Biomedical Engineering Reference
In-Depth Information
Cell Infusion in Patients with Ischemic cardiOmyopathy]), 2009
(CADUCEUS trial [CADUCEUS: CArdiosphere-Derived aUtologous
stem CElls to reverse ventricUlar dySfunction]), and 2011 (TICAP
trial [TICAP: Transcoronary Infusion of Cardiac Progenitor Cells in
Patients with Single Ventricle Physiology]). The SCIPIO trial focuses
on the generation of new cardiomyocytes from autologous CPCs by
intracoronary injection in patients with ischemic cardiomyopathy,
the CADUCEUS trial focuses on the injection of autologous CPCs into
a cardiosphere-derived culture system via intracoronary delivery in
patients having recent AMI and affected by ventricular dysfunction,
the TICAP trial focuses on transcoronary infusion of cardiac CPCs
in patients with hypoplastic left heart syndrome—single-ventricle
heart failure.
3.5
Proposed Mechanisms
Cell transplantation can improve cardiac function after myocardial
infarction. However, it is unclear whether the effect is due to the
production of new cardiomyocytes. There are three main general
mechanisms that may explain cardiac function recovery after stem
cell therapy: (1) angiogenesis and release of factors that improve
the function of existing cells, (2) direct effect with differentiation
of administered cells into cellular constituents of the heart
(cardiomyocytes, conduction system cells, endothelial cells, and
cardiac fibroblasts), and (3) indirect effect of administered cells by
promoting endogenous heart regeneration thought activation of
cardiac niche [53] (Fig. 3.2).
Stem Cell Injection
Cell Homing and Engraftment
Paracrine effects Direct cell differentiation
[Production of growth factors [Cardiomyocytes, endothelial cells,
and cytokines] conduction cells]
Reduction of inflammation
Reduction of apoptosis Cardiac tissue regeneration
Homing of resident stem cells Cardiac function restoration
(From heart or BM)
Figure 3.2
Proposed mechanisms of action of stem/progenitor cells in
heart tissue regeneration.
