Functions of Mesenchymal Stem Cells in Cardiac Repair
Myocardial infarction (MI) and heart failure (HF) are significant contributors of mortality worldwide. Mesenchymal stem cells (MSCs) hold a great potential for cardiac regenerative medicine-based therapies. Their therapeutic potential has been widely inve
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Functions of Mesenchymal Stem Cells in Cardiac Repair Selçuk Öztürk, Ayşe Eser Elçin, and Yaşar Murat Elçin
Abstract
and cross-talk between cells are not fully known yet. Increasing line of evidence also suggests that secretomes of MSCs and/or their extracellular vesicles play significant roles in a paracrine manner while mediating these functions. This chapter aims to summarize and highlight cardiac repair functions of MSCs during cardiac repair.
Myocardial infarction (MI) and heart failure (HF) are significant contributors of mortality worldwide. Mesenchymal stem cells (MSCs) hold a great potential for cardiac regenerative medicine-based therapies. Their therapeutic potential has been widely investigated in various in-vitro and in-vivo preclinical models. Besides, they have been tested in clinical trials of MI and HF with various outcomes. Differentiation to lineages of cardiac cells, neovascularization, anti-fibrotic, anti-inflammatory, anti-apoptotic and immune modulatory effects are the main drivers of MSC functions during cardiac repair. However, the main mechanisms regulating these functions S. Öztürk Faculty of Science, Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory, Ankara University, Ankara, Turkey Faculty of Medicine, Department of Cardiology, Yozgat Bozok University, Yozgat, Turkey A. E. Elçin Faculty of Science, and Ankara University Stem Cell Institute, Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory, Ankara University, Ankara, Turkey Y. M. Elçin (*) Faculty of Science, Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory, Ankara University, Ankara, Turkey Biovalda Health Technologies, Inc., Ankara, Turkey e-mail: [email protected]
Keywords
Anti-fibrotic effect · Cardiac repair · Differentiation · Extracellular vesicles · Heart failure · Immune modulation · Mesenchymal stem cells · Myocardial infarction · Neovascularization · Paracrine function
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Introduction
Cardiovascular diseases (CVDs) including myocardial infarction (MI) and the resulting heart failure (HF) are important causes of death and disability worldwide. This is because of the inadequate renewal capacity of the heart after a pathologic incident. Approximately one billion cardiomyocytes and two to three billion myocardial cells of the endothelium and the vascular smooth muscle die after an MI and the remaining tissue is replaced by a fibrotic collagenous scar subsequently leading to decline in cardiac performance. This is the main pathophysiological pathway progressing irreversibly to HF and death (Majka
S. Öztürk et al.
et al. 2017). Although there have been significant improvements in cardiac therapies that reverse or slow this process partially, none of the available treatments except heart transplantation can completely achieve this goal (Majka et al. 2017; Elnakish et al. 2012). Stem cell therapies aim to replace damaged heart tissue with fully functional cardiomyocytes that entirely proliferate and couple with the surrounding myocardium electromechanically and promote neovascula
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