cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2011-5-99-105cardiovascular-1947Research ArticleОБЗОРЫREVIEWSВозможности использования стволовых клеток для лечения больных с ишемической болезнью сердца. Часть II. Мононуклеарная фракция клеток костного мозгаtem cells in treating patients with coronary heart disease. Part II. Bone marrow-derived mononuclear cellsЖуковаН. С.ZhukovaN. S.

ст.н.с. отдела неотложной кардиологии

Москва

nataliajukova@rambler.ruСтароверовИ. И.StaroverovI. I.

вед.н.с. отдела

Москва

ФГУ Российский кардиологический научно-производственный комплекс РосздраваRussian Cardiology Scientific and Clinical Complex20112010201110599105Copyright © Жукова Н.С., Староверов И.И., 20112011Жукова Н.С., Староверов И.И.Zhukova N.S., Staroverov I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1947

Клеточная кардиомиопластика — относительно новый подход к восстановлению функции сердца, поврежденного в результате инфаркта миокарда (ИМ). Экспериментальные и первые клинические исследования по трансплантации стволовых клеток (СК) больным острым ИМ и сердечной недостаточностью показали возможность улучшения перфузии и сократимости миокарда за счет ангиогенеза, уменьшения апоптоза кардиомиоцитов (КМЦ) и ремоделирования левого желудочка. Однако, несмотря на многообещающие результаты, остается много препятствий для того, чтобы СК стали использоваться для лечения пациентов с сердечно-сосудистыми заболеваниями. Многие фундаментальные вопросы еще только предстоит выяснить в будущих исследованиях: механизмы хоуминга, дифференцировки и приживления трансплантированных СК, механизмы влияния трансплантированных клеток на сердечную функцию и др. Остается предметом дискуссии наиболее предпочтительный источник СК для трансплантации в клинике, способ доставки клеток в миокард, время проведения кардиомиопластики, количество клеток в трансплантате и способы его подготовки. Во второй части обзора представлена характеристика мононуклеарной фракции клеток костного мозга, которая наиболее широко используется в клинических исследованиях, изучающих влияние этого типа клеток на функциональное состояние поврежденного миокарда. Обсуждены некоторые проблемы и вопросы безопасности клеточной терапии сердца.

Cell cardiomyoplasty is a relatively new approach to restoring cardiac function after myocardial infarction (MI). Experimental and first clinical studies on stem cell (SC) transplantation in patients with acute MI and heart failure have demonstrated the improved myocardial perfusion and myocardial contractility, due to angiogenesis, reduced cardiomyocyte (CMC) apoptosis, and regressed left ventricular remodelling. However, despite these promising results, there are some barriers for a wider use of SC in treating cardiovascular patients. Multiple key aspects are yet to be clarified in future studies, including the mechanisms of transplanted SC homing, differentiation, and engraftment, the mechanisms of transplanted cell effects on cardiac function, etc. Such issues as the preferential source for SC transplantation in clinical settings, the method of cell transport into myocardium, the optimal cardiomyoplasty time, the number of the transplanted cells and the methods for their pre-transplantation processing are still under discussion. The second part of the present review describes the bone-derived mononuclear cells, as the cell fraction which is widely used in the clinical studies on SC and myocardial injury. Some problems and safety aspects of SC therapy in cardiac patients are discussed.

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The authors declare that there are no conflicts of interest present.