With increasing focus on the advance towards curative solutions, it is hard not to be excited by the potential of
stem cell-based therapy. Application of the stem cell paradigm to cardiovascular medicine has fostered the evolution of
novel approaches aimed at reversing injury caused by ischemic and non-ischemic cardiomyopathy. The feasibility and
safety of stem cell use has been established in over 3, 000 patients with either recent myocardial infarction or chronic
organ failure. Nonetheless, the efficacy of stem cell therapy continues to remain in question. Initial clinical trials have
focused on evaluation of multiple adult stem cell phenotypes in their unaltered, naïve state as a “first generation” resource
for repair. Though significant strides in perfecting delivery of these biologics to the diseased heart have been achieved, the
benefits with regard to myocardial functional recovery have been modest at best. One approach towards optimizing
outcome may lie upon preemptive guidance of stem cells down the pathway of myocyte regeneration. As seen with
pharmacotherapeutics in the last century, successful translation of “second generation” biotherapeutics in the 21st century
will require close integration of a community of practice and science to ensure broad application of this emerging
technology in the treatment of heart disease.
Keywords: Regenerative medicine, Cell therapy, Heart Disease, Myoblast, Bone marrow mononuclear cell, Endothelial
progenitor, Mesenchymal stem cell, Induced pluripotency stem cell.
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