Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Aug 26, 2019; 11(8): 445-451
Published online Aug 26, 2019. doi: 10.4252/wjsc.v11.i8.445
Moving forward on the pathway of cell-based therapies in ischemic heart disease and heart failure – time for new recommendations?
Miruna Mihaela Micheu
Miruna Mihaela Micheu, Department of Cardiology, Clinical Emergency Hospital of Bucharest, Bucharest 014461, Romania
Author contributions: Micheu MM conceived the study and wrote the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Miruna Mihaela Micheu, MD, PhD, Doctor, Department of Cardiology, Clinical Emergency Hospital of Bucharest, Floreasca Street 8, Bucharest 014452, Romania. mirunamicheu@yahoo.com
Telephone: +40-72-2451755
Received: February 21, 2019
Peer-review started: February 22, 2019
First decision: April 16, 2019
Revised: April 19, 2019
Accepted: June 20, 2019
Article in press: June 20, 2019
Published online: August 26, 2019

Although substantial advances have been made in treating ischemic heart disease and subsequent heart failure, the overall morbidity and mortality from these conditions remain high. Stem cell-based therapy has emerged as a promising approach for prompting cardiac rejuvenation. Various cell types have been tested in the clinical arena, proving consistent safety results. As for efficiency outcomes, contradictory findings have been reported, partly due to inconsistency in study protocols but also due to poor survival, engraftment and differentiation of transplanted cells in the hostile milieu of the ischemic host tissue. Studies have varied in terms of route of delivery, type and dose of implanted stem cells, patient selection and randomization, and assessment of therapeutic effect. Founded on the main achievements and challenges within almost 20 years of research, a number of official documents have been published by leading experts in the field. Core recommendations have focused on developing and optimizing effective strategies to enrich cell retention and their regenerative potential. Issued consensus and position papers have stemmed from an unmet need to provide a harmonized framework for future research, resulting in improved therapeutic application of cell-based therapies for cardiac regeneration and repair.

Keywords: Stem cell therapy, Ischemic heart disease, Heart failure, Cardiac regeneration, Recommendations

Core tip: Ischemic heart disease and resulting heart failure remain a major public health problem worldwide in spite of therapeutic progresses. Almost two decades ago, stem cell-based therapy appeared as a promising method to stimulate cardiac regeneration. Based on the main findings and challenges faced during clinical trials within this timeframe, a number of consensus and position papers have been issued by key opinion leaders, with the specific aim to empower cell-based cardiac repair and regeneration in patients with the aforesaid maladies.