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Stem Cells for Cardiovascular Regeneration

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Regenerative Medicine - from Protocol to Patient

Abstract

Ischemic disorders are the main cause of death in the Western world. With more patients surviving their acute myocardial infarction and an aging population, congestive heart failure is the rising health problem. At present, heart transplantation remains the only curative treatment for end stage heart failure. The discrepancy between demand and supply of donor organs does not fill the clinical need. This explains the huge efforts made in the field of stem cell research trying to establish alternative methods for endogenous tissue regeneration and to find sources for tissue replacement. In contrast to adult stem cells mainly acting in a paracrine fashion pluripotent stem cells have the potential to generate transplantable myocardial and vascular tissue.

Due to the low percentage of cardiovascular progenitor cells in pluripotent stem cell cultures, various approaches using exogenous factors aim for their amplification and purification in vitro. However, one future key technology may be genetic forward programming based on profound understanding of differentiation pathways in order to direct stem cell differentiation towards cardiovascular fates. In this regard, subtype specific programming has already been achieved by overexpression of distinct early cardiovascular transcription factors leading to populations of either predominantly early/intermediate type cardiomyocytes or differentiated ventricular myocardial cells, respectively. In addition, techniques for gentle purification of myocardial and vascular progenitor cells will have to be further refined in order to enable the generation of highly specific, pure and safe cell populations for transplantations and for tissue engineering.

In contrast, circulating bone marrow-derived progenitor cells have the potential not to replace diseased cardiovascular tissue but to stimulate its endogenous regeneration. Various approaches have recently been introduced to mobilise these cells from their physiological niche and to facilitate a sufficient recruitment into the diseased tissue. While the therapeutic impact of these cells is already being investigated in clinical trials at present, further methodological refinements may once allow their use in clinical routine.

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Authors and Affiliations

  1. Medical University of Innsbruck, Anichstr 35, 6020, Innsbruck, Austria

    Christoph Brenner & Wolfgang-Michael Franz

  2. Reference and Translation Center for Cardiac Stem Cell Therapy (RTC), University of Rostock, Schillingallee 68, 18057, Rostock, Germany

    Robert David

Authors
  1. Christoph Brenner
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  2. Robert David
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  3. Wolfgang-Michael Franz
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Correspondence to Wolfgang-Michael Franz .

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Editors and Affiliations

  1. Department of Cardiac Surgery and Refere, University of Rostock, Rostock, Mecklenburg-Vorpomm., Germany

    Gustav Steinhoff

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Brenner, C., David, R., Franz, WM. (2016). Stem Cells for Cardiovascular Regeneration. In: Steinhoff, G. (eds) Regenerative Medicine - from Protocol to Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-27610-6_6

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