-based therapy, and engineered heart tissue

Samuel Golpanian, Ariel Wolf, Konstantinos E. Hatzistergos, Joshua Hare

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Mesenchymal stem cells (MSCs) are broadly distributed cells that retain postnatal capacity for selfrenewal and multilineage differentiation. MSCs evade immune detection, secrete an array of anti-inflammatory and anti-fibrotic mediators, and very importantly activate resident precursors. These properties form the basis for the strategy of clinical application of cell-based therapeutics for inflammatory and fibrotic conditions. In cardiovascular medicine, administration of autologous or allogeneic MSCs in patients with ischemic and nonischemic cardiomyopathy holds significant promise. Numerous preclinical studies of ischemic and nonischemic cardiomyopathy employing MSC-based therapy have demonstrated that the properties of reducing fibrosis, stimulating angiogenesis, and cardiomyogenesis have led to improvements in the structure and function of remodeled ventricles. Further attempts have been made to augment MSCs’ effects through genetic modification and cell preconditioning. Progression of MSC therapy to early clinical trials has supported their role in improving cardiac structure and function, functional capacity, and patient quality of life. Emerging data have supported larger clinical trials that have been either completed or are currently underway. Mechanistically, MSC therapy is thought to benefit the heart by stimulating innate anti-fibrotic and regenerative responses. The mechanisms of action involve paracrine signaling, cell-cell interactions, and fusion with resident cells. Trans-differentiation of MSCs to bona fide cardiomyocytes and coronary vessels is also thought to occur, although at a nonphysiological level. Recently, MSC-based tissue engineering for cardiovascular disease has been examined with quite encouraging results. This review discusses MSCs from their basic biological characteristics to their role as a promising therapeutic strategy for clinical cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)1127-1168
Number of pages42
JournalPhysiological Reviews
Volume96
Issue number3
DOIs
StatePublished - Jul 1 2016

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Cell- and Tissue-Based Therapy
Mesenchymal Stromal Cells
Cardiomyopathies
Cardiovascular Diseases
Paracrine Communication
Clinical Trials
Cell Fusion
Tissue Engineering
Cardiac Myocytes
Cell Communication
Coronary Vessels
Fibrosis
Anti-Inflammatory Agents
Quality of Life
Medicine
Therapeutics

ASJC Scopus subject areas

  • Physiology
  • Medicine(all)
  • Molecular Biology
  • Physiology (medical)

Cite this

Rebuilding the damaged heart : Mesenchymal stem cells, cell-based therapy, and engineered heart tissue. / Golpanian, Samuel; Wolf, Ariel; Hatzistergos, Konstantinos E.; Hare, Joshua.

In: Physiological Reviews, Vol. 96, No. 3, 01.07.2016, p. 1127-1168.

Research output: Contribution to journalArticle

Golpanian, Samuel ; Wolf, Ariel ; Hatzistergos, Konstantinos E. ; Hare, Joshua. / Rebuilding the damaged heart : Mesenchymal stem cells, cell-based therapy, and engineered heart tissue. In: Physiological Reviews. 2016 ; Vol. 96, No. 3. pp. 1127-1168.
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