Can the outcomes of mesenchymal stem cell‐based therapy for myocardial infarction be improved? Providing weapons and armour to cells

摘要

Use of mesenchymal stem cell ( ) transplantation after myocardial infarction ( ) has been found to have infarct‐limiting effects in numerous experimental and clinical studies. However, recent meta‐analyses of randomized clinical trials on ‐based therapy have highlighted the need for improving its efficacy. There are two principal approaches for increasing therapeutic effect of s: (i) preventing massive death in ischaemic tissue and (ii) increasing production of cardioreparative growth factors and cytokines with transplanted s. In this review, we aim to integrate our current understanding of genetic approaches that are used for modification of s to enable their improved survival, engraftment, integration, proliferation and differentiation in the ischaemic heart. Genetic modification of s resulting in increased secretion of paracrine factors has also been discussed. In addition, data on preconditioning with physical, chemical and pharmacological factors prior to transplantation are summarized. seeding on three‐dimensional polymeric scaffolds facilitates formation of both intercellular connections and contacts between cells and the extracellular matrix, thereby enhancing cell viability and function. Use of genetic and non‐genetic approaches to modify function holds great promise for regenerative therapy of myocardial ischaemic injury.