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CARDIAC STEM CELLS
LAY REVIEW

 

Heart disease remains the leading cause of death in the United States and Europe (10).  Although there have been significant advances in the diagnosis and treatment of heart disorders, the number of cases and related deaths continues have been increasing (1).  Therefore, the medical and scientific communities are exploring the alternative of utilizing stem cells in cardiac repair.  The discovery of the cardiac stem cell has expanded the potential for clinical utilization of stem cells to regenerate functional myocardial tissue after damage.

The existence of the cardiac stem cell has challenged the traditionally accepted notion that the adult heart is a post-mitotic organ lacking self-renewal properties.  Cardiac stem cells are clonogenic, multipotent, and capable of self-renewal (6). Cardiac stem cells are capable of differentiating into the three cell types that constitute the adult mammalian heart: cardiomyocytes, smooth muscle cells, and endothelial cells (Figure 1) (4).  Cardiac stem cells are identified by the following cell surface markers: c-kit, Sca-1, and MDR1 (4).

The intrinsic properties of cardiac stem cells present them with vast therapeutic potential in clinical settings.  Myocardial infarction results in extensive death of cardiomyocytes, which correlates with potential heart failure and reduced life expectancy (7,9). Following further investigation, cardiac stem cells may play a crucial role in the development of therapeutic approaches to improve damaged and dysfunctional heart tissue following myocardial infarction. 

However, despite the great therapeutic potential of cardiac stem cells, there are many challenges regarding their applications in the clinical setting that must to be addressed.  Therefore, researchers and clinicians must address many concerns and challenges before cardiac stem cells become commonplace in clinical medicine.

References

  1. Boyle AJ, Schulman SP, Hare JM.  Is stem cell therapy ready for patients. Stem cell therapy for cardiac repair. Circulation 2006;114:339-52.
  2. Toma C, Pittenger MF, Cahill KS, Bryne BJ, Kessler PD.  Human mesenchymal stem cells differentiate to a cardiomyocyte phenotype in the adult murine heart. Circulation 2002;93-8.
  3. Kehat I, Kenyagin-Karsenti D, Snir M, Segev H, Amit M, Gepstein A, Livne E, Binah O, Itskovitz-Eldor J, Gepstein L. Human embryonic stem cells can differentiate into myocytes with structural and functional properties of cardiomyocytes. J Clin Invest 2001;107:407-14.
  4. Beltrami AP, Bariucchi L, Torella D, Baker M, Limana F, Chimenti S, Kasahara H, Rota M, Musso E, Urbanek K, Leri A, Kajstura J, Nadal-Ginard B, Anversa P. Adult cardiac stem cells are multipotent and support myocardial regeneration. Cell 2003;114:763-76.
  5. Urbanek K, Quaini F, Tasca G, Torella D, Castaldo C, Nadal-Ginard B, Leri A, Kajstura J, Quaini E, Anversa P. Intense myocyte formation from cardiac stem cells in human cardiac hypertrophy. Proc Natl Acad Sci USA 2003;100:10440-45.
  6. Messina E, De Angelis L, Frati G, Morrone S, Chimenti S, Fiordaliso F, Salio M, Battaglia M, Latronico MVG, Coletta M, Vivarelli E, Frati L, Cossu G, Giacomello A.  Isolation and expansion of adult cardiac stem cells from human and murine heart. Circulation Res 2004;95:911-21.
  7. Min J, Yang Y, Converso KL, Liu L, Huang Q, Morgan JP, Xiao Y.  Transplantation of embryonic stem cells improves cardiac function in postinfarcted rats.  J Applied Physiol 2002;92: 288-96.
  8. Orlic D, Kajstura J, Chimenti S, Limana F, Jakoniuk I, Quaini F, Nadal-Ginard B, Bodine DM, Leri A, Anversa P. Mobilized bone marrow cells repair the infarcted heart, improving function and survival. Proc Natl Aca Sci USA 2001;98:10344-49.
  9. Schachinger V, Dimmeler S, Zeiher AM. Stem cells after myocardial infarction.  Herz 2006;31:127-36.
  10. Oettgen P.  Cardiac stem cell therapy: need for optimization of efficacy and safety monitoring. Circulation 2006;114:353-8.
  11. Martin CM, Meeson AP, Robertson SM, Hawke TJ, Richardson JA, Bates S, Goetsch SC, Gallardo TD, Garry DJ. Persistent expression of the ATP-binding cassette transporter, Abc g2, identifies SP cells in the developing and adult heart. Dev Biol 2003;265:262-75.
  12. Strauer BE, Brehm M, Zeus T, Kostering M, Hernandez A, Sorg RV, Kogler G, Wernet P. Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans. Circulation. 2002;106: 1913-18.
  13. Danalache BA, Paquin J, Wang D, Grygorczyk R, Moore JC, Mummery CL, Gutkowska J, Jankowski M. Nitric oxide signaling in oxytocin-mediated cardiomyogenesis.  Stem Cells 2007;25:679-88.