Allogeneic Mesenchymal Stem Cells and Biomaterials: The Perfect Match for Cardiac Repair?

Abstract

Coronary heart disease is the leading cause of death worldwide with huge socio-economic consequences. Cell therapy, and particularly mesenchymal stem cells (MSC), are considered a promising option to treat this disorder, due to their robust trophic and immunomodulatory properties. However, limitations such as their low rate of engraftment and poor survival after administration into the heart have precluded their large-scale clinical use. Nevertheless, the combination of MSC with polymer-made scaffolds or hydrogels has proven to enhance their retention and, therefore, their efficacy. Additionally, their allogeneic use could permit the creation of ready-to-use cell patches able to improve their feasibility and promote their application in clinical settings. In this review, the experimental and clinical results derived from the use of MSC in cardiac pathology, as well as advances in the bioengineering field to improve the potential of therapeutic cells, are extensively discussed. Additionally, the current understanding of the heart response to the allogeneic MSC transplants is addressed.

Keywords: allogeneic patch; biomaterials; mesenchymal stem cells; myocardial infarction.

Figure 1

Therapeutic benefit of bone marrow and adipose derived mesenchymal stem cells for cardiac therapy (A). Mesenchymal stem cells (MSC) have been applied in combination with biomaterials to enhance their retention in the damaged area. (B) MSC exert a paracrine therapeutic action by secreting growth factors and cytokines to the surrounding environment.

Figure 2

Therapeutic “off-the-shelf” myocardial patches containing stem cells and derived cells and cytokines. MSC: Mesenchymal Stem Cells; SC: Stem Cells; iPSC: induced Pluripotent Stem Cells; ECM: Extracellular Matrix.