J.Jpn. Surg. Soc.. 113(5): 441-445, 2012

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Feature topic

MYOCARDIAL REGENERATION WITH CELL TRANSPLANTATION THERAPY

Morbidity and mortality in heart failure (HF) remain high in developed countries. Cardiac regenerative therapy with stem cells has the potential to improve the treatment of HF. Several cell sources have been investigated for cardiac cell transplantation therapy. The most representative cell sources are bone marrow stem cells, skeletal myoblasts, and cardiac progenitor cells. Skeletal myoblasts raise the issue of arrhythmogenicity. Regenerative cardiomyocytes derived from human embryonic stem cells (hESCs) or human induced pluripotent stem cells (hiPSCs) are the most promising, because ESCs and iPSCs can potentially generate both contraction recovery and electromechanical coupling with host cardiomyocytes. The functional mechanism of myocardial cell transplantation therapy may be cardiac differentiation, cytokine effects, neovascularization, and intrinsic cardiac progenitor differentiation. It is critical to establish the differentiation protocol from hESCs and hiPSCs to cardiomyocytes. The survival of transplanted cells is also very important. The clinical application of myocardial cell therapy is anxiously awaited for the treatment of HF.

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