Clinical application and prospect of bone marrow stem cells for myocardial infarction
- VernacularTitle:骨髓干细胞治疗心肌梗死临床应用现状与前景
- Author:
Bei ZHAO
;
Yan WU
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2007;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:At present,application revascularization and drug treatment may arrest aggravation of heart function and arrhythmic development,but effectiveness is limited.Infarcted myocardial cells are still impossible to regenerate.How to make necrotic myocardial cell regeneration and diastolic myocardial function is the problem to solve.OBJECTIVE:To analyze the study progress of bone marrow stem cells in treatment of myocardial infarction.RETRIEVAL STRATEGY:A computerized online database of Pubmed was searched to identify articles published from May 2000 to July 2006 with the key words of "the marrow stem-cell,cell transplant,myocardial infarction" in English.Simultaneously,articles published between October 1997 and December 2006 were identified in China Journal Full-text Database with the same key word in Chinese.Sixty-seven articles were retrieved and data were selected primarily.Inclusive criteria:①articles related to the transplantation of bone marrow stem cells for the treatment of myocardial infarction,②in the same field,articles recently published or in authoritative journals.Exclusive criteria:①articles of repetitive study,and ②Meta analysis.LITERATURE EVALUATION:Articles mainly analyzes the transplantation of stem cells for the treatment of myocardial infarction.Of the 30 included articles,10 were reviews and the rest was clinical or basic studies.DATA SYNTHESIS:①Bone marrow stem cells are composed of bone marrow mononuclear cells,hematopoietic stem cells,bone marrow mesenchymal stem cells,endothelial stem/progenitor cells,multipotent adult progenitor cells and so on.②After the transplantation,bone marrow stem cells can differentiate into myocardiocytes,and do effectively electromechanical coupling with receptors.Bone marrow stem cells can promote the angiogenesis in ischemic region,avoid ethical dispute and immunological rejection,and these cells are easy to collect.Bone marrow stem cells are adult stem cells,and its transdifferentiation deserves further study.Many clinical studies showed that autogeneic bone marrow stem cell transplantation for the treatment of acute myocardial infarction and heart failure could be achieved.③Matrix metalloproteinase,stem cell factor and stromal cell chemokine from bone marrow stem cells play important roles in stem cell mobilization,homing and myocardial repair.Tissue injury and high-level multipotential stem cells are two key factors of the differentiation of bone marrow stem cells in myocardial microenvironment.④ Problems in bone marrow stem cell transplantation included cell type,regulatory mechanism of transdifferentiation,optimal time,manner and safety of transplantation,etc.CONCLUSION:Through establishing complete animal model,the possibility of each technique in clinical procedures is explored.Bone marrow stem cells in treatment of acute myocardial infarction may become a new method,which has different from traditional drug treatment,interventional therapy of cardiovascular disease and surgical intervention.
