Healing the Ischaemic Heart: A Critical Review of Stem Cell Therapies

Rev Cardiovasc Med. 2023 Apr 19;24(4):122. doi: 10.31083/j.rcm2404122. eCollection 2023 Apr.

Abstract

Ischaemic heart disease (IHD) remains the leading cause of mortality worldwide. Current pharmaceutical treatments focus on delaying, rather than preventing disease progression. The only curative treatment available is orthotopic heart transplantation, which is greatly limited by a lack of available donors and the possibility for immune rejection. As a result, novel therapies are consistently being sought to improve the quality and duration of life of those suffering from IHD. Stem cell therapies have garnered attention globally owing to their potential to replace lost cardiac cells, regenerate the ischaemic myocardium and to release protective paracrine factors. Despite recent advances in regenerative cardiology, one of the biggest challenges in the clinical translation of cell-based therapies is determining the most efficacious cell type for repair. Multiple cell types have been investigated in clinical trials; with inconsistent methodologies and isolation protocols making it difficult to draw strong conclusions. This review provides an overview of IHD focusing on pathogenesis and complications, followed by a summary of different stem cells which have been trialled for use in the treatment of IHD, and ends by exploring the known mechanisms by which stem cells mediate their beneficial effects on ischaemic myocardium.

Keywords: adult stem cells; clinical trials; ischaemic heart disease; paracrine mechanisms; pluripotent stem cells; stem cells.

Publication types

  • Review

Grants and funding

This study is supported by a project funded by the Health Research Council of New Zealand to RK (Grant #22/632). DT was supported by the Phyllis Paykel Memorial Scholarship and the Department of Physiology, the University of Otago, during his MBChB/PhD study. AYG was supported by the Otago Medical School Scholarship and the Department of Physiology, the University of Otago, during his BMedSc(Hons) study.