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J Thorac Cardiovasc Surg 2007;133:599-600
© 2007 The American Association for Thoracic Surgery

Editorial

Bone marrow cell therapy for heart disease: A few good men and women wanted

Shafie Fazel, MD, PhD*

Division of Cardiac Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Received for publication October 1, 2006; revisions received October 14, 2006; accepted for publication October 25, 2006.

* Address for reprints: Shafie Fazel, MD, PhD, 4N-466, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G-2C4. (Email: shafie.fazel@sympatico.ca).

The first 20% of the full text of this article appears below.

GoMore than a decade ago, the concept of cell replacement therapy to treat heart failure was born.1Go The initial framework proposed that if congestive heart failure is caused by the loss of contractile units in the heart, then replacement of contractile units should reverse heart failure. Initially, fetal cardiomyocytes were used, but the implanted cells did not beat with the rest of the cardiomyocytes, and the cells remained functionally isolated. Other muscle cell types, including skeletal myoblasts and smooth muscle cells, also failed to adopt a contractile phenotype. The implantation of these noncontractile units, however, was shown to improve cardiac function. It was argued that the implantation of autologous contractile units would improve cardiac function above and beyond that accomplished with noncontractile cells, and the search began to shift from committed muscle cells to noncommitted stem cells that could potentially be induced to become cardiomyocyte like.

A flurry of activity ensued, and in the rush to discover this new landscape, one is left with the impression that a few tumbled. Although a handful of groups focused on the embryonic stem cells, the majority turned to an autologous source of stem cells to avoid the ethical quagmire that accompanies the use of embryonic stem cells for therapeutic purposes. Scientists knew the bone marrow stem cells well. Reports emerged that hematopoietic stem cells could transdifferentiate into cardiomyocytes. This was convenient because the bone marrow is easy to aspirate, and the stem cells are easy . . . [Full Text of this Article]


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J. Thorac. Cardiovasc. Surg. 2007 133: 717-725. [Abstract] [Full Text] [PDF]





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