Myocardial Restoration: Is It the Cell or the Architecture or Both?

Table 1

Cell sources for Cell therapy.

Cell types	Sources	Advantages	Disadvantages	Delivery	Animal model	Outcome	Clinical application	Mechanism	References
Skeletal myoblast	Skeletal muscle	Contractile, highly resistant to ischemia, large volume, autologous	Arrythmia, poor coupling with host tissue	Intramyocardial injection, intracoronary infusion	Rat, sheep	LVEF ↑ EDV ↓ LVSP ↑	intracoronary infusion	Myogenesis Paracrine effect	[41–43]
Embryonic stem cell-derived CMs	Embryo	Less tumorigenesis, contractile cells	Ethical issue Purification	Intramyocardial injection	Mouse, Rat, Monkey	LVEF ↑ EDV ↓, Wall thickness ↑	N.A	Myogenesis Paracrine effect	[30, 44]
Bone marrow mononuclear cells	Bone marrow	Autologous, large quantity	No myogenesis	Intramyocardial injection or intracoronary infusion	Rat, Canine, Pig	LVEF ↑	LVEF ↑ 0–8.1%	Paracrine effect	[45–48]
Mesenchymal stem cells	Bone marrow, cord blood, adipose tissue	Differentiate to CMs Paracrine effects Autologous Large quantity	Low differentiation rate	Intracoronary infusion Intramyocardial injection	Rat, Pig	LVEF ↑, EDV ↓, ESV↓	LVEF ↑ 12%, intracoronary	Myogenesis Paracrine effect	[49–51]
VSELs	Bone marrow	Pluripotent as embryonic stem cell Autologous	Small quantity	Intracoronary delivery, Intramyocardial injection	Mice	LVEF ↑ Wall thickness ↑	N.A	Myogenesis Paracrine effect	[52]
Cardiac Stem cells	Heart muscle	Contractile Paracrine effect Autologous	Small quantity Cardiac biopsy or surgical sampling	Intracoronary infusion, intramyocardial injection	Mice, Rat	LVEF ↑; Wall thickness ↑	Yes	Myogenesis Paracrine effect	[26]
iPSC	Dermal fibroblast	Pluripotent, can differentiate to CMs Autologous Large quantity	Gene transfer Tumorigenesis	Intramyocardial injection		LVEF ↑EDV ↓ ESV ↓ Cell differentiate in vitro and in vivo to CMs	N.A	Myogenesis Paracrine effect	[53]

VSELs: very small embryonic like stem cells; iPSC: induced pluripotent stem cells; CMs: cardiomyocytes; LVEF: left ventricular ejection fraction; EDV: end diastolic volume; LVSP: left ventricular systolic pressure.