What is the clinical evidence from this study?

Study design: Review. Population: Myocardial infarction. Intervention: Bone marrow mesenchymal stem cells.

November 2, 2017Stem Cell Research & Therapy183 citationsOpen Access

A brief review: the therapeutic potential of bone marrow mesenchymal stem cells in myocardial infarction

MCMiao ChiFourth Affiliated Hospital of China Medical University MLMingming LeiChengdu Sport University WHWeina HuSouth China Agricultural University

Key Result

Bone marrow mesenchymal stem cells show therapeutic potential for myocardial infarction via differentiation and angiogenesis, though poor viability of transplanted cells remains a challenge.

Structured PICO

Does bone marrow mesenchymal stem cell transplantation improve cardiac repair and function in myocardial infarction?

Population

Patients and animal models with myocardial infarction

Intervention

Bone marrow mesenchymal stem cell (BMSC) transplantation

BMSCs show therapeutic potential for myocardial infarction repair through multiple mechanisms, but poor survival of transplanted cells and a lack of human clinical trials remain major hurdles.

Limitations

Reduced viability of transplanted BMSCs due to inadequate blood supply, poor nourishment, and free radicals
Lack of specific surface markers for BMSCs
Potential for spontaneous malignant transformation during long-term expansion
Implanted BMSCs sometimes fail to metabolically stabilize or recover electromechanical function
Lack of large-scale clinical trials in humans
Potential biohazard of spontaneous malignant transformation in long-term expansion
Lack of clinical research in human trials

Abstract

Myocardial infarction (MI) results in dysfunction and irreversible loss of cardiomyocytes and is among the most serious health threats today. Bone marrow mesenchymal stem cells (BMSCs), with their capacity for multidirectional differentiation, low immunogenicity, and high portability, can serve as ideal seed cells in cardiovascular disease therapy. In this review, we examine recent literature concerning the application of BMSCs for the treatment of MI and consider the following aspects: activity of transplanted cells, migration and homing of BMSCs, immunomodulatory and anti-inflammatory effects of BMSCs, anti-fibrotic activity of BMSCs, the role of BMSCs in angiogenesis, and differentiation of BMSCs into cardiomyocyte-like cells and endothelial cells. Each aspect is complementary to the others and together they promote the repair of cardiomyocytes by BMSCs after MI. Although transplantation of BMSCs has enabled new options for MI treatment, the critical issue we must now address is the reduced viability of transplanted BMSCs due to inadequate blood supply, poor nourishment of cells, and generation of free radicals. More clinical trials are needed to prove the therapeutic potential of BMSCs in MI.

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