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Editorial
. 2017 May 12;120(10):1530-1532.
doi: 10.1161/CIRCRESAHA.117.310954.

Immunomodulation Is the Key to Cardiac Repair

Tariq Hamid  1 , Sumanth D Prabhu  2
Affiliations
Editorial

Immunomodulation Is the Key to Cardiac Repair

Tariq Hamid et al. Circ Res. .
No abstract available

Keywords: Editorials; cell therapy; immunomodulation; inflammation; mesenchymal stem cells; myocardial infarction.

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Figure
Figure
Potential mechanisms underlying the reparative effects of mesenchymal stem cells (MSCs), with the implications of new findings elucidated by the study of Luger et al in blue. MSCs are thought to induce repair predominantly by the secretion of paracrine factors (including those clustered in exosomes) that induce a variety of local effects including the modulation of inflammation, activation of endogenous repair mechanisms, and vascular growth. As cell engraftment rates have been generally been reported to be low, MSC differentiation into cardiomyocytes and other cell types (e.g., endothelial cells [ECs] and vascular smooth muscle cells [VSMCs]) is thought to play a more minor role (dashed arrows). Intravenous delivery of MSCs results in a global distribution of cells that includes the heart, but with the majority of MSCs residing in organs aside from the myocardium. Through as-of-yet poorly defined mechanisms, this produces systemic (and local) immunomodulation and anti-inflammatory responses that in turn augment cardiac repair. Primary targeting of specific pro-inflammatory immune cell subsets, either as an adjunct to MSC therapy or as a stand-alone approach, may further augment systemic anti-inflammatory effects and subsequent cardiac repair.
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