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Mesenchymal stem cell therapy: A promising cell‐based therapy for treatment of myocardial infarction
Authors:Ayman El‐Sayed Shafei  Mahmoud Ahmed Ali  Hazem G. Ghanem  Ahmed I. Shehata  Ahmed A. Abdelgawad  Hossam R. Handal  Kareem A. Talaat  Ahmed E. Ashaal  Amal S. El‐Shal
Affiliation:1. Biomedical Research Department, Military Armed Forces College of Medicine, Cairo, Egypt;2. Armed Forces College of Medicine, Cairo, Egypt;3. Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Abstract:For decades, mesenchymal stem (MSCs) cells have been used for cardiovascular diseases as regenerative therapy. This review is an attempt to summarize the types of MSCs involved in myocardial infarction (MI) therapy, as well as its possible mechanisms effects, especially the paracrine one in MI focusing on the studies (human and animal) conducted within the last 10 years. Recently, reports showed that MSC therapy could have infarct‐limiting effects after MI in both experimental and clinical trials. In this context, various types of MSCs can help cardiac regeneration by either revitalizing the cardiac stem cells or revascularizing the arteries and veins of the heart. Furthermore, MSCs could produce paracrine growth factors that increase the survival of nearby cardiomyocytes, as well as increase angiogenesis through recruitment of stem cell from bone marrow or inducing vessel growth from existing capillaries. Recent research suggests that the paracrine effects of MSCs could be mediated by extracellular vesicles including exosomes. Exosomal microRNAs (miRNAs) released by MSCs are promising therapeutic hotspot target for MI. This could be attributed to the role of miRNA in cardiac biology, including cardiac regeneration, stem cell differentiation, apoptosis, neovascularization, cardiac contractility and cardiac remodeling. Furthermore, gene‐modified MSCs could be a recent promising therapy for MI to enhance the paracrine effects of MSCs, including better homing and effective cell targeted tissue regeneration. Although MSC therapy has achieved considerable attention and progress, there are critical challenges that remains to be overcome to achieve the most effective successful cell‐based therapy in MI.
Keywords:cardiac regeneration  exosomes  gene‐modified MSCs  microRNA  mesenchymal stem cells  myocardial infarction  paracrine effects
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