Mesenchymal Stem Cells Therapies on Fibrotic Heart Diseases

Abstract

Stem cell therapy is a promising alternative approach to heart diseases. The most prevalent source of multipotent stem cells, usually called somatic or adult stem cells (mesenchymal stromal/stem cells, MSCs) used in clinical trials is bone marrow (BM-MSCs), adipose tissue (AT-MSCs), umbilical cord (UC-MSCs) and placenta. Therapeutic use of MSCs in cardiovascular diseases is based on the benefits in reducing cardiac fibrosis and inflammation that compose the cardiac remodeling responsible for the maintenance of normal function, something which may end up causing progressive and irreversible dysfunction. Many factors lead to cardiac fibrosis and failure, and an effective therapy is lacking to reverse or attenuate this condition. Different approaches have been shown to be promising in surpassing the poor survival of transplanted cells in cardiac tissue to provide cardioprotection and prevent cardiac remodeling. This review includes the description of pre-clinical and clinical investigation of the therapeutic potential of MSCs in improving ventricular dysfunction consequent to diverse cardiac diseases.

Keywords: cardiac fibrosis; cardiovascular diseases; mesenchymal stem cells.

Figure 1

MSCs therapy in cardiomyopathy. MSCs release growth factors, microRNAs and cytokines, directly or in extracellular vesicles, which modulate different aspects of cardiomyopathies. MSCs reduce fibrosis by modulating MMPs, reducing collagen deposition and inhibiting the conversion of cardiac fibroblasts to myofibroblasts. MSCs also reduce inflammation, stimulate angiogenesis and reduce cardiomyocyte apoptosis. All of these factors result in cardiac function improvement, as observed in pre-clinical models. MMP: matrix metalloproteinases. Created using https://smart.servier.com/.